pbp_a_hnumber	pbp_a_plan_identifier	segment_id	pbp_a_ben_cov	pbp_a_plan_type	orgtype	bid_id	version	pbp_a_contract_partd_flag	pbp_a_platino_flag	pbp_a_last_data_entry_date	pbpver	pbp_a_ready_for_upload_date_tm	pbp_a_BPT_MA_date_time	pbp_a_BPT_PD_date_time	pbp_a_BPT_MSA_date_time	pbp_a_upload_date_time	pbp_a_org_name	pbp_a_org_marketing_name	pbp_a_org_website	pbp_a_plan_name	pbp_a_org_type	pbp_a_plan_type	pbp_a_network_flag	pbp_a_ben_cov	pbp_a_hospice_care_yn	pbp_a_service_area	pbp_a_contract_number	pbp_a_plan_identifier	pbp_a_segment_id	pbp_a_contract_period	pbp_a_plan_geog_name	pbp_a_segment_name	pbp_a_eghp_yn	pbp_a_est_memb	pbp_a_continue_yn	pbp_a_continue_costshare_yn	pbp_a_platino_yn	pbp_a_special_need_flag	pbp_a_special_need_plan_type	pbp_a_snp_institutional_type	pbp_a_snp_pct	pbp_a_snp_pop	pbp_a_snp_cond	pbp_a_opd_web_addr	pbp_a_formulary_web_addr	pbp_a_pharmacy_website	pbp_a_curmbr_phone	pbp_a_curmbr_phone_ext	pbp_a_curmbr_loc_phone	pbp_a_curmbr_loc_phone_ext	pbp_a_prombr_phone	pbp_a_prombr_phone_ext	pbp_a_prombr_loc_phone	pbp_a_prombr_loc_phone_ext	pbp_a_pd_curmbr_phone	pbp_a_pd_curmbr_phone_ext	pbp_a_pd_curmbr_loc_phone	pbp_a_pd_curmbr_loc_phone_ext	pbp_a_pd_prombr_phone	pbp_a_pd_prombr_phone_ext	pbp_a_pd_prombr_loc_phone	pbp_a_pd_prombr_loc_phone_ext	pbp_a_ttytdd_curmbr_phone	pbp_a_ttytdd_curmbr_phone_ext	pbp_a_ttytdd_cur_loc_phone	pbp_a_ttytdd_cur_loc_phone_ext	pbp_a_ttytdd_prombr_phone	pbp_a_ttytdd_prombr_phone_ext	pbp_a_ttytdd_pro_loc_phone	pbp_a_ttytdd_pro_loc_phone_ext	pbp_a_pd_ttytdd_curmbr_phone	pbp_a_pd_ttytdd_curmbr_phn_ext	pbp_a_pd_ttytdd_cur_loc_phone	pbp_a_pd_ttytdd_cur_loc_phn_ex	pbp_a_pd_ttytdd_prombr_phone	pbp_a_pd_ttytdd_prombr_phn_ext	pbp_a_pd_ttytdd_pro_loc_phone	pbp_a_pd_ttytdd_pro_loc_phn_ex	pbp_a_ffs_bid_b_yn	pbp_a_ffs_bid_c_yn	pbp_a_ffs_bid_d_yn
E0654	801	0		30	13	E0654_801_0	1	1		06/06/2011	2012.02	06/06/2011 04:01:03 PM Eastern Daylight Time				06/06/2011 04:01:15 PM Eastern Daylight Time	IBT VOLUNTARY EMPLOYEE BENEFITS TRUST	TEAMStar Medicare Part D Prescription Drug Program	www.teamstarpartd.com	IBT VEBA (Employer PDP)	13	30					E0654	801	0	2012	National		1					2							http://www.rxsolutions.com/pdpclientformulary/formulary.asp?var=IBTPDPGOLDinfoid=IBT	www.rxsolutions.com									(866)-524-4173		(866)-524-4173		(866)-524-4173		(866)-524-4173										(866)-524-4174		(866)-524-4174		(866)-524-4174		(866)-524-4174				
E2332	801	0		30	13	E2332_801_0	1	1		05/23/2011	2012.02	05/23/2011 02:43:30 PM Eastern Daylight Time				05/23/2011 02:44:39 PM Eastern Daylight Time	NATIONAL RURAL ELECTRIC COOPERATIVE ASSOCIATION	National Rural Electric Cooperative Association	www.nreca.coop	NRECA Medicare Part D Plan (Employer PDP)	13	30					E2332	801	0	2012	NRECA Medicare Part D Plan-Nationwide		1					2							http://nreca.medicareplanrx.com	http://nreca.medicareplanrx.com									(866)-586-7322		(866)-586-7322		(866)-673-2299		(866)-673-2299										(866)-236-1069		(866)-236-1069		(866)-236-1069		(866)-236-1069				
E2630	801	0		30	13	E2630_801_0	1	1		05/26/2011	2012.02	05/26/2011 09:45:20 AM Eastern Daylight Time				05/26/2011 09:45:31 AM Eastern Daylight Time	C AND O EMPLOYEES HOSPITAL ASSOCIATION	C and O Employees Hospital Association	www.coeha.com	C and O Employees Hospital Association (Employer PDP)	13	30					E2630	801	0	2012	Virginia, West VA, Kentucky, Ohio, Indiana		1					2							http://www.coeha.com	http://www.informedrx.com									(800)-679-9135		(540)-862-5728		(800)-679-9135		(540)-862-5728										(711)-000-0000		(711)-000-0000		(711)-000-0000		(711)-000-0000				
E2868	801	0		30	13	E2868_801_0	1	1		05/25/2011	2012.02	05/25/2011 09:54:50 AM Eastern Daylight Time				05/25/2011 02:00:25 PM Eastern Daylight Time	CARPENTER'S HEALTH  AND WELFARE TRUST FUND OF STL	Carpenters' District Council of Greater St. Louis	http://www.carpdc.org/	Carpenters' 2012 Plan (Employer PDP)	13	30					E2868	801	0	2012	National		1					2							http://www.medcohealth.com	http://www.medcohealth.com/									(800)-301-3002		(314)-644-4802		(800)-301-3002		(314)-644-4802										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
E3014	801	0		30	13	E3014_801_0	4	1		05/21/2011	2012.02	05/21/2011 11:29:04 AM Eastern Daylight Time				05/26/2011 12:30:16 PM Eastern Daylight Time	PSERS HOP PROGRAM	Pennsylvania Public School Employees Retirement Sy	http://www.psers.state.pa.us/hop/hop.htm	PSERS HOP (Employer PDP)	13	30					E3014	801	0	2012	National		1					2							http://www.hopbenefits.com/medicareRx/drugData/	http://www.hopbenefits.com/medicareRx/index.cfm?fa=findPharmacy									(888)-239-1301		(888)-239-1301		(800)-773-7725		(800)-773-7725										(800)-498-5428		(800)-498-5428		(800)-498-5428		(800)-498-5428				
E4744	801	0		30	13	E4744_801_0	1	1		05/26/2011	2012.02	05/26/2011 12:27:55 PM Central Daylight Time				05/26/2011 01:43:04 PM Central Daylight Time	MO DOT AND MSHP MEDICAL AND LIFE INS PLAN	MISSOURI DEPARTMENT OF TRANSPORTATION	http://www.modot.state.mo.us/	Missouri Department of Transportaion/ Highway Patr (Employer PDP)	13	30					E4744	801	0	2012	National		1					2							http://www.Catalystrx.com/	http://www.Catalystrx.com/									(800)-601-3002		(573)-751-2551		(800)-601-3002		(573)-751-2551										(800)-221-6915		(800)-221-6915		(800)-221-6915		(800)-221-6915				
E5088	801	0	1	40	14	E5088_801_0	9	2		07/21/2011	2012.02	07/21/2011 04:14:59 PM Mountain Daylight Time	06/06/2011 06:15:51 PM Mountain Daylight Time			07/21/2011 04:17:38 PM Mountain Daylight Time	DESERET HEALTHCARE EMPLOYEE BENEFITS TRUST	Deseret Mutual	www.dmba.com	Deseret Secure (Employer PFFS)	14	40	1	1			E5088	801	0	2012	National Area		1	11972	2			2									(800)-777-3622		(801)-578-5600		(800)-777-3622		(801)-578-5600										(800)-333-9715		(801)-578-5655		(800)-333-9715		(801)-578-5655										2	2	2
E6322	801	0		30	13	E6322_801_0	1	1		05/26/2011	2012.02	05/26/2011 02:43:22 PM Central Daylight Time				05/26/2011 02:43:26 PM Central Daylight Time	KENTUCKY RETIREMENT SYSTEM	Kentucky Retirement Systems	https://www.kyret.ky.gov	Kentucky Retirement Systems (Employer PDP)	13	30					E6322	801	0	2012	Kentucky Retirement Systems		1					2							www.catalystrx.com	www.catalystrx.com									(877)-235-1941		(502)-696-8800		(800)-928-4646		(502)-696-8800										(888)-206-8041		(502)-696-8700		(877)-247-6985		(502)-696-8700				
E7316	801	0		30	13	E7316_801_0	3	1		05/20/2011	2012.02	05/20/2011 10:43:36 AM Eastern Daylight Time				05/26/2011 12:30:16 PM Eastern Daylight Time	UNION PACIFIC RAILROAD EMPLOYES HEALTH SYSTEMS	Union Pacific Railroad  Employes Health Systems	www.uphealth.com	The UPREHS Prime Medicare Plan (Employer PDP)	13	30					E7316	801	0	2012	National		1					2							https://www.uphealth.com/medicare/formularies.shtml	https://www.uphealth.com/secure_member/rxRefill100.shtml									(800)-547-0421		(801)-595-4300		(800)-547-0421		(801)-595-4300										(711)-000-0000		(711)-000-0000		(711)-000-0000		(711)-000-0000				
E7848	801	0		30	13	E7848_801_0	1	1		05/25/2011	2012.02	05/25/2011 10:18:04 AM Central Daylight Time				05/25/2011 10:19:44 AM Central Daylight Time	OKLAHOMA STATE AND EDUCATION EMP GRP INS BOARD	HealthChoice	www.sib.ok.gov	OK State and Education Emp Group Ins Board (Employer PDP)	13	30					E7848	801	0	2012	State of Oklahoma		1					2							www.sib.ok.gov	www.sib.ok.gov									(800)-865-5142		(405)-717-8699		(800)-865-5142		(405)-717-8699										(866)-447-0436		(405)-949-2281		(866)-447-0436		(405)-949-2281				
H0084	001	0	1	04	01	H0084_001_0	9	1		08/09/2011	2012.02	08/09/2011 09:04:41 AM Eastern Daylight Time	08/06/2011 04:38:00 PM Eastern Daylight Time	08/09/2011 10:03:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Medicare Advantage (PPO)	01	04		1			H0084	001	0	2012	Texas		2	1214	2			2						http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-711-1656		(800)-711-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0084	003	0	1	04	01	H0084_003_0	7	1		07/19/2011	2012.02	07/19/2011 09:12:16 AM Eastern Daylight Time	08/05/2011 05:17:00 PM Eastern Daylight Time	08/09/2011 10:03:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Silver Rx (PPO SNP)	01	04		1			H0084	003	0	2012	Texas		2		2			1	4		1		00000000000000000100	http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-713-1656		(800)-713-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0084	004	0	1	04	01	H0084_004_0	6	1		08/09/2011	2012.02	08/09/2011 09:08:18 AM Eastern Daylight Time	08/05/2011 05:18:00 PM Eastern Daylight Time	08/09/2011 10:03:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Gold Rx (PPO SNP)	01	04		1			H0084	004	0	2012	Texas		2		2			1	4		1		00000000000000000100	http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-713-1656		(800)-713-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0084	005	0	1	04	01	H0084_005_0	6	1	2	07/19/2011	2012.02	07/19/2011 09:13:55 AM Eastern Daylight Time	08/05/2011 05:18:00 PM Eastern Daylight Time	08/09/2011 10:03:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Dual Advantage (PPO SNP)	01	04		1			H0084	005	0	2012	Texas		2		2			1	3		1	1		http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-713-1656		(800)-713-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0084	006	0	1	04	01	H0084_006_0	7	1		08/08/2011	2012.02	08/08/2011 02:14:00 PM Eastern Daylight Time	08/05/2011 05:18:00 PM Eastern Daylight Time	08/09/2011 10:03:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Silver Rx (PPO SNP)	01	04		1			H0084	006	0	2012	Illinois		2		2			1	4		1		00000000000000000100	http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-713-1656		(800)-713-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0084	007	0	1	04	01	H0084_007_0	6	1		08/09/2011	2012.02	08/09/2011 09:06:51 AM Eastern Daylight Time	08/05/2011 05:18:00 PM Eastern Daylight Time	08/09/2011 10:03:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Gold Rx (PPO SNP)	01	04		1			H0084	007	0	2012	Illinois		2		2			1	4		1		00000000000000000100	http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-713-1656		(800)-713-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0084	009	0	1	04	01	H0084_009_0	5	1		08/09/2011	2012.02	08/09/2011 09:07:36 AM Eastern Daylight Time	08/07/2011 12:28:00 AM Eastern Daylight Time	08/09/2011 10:03:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Medicare Advantage (PPO)	01	04		1			H0084	009	0	2012	Illinois		2	1214	2			2						http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-713-1656		(800)-713-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0084	010	0	1	04	01	H0084_010_0	7	1		08/08/2011	2012.02	08/08/2011 01:11:48 PM Eastern Daylight Time	08/05/2011 05:19:00 PM Eastern Daylight Time	08/09/2011 10:03:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Silver Rx (PPO SNP)	01	04		1			H0084	010	0	2012	Iowa		2		2			1	4		1		00000000000000000100	http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-713-1656		(800)-713-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0084	011	0	1	04	01	H0084_011_0	6	1		08/09/2011	2012.02	08/09/2011 09:05:26 AM Eastern Daylight Time	08/05/2011 05:19:00 PM Eastern Daylight Time	08/09/2011 10:04:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Gold Rx (PPO SNP)	01	04		1			H0084	011	0	2012	Iowa		2		2			1	4		1		00000000000000000100	http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-713-1656		(800)-713-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0084	012	0	1	04	01	H0084_012_0	6	1	2	08/08/2011	2012.02	08/08/2011 01:13:51 PM Eastern Daylight Time	08/05/2011 05:19:00 PM Eastern Daylight Time	08/09/2011 10:04:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Dual Advantage (PPO SNP)	01	04		1			H0084	012	0	2012	Iowa		2		2			1	3		1	1		http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-713-1656		(800)-713-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0084	013	0	1	04	01	H0084_013_0	5	1		08/09/2011	2012.02	08/09/2011 09:06:10 AM Eastern Daylight Time	08/07/2011 12:28:00 AM Eastern Daylight Time	08/09/2011 10:04:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Medicare Advantage (PPO)	01	04		1			H0084	013	0	2012	Iowa		2	1214	2			2						http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-713-1656		(800)-713-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0084	014	0	1	04	01	H0084_014_0	7	1		07/15/2011	2012.02	07/15/2011 01:41:49 PM Eastern Daylight Time	08/05/2011 05:20:00 PM Eastern Daylight Time	08/09/2011 10:04:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Silver Rx (PPO SNP)	01	04		1			H0084	014	0	2012	Indiana		2		2			1	4		1		00000000000000000100	http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-713-1656		(800)-713-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0084	015	0	1	04	01	H0084_015_0	6	1		08/09/2011	2012.02	08/09/2011 09:09:02 AM Eastern Daylight Time	08/05/2011 05:20:00 PM Eastern Daylight Time	08/09/2011 10:04:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Gold Rx (PPO SNP)	01	04		1			H0084	015	0	2012	Indiana		2		2			1	4		1		00000000000000000100	http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-713-1656		(800)-713-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0084	016	0	1	04	01	H0084_016_0	6	1	2	08/08/2011	2012.02	08/08/2011 01:24:21 PM Eastern Daylight Time	08/05/2011 05:20:00 PM Eastern Daylight Time	08/09/2011 10:04:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Dual Advantage (PPO SNP)	01	04		1			H0084	016	0	2012	Indiana		2		2			1	3		1	1		http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-713-1656		(800)-713-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0084	017	0	1	04	01	H0084_017_0	5	1		08/09/2011	2012.02	08/09/2011 09:09:41 AM Eastern Daylight Time	08/07/2011 12:29:00 AM Eastern Daylight Time	08/09/2011 10:04:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Medicare Advantage (PPO)	01	04		1			H0084	017	0	2012	Indiana		2	1214	2			2						http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-713-1656		(800)-713-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0084	018	0	1	04	01	H0084_018_0	7	1		08/08/2011	2012.02	08/08/2011 01:26:36 PM Eastern Daylight Time	08/05/2011 05:20:00 PM Eastern Daylight Time	08/09/2011 10:04:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Silver Rx (PPO SNP)	01	04		1			H0084	018	0	2012	New Mexico		2		2			1	4		1		00000000000000000100	http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-713-1656		(800)-713-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0084	019	0	1	04	01	H0084_019_0	6	1		08/09/2011	2012.02	08/09/2011 09:10:22 AM Eastern Daylight Time	08/05/2011 05:21:00 PM Eastern Daylight Time	08/09/2011 10:04:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Gold Rx (PPO SNP)	01	04		1			H0084	019	0	2012	New Mexico		2		2			1	4		1		00000000000000000100	http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-713-1656		(800)-713-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0084	021	0	1	04	01	H0084_021_0	5	1		08/09/2011	2012.02	08/09/2011 09:11:01 AM Eastern Daylight Time	08/07/2011 12:29:00 AM Eastern Daylight Time	08/09/2011 10:04:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Medicare Advantage (PPO)	01	04		1			H0084	021	0	2012	New Mexico		2	1214	2			2						http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-713-1656		(800)-713-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0084	022	0	1	04	01	H0084_022_0	7	1		08/08/2011	2012.02	08/08/2011 01:32:55 PM Eastern Daylight Time	08/05/2011 05:21:00 PM Eastern Daylight Time	08/09/2011 10:05:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Silver Rx (PPO SNP)	01	04		1			H0084	022	0	2012	New York		2		2			1	4		1		00000000000000000100	http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-713-1656		(800)-713-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0084	023	0	1	04	01	H0084_023_0	8	1		08/09/2011	2012.02	08/09/2011 09:11:44 AM Eastern Daylight Time	08/05/2011 05:21:00 PM Eastern Daylight Time	08/09/2011 10:05:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Gold Rx (PPO SNP)	01	04		1			H0084	023	0	2012	New York		2		2			1	4		1		00000000000000000100	http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-713-1656		(800)-713-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0084	025	0	1	04	01	H0084_025_0	5	1		08/09/2011	2012.02	08/09/2011 09:12:18 AM Eastern Daylight Time	08/07/2011 12:29:00 AM Eastern Daylight Time	08/09/2011 10:05:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Medicare Advantage (PPO)	01	04		1			H0084	025	0	2012	New York		2	1214	2			2						http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-713-1656		(800)-713-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0104	010	1	1	04	01	H0104_010_1	8	1		08/02/2011	2012.02	08/02/2011 09:01:50 AM Central Daylight Time	08/05/2011 10:29:51 AM Central Daylight Time	08/05/2011 10:30:03 AM Central Daylight Time		08/05/2011 12:44:17 PM Central Daylight Time	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Blue Cross and Blue Shield of Alabama	www.bcbsalmedicare.com	Blue Advantage Premier (PPO)	01	04		1			H0104	010	1	2012	H0104 Plan 010 Areas 1 through 5	Limited to certain counties	2	1462	2			2						www.bcbsalmedicare.com	www.bcbsalmedicare.com/medicare/plans/blueadvantage/tools.cfm	www.bcbsalmedicare.com/medicare/plans/blueadvantage/tools.cfm	(888)-234-8266		(888)-234-8266		(888)-873-4707		(888)-873-4707		(888)-234-8266		(888)-234-8266		(888)-873-4707		(888)-873-4707		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0104	010	2	1	04	01	H0104_010_2	7	1		08/01/2011	2012.02	08/01/2011 03:06:46 PM Central Daylight Time	08/05/2011 10:30:22 AM Central Daylight Time	08/05/2011 10:30:34 AM Central Daylight Time		08/05/2011 12:44:17 PM Central Daylight Time	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Blue Cross and Blue Shield of Alabama	www.bcbsalmedicare.com	Blue Advantage Premier (PPO)	01	04		1			H0104	010	2	2012	H0104 Plan 010 Areas 1 through 5	Limited to certain counties	2	125	2			2						www.bcbsalmedicare.com	www.bcbsalmedicare.com/medicare/plans/blueadvantage/tools.cfm	www.bcbsalmedicare.com/medicare/plans/blueadvantage/tools.cfm	(888)-234-8266		(888)-234-8266		(888)-873-4707		(888)-873-4707		(888)-234-8266		(888)-234-8266		(888)-873-4707		(888)-873-4707		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0104	010	3	1	04	01	H0104_010_3	7	1		08/01/2011	2012.02	08/01/2011 03:08:15 PM Central Daylight Time	08/05/2011 10:30:54 AM Central Daylight Time	08/05/2011 10:31:05 AM Central Daylight Time		08/05/2011 12:44:17 PM Central Daylight Time	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Blue Cross and Blue Shield of Alabama	www.bcbsalmedicare.com	Blue Advantage Premier (PPO)	01	04		1			H0104	010	3	2012	H0104 Plan 010 Areas 1 through 5	Limited to certain counties	2	478	2			2						www.bcbsalmedicare.com	www.bcbsalmedicare.com/medicare/plans/blueadvantage/tools.cfm	www.bcbsalmedicare.com/medicare/plans/blueadvantage/tools.cfm	(888)-234-8266		(888)-234-8266		(888)-873-4707		(888)-873-4707		(888)-234-8266		(888)-234-8266		(888)-873-4707		(888)-873-4707		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0104	010	4	1	04	01	H0104_010_4	7	1		08/01/2011	2012.02	08/01/2011 03:09:38 PM Central Daylight Time	08/05/2011 10:31:23 AM Central Daylight Time	08/05/2011 10:31:39 AM Central Daylight Time		08/05/2011 12:44:17 PM Central Daylight Time	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Blue Cross and Blue Shield of Alabama	www.bcbsalmedicare.com	Blue Advantage Premier (PPO)	01	04		1			H0104	010	4	2012	H0104 Plan 010 Areas 1 through 5	Limited to certain counties	2	3620	2			2						www.bcbsalmedicare.com	www.bcbsalmedicare.com/medicare/plans/blueadvantage/tools.cfm	www.bcbsalmedicare.com/medicare/plans/blueadvantage/tools.cfm	(888)-234-8266		(888)-234-8266		(888)-873-4707		(888)-873-4707		(888)-234-8266		(888)-234-8266		(888)-873-4707		(888)-873-4707		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0104	010	5	1	04	01	H0104_010_5	7	1		08/01/2011	2012.02	08/01/2011 03:10:54 PM Central Daylight Time	08/05/2011 10:31:59 AM Central Daylight Time	08/05/2011 10:32:11 AM Central Daylight Time		08/05/2011 12:44:17 PM Central Daylight Time	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Blue Cross and Blue Shield of Alabama	www.bcbsalmedicare.com	Blue Advantage Premier (PPO)	01	04		1			H0104	010	5	2012	H0104 Plan 010 Areas 1 through 5	Limited to certain counties	2	1585	2			2						www.bcbsalmedicare.com	www.bcbsalmedicare.com/medicare/plans/blueadvantage/tools.cfm	www.bcbsalmedicare.com/medicare/plans/blueadvantage/tools.cfm	(888)-234-8266		(888)-234-8266		(888)-873-4707		(888)-873-4707		(888)-234-8266		(888)-234-8266		(888)-873-4707		(888)-873-4707		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0104	011	1	1	04	01	H0104_011_1	5	1		08/02/2011	2012.02	08/02/2011 10:35:46 AM Central Daylight Time	08/05/2011 10:32:28 AM Central Daylight Time	08/05/2011 10:32:39 AM Central Daylight Time		08/05/2011 02:03:20 PM Central Daylight Time	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Blue Cross and Blue Shield of Alabama	www.bcbsalmedicare.com	Blue Advantage Complete (PPO)	01	04		1			H0104	011	1	2012	H0104 Plan 011 Areas 1 through 6	State of Alabama	2	357	2			2						www.bcbsalmedicare.com	www.bcbsalmedicare.com/medicare/plans/blueadvantage/tools.cfm	www.bcbsalmedicare.com/medicare/plans/blueadvantage/tools.cfm	(888)-234-8266		(888)-234-8266		(888)-873-4707		(888)-873-4707		(888)-234-8266		(888)-234-8266		(888)-873-4707		(888)-873-4707		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0104	011	2	1	04	01	H0104_011_2	5	1		08/02/2011	2012.02	08/02/2011 10:37:25 AM Central Daylight Time	08/05/2011 10:32:56 AM Central Daylight Time	08/05/2011 10:33:05 AM Central Daylight Time		08/05/2011 02:03:20 PM Central Daylight Time	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Blue Cross and Blue Shield of Alabama	www.bcbsalmedicare.com	Blue Advantage Complete (PPO)	01	04		1			H0104	011	2	2012	H0104 Plan 011 Areas 1 through 6	State of Alabama	2	1259	2			2						www.bcbsalmedicare.com	www.bcbsalmedicare.com/medicare/plans/blueadvantage/tools.cfm	www.bcbsalmedicare.com/medicare/plans/blueadvantage/tools.cfm	(888)-234-8266		(888)-234-8266		(888)-873-4707		(888)-873-4707		(888)-234-8266		(888)-234-8266		(888)-873-4707		(888)-873-4707		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0104	011	3	1	04	01	H0104_011_3	5	1		08/02/2011	2012.02	08/02/2011 10:38:12 AM Central Daylight Time	08/05/2011 10:33:23 AM Central Daylight Time	08/05/2011 10:33:34 AM Central Daylight Time		08/05/2011 02:03:20 PM Central Daylight Time	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Blue Cross and Blue Shield of Alabama	www.bcbsalmedicare.com	Blue Advantage Complete (PPO)	01	04		1			H0104	011	3	2012	H0104 Plan 011 Areas 1 through 6	State of Alabama	2	12433	2			2						www.bcbsalmedicare.com	www.bcbsalmedicare.com/medicare/plans/blueadvantage/tools.cfm	www.bcbsalmedicare.com/medicare/plans/blueadvantage/tools.cfm	(888)-234-8266		(888)-234-8266		(888)-873-4707		(888)-873-4707		(888)-234-8266		(888)-234-8266		(888)-873-4707		(888)-873-4707		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0104	011	4	1	04	01	H0104_011_4	5	1		08/02/2011	2012.02	08/02/2011 10:38:52 AM Central Daylight Time	08/05/2011 10:33:53 AM Central Daylight Time	08/05/2011 10:34:04 AM Central Daylight Time		08/05/2011 02:03:20 PM Central Daylight Time	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Blue Cross and Blue Shield of Alabama	www.bcbsalmedicare.com	Blue Advantage Complete (PPO)	01	04		1			H0104	011	4	2012	H0104 Plan 011 Areas 1 through 6	State of Alabama	2	4818	2			2						www.bcbsalmedicare.com	www.bcbsalmedicare.com/medicare/plans/blueadvantage/tools.cfm	www.bcbsalmedicare.com/medicare/plans/blueadvantage/tools.cfm	(888)-234-8266		(888)-234-8266		(888)-873-4707		(888)-873-4707		(888)-234-8266		(888)-234-8266		(888)-873-4707		(888)-873-4707		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0104	011	5	1	04	01	H0104_011_5	5	1		08/02/2011	2012.02	08/02/2011 10:39:43 AM Central Daylight Time	08/05/2011 10:34:26 AM Central Daylight Time	08/05/2011 10:34:37 AM Central Daylight Time		08/05/2011 02:03:20 PM Central Daylight Time	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Blue Cross and Blue Shield of Alabama	www.bcbsalmedicare.com	Blue Advantage Complete (PPO)	01	04		1			H0104	011	5	2012	H0104 Plan 011 Areas 1 through 6	State of Alabama	2	1339	2			2						www.bcbsalmedicare.com	www.bcbsalmedicare.com/medicare/plans/blueadvantage/tools.cfm	www.bcbsalmedicare.com/medicare/plans/blueadvantage/tools.cfm	(888)-234-8266		(888)-234-8266		(888)-873-4707		(888)-873-4707		(888)-234-8266		(888)-234-8266		(888)-873-4707		(888)-873-4707		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0104	011	6	1	04	01	H0104_011_6	5	1		08/02/2011	2012.02	08/02/2011 10:40:27 AM Central Daylight Time	08/05/2011 10:34:56 AM Central Daylight Time	08/05/2011 10:35:07 AM Central Daylight Time		08/05/2011 02:03:20 PM Central Daylight Time	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Blue Cross and Blue Shield of Alabama	www.bcbsalmedicare.com	Blue Advantage Complete (PPO)	01	04		1			H0104	011	6	2012	H0104 Plan 011 Areas 1 through 6	State of Alabama	2	18169	2			2						www.bcbsalmedicare.com	www.bcbsalmedicare.com/medicare/plans/blueadvantage/tools.cfm	www.bcbsalmedicare.com/medicare/plans/blueadvantage/tools.cfm	(888)-234-8266		(888)-234-8266		(888)-873-4707		(888)-873-4707		(888)-234-8266		(888)-234-8266		(888)-873-4707		(888)-873-4707		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0104	801	0	1	04	01	H0104_801_0	2	1		05/24/2011	2012.02	05/24/2011 04:36:56 PM Central Daylight Time	06/02/2011 03:20:14 PM Central Daylight Time			06/03/2011 10:01:17 AM Central Daylight Time	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Blue Cross and Blue Shield of Alabama	www.bcbsalmedicare.com	Blue Advantage Employer Group Plan 801 (PPO)	01	04		1			H0104	801	0	2012	State of Alabama		1	100	2			2						www.bcbsalmedicare.com	www.bcbsalmedicare.com/medicare/plans/blueadvantage/tools.cfm	www.bcbsalmedicare.com/medicare/plans/blueadvantage/tools.cfm	(888)-234-8266		(888)-234-8266		(888)-873-4707		(888)-873-4707										(711)		(711)		(711)		(711)										1	1	1
H0104	802	0	1	04	01	H0104_802_0	2	1		05/26/2011	2012.02	05/26/2011 01:11:30 PM Central Daylight Time	06/02/2011 03:20:26 PM Central Daylight Time			06/03/2011 09:26:14 AM Central Daylight Time	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Blue Cross and Blue Shield of Alabama	www.bcbsalmedicare.com	Blue Advantage Employer Group Plan 802 (PPO)	01	04		1			H0104	802	0	2012	State of Alabama		1	100	2			2						www.bcbsalmedicare.com	www.bcbsalmedicare.com/medicare/plans/blueadvantage/tools.cfm	www.bcbsalmedicare.com/medicare/plans/blueadvantage/tools.cfm	(888)-234-8266		(888)-234-8266		(888)-873-4707		(888)-873-4707		(888)-234-8266		(888)-234-8266		(888)-873-4707		(888)-873-4707		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H0104	804	0	1	04	01	H0104_804_0	2	1		05/24/2011	2012.02	05/24/2011 04:35:41 PM Central Daylight Time	06/02/2011 03:20:34 PM Central Daylight Time			06/03/2011 10:01:17 AM Central Daylight Time	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Blue Cross and Blue Shield of Alabama	www.bcbsalmedicare.com	Blue Advantage Employer Group Plan 804 (PPO)	01	04		1			H0104	804	0	2012	State of Alabama		1	100	2			2						www.bcbsalmedicare.com	www.bcbsalmedicare.com/medicare/plans/blueadvantage/tools.cfm	www.bcbsalmedicare.com/medicare/plans/blueadvantage/tools.cfm	(888)-234-8266		(888)-234-8266		(888)-873-4707		(888)-873-4707		(888)-234-8266		(888)-234-8266		(888)-873-4707		(888)-873-4707		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H0105	001	0	1	20	08	H0105_001_0	1	1		05/23/2011	2012.02	05/23/2011 10:26:10 AM Eastern Daylight Time		05/20/2011 04:22:00 PM Eastern Daylight Time		05/23/2011 10:28:52 AM Eastern Daylight Time	THE METHODIST OAKS	The Methodist Oaks d.b.a. The Oaks PACE	http://www.theoakspace.com	The Methodist Oaks d.b.a. The Oaks PACE (PACE)	08	20		1			H0105	001	0	2012	Rural South Carolina		2		2			2							www.groveparkpharmacy.com	www.groveparkpharmacy.com									(855)-268-5300		(803)-268-5300		(855)-268-5300		(803)-268-5300										(855)-268-5300		(803)-268-5300		(855)-268-5300		(803)-268-5300				
H0105	002	0	1	20	08	H0105_002_0	1	1		05/23/2011	2012.02	05/23/2011 10:26:25 AM Eastern Daylight Time		05/20/2011 04:22:00 PM Eastern Daylight Time		05/23/2011 10:28:52 AM Eastern Daylight Time	THE METHODIST OAKS	The Methodist Oaks d.b.a. The Oaks PACE	http://www.theoakspace.com	The Methodist Oaks d.b.a. The Oaks PACE (PACE)	08	20		1			H0105	002	0	2012	Rural South Carolina		2		2			2							www.groveparkpharmacy.com	www.groveparkpharmacy.com									(855)-268-5300		(803)-268-5300		(855)-268-5300		(803)-268-5300										(855)-268-5300		(803)-268-5300		(855)-268-5300		(803)-268-5300				
H0108	004	0	1	01	01	H0108_004_0	5	1		07/08/2011	2012.02	07/08/2011 04:29:58 PM Eastern Daylight Time	08/05/2011 08:36:57 AM Eastern Daylight Time	08/04/2011 11:00:35 AM Eastern Daylight Time		08/08/2011 02:21:35 PM Eastern Daylight Time	HUMANA HEALTH PLAN OF CALIFORNIA, INC.	Humana Health Plan of California, Inc.	www.humana-medicare.com	Humana Gold Plus H0108-004 (HMO)	01	01		1			H0108	004	0	2012	Fresno,Kings  and Madera counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0108	005	0	1	01	01	H0108_005_0	6	1		07/08/2011	2012.02	07/08/2011 04:31:09 PM Eastern Daylight Time	08/05/2011 08:40:30 AM Eastern Daylight Time	08/04/2011 11:00:57 AM Eastern Daylight Time		08/08/2011 02:21:35 PM Eastern Daylight Time	HUMANA HEALTH PLAN OF CALIFORNIA, INC.	Humana Health Plan of California, Inc.	www.humana-medicare.com	Humana Gold Plus H0108-005 (HMO)	01	01		1			H0108	005	0	2012	Riverside and San Bernardino counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0108	006	0	1	02	01	H0108_006_0	6	1		07/08/2011	2012.02	07/08/2011 04:33:56 PM Eastern Daylight Time	08/05/2011 09:34:47 AM Eastern Daylight Time	08/04/2011 11:01:16 AM Eastern Daylight Time		08/08/2011 02:27:59 PM Eastern Daylight Time	HUMANA HEALTH PLAN OF CALIFORNIA, INC.	Humana Health Plan of California, Inc.	www.humana-medicare.com	Humana Gold Plus H0108-006 (HMO-POS)	01	02		1			H0108	006	0	2012	Riverside and San Bernardino counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0108	008	0	1	01	01	H0108_008_0	5	1		07/08/2011	2012.02	07/08/2011 04:35:08 PM Eastern Daylight Time	08/05/2011 09:27:52 AM Eastern Daylight Time	08/04/2011 11:01:36 AM Eastern Daylight Time		08/08/2011 02:27:59 PM Eastern Daylight Time	HUMANA HEALTH PLAN OF CALIFORNIA, INC.	Humana Health Plan of California, Inc.	www.humana-medicare.com	Humana Gold Plus H0108-008 (HMO)	01	01		1			H0108	008	0	2012	San Diego County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0108	009	0	1	02	01	H0108_009_0	6	1		07/08/2011	2012.02	07/08/2011 04:36:55 PM Eastern Daylight Time	08/05/2011 09:32:31 AM Eastern Daylight Time	08/04/2011 11:01:55 AM Eastern Daylight Time		08/08/2011 02:34:23 PM Eastern Daylight Time	HUMANA HEALTH PLAN OF CALIFORNIA, INC.	Humana Health Plan of California, Inc.	www.humana-medicare.com	Humana Gold Plus H0108-009 (HMO-POS)	01	02		1			H0108	009	0	2012	San Diego County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0108	010	0	1	02	01	H0108_010_0	6	1		07/07/2011	2012.02	07/07/2011 01:27:13 PM Eastern Daylight Time	08/05/2011 09:31:02 AM Eastern Daylight Time	08/04/2011 11:02:15 AM Eastern Daylight Time		08/08/2011 02:34:23 PM Eastern Daylight Time	HUMANA HEALTH PLAN OF CALIFORNIA, INC.	Humana Health Plan of California, Inc.	www.humana-medicare.com	Humana Gold Plus H0108-010 (HMO-POS)	01	02		1			H0108	010	0	2012	Fresno and Kings counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0108	011	0	1	01	01	H0108_011_0	6	1		07/08/2011	2012.02	07/08/2011 04:37:47 PM Eastern Daylight Time	08/05/2011 09:32:34 AM Eastern Daylight Time	08/04/2011 11:02:35 AM Eastern Daylight Time		08/08/2011 02:38:04 PM Eastern Daylight Time	HUMANA HEALTH PLAN OF CALIFORNIA, INC.	Humana Health Plan of California, Inc.	www.humana-medicare.com	Humana Gold Plus H0108-011 (HMO)	01	01		1			H0108	011	0	2012	Los Angeles County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0108	012	0	1	02	01	H0108_012_0	6	1		07/08/2011	2012.02	07/08/2011 04:39:33 PM Eastern Daylight Time	08/05/2011 09:33:39 AM Eastern Daylight Time	08/04/2011 11:02:54 AM Eastern Daylight Time		08/08/2011 02:38:04 PM Eastern Daylight Time	HUMANA HEALTH PLAN OF CALIFORNIA, INC.	Humana Health Plan of California, Inc.	www.humana-medicare.com	Humana Gold Plus H0108-012 (HMO-POS)	01	02		1			H0108	012	0	2012	Los Angeles County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0108	013	0	1	01	01	H0108_013_0	6	1		07/08/2011	2012.02	07/08/2011 04:40:00 PM Eastern Daylight Time	08/05/2011 09:34:39 AM Eastern Daylight Time	08/04/2011 11:03:14 AM Eastern Daylight Time		08/08/2011 02:41:48 PM Eastern Daylight Time	HUMANA HEALTH PLAN OF CALIFORNIA, INC.	Humana Health Plan of California, Inc.	www.humana-medicare.com	Humana Gold Plus H0108-013 (HMO)	01	01		1			H0108	013	0	2012	Orange County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0108	014	0	1	02	01	H0108_014_0	6	1		07/08/2011	2012.02	07/08/2011 05:04:24 PM Eastern Daylight Time	08/05/2011 09:35:30 AM Eastern Daylight Time	08/04/2011 11:03:34 AM Eastern Daylight Time		08/08/2011 02:41:48 PM Eastern Daylight Time	HUMANA HEALTH PLAN OF CALIFORNIA, INC.	Humana Health Plan of California, Inc.	www.humana-medicare.com	Humana Gold Plus H0108-014 (HMO-POS)	01	02		1			H0108	014	0	2012	Orange County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0108	801	0	1	01	01	H0108_801_0	7	1		07/06/2011	2012.02	07/06/2011 10:49:24 AM Eastern Daylight Time	05/27/2011 03:28:04 PM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA HEALTH PLAN OF CALIFORNIA, INC.	Humana Health Plan of California, Inc.	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H0108	801	0	2012	Select counties in California		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H0108	802	0	1	01	01	H0108_802_0	2	1		07/06/2011	2012.02	07/06/2011 10:54:57 AM Eastern Daylight Time	05/27/2011 03:36:32 PM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA HEALTH PLAN OF CALIFORNIA, INC.	Humana Health Plan of California, Inc.	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H0108	802	0	2012	Select counties in California		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
H0108	803	0	1	01	01	H0108_803_0	2	1		07/06/2011	2012.02	07/06/2011 10:55:01 AM Eastern Daylight Time	05/27/2011 03:37:29 PM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA HEALTH PLAN OF CALIFORNIA, INC.	Humana Health Plan of California, Inc.	www.humana-medicare.com	Humana Employer Sponsored Non-CY (HMO)	01	01		1			H0108	803	0	2012	Select counties in California		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H0117	005	0	1	01	01	H0117_005_0	7	1		07/21/2011	2012.02	07/21/2011 01:46:07 PM Eastern Daylight Time	08/05/2011 02:04:04 PM Eastern Daylight Time	08/04/2011 05:45:11 PM Eastern Daylight Time		08/08/2011 03:21:23 PM Eastern Daylight Time	WELLCARE OF OHIO, INC.	WellCare	www.wellcare.com	WellCare Value (HMO)	01	01		1			H0117	005	0	2012	Cleveland, Columbus, Cincinnati Metro Areas		2		2			2						www.wellcare.com	www.wellcare.com	www.wellcare.com	(866)-687-8815		(866)-687-8815		(877)-232-7119		(877)-232-7119		(866)-687-8815		(866)-687-8815		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H0117	007	0	1	01	01	H0117_007_0	8	1	2	07/21/2011	2012.02	07/21/2011 01:46:19 PM Eastern Daylight Time	08/05/2011 02:04:21 PM Eastern Daylight Time	08/04/2011 05:48:13 PM Eastern Daylight Time		08/08/2011 03:21:23 PM Eastern Daylight Time	WELLCARE OF OHIO, INC.	WellCare	www.wellcare.com	WellCare Access (HMO SNP)	01	01		1			H0117	007	0	2012	Cleveland, Columbus, Cincinnati and Metro Areas		2		2			1	3		1	1		www.wellcare.com	www.wellcare.com	www.wellcare.com	(866)-530-9487		(866)-530-9487		(877)-232-7119		(877)-232-7119		(866)-530-9487		(866)-530-9487		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H0141	001	0	1	01	01	H0141_001_0	8	1	2	08/09/2011	2012.02	08/09/2011 03:17:58 PM Eastern Daylight Time	08/09/2011 04:50:48 PM Eastern Daylight Time	08/09/2011 04:50:41 PM Eastern Daylight Time		08/09/2011 04:58:02 PM Eastern Daylight Time	CARESOURCE MICHIGAN	CareSource	www.caresource.com	CareSource Advantage (HMO SNP)	01	01		1			H0141	001	0	2012	12 counties in the State of Michigan		2	817	2			1	3		1	3		www.caresource.com	www.caresource.com	www.caresource.com	(877)-725-4581		(877)-725-4581		(877)-725-4581		(877)-725-4581		(877)-725-4581		(877)-725-4581		(877)-725-4581		(877)-725-4581		(800)-649-3777		(800)-649-3777		(800)-649-3777		(800)-649-3777		(800)-649-3777		(800)-649-3777		(800)-649-3777		(800)-649-3777		2	2	2
H0150	001	0	1	01	01	H0150_001_0	5	1		08/05/2011	2012.02	08/05/2011 02:59:43 PM Central Daylight Time	08/05/2011 02:14:40 PM Central Daylight Time	08/04/2011 05:29:28 PM Central Daylight Time		08/09/2011 04:56:32 PM Central Daylight Time	HEALTHSPRING OF ALABAMA, INC.	Healthspring of Alabama, Inc.	www.healthspring.com	HealthyAdvantage Preferred (HMO)	01	01		1			H0150	001	0	2012	Alabama		2		2			2						www.healthspring.com	www.healthspring.com	www.healthspring.com	(800)-952-1992		(800)-952-1992		(888)-767-1879		(888)-767-1879		(800)-952-1992		(800)-952-1992		(888)-767-1879		(888)-767-1879		(877)-262-9090		(877)-262-9090		(877)-262-9090		(877)-262-9090		(877)-262-9090		(877)-262-9090		(866)-845-7230		(866)-845-7230		2	2	2
H0150	007	0	1	01	01	H0150_007_0	5	1	2	08/05/2011	2012.02	08/05/2011 03:13:39 PM Central Daylight Time	08/05/2011 02:18:57 PM Central Daylight Time	08/04/2011 05:30:14 PM Central Daylight Time		08/09/2011 04:56:32 PM Central Daylight Time	HEALTHSPRING OF ALABAMA, INC.	Healthspring of Alabama, Inc.	www.healthspring.com	TotalCare (HMO SNP)	01	01		1			H0150	007	0	2012	Alabama		2		2			1	3		1	2		www.healthspring.com	www.healthspring.com	www.healthspring.com	(800)-952-1992		(800)-952-1992		(888)-767-1879		(888)-767-1879		(800)-952-1992		(800)-952-1992		(888)-767-1879		(888)-767-1879		(877)-262-9090		(877)-262-9090		(877)-262-9090		(877)-262-9090		(877)-262-9090		(877)-262-9090		(866)-845-7230		(866)-845-7230		2	2	2
H0150	012	0	1	01	01	H0150_012_0	2	1		07/20/2011	2012.02	07/20/2011 02:42:02 PM Central Daylight Time	05/27/2011 06:39:05 PM Central Daylight Time			07/20/2011 06:58:50 PM Central Daylight Time	HEALTHSPRING OF ALABAMA, INC.	Healthspring of Alabama, Inc.	www.healthspring.com	HealthyAdvantage (HMO)	01	01		1			H0150	012	0	2012	Alabama		2		2			2						www.healthspring.com	www.healthspring.com	www.healthspring.com	(800)-952-1992		(800)-952-1992		(888)-767-1879		(888)-767-1879										(877)-262-9090		(877)-262-9090		(877)-262-9090		(877)-262-9090										2	2	2
H0150	023	0	1	02	01	H0150_023_0	3	1		08/05/2011	2012.02	08/05/2011 03:19:56 PM Central Daylight Time	08/05/2011 02:22:26 PM Central Daylight Time	08/04/2011 05:30:54 PM Central Daylight Time		08/09/2011 04:56:32 PM Central Daylight Time	HEALTHSPRING OF ALABAMA, INC.	Healthspring of Alabama, Inc.	www.healthspring.com	HealthyAdvantage Premier (HMO-POS)	01	02		1			H0150	023	0	2012	Alabama		2		2			2						www.healthspring.com	www.healthspring.com	www.healthspring.com	(800)-952-1992		(800)-952-1992		(888)-767-1879		(888)-767-1879		(800)-952-1992		(800)-952-1992		(888)-767-1879		(888)-767-1879		(877)-262-9090		(877)-262-9090		(877)-262-9090		(877)-262-9090		(877)-262-9090		(877)-262-9090		(866)-845-7230		(866)-845-7230		2	2	2
H0150	802	0	1	01	01	H0150_802_0	3	1		08/02/2011	2012.02	08/02/2011 10:15:47 AM Central Daylight Time	05/31/2011 05:56:37 PM Central Daylight Time			08/02/2011 04:47:01 PM Central Daylight Time	HEALTHSPRING OF ALABAMA, INC.	Healthspring of Alabama, Inc.	www.healthspring.com	Retiree Advantage (HMO)	01	01		1			H0150	802	0	2012	Alabama		1		2			2						www.healthspring.com	www.healthspring.com	www.healthspring.com	(800)-952-1992		(800)-952-1992		(888)-767-1879		(888)-767-1879										(877)-262-9090		(877)-262-9090		(877)-262-9090		(877)-262-9090										2	1	2
H0150	804	0	1	01	01	H0150_804_0	3	1		08/02/2011	2012.02	08/02/2011 10:16:30 AM Central Daylight Time	05/31/2011 05:58:04 PM Central Daylight Time			08/02/2011 04:47:01 PM Central Daylight Time	HEALTHSPRING OF ALABAMA, INC.	Healthspring of Alabama, Inc.	www.healthspring.com	Retiree Advantage Preferred (HMO)	01	01		1			H0150	804	0	2012	Alabama		1		2			2						www.healthspring.com	www.healthspring.com	www.healthspring.com	(800)-952-1992		(800)-952-1992		(888)-767-1879		(888)-767-1879		(800)-952-1992		(800)-952-1992		(800)-331-6293		(800)-331-6293		(877)-262-9090		(877)-262-9090		(877)-262-9090		(877)-262-9090		(877)-262-9090		(877)-262-9090		(866)-845-7230		(866)-845-7230		2	1	2
H0151	001	0	1	01	01	H0151_001_0	6	1		08/08/2011	2012.02	08/08/2011 10:53:18 AM Central Daylight Time	08/05/2011 10:45:52 AM Central Daylight Time	08/05/2011 01:11:32 PM Central Daylight Time		08/09/2011 01:25:28 PM Central Daylight Time	UNITEDHEALTHCARE OF ALABAMA, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H0151	001	0	2012	Select Alabama Counties		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0151	015	0	1	01	01	H0151_015_0	4	1	2	07/20/2011	2012.02	07/20/2011 01:24:41 PM Central Daylight Time	08/05/2011 10:47:15 AM Central Daylight Time	08/05/2011 12:51:07 PM Central Daylight Time		08/09/2011 01:25:28 PM Central Daylight Time	UNITEDHEALTHCARE OF ALABAMA, INC.	SecureHorizons by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H0151	015	0	2012	Select Alabama Counties		2		2			1	3		1	2		www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-711-6088		(800)-711-6088		(800)-555-5757		(800)-555-5757		(800)-711-6088		(800)-711-6088		(800)-555-5757		(800)-555-5757		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0151	025	0	1	01	01	H0151_025_0	6	1		08/08/2011	2012.02	08/08/2011 11:07:54 AM Central Daylight Time	08/05/2011 10:48:30 AM Central Daylight Time	08/05/2011 01:11:48 PM Central Daylight Time		08/09/2011 01:25:28 PM Central Daylight Time	UNITEDHEALTHCARE OF ALABAMA, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H0151	025	0	2012	Mobile County		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0151	801	0	1	01	01	H0151_801_0	2	1		07/06/2011	2012.02	07/06/2011 04:26:43 PM Central Daylight Time	06/03/2011 03:10:39 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	UNITEDHEALTHCARE OF ALABAMA, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0151	801	0	2012	Select Counties in Alabama		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0151	804	0	1	01	01	H0151_804_0	2	1		07/06/2011	2012.02	07/06/2011 04:35:06 PM Central Daylight Time	06/03/2011 03:11:01 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	UNITEDHEALTHCARE OF ALABAMA, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0151	804	0	2012	Select Counties in AL		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0151	805	0	1	01	01	H0151_805_0	2	1		07/06/2011	2012.02	07/06/2011 04:35:14 PM Central Daylight Time	06/03/2011 03:11:24 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	UNITEDHEALTHCARE OF ALABAMA, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0151	805	0	2012	Select counties in AL		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548										(711)		(711)		(711)		(711)										2	2	2
H0154	001	0	1	01	01	H0154_001_0	7	1		07/08/2011	2012.02	07/08/2011 02:55:01 PM Central Daylight Time	08/08/2011 05:06:43 PM Central Daylight Time	08/08/2011 05:06:43 PM Central Daylight Time		08/08/2011 05:43:23 PM Central Daylight Time	VIVA HEALTH, INC.	VIVA Medicare Plus	http://www.vivamedicaremember.com/	VIVA Medicare Plus Rx (HMO)	01	01		1			H0154	001	0	2012	Central Alabama and Mobile Area		2	19492	2			2						www.vivamedicaremember.com	http://www.vivamedicaremember.com/Download.aspx?ID=253Type=doc	http://www.vivamedicaremember.com/Download.aspx?ID=329Type=doc	(800)-633-1542		(205)-918-2067		(888)-830-8482		(205)-933-8482		(800)-633-1542		(205)-918-2067		(888)-830-8482		(205)-933-8482		(800)-548-2546		(800)-548-2546		(800)-548-2546		(800)-548-2546		(800)-548-2546		(800)-548-2546		(800)-548-2546		(800)-548-2546		2	2	2
H0154	008	0	1	01	01	H0154_008_0	6	1		07/08/2011	2012.02	07/08/2011 10:57:16 AM Central Daylight Time	06/04/2011 04:47:40 PM Central Daylight Time			07/08/2011 02:57:58 PM Central Daylight Time	VIVA HEALTH, INC.	VIVA Medicare Plus	http://www.vivamedicaremember.com/	VIVA Medicare Plus Select (HMO)	01	01		1			H0154	008	0	2012	Central Alabama and Mobile Area		2	973	2			2						www.vivamedicaremember.com	http://www.vivamedicaremember.com/Download.aspx?ID=253Type=doc	http://www.vivamedicaremember.com/Download.aspx?ID=329Type=doc	(800)-633-1542		(205)-918-2067		(888)-830-8482		(205)-933-8482										(800)-548-2546		(800)-548-2546		(800)-548-2546		(800)-548-2546										2	2	2
H0154	011	0	1	01	01	H0154_011_0	7	1		07/08/2011	2012.02	07/08/2011 10:57:34 AM Central Daylight Time	06/04/2011 04:48:58 PM Central Daylight Time	07/22/2011 06:31:54 AM Central Daylight Time		07/22/2011 06:40:56 AM Central Daylight Time	VIVA HEALTH, INC.	VIVA Medicare Plus	http://www.vivamedicaremember.com/	VIVA Medicare Plus Rx Premier (HMO)	01	01		1			H0154	011	0	2012	Central Alabama and Mobile Area		2	5599	2			2						www.vivamedicaremember.com	http://www.vivamedicaremember.com/Download.aspx?ID=253Type=doc	http://www.vivamedicaremember.com/Download.aspx?ID=329Type=doc	(800)-633-1542		(205)-918-2067		(888)-830-8482		(205)-933-8482		(800)-633-1542		(205)-918-2067		(888)-830-8482		(205)-933-8482		(800)-548-2546		(800)-548-2546		(800)-548-2546		(800)-548-2546		(800)-548-2546		(800)-548-2546		(800)-548-2546		(800)-548-2546		2	2	2
H0154	012	0	1	01	01	H0154_012_0	8	1	2	08/08/2011	2012.02	08/08/2011 05:40:42 PM Central Daylight Time	08/08/2011 05:07:02 PM Central Daylight Time	08/08/2011 05:07:02 PM Central Daylight Time		08/08/2011 05:43:23 PM Central Daylight Time	VIVA HEALTH, INC.	VIVA Medicare Plus	http://www.vivamedicaremember.com/	VIVA Medicare Plus Rx Extra Value (HMO SNP)	01	01		1			H0154	012	0	2012	Central Alabama and Mobile Area		2	18910	2			1	3		1	4		www.vivamedicaremember.com	http://www.vivamedicaremember.com/Download.aspx?ID=253Type=doc	http://www.vivamedicaremember.com/Download.aspx?ID=329Type=doc	(800)-633-1542		(205)-918-2067		(888)-830-8482		(205)-933-8482		(800)-633-1542		(205)-918-2067		(888)-830-8482		(205)-933-8482		(800)-548-2546		(800)-548-2546		(800)-548-2546		(800)-548-2546		(800)-548-2546		(800)-548-2546		(800)-548-2546		(800)-548-2546		2	2	2
H0154	801	0	1	01	01	H0154_801_0	4	1		05/31/2011	2012.02	05/31/2011 09:38:18 AM Central Daylight Time	06/04/2011 04:51:32 PM Central Daylight Time			06/06/2011 03:00:48 PM Central Daylight Time	VIVA HEALTH, INC.	VIVA Medicare Plus	http://www.vivamedicaremember.com/	VIVA Medicare Plus Rx Group Plan (HMO)	01	01		1			H0154	801	0	2012	State of Alabama		1	50	2			2						www.vivamedicaremember.com	http://www.vivamedicaremember.com/Download.aspx?ID=253Type=doc	http://www.vivamedicaremember.com/Download.aspx?ID=329Type=doc	(800)-633-1542		(205)-918-2067		(888)-830-8482		(205)-933-8482		(800)-633-1542		(205)-918-2067		(888)-830-8482		(205)-933-8482		(800)-548-2546		(800)-548-2546		(800)-548-2546		(800)-548-2546		(800)-548-2546		(800)-548-2546		(800)-548-2546		(800)-548-2546		1	1	1
H0154	802	0	1	01	01	H0154_802_0	4	1		05/31/2011	2012.02	05/31/2011 03:44:18 PM Central Daylight Time	06/04/2011 04:52:50 PM Central Daylight Time			06/06/2011 03:00:48 PM Central Daylight Time	VIVA HEALTH, INC.	VIVA Medicare Plus	http://www.vivamedicaremember.com/	VIVA Medicare Plus Select Group Plan (HMO)	01	01		1			H0154	802	0	2012	State of Alabama		1	50	2			2						www.vivamedicaremember.com	http://www.vivamedicaremember.com/Download.aspx?ID=253Type=doc	http://www.vivamedicaremember.com/Download.aspx?ID=329Type=doc	(800)-633-1542		(205)-918-2067		(888)-830-8482		(205)-933-8482										(800)-548-2546		(800)-548-2546		(800)-548-2546		(800)-548-2546										1	1	1
H0154	803	0	1	01	01	H0154_803_0	4	1		05/31/2011	2012.02	05/31/2011 03:44:41 PM Central Daylight Time	06/04/2011 04:54:12 PM Central Daylight Time			06/06/2011 03:00:48 PM Central Daylight Time	VIVA HEALTH, INC.	VIVA Medicare Plus	http://www.vivamedicaremember.com/	VIVA Medicare Plus Rx Group Plan (not CY) (HMO)	01	01		1			H0154	803	0	2012	State of Alabama		1	50	2			2						www.vivamedicaremember.com	http://www.vivamedicaremember.com/Download.aspx?ID=253Type=doc	http://www.vivamedicaremember.com/Download.aspx?ID=329Type=doc	(800)-633-1542		(205)-918-2067		(888)-830-8482		(205)-933-8482		(800)-633-1542		(205)-918-2067		(888)-830-8482		(205)-933-8482		(800)-548-2546		(800)-548-2546		(800)-548-2546		(800)-548-2546		(800)-548-2546		(800)-548-2546		(800)-548-2546		(800)-548-2546		1	1	1
H0216	001	0	1	20	08	H0216_001_0	2	1		10/20/2011	2012.02	10/20/2011 07:01:22 AM Mountain Daylight Time		10/18/2011 03:41:31 PM Mountain Daylight Time		10/20/2011 07:03:43 AM Mountain Daylight Time	PACE IOWA	Immanuel Pathways	www.immanuelcommunities.com	PACE Iowa (PACE)	08	20		1			H0216	001	0	2012	PACE Iowa		2		2			2							www.immanuelcommunities.com	www.immanuelcommunities.com									(800)-000-0000		(712)-256-7284		(800)-000-0000		(712)-256-7284										(800)-000-0000		(712)-256-7284		(800)-000-0000		(712)-256-7284				
H0216	002	0	1	20	08	H0216_002_0	1	1		09/29/2011	2012.02	09/29/2011 07:59:03 AM Mountain Daylight Time		09/28/2011 11:26:54 AM Mountain Daylight Time		09/29/2011 08:07:11 AM Mountain Daylight Time	PACE IOWA	Immanuel Pathways	www.immanuelcommunities.com	PACE Iowa (PACE)	08	20		1			H0216	002	0	2012	PACE Iowa		2		2			2							www.immanuelcommunities.com	www.immanuelcommunities.com									(800)-000-0000		(712)-256-7284		(800)-000-0000		(712)-256-7284										(800)-000-0000		(712)-256-7284		(800)-000-0000		(712)-256-7284				
H0248	001	0	1	04	01	H0248_001_0	6	1		06/30/2011	2012.02	06/30/2011 02:57:27 PM Eastern Daylight Time	08/05/2011 08:35:20 AM Eastern Daylight Time	08/04/2011 11:03:53 AM Eastern Daylight Time		08/08/2011 02:45:20 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H0248-001 (PPO)	01	04		1			H0248	001	0	2012	Honolulu County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0248	002	0	1	04	01	H0248_002_0	9	1		07/14/2011	2012.02	07/14/2011 08:39:19 AM Eastern Daylight Time	08/05/2011 08:39:36 AM Eastern Daylight Time	08/04/2011 11:04:13 AM Eastern Daylight Time		08/08/2011 02:45:20 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H0248-002 (PPO)	01	04		1			H0248	002	0	2012	Honolulu and Kauai counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0251	002	0	1	01	01	H0251_002_0	6	1	2	07/22/2011	2012.02	07/22/2011 11:40:52 AM Central Daylight Time	08/04/2011 08:58:49 PM Central Daylight Time	08/09/2011 01:22:10 PM Central Daylight Time		08/09/2011 02:22:44 PM Central Daylight Time	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	UnitedHealthcare Community Plan	www.UHCDualComplete.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H0251	002	0	2012	Tennessee Counties		2		2			1	3		1	5		www.UHCDualComplete.com	https://www.uhcrivervalley.com/SecurePlusComplete	www.prescriptionsolutions.com	(800)-690-1606		(800)-690-1606		(888)-565-8170		(888)-565-8170		(800)-690-1606		(800)-690-1606		(888)-565-8170		(888)-565-8170		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0294	001	0	1	04	01	H0294_001_0	7	1		08/08/2011	2012.02	08/08/2011 02:13:22 PM Eastern Daylight Time	08/05/2011 05:22:00 PM Eastern Daylight Time	08/09/2011 10:05:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS WISCONSIN INSURANCE COMPANY	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Silver Rx (PPO SNP)	01	04		1			H0294	001	0	2012	Wisconsin		2		2			1	4		1		00000000000000000100	http://www.careimprovementplus.com	www.careimprovementplus.com	www.careimprovementplus.com	(800)-204-1002		(800)-204-1002		(800)-711-1656		(800)-711-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0294	002	0	1	04	01	H0294_002_0	6	1		08/09/2011	2012.02	08/09/2011 09:13:03 AM Eastern Daylight Time	08/05/2011 05:22:00 PM Eastern Daylight Time	08/09/2011 10:05:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS WISCONSIN INSURANCE COMPANY	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Gold Rx (PPO SNP)	01	04		1			H0294	002	0	2012	Wisconsin		2		2			1	4		1		00000000000000000100	http://www.careimprovementplus.com	www.careimprovementplus.com	www.careimprovementplus.com	(800)-204-1002		(800)-204-1002		(800)-711-1656		(800)-711-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0294	004	0	1	04	01	H0294_004_0	5	1		08/09/2011	2012.02	08/09/2011 09:13:38 AM Eastern Daylight Time	08/08/2011 05:56:00 PM Eastern Daylight Time	08/09/2011 10:05:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS WISCONSIN INSURANCE COMPANY	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Medicare Advantage (PPO)	01	04		1			H0294	004	0	2012	Wisconsin		2	1214	2			2						http://www.careimprovementplus.com	www.careimprovementplus.com	www.careimprovementplus.com	(800)-204-1002		(800)-204-1002		(800)-711-1656		(800)-711-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0294	005	0	1	04	01	H0294_005_0	4	1		06/22/2011	2012.02	06/22/2011 02:59:39 PM Eastern Daylight Time	05/31/2011 12:41:00 PM Eastern Daylight Time			06/23/2011 10:11:29 AM Eastern Daylight Time	CARE IMPROVEMENT PLUS WISCONSIN INSURANCE COMPANY	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Medicare Advantage Only (PPO)	01	04		1			H0294	005	0	2012	Wisconsin		2	1214	2			2						http://www.careimprovementplus.com	www.careimprovementplus.com	www.careimprovementplus.com	(800)-204-1002		(800)-204-1002		(800)-711-1656		(800)-711-1656										(711)		(711)		(711)		(711)										2	2	2
H0302	001	0	1	01	01	H0302_001_0	6	1		07/18/2011	2012.02	07/18/2011 01:02:03 PM US Mountain Standard Time	08/04/2011 08:18:07 AM US Mountain Standard Time	08/04/2011 07:49:58 AM US Mountain Standard Time		08/08/2011 10:08:48 AM US Mountain Standard Time	BANNER MEDISUN, INC.	Banner MediSun	http://www.bannermedisun.com	MediSunONE Plus (HMO)	01	01		1			H0302	001	0	2012	Maricopa  County and part of Pinal County		2	20149	2			2						www.bannermedisun.com	http://www.bannerhealth.com/NR/rdonlyres/6DD8C932-360A-4822-9C71-3BAED970E4DE/0/Formulary2011.pdf	http://www.bannerhealth.com/_MediSun/Prescriptions/_Prescription+Coverage.htm	(800)-446-8331		(623)-974-7430		(800)-446-8331		(623)-974-7430		(800)-446-8331		(623)-974-7430		(800)-446-8331		(623)-974-7430		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		2	2	2
H0302	006	0	1	01	01	H0302_006_0	9	1		08/18/2011	2012.02	08/18/2011 09:40:46 AM US Mountain Standard Time	08/17/2011 11:47:10 AM US Mountain Standard Time	08/18/2011 09:03:50 AM US Mountain Standard Time		08/18/2011 09:43:46 AM US Mountain Standard Time	BANNER MEDISUN, INC.	Banner MediSun	www.bannermedisun.com	MediSunONE Classic (HMO)	01	01		1			H0302	006	0	2012	Maricopa County and part of Pinal County		2	426	2			2						www.bannermedisun.com	http://www.bannerhealth.com/NR/rdonlyres/6DD8C932-360A-4822-9C71-3BAED970E4DE/0/Formulary2011.pdf	http://www.bannerhealth.com/_MediSun/Prescriptions/_Prescription+Coverage.htm	(800)-446-8331		(623)-974-7430		(800)-446-8331		(623)-974-7430		(800)-446-8331		(623)-974-7430		(800)-446-8331		(623)-974-7430		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		2	2	2
H0302	007	0	1	01	01	H0302_007_0	7	1		07/18/2011	2012.02	07/18/2011 01:03:24 PM US Mountain Standard Time	08/04/2011 08:19:46 AM US Mountain Standard Time	08/04/2011 07:52:01 AM US Mountain Standard Time		08/08/2011 10:19:58 AM US Mountain Standard Time	BANNER MEDISUN, INC.	Banner MediSun	www.bannermedisun.com	MediSunONE Premier (HMO)	01	01		1			H0302	007	0	2012	Maricopa County and part of  Pinal County		2	2002	2			2						www.bannermedisun.com	http://www.bannerhealth.com/NR/rdonlyres/6DD8C932-360A-4822-9C71-3BAED970E4DE/0/Formulary2011.pdf	http://www.bannerhealth.com/_MediSun/Prescriptions/_Prescription+Coverage.htm	(800)-446-8331		(623)-974-7430		(800)-446-8331		(623)-974-7430		(800)-446-8331		(623)-974-7430		(800)-446-8331		(623)-974-7430		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		2	2	2
H0303	013	0	1	01	01	H0303_013_0	5	1		08/08/2011	2012.02	08/08/2011 11:10:00 AM Central Daylight Time	08/05/2011 05:16:05 PM Central Daylight Time	08/05/2011 01:12:03 PM Central Daylight Time		08/09/2011 01:25:28 PM Central Daylight Time	PACIFICARE OF ARIZONA, INC	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H0303	013	0	2012	Pima County		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0303	015	0	1	01	01	H0303_015_0	5	1		08/08/2011	2012.02	08/08/2011 11:09:50 AM Central Daylight Time	08/05/2011 05:15:34 PM Central Daylight Time	08/05/2011 01:12:20 PM Central Daylight Time		08/09/2011 01:25:28 PM Central Daylight Time	PACIFICARE OF ARIZONA, INC	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H0303	015	0	2012	Maricopa and Pinal counties		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(877)-370-2843		(877)-370-2843		(800)-547-5514		(800)-547-5514		(877)-370-2843		(877)-370-2843		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0303	034	0	1	01	01	H0303_034_0	3	1	2	07/22/2011	2012.02	07/22/2011 11:43:18 AM Central Daylight Time	08/05/2011 12:32:05 PM Central Daylight Time	08/05/2011 12:51:52 PM Central Daylight Time		08/09/2011 12:05:43 PM Central Daylight Time	PACIFICARE OF ARIZONA, INC	SecureHorizons by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Dual Complete LP (HMO SNP)	01	01		1			H0303	034	0	2012	Maricopa, Pima, and part of Pinal counties		2		2			1	3		1	2		www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(866)-480-2063		(866)-480-2063		(888)-834-3721		(888)-834-3721		(866)-480-2063		(866)-480-2063		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0303	801	0	1	01	01	H0303_801_0	2	1		07/06/2011	2012.02	07/06/2011 04:35:22 PM Central Daylight Time	06/03/2011 02:11:29 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	PACIFICARE OF ARIZONA, INC	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0303	801	0	2012	AZ Employer Sponsored Plan Service Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548										(711)		(711)		(711)		(711)										2	2	2
H0303	804	0	1	01	01	H0303_804_0	2	1		07/06/2011	2012.02	07/06/2011 04:35:26 PM Central Daylight Time	06/03/2011 02:11:50 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	PACIFICARE OF ARIZONA, INC	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0303	804	0	2012	AZ Employer Sponsored Plan Service Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0303	805	0	1	01	01	H0303_805_0	2	1		07/06/2011	2012.02	07/06/2011 04:35:32 PM Central Daylight Time	06/03/2011 02:12:13 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	PACIFICARE OF ARIZONA, INC	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0303	805	0	2012	AZ Employer Sponsored Plan Service Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0307	008	0	1	02	01	H0307_008_0	6	1		07/08/2011	2012.02	07/08/2011 02:40:05 PM Eastern Daylight Time	08/05/2011 09:36:26 AM Eastern Daylight Time	08/04/2011 11:04:34 AM Eastern Daylight Time		08/08/2011 02:50:18 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Reader's Digest Healthy Living Plan (HMO-POS)	01	02		1			H0307	008	0	2012	Maricopa and Pinal (Partial) counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0307	009	0	1	02	01	H0307_009_0	6	1		07/08/2011	2012.02	07/08/2011 02:33:46 PM Eastern Daylight Time	08/05/2011 08:32:32 AM Eastern Daylight Time	08/04/2011 11:04:50 AM Eastern Daylight Time		08/08/2011 02:50:18 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Reader's Digest Healthy Living Plan (HMO-POS)	01	02		1			H0307	009	0	2012	Yavapai,Cochise, Pima and Pinal (Partial) counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0307	011	0	1	01	01	H0307_011_0	5	1		07/08/2011	2012.02	07/08/2011 02:28:30 PM Eastern Daylight Time	08/05/2011 08:38:49 AM Eastern Daylight Time	08/04/2011 11:05:10 AM Eastern Daylight Time		08/08/2011 02:53:47 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Reader's Digest Healthy Living Plan (HMO)	01	01		1			H0307	011	0	2012	Maricopa and Pinal (Partial) counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0307	012	0	1	02	01	H0307_012_0	6	1		07/08/2011	2012.02	07/08/2011 02:25:31 PM Eastern Daylight Time	08/05/2011 09:38:13 AM Eastern Daylight Time	08/04/2011 11:05:34 AM Eastern Daylight Time		08/08/2011 02:53:47 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Reader's Digest Healthy Living Plan (HMO-POS)	01	02		1			H0307	012	0	2012	Mohave County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0307	013	0	1	02	01	H0307_013_0	6	1		07/08/2011	2012.02	07/08/2011 02:20:48 PM Eastern Daylight Time	08/05/2011 09:37:21 AM Eastern Daylight Time	08/04/2011 11:05:54 AM Eastern Daylight Time		08/08/2011 02:57:33 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Reader's Digest Healthy Living Plan (HMO-POS)	01	02		1			H0307	013	0	2012	Yavapai County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0307	801	0	1	01	01	H0307_801_0	3	1		07/05/2011	2012.02	07/05/2011 03:42:26 PM Eastern Daylight Time	05/27/2011 03:17:19 PM Eastern Daylight Time			07/06/2011 11:29:15 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H0307	801	0	2012	Select counties in Arizona		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H0307	802	0	1	01	01	H0307_802_0	3	1		07/05/2011	2012.02	07/06/2011 08:15:26 AM Eastern Daylight Time	05/27/2011 03:44:35 PM Eastern Daylight Time			07/06/2011 11:29:15 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H0307	802	0	2012	Select counties in Arizona		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
H0307	803	0	1	01	01	H0307_803_0	3	1		07/05/2011	2012.02	07/06/2011 08:15:30 AM Eastern Daylight Time	05/27/2011 03:45:33 PM Eastern Daylight Time			07/06/2011 11:29:15 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Employer Sponsored Non-CY (HMO)	01	01		1			H0307	803	0	2012	Select counties in Arizona		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H0316	002	0	1	02	01	H0316_002_0	6	1		08/08/2011	2012.02	08/08/2011 11:11:23 AM Central Daylight Time	08/05/2011 12:33:58 PM Central Daylight Time	08/05/2011 01:12:36 PM Central Daylight Time		08/09/2011 01:25:28 PM Central Daylight Time	UNITEDHEALTHCARE OF ARIZONA,  INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H0316	002	0	2012	Southern Arizona		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0316	014	0	1	02	01	H0316_014_0	6	1		08/08/2011	2012.02	08/08/2011 11:11:11 AM Central Daylight Time	08/05/2011 12:36:25 PM Central Daylight Time	08/05/2011 01:12:51 PM Central Daylight Time		08/09/2011 01:25:28 PM Central Daylight Time	UNITEDHEALTHCARE OF ARIZONA,  INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H0316	014	0	2012	Yavapai County		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0316	801	0	1	01	01	H0316_801_0	2	1		07/06/2011	2012.02	07/06/2011 04:35:39 PM Central Daylight Time	06/03/2011 02:12:53 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	UNITEDHEALTHCARE OF ARIZONA,  INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0316	801	0	2012	AZ Employer Sponsored Plan Service Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0316	804	0	1	01	01	H0316_804_0	2	1		07/06/2011	2012.02	07/06/2011 04:35:44 PM Central Daylight Time	06/03/2011 02:13:13 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	UNITEDHEALTHCARE OF ARIZONA,  INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0316	804	0	2012	AZ Employer Sponsored Plan Service Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0316	806	0	1	01	01	H0316_806_0	2	1		07/06/2011	2012.02	07/06/2011 04:35:49 PM Central Daylight Time	06/03/2011 02:13:31 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	UNITEDHEALTHCARE OF ARIZONA,  INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0316	806	0	2012	AZ Employer Sponsored Plan Service Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548										(711)		(711)		(711)		(711)										2	2	2
H0317	001	0	1	04	01	H0317_001_0	8	1		07/01/2011	2012.02	07/01/2011 03:39:24 PM Eastern Daylight Time	08/05/2011 08:31:19 AM Eastern Daylight Time	08/04/2011 11:06:14 AM Eastern Daylight Time		08/08/2011 02:57:33 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Reader's Digest Healthy Living Plan (PPO)	01	04		1			H0317	001	0	2012	Maricopa and Yavapai counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0317	002	0	1	04	01	H0317_002_0	9	1		06/24/2011	2012.02	06/24/2011 02:23:34 PM Eastern Daylight Time	08/05/2011 08:28:10 AM Eastern Daylight Time	08/04/2011 11:06:36 AM Eastern Daylight Time		08/08/2011 03:39:19 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Reader's Digest Healthy Living Plan (PPO)	01	04		1			H0317	002	0	2012	Maricopa County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0317	004	0	1	04	01	H0317_004_0	9	1		07/01/2011	2012.02	07/01/2011 03:39:54 PM Eastern Daylight Time	08/05/2011 08:33:37 AM Eastern Daylight Time	08/04/2011 11:06:57 AM Eastern Daylight Time		08/08/2011 03:39:19 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Reader's Digest Healthy Living Plan (PPO)	01	04		1			H0317	004	0	2012	Select counties in Arizona		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0317	006	0	1	04	01	H0317_006_0	8	1		07/01/2011	2012.02	07/01/2011 03:40:13 PM Eastern Daylight Time	08/05/2011 08:38:01 AM Eastern Daylight Time	08/04/2011 11:07:17 AM Eastern Daylight Time		08/08/2011 03:44:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Reader's Digest Healthy Living Plan (PPO)	01	04		1			H0317	006	0	2012	Yavapai County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0317	007	0	1	04	01	H0317_007_0	6	1		07/01/2011	2012.02	07/01/2011 03:40:37 PM Eastern Daylight Time	08/05/2011 08:41:25 AM Eastern Daylight Time	08/04/2011 11:07:39 AM Eastern Daylight Time		08/08/2011 03:44:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Reader's Digest Healthy Living Plan (PPO)	01	04		1			H0317	007	0	2012	Mohave County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0318	002	0	1	01	01	H0318_002_0	5	1		08/05/2011	2012.02	08/05/2011 09:18:38 AM Central Daylight Time	08/04/2011 02:16:31 PM Central Daylight Time	08/04/2011 09:30:35 AM Central Daylight Time		08/08/2011 07:54:55 AM Central Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Select Plan (HMO)	01	01		1			H0318	002	0	2012	Maricopa County		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H0318	801	0	1	01	01	H0318_801_0	3	1		06/02/2011	2012.02	06/02/2011 04:53:06 PM Eastern Daylight Time	06/01/2011 01:04:32 PM Eastern Daylight Time			06/03/2011 06:19:28 PM Eastern Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan (HMO)	01	01		1			H0318	801	0	2012	Arizona		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748										1	1	1
H0318	802	0	1	01	01	H0318_802_0	2	1		04/22/2011	2012.02	04/22/2011 09:39:04 AM Eastern Daylight Time	06/01/2011 01:14:23 PM Eastern Daylight Time			06/03/2011 06:19:28 PM Eastern Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan w/Rx CY (HMO)	01	01		1			H0318	802	0	2012	Arizona		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		1	1	1
H0319	001	0	1	04	01	H0319_001_0	3	1		08/09/2011	2012.02	08/09/2011 11:45:26 AM Central Daylight Time	08/09/2011 07:49:07 AM Central Daylight Time	08/05/2011 12:52:14 PM Central Daylight Time		08/09/2011 03:53:30 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	Evercare by UnitedHealthcare	www.EvercareHealthPlans.com	UnitedHealthcare Nursing Home Plan (PPO SNP)	01	04		1			H0319	001	0	2012	Maricopa, Pima, and Pinal counties		2		2			1	1	1	1			www.EvercareHealthPlans.com	evercarehealthplans.com/prescription_drug_coverage.jsp	www.PrescriptionSolutions.com	(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0320	005	0	1	01	01	H0320_005_0	9	1		08/09/2011	2012.02	08/09/2011 09:17:28 AM Central Daylight Time	08/07/2011 12:32:22 PM Central Daylight Time	08/04/2011 12:35:32 PM Central Daylight Time		08/09/2011 01:16:20 PM Central Daylight Time	ARCADIAN HEALTH PLAN, INC.	Desert Canyon Community Care	www.desertcanyoncommunitycare.com	Desert Canyon Community Care-Plus (HMO)	01	01		1			H0320	005	0	2012	Mohave		2		2			2							www.desertcanyoncommunitycare.com	www.desertcanyoncommunitycare.com	(800)-573-8597		(800)-573-8597		(800)-887-6177		(928)-777-9226		(800)-573-8597		(800)-573-8597		(800)-887-6177		(928)-777-9226		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H0320	006	0	1	01	01	H0320_006_0	9	1		08/08/2011	2012.02	08/08/2011 11:19:17 AM Central Daylight Time	08/07/2011 02:01:15 PM Central Daylight Time	08/04/2011 12:36:17 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARCADIAN HEALTH PLAN, INC.	Desert Canyon Community Care	www.desertcanyoncommunitycare.com	Desert Canyon Community Care-Plus (HMO)	01	01		1			H0320	006	0	2012	Yavapai		2		2			2							www.desertcanyoncommunitycare.com	www.desertcanyoncommunitycare.com	(800)-573-8597		(800)-573-8597		(800)-887-6177		(928)-777-9226		(800)-573-8597		(800)-573-8597		(800)-887-6177		(928)-777-9226		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H0321	002	0	1	01	01	H0321_002_0	7	1	2	07/22/2011	2012.02	07/22/2011 11:44:17 AM Central Daylight Time	08/09/2011 01:54:59 PM Central Daylight Time	08/05/2011 12:52:36 PM Central Daylight Time		08/09/2011 02:22:44 PM Central Daylight Time	ARIZONA PHYSICIANS IPA, INC.	UnitedHealthcare Community Plan	www.UHCDualComplete.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H0321	002	0	2012	Maricopa, Pima, Yuma, Mohave and Related Counties		2		2			1	3		1	3		www.UHCDualComplete.com	www.myapipa.com	www.prescriptionsolutions.com	(877)-614-0623		(877)-614-0623		(888)-565-8170		(888)-565-8170		(877)-614-0623		(877)-614-0623		(888)-565-8170		(888)-565-8170		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0332	001	0	1	01	01	H0332_001_0	8	1		07/27/2011	2012.02	07/27/2011 10:46:42 AM Central Daylight Time	07/27/2011 10:46:03 AM Central Daylight Time			07/27/2011 01:45:35 PM Central Daylight Time	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	KelseyCare Advantage Essential (HMO)	01	01		1			H0332	001	0	2012	Harris, Ft Bend, Galveston and Montgomery counties		2	3886	2			2						www.Kelseycareadvantage.com	www.kelseycareadvantage.com	www.kelseycareadvantage.com	(866)-535-8343		(713)-442-2273		(800)-663-7146		(713)-442-2273										(866)-302-9336		(713)-442-9537		(866)-302-9336		(713)-442-9537										2	2	2
H0332	002	0	1	01	01	H0332_002_0	9	1		08/05/2011	2012.02	08/05/2011 09:51:13 AM Central Daylight Time	08/05/2011 01:57:29 PM Central Daylight Time	08/05/2011 11:07:42 AM Central Daylight Time		08/05/2011 02:34:09 PM Central Daylight Time	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	KelseyCare Advantage Rx (HMO)	01	01		1			H0332	002	0	2012	Harris, Ft Bend, Galveston and Montgomery counties		2	12696	2			2						www.Kelseycareadvantage.com	www.kelseycareadvantage.com	www.kelseycareadvantage.com	(866)-535-8343		(713)-442-2273		(800)-663-7146		(713)-442-2273		(866)-535-8343		(713)-442-2273		(866)-535-8343		(713)-442-2273		(866)-302-9336		(713)-442-9537		(866)-302-9336		(713)-442-9537		(866)-302-9336		(713)-442-9537		(866)-302-9336		(713)-442-9537		2	2	2
H0332	003	0	1	02	01	H0332_003_0	6	1		07/22/2011	2012.02	07/22/2011 02:05:28 PM Central Daylight Time	07/22/2011 01:52:12 PM Central Daylight Time			07/22/2011 02:13:19 PM Central Daylight Time	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	KelseyCare Advantage Essential + Choice (HMO-POS)	01	02		1			H0332	003	0	2012	Harris, Ft Bend, Galveston and Montgomery counties		2	1741	2			2						www.Kelseycareadvantage.com	www.kelseycareadvantage.com	www.kelseycareadvantage.com	(866)-535-8343		(713)-442-2273		(800)-663-7146		(713)-442-2273										(866)-302-9336		(713)-442-9537		(866)-302-9336		(713)-442-9537										2	2	2
H0332	004	0	1	02	01	H0332_004_0	10	1		08/05/2011	2012.02	08/05/2011 09:52:27 AM Central Daylight Time	08/05/2011 01:59:09 PM Central Daylight Time	08/05/2011 11:09:04 AM Central Daylight Time		08/05/2011 02:34:09 PM Central Daylight Time	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	KelseyCare Advantage Rx + Choice (HMO-POS)	01	02		1			H0332	004	0	2012	Harris, Ft Bend, Galveston and Montgomery counties		2	1385	2			2						www.Kelseycareadvantage.com	www.kelseycareadvantage.com	www.kelseycareadvantage.com	(866)-535-8343		(713)-442-2273		(800)-663-7146		(713)-442-2273		(866)-535-8343		(713)-442-2273		(866)-535-8343		(713)-442-2273		(866)-302-9336		(713)-442-9537		(866)-302-9336		(713)-442-9537		(866)-302-9336		(713)-442-9537		(866)-302-9336		(713)-442-9537		2	2	2
H0332	801	0	1	01	01	H0332_801_0	4	1		05/24/2011	2012.02	05/24/2011 10:40:25 AM Central Daylight Time	06/03/2011 06:19:03 PM Central Daylight Time			06/05/2011 02:26:44 PM Central Daylight Time	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	KelseyCare Advantage Essential Retiree (HMO)	01	01		1			H0332	801	0	2012	Texas		1	9	2			2						www.Kelseycareadvantage.com	www.kelseycareadvantage.com	www.kelseycareadvantage.com	(866)-534-0554		(713)-442-9550		(800)-663-7146		(713)-442-2273										(866)-302-9336		(713)-442-9537		(866)-302-9336		(713)-442-9537										2	2	2
H0332	803	0	1	01	01	H0332_803_0	4	1		05/24/2011	2012.02	05/24/2011 10:40:57 AM Central Daylight Time	06/03/2011 06:19:59 PM Central Daylight Time			06/05/2011 02:26:44 PM Central Daylight Time	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	KelseyCare Advantage Rx Retiree (HMO)	01	01		1			H0332	803	0	2012	Texas		1	1062	2			2						www.Kelseycareadvantage.com	www.kelseycareadvantage.com	www.kelseycareadvantage.com	(866)-534-0554		(713)-442-9550		(800)-663-7146		(713)-442-2273		(866)-534-0554		(713)-442-9550		(800)-663-7146		(713)-442-2273		(866)-302-9336		(713)-442-9537		(866)-302-9336		(713)-442-9537		(866)-302-9336		(713)-442-9537		(866)-302-9336		(713)-442-9537		2	2	2
H0332	804	0	1	02	01	H0332_804_0	4	1		05/24/2011	2012.02	05/24/2011 10:41:10 AM Central Daylight Time	06/03/2011 06:20:54 PM Central Daylight Time			06/05/2011 02:26:44 PM Central Daylight Time	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	KelseyCare Advantage Essential + Choice Retiree (HMO-POS)	01	02		1			H0332	804	0	2012	Texas		1	9	2			2						www.Kelseycareadvantage.com	www.kelseycareadvantage.com	www.kelseycareadvantage.com	(866)-534-0554		(713)-442-9550		(800)-663-7146		(713)-442-2273										(866)-302-9336		(713)-442-9537		(866)-302-9336		(713)-442-9537										2	2	2
H0332	805	0	1	02	01	H0332_805_0	4	1		05/24/2011	2012.02	05/24/2011 10:41:29 AM Central Daylight Time	06/03/2011 06:21:49 PM Central Daylight Time			06/05/2011 02:26:44 PM Central Daylight Time	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	KelseyCare Advantage Rx + Choice Retiree (HMO-POS)	01	02		1			H0332	805	0	2012	Texas		1	9	2			2						www.Kelseycareadvantage.com	www.kelseycareadvantage.com	www.kelseycareadvantage.com	(866)-534-0554		(713)-442-9550		(800)-663-7146		(713)-442-2273		(866)-534-0554		(713)-442-9550		(800)-663-7146		(713)-442-2273		(866)-302-9336		(713)-442-9537		(866)-302-9336		(713)-442-9537		(866)-302-9336		(713)-442-9537		(866)-302-9336		(713)-442-9537		2	2	2
H0332	806	0	1	01	01	H0332_806_0	4	1		05/24/2011	2012.02	05/24/2011 10:41:41 AM Central Daylight Time	06/03/2011 06:22:46 PM Central Daylight Time			06/05/2011 02:26:44 PM Central Daylight Time	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	KelseyCare Advantage Essential Retiree (HMO)	01	01		1			H0332	806	0	2012	Harris, Ft Bend, Galveston and Montgomery counties		1	9	2			2						www.Kelseycareadvantage.com	www.kelseycareadvantage.com	www.kelseycareadvantage.com	(866)-534-0554		(713)-442-9550		(800)-663-7146		(713)-442-2273										(866)-302-9336		(713)-442-9537		(866)-302-9336		(713)-442-9537										2	2	2
H0332	807	0	1	01	01	H0332_807_0	4	1		05/24/2011	2012.02	05/24/2011 10:42:00 AM Central Daylight Time	06/03/2011 06:23:38 PM Central Daylight Time			06/05/2011 02:26:44 PM Central Daylight Time	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	KelseyCare Advantage Rx Retiree (HMO)	01	01		1			H0332	807	0	2012	Harris, Ft Bend, Galveston and Montgomery counties		1	2010	2			2						www.Kelseycareadvantage.com	www.kelseycareadvantage.com	www.kelseycareadvantage.com	(866)-534-0554		(713)-442-9550		(800)-663-7146		(713)-442-2273		(866)-534-0554		(713)-442-9550		(800)-663-7146		(713)-442-2273		(866)-302-9336		(713)-442-9537		(866)-302-9336		(713)-442-9537		(866)-302-9336		(713)-442-9537		(866)-302-9336		(713)-442-9537		2	2	2
H0332	808	0	1	02	01	H0332_808_0	4	1		05/24/2011	2012.02	05/24/2011 10:42:13 AM Central Daylight Time	06/03/2011 06:24:31 PM Central Daylight Time			06/05/2011 02:26:44 PM Central Daylight Time	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	KelseyCare Advantage Essential + Choice Retiree (HMO-POS)	01	02		1			H0332	808	0	2012	Harris, Ft Bend, Galveston and Montgomery counties		1	9	2			2						www.Kelseycareadvantage.com	www.kelseycareadvantage.com	www.kelseycareadvantage.com	(866)-534-0554		(713)-442-9550		(800)-663-7146		(713)-442-2273										(866)-302-9336		(713)-442-9537		(866)-302-9336		(713)-442-9537										2	2	2
H0332	809	0	1	02	01	H0332_809_0	4	1		05/24/2011	2012.02	05/24/2011 10:42:30 AM Central Daylight Time	06/03/2011 06:25:36 PM Central Daylight Time			06/05/2011 02:26:44 PM Central Daylight Time	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	KelseyCare Advantage Rx + Choice Retiree (HMO-POS)	01	02		1			H0332	809	0	2012	Harris, Ft Bend, Galveston and Montgomery counties		1	378	2			2						www.Kelseycareadvantage.com	www.kelseycareadvantage.com	www.kelseycareadvantage.com	(866)-534-0554		(713)-442-9550		(800)-663-7146		(713)-442-2273		(866)-534-0554		(713)-442-9550		(800)-663-7146		(713)-442-2273		(866)-302-9336		(713)-442-9537		(866)-302-9336		(713)-442-9537		(866)-302-9336		(713)-442-9537		(866)-302-9336		(713)-442-9537		2	2	2
H0346	001	0	1	20	08	H0346_001_0	1	1		05/26/2011	2012.02	05/26/2011 05:57:24 PM Eastern Daylight Time		05/26/2011 05:50:54 PM Eastern Daylight Time		05/26/2011 06:10:57 PM Eastern Daylight Time	PACE VERMONT, INC.	PACE Vermont, Inc	www.pacevt.org	PACE Vermont - Duals (PACE)	08	20		1			H0346	001	0	2012	Chittenden, Rutland, Bennington,Grand Isle Countys		2		2			2							www.pacevt.org	www.pacevt.org									(888)-655-6708		(802)-655-6700		(888)-655-6708		(802)-655-6700										(802)-655-6700		(802)-655-6700		(802)-655-6700		(802)-655-6700				
H0346	002	0	1	20	08	H0346_002_0	1	1		05/26/2011	2012.02	05/26/2011 05:58:05 PM Eastern Daylight Time		05/26/2011 05:51:14 PM Eastern Daylight Time		05/26/2011 06:10:57 PM Eastern Daylight Time	PACE VERMONT, INC.	PACE Vermont, Inc	www.pacevt.org	PACE Vermont (PACE)	08	20		1			H0346	002	0	2012	Chittenden,Rutland,Grand Isle, Bennington County		2		2			2							www.pacevt.org	www.pacevt.org									(888)-655-6708		(802)-776-2900		(888)-655-6708		(802)-655-6700										(802)-655-6700		(802)-655-6700		(802)-655-6700		(802)-655-6700				
H0351	014	0	1	01	01	H0351_014_0	5	1		07/14/2011	2012.02	07/14/2011 02:20:41 PM US Mountain Standard Time	08/05/2011 10:44:42 AM Pacific Daylight Time	08/04/2011 02:09:04 PM Pacific Daylight Time		08/05/2011 02:37:11 PM Pacific Daylight Time	HEALTH NET OF ARIZONA, INC.	Health Net of Arizona, Inc.	www.healthnet.com	Health Net Ruby 1 (HMO)	01	01		1			H0351	014	0	2012	Maricopa, Pinal, Pima, Sta Cruz, Cochise		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-977-7522		(800)-977-7522		(800)-422-7311		(800)-422-7311		(800)-977-7522		(800)-977-7522		(800)-422-7311		(800)-422-7311		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		2	2	2
H0351	029	0	1	01	01	H0351_029_0	6	1	2	08/11/2011	2012.02	08/11/2011 05:37:26 PM US Mountain Standard Time	08/11/2011 03:47:56 PM Pacific Daylight Time	08/04/2011 02:25:48 PM Pacific Daylight Time		08/12/2011 10:18:51 AM Pacific Daylight Time	HEALTH NET OF ARIZONA, INC.	Health Net of Arizona, Inc.	www.healthnet.com	Health Net Amber (HMO SNP)	01	01		1			H0351	029	0	2012	Maricopa, Pinal, Pima, Sta Cruz, Cochise		2		2			1	3		1	2		www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-977-7522		(800)-977-7522		(800)-422-7311		(800)-422-7311		(800)-977-7522		(800)-977-7522		(800)-422-7311		(800)-422-7311		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		2	2	2
H0351	030	0	1	01	01	H0351_030_0	3	1		07/13/2011	2012.02	07/13/2011 11:14:16 AM US Mountain Standard Time	07/13/2011 10:49:14 AM Pacific Daylight Time			07/14/2011 02:48:09 PM Pacific Daylight Time	HEALTH NET OF ARIZONA, INC.	Health Net of Arizona, Inc.	www.healthnet.com	Health Net Green (HMO)	01	01		1			H0351	030	0	2012	Maricopa, Pinal, Pima, Sta Cruz, Cochise		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-977-7522		(800)-977-7522		(800)-422-7311		(800)-422-7311										(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757										2	2	2
H0351	035	0	1	01	01	H0351_035_0	5	1		07/13/2011	2012.02	07/13/2011 11:14:53 AM US Mountain Standard Time	08/05/2011 10:45:24 AM Pacific Daylight Time	08/04/2011 02:24:24 PM Pacific Daylight Time		08/05/2011 02:37:11 PM Pacific Daylight Time	HEALTH NET OF ARIZONA, INC.	Health Net of Arizona, Inc.	www.healthnet.com	Health Net Ruby 4 (HMO)	01	01		1			H0351	035	0	2012	Cochise, Pima, Santa Cruz		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-977-7522		(800)-977-7522		(800)-422-7311		(800)-422-7311		(800)-977-7522		(800)-977-7522		(800)-422-7311		(800)-422-7311		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		2	2	2
H0351	036	0	1	01	01	H0351_036_0	5	1		07/13/2011	2012.02	07/13/2011 11:19:01 AM US Mountain Standard Time	08/05/2011 10:45:38 AM Pacific Daylight Time	08/04/2011 02:22:52 PM Pacific Daylight Time		08/05/2011 02:37:11 PM Pacific Daylight Time	HEALTH NET OF ARIZONA, INC.	Health Net of Arizona, Inc.	www.healthnet.com	Health Net Ruby 4 (HMO)	01	01		1			H0351	036	0	2012	Maricopa, Pinal		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-977-7522		(800)-977-7522		(800)-422-7311		(800)-422-7311		(800)-977-7522		(800)-977-7522		(800)-422-7311		(800)-422-7311		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		2	2	2
H0351	038	0	1	01	01	H0351_038_0	5	1		07/13/2011	2012.02	07/13/2011 11:18:51 AM US Mountain Standard Time	08/05/2011 10:45:50 AM Pacific Daylight Time	08/04/2011 02:21:30 PM Pacific Daylight Time		08/05/2011 02:37:11 PM Pacific Daylight Time	HEALTH NET OF ARIZONA, INC.	Health Net of Arizona, Inc.	www.healthnet.com	Health Net Jade (HMO SNP)	01	01		1			H0351	038	0	2012	Maricopa, Pima and Pinal Counties		2		2			1	4		1		00000000000000000100	www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-977-7522		(800)-977-7522		(800)-422-7311		(800)-422-7311		(800)-977-7522		(800)-977-7522		(800)-422-7311		(800)-422-7311		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		2	2	2
H0351	801	0	1	01	01	H0351_801_0	2	1		05/25/2011	2012.02	05/25/2011 02:29:55 PM US Mountain Standard Time	06/05/2011 10:18:22 AM Pacific Daylight Time			06/05/2011 12:38:27 PM Pacific Daylight Time	HEALTH NET OF ARIZONA, INC.	Health Net of Arizona, Inc.	www.healthnet.com	Health Net EG (HMO)	01	01		1			H0351	801	0	2012	All AZ Counties		1		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-977-7522		(800)-977-7522		(800)-422-7311		(800)-422-7311		(800)-977-7522		(800)-977-7522		(800)-422-7311		(800)-422-7311		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		1	1	1
H0351	803	0	1	01	01	H0351_803_0	2	1		05/25/2011	2012.02	05/25/2011 02:32:56 PM US Mountain Standard Time	06/05/2011 10:35:26 AM Pacific Daylight Time			06/05/2011 12:38:27 PM Pacific Daylight Time	HEALTH NET OF ARIZONA, INC.	Health Net of Arizona, Inc.	www.healthnet.com	Health Net EG (HMO)	01	01		1			H0351	803	0	2012	All AZ Counties		1		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-977-7522		(800)-977-7522		(800)-422-7311		(800)-422-7311										(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757										1	1	1
H0351	804	0	1	01	01	H0351_804_0	2	1		05/25/2011	2012.02	05/25/2011 02:33:44 PM US Mountain Standard Time	06/05/2011 10:39:14 AM Pacific Daylight Time			06/05/2011 12:38:27 PM Pacific Daylight Time	HEALTH NET OF ARIZONA, INC.	Health Net of Arizona, Inc.	www.healthnet.com	Health Net EG (HMO)	01	01		1			H0351	804	0	2012	All AZ Counties		1		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-977-7522		(800)-977-7522		(800)-422-7311		(800)-422-7311		(800)-977-7522		(800)-977-7522		(800)-422-7311		(800)-422-7311		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		(800)-977-6757		1	1	1
H0354	001	0	1	01	01	H0354_001_0	10	1		08/05/2011	2012.02	08/05/2011 03:32:57 PM US Mountain Standard Time	08/05/2011 10:19:50 AM US Mountain Standard Time	08/05/2011 10:26:28 AM US Mountain Standard Time		08/05/2011 03:53:36 PM US Mountain Standard Time	CIGNA HEALTHCARE OF ARIZONA, INC.	CIGNA HealthCare of Arizona	www.cignamedicare.com	CIGNA Medicare Select Plus Rx-Standard (HMO)	01	01		1			H0354	001	0	2012	Maricopa County, Apache Jct and Queen Creek		2		2			2						www.cignamedicare.com	www.cignamedicare.com	www.cignamedicare.com	(800)-627-7534		(800)-627-7534		(800)-592-9231		(800)-592-9231		(800)-627-7534		(800)-627-7534		(800)-592-9231		(800)-592-9231		(800)-987-8816		(800)-987-8816		(800)-987-8816		(800)-987-8816		(800)-987-8816		(800)-987-8816		(800)-987-8816		(800)-987-8816		2	2	2
H0354	012	0	1	01	01	H0354_012_0	9	1	2	08/05/2011	2012.02	08/05/2011 03:42:27 PM US Mountain Standard Time	08/05/2011 10:18:34 AM US Mountain Standard Time	08/05/2011 10:28:04 AM US Mountain Standard Time		08/05/2011 03:53:36 PM US Mountain Standard Time	CIGNA HEALTHCARE OF ARIZONA, INC.	CIGNA HealthCare of Arizona	www.cignamedicare.com	CIGNA Medicare Select Plus Rx-Dual (HMO SNP)	01	01		1			H0354	012	0	2012	Maricopa County, Apache Jct and Queen Creek		2		2			1	3		1	2		www.cignamedicare.com	www.cignamedicare.com	www.cignamedicare.com	(800)-627-7534		(800)-627-7534		(800)-592-9231		(800)-592-9231		(800)-627-7534		(800)-627-7534		(800)-592-9231		(800)-592-9231		(800)-987-8816		(800)-987-8816		(800)-987-8816		(800)-987-8816		(800)-987-8816		(800)-987-8816		(800)-987-8816		(800)-987-8816		2	2	2
H0354	018	0	1	01	01	H0354_018_0	10	1		08/05/2011	2012.02	08/05/2011 03:33:49 PM US Mountain Standard Time	08/05/2011 10:17:06 AM US Mountain Standard Time	08/05/2011 10:35:44 AM US Mountain Standard Time		08/05/2011 03:53:36 PM US Mountain Standard Time	CIGNA HEALTHCARE OF ARIZONA, INC.	CIGNA HealthCare of Arizona	www.cignamedicare.com	CIGNA Medicare Select Plus Rx-Premium (HMO)	01	01		1			H0354	018	0	2012	Maricopa County and Apache Jct and Queen Creek		2		2			2						www.cignamedicare.com	www.cignamedicare.com	www.cignamedicare.com	(800)-627-7534		(800)-627-7534		(800)-592-9231		(800)-592-9231		(800)-627-7534		(800)-627-7534		(800)-592-9231		(800)-592-9231		(800)-987-8816		(800)-987-8816		(800)-987-8816		(800)-987-8816		(800)-987-8816		(800)-987-8816		(800)-987-8816		(800)-987-8816		2	2	2
H0354	801	0	1	01	01	H0354_801_0	2	1		06/03/2011	2012.02	06/03/2011 08:10:51 AM US Mountain Standard Time	07/22/2011 10:25:02 AM US Mountain Standard Time			07/29/2011 11:17:08 AM US Mountain Standard Time	CIGNA HEALTHCARE OF ARIZONA, INC.	CIGNA HealthCare of Arizona	www.cignamedicare.com	CIGNA Medicare Select-Employer (HMO)	01	01		1			H0354	801	0	2012	All Counties in Arizona		1		2			2						www.cignamedicare.com	www.cignamedicare.com	www.cignamedicare.com	(800)-627-7534		(800)-627-7534		(800)-592-9231		(800)-592-9231										(800)-987-8816		(800)-987-8816		(800)-987-8816		(800)-987-8816										1	1	1
H0354	804	0	1	01	01	H0354_804_0	2	1		06/03/2011	2012.02	06/03/2011 08:11:23 AM US Mountain Standard Time	07/27/2011 03:02:46 PM US Mountain Standard Time			07/29/2011 11:17:08 AM US Mountain Standard Time	CIGNA HEALTHCARE OF ARIZONA, INC.	CIGNA HealthCare of Arizona	www.cignamedicare.com	CIGNA Medicare Select Plus Rx-Employer Calendar Yr (HMO)	01	01		1			H0354	804	0	2012	All Counties in Arizona		1		2			2						www.cignamedicare.com	www.cignamedicare.com	www.cignamedicare.com	(800)-627-7534		(800)-627-7534		(800)-592-9231		(800)-592-9231		(800)-627-7534		(800)-627-7534		(800)-592-9231		(800)-592-9231		(800)-987-8816		(800)-987-8816		(800)-987-8816		(800)-987-8816		(800)-987-8816		(800)-987-8816		(800)-987-8816		(800)-987-8816		1	1	1
H0354	805	0	1	01	01	H0354_805_0	2	1		06/03/2011	2012.02	06/03/2011 08:11:37 AM US Mountain Standard Time	07/22/2011 10:26:38 AM US Mountain Standard Time			07/29/2011 11:17:08 AM US Mountain Standard Time	CIGNA HEALTHCARE OF ARIZONA, INC.	CIGNA HealthCare of Arizona	www.cignamedicare.com	CIGNA Medicare Select Plus Rx-Employer NonCal Yr (HMO)	01	01		1			H0354	805	0	2012	All Counties in Arizona		1		2			2						www.cignamedicare.com	www.cignamedicare.com	www.cignamedicare.com	(800)-627-7534		(800)-627-7534		(800)-592-9231		(800)-592-9231		(800)-627-7534		(800)-627-7534		(800)-592-9231		(800)-592-9231		(800)-987-8816		(800)-987-8816		(800)-987-8816		(800)-987-8816		(800)-987-8816		(800)-987-8816		(800)-987-8816		(800)-987-8816		1	1	1
H0390	001	0	1	20	08	H0390_001_0	1	1		03/20/2012	2012.02	03/20/2012 01:28:02 PM Eastern Daylight Time		03/19/2012 05:29:07 PM Eastern Daylight Time		03/20/2012 01:30:25 PM Eastern Daylight Time	PACE OF SOUTHWEST MICHIGAN, INC.	PACE of Southwest Michigan	theresesaggauareaagencyonaging.org	PACE of Southwest Michigan - Dual (PACE)	08	20		1			H0390	001	0	2012	PACE of Southwest Michigan - Dual		2		2			2							theresesaggau@areaagencyonaging.org	www.seniorscript.com									(269)-982-7767		(269)-982-7767		(269)-982-7767		(269)-982-7767										(269)-982-7767		(269)-982-7767		(269)-982-7767		(269)-982-7767				
H0390	002	0	1	20	08	H0390_002_0	1	1		03/20/2012	2012.02	03/20/2012 01:28:32 PM Eastern Daylight Time		03/19/2012 05:29:07 PM Eastern Daylight Time		03/20/2012 01:30:25 PM Eastern Daylight Time	PACE OF SOUTHWEST MICHIGAN, INC.	PACE of Southwest Michigan	theresesaggauareaagencyonaging.org	PACE of Southwest Michigan - Medicare Only (PACE)	08	20		1			H0390	002	0	2012	PACE of Southwest Michigan - Medicare Only		2		2			2							theresesaggau@areaagencyonaging.org	www.seniorscript.com									(269)-982-7767		(269)-982-7767		(269)-982-7767		(269)-982-7767										(269)-982-7767		(269)-982-7767		(269)-982-7767		(269)-982-7767				
H0401	002	0	1	02	01	H0401_002_0	7	1		08/08/2011	2012.02	08/08/2011 11:12:01 AM Central Daylight Time	08/05/2011 10:49:45 AM Central Daylight Time	08/05/2011 01:13:07 PM Central Daylight Time		08/09/2011 01:25:28 PM Central Daylight Time	UNITEDHEALTHCARE OF ARKANSAS, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H0401	002	0	2012	Select Counties in Arkansas		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0401	801	0	1	01	01	H0401_801_0	2	1		07/06/2011	2012.02	07/06/2011 04:35:56 PM Central Daylight Time	06/03/2011 03:12:05 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	UNITEDHEALTHCARE OF ARKANSAS, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0401	801	0	2012	Benton and Washington Counties		1		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0401	804	0	1	01	01	H0401_804_0	2	1		07/06/2011	2012.02	07/06/2011 04:36:02 PM Central Daylight Time	06/03/2011 03:12:25 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	UNITEDHEALTHCARE OF ARKANSAS, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0401	804	0	2012	Benton and Washington Counties		1		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548										(711)		(711)		(711)		(711)										2	2	2
H0401	805	0	1	01	01	H0401_805_0	2	1		07/06/2011	2012.02	07/06/2011 04:36:10 PM Central Daylight Time	06/03/2011 03:12:44 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	UNITEDHEALTHCARE OF ARKANSAS, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0401	805	0	2012	Select Counites in AR		1		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0408	002	0	1	02	01	H0408_002_0	4	1		08/19/2011	2012.02	08/19/2011 03:36:55 PM Central Daylight Time	08/19/2011 11:56:56 AM Central Daylight Time	08/05/2011 12:52:59 PM Central Daylight Time		08/19/2011 04:19:30 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	Evercare by UnitedHealthcare	www.EvercareHealthPlans.com	UnitedHealthcare Nursing Home Plan (HMO-POS SNP)	01	02		1			H0408	002	0	2012	Nashville, Knoxville area		2		2			1	1	1	1			www.EvercareHealthPlans.com	evercarehealthplans.com/prescription_drug_coverage.jsp	www.PrescriptionSolutions.com	(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0423	001	0	1	01	01	H0423_001_0	9	1	2	07/07/2011	2012.01	07/07/2011 05:33:57 PM Eastern Daylight Time	07/28/2011 06:29:34 PM Eastern Daylight Time	07/29/2011 05:11:32 PM Eastern Daylight Time		07/30/2011 07:13:47 PM Eastern Daylight Time	METROPLUS HEALTH PLAN, INC.	MetroPlus Health Plan	www.metroplusmedicare.org	MetroPlus Advantage Plan (HMO SNP)	01	01		1			H0423	001	0	2012	NYC - The Bronx, Brooklyn, Manhattan, Queens		2		2			1	3		1	2		www.metroplusmedicare.org	www.metroplus.org	www.informedrx.com	(866)-986-0356		(866)-986-0356		(866)-986-0356		(866)-986-0356		(866)-986-0356		(866)-986-0356		(866)-986-0356		(866)-986-0356		(800)-881-2812		(800)-881-2812		(800)-881-2812		(800)-881-2812		(800)-881-2812		(800)-881-2812		(800)-881-2812		(800)-881-2812		2	1	1
H0423	002	0	1	01	01	H0423_002_0	7	1		07/13/2011	2012.01	07/13/2011 11:24:10 AM Eastern Daylight Time	07/28/2011 05:35:16 PM Eastern Daylight Time	07/29/2011 05:11:40 PM Eastern Daylight Time		07/30/2011 07:13:47 PM Eastern Daylight Time	METROPLUS HEALTH PLAN, INC.	MetroPlus Health Plan	www.metroplusmedicare.org	MetroPlus Medicare Partnership in Care Plan (HMO SNP)	01	01		1			H0423	002	0	2012	NYC - The Bronx, Brooklyn, Manhattan, Queens		2		2			1	4		1		00000000001000000000	www.metroplusmedicare.org	www.metroplus.org	www.informedrx.com	(866)-986-0356		(866)-986-0356		(866)-986-0356		(866)-986-0356		(866)-986-0356		(866)-986-0356		(866)-986-0356		(866)-986-0356		(800)-881-2812		(800)-881-2812		(800)-881-2812		(800)-881-2812		(800)-881-2812		(800)-881-2812		(800)-881-2812		(800)-881-2812		2	1	1
H0423	003	0	1	01	01	H0423_003_0	8	1	2	07/07/2011	2012.01	07/07/2011 05:34:10 PM Eastern Daylight Time	08/12/2011 09:50:13 AM Eastern Daylight Time	08/12/2011 10:21:57 AM Eastern Daylight Time		08/12/2011 10:25:51 AM Eastern Daylight Time	METROPLUS HEALTH PLAN, INC.	MetroPlus Health Plan	www.metroplusmedicare.org	MetroPlus Select Plan (HMO SNP)	01	01		1			H0423	003	0	2012	NYC - The Bronx, Brooklyn, Manhattan, Queens		2		2			1	3		1	5		www.metroplusmedicare.org	www.metroplus.org	www.informedrx.com	(866)-986-0356		(866)-986-0356		(866)-986-0356		(866)-986-0356		(866)-986-0356		(866)-986-0356		(866)-986-0356		(866)-986-0356		(800)-881-2812		(800)-881-2812		(800)-881-2812		(800)-881-2812		(800)-881-2812		(800)-881-2812		(800)-881-2812		(800)-881-2812		2	1	1
H0423	004	0	1	01	01	H0423_004_0	9	1		08/08/2011	2012.01	08/08/2011 10:33:50 AM Eastern Daylight Time	08/18/2011 04:13:40 PM Eastern Daylight Time	08/19/2011 09:27:22 AM Eastern Daylight Time		08/19/2011 09:31:45 AM Eastern Daylight Time	METROPLUS HEALTH PLAN, INC.	MetroPlus Health Plan	www.metroplusmedicare.org	MetroPlus Platinum (HMO)	01	01		1			H0423	004	0	2012	NYC - The Bronx, Brooklyn, Manhattan, Queens		2		2			2						www.metroplusmedicare.org	www.metroplus.org	www.informedrx.com	(866)-986-0356		(866)-986-0356		(866)-986-0356		(866)-986-0356		(866)-986-0356		(866)-986-0356		(866)-986-0356		(866)-986-0356		(800)-881-2812		(800)-881-2812		(800)-881-2812		(800)-881-2812		(800)-881-2812		(800)-881-2812		(800)-881-2812		(800)-881-2812		2	1	1
H0490	001	0	1	01	01	H0490_001_0	12	1		08/01/2011	2012.02	08/01/2011 10:51:19 AM Pacific Daylight Time	08/04/2011 07:14:00 PM Pacific Daylight Time	08/04/2011 02:04:00 PM Pacific Daylight Time		08/05/2011 02:51:40 PM Pacific Daylight Time	MOLINA HEALTHCARE OF OHIO	Molina Healthcare of Ohio	www.molinamedicare.com	Molina Medicare Options (HMO)	01	01		1			H0490	001	0	2012	Ohio Urban Area		2		2			2						www.molinamedicare.com	www.molinamedicare.com	www.molinamedicare.com	(866)-472-4584		(866)-472-4584		(866)-403-8293		(866)-403-8293		(866)-472-4584		(866)-472-4584		(866)-403-8293		(866)-403-8293		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		2	2	2
H0490	004	0	1	01	01	H0490_004_0	11	1	2	08/01/2011	2012.02	08/01/2011 10:51:27 AM Pacific Daylight Time	08/04/2011 07:14:00 PM Pacific Daylight Time	08/04/2011 02:04:00 PM Pacific Daylight Time		08/05/2011 02:51:40 PM Pacific Daylight Time	MOLINA HEALTHCARE OF OHIO	Molina Healthcare of Ohio	www.molinamedicare.com	Molina Medicare Options Plus (HMO SNP)	01	01		1			H0490	004	0	2012	Ohio Urban Area		2		2			1	3		1	5		www.molinamedicare.com	www.molinamedicare.com	www.molinamedicare.com	(866)-472-4584		(866)-472-4584		(866)-403-8293		(866)-403-8293		(866)-472-4584		(866)-472-4584		(866)-403-8293		(866)-403-8293		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		2	2	2
H0504	015	0	1	01	01	H0504_015_0	8	1		08/09/2011	2012.02	08/09/2011 08:37:55 AM Pacific Daylight Time	08/09/2011 09:11:40 AM Pacific Daylight Time	08/05/2011 03:17:30 PM Pacific Daylight Time		08/09/2011 12:21:06 PM Pacific Daylight Time	CALIFORNIA PHYSICIANS' SERVICE	Blue Shield of California	www.blueshieldca.com/findamedicareplan	Blue Shield 65 Plus (HMO)	01	01		1			H0504	015	0	2012	Los Angeles (Partial)/Orange Counties		2		2			2						www.blueshieldca.com	https://www.blueshieldca.com/medicarepartdplans/formulary/	www.blueshieldca.com	(800)-776-4466		(800)-776-4466		(800)-488-8000		(800)-488-8000		(800)-776-4466		(800)-776-4466		(800)-488-8000		(800)-488-8000		(800)-794-1099		(800)-794-1099		(888)-595-0000		(888)-595-0000		(800)-794-1099		(800)-794-1099		(888)-595-0000		(888)-595-0000		2	2	2
H0504	017	0	1	01	01	H0504_017_0	7	1		08/09/2011	2012.02	08/09/2011 08:36:01 AM Pacific Daylight Time	08/09/2011 09:14:23 AM Pacific Daylight Time	08/09/2011 08:01:32 AM Pacific Daylight Time		08/09/2011 02:25:23 PM Pacific Daylight Time	CALIFORNIA PHYSICIANS' SERVICE	Blue Shield of California	www.blueshieldca.com/findamedicareplan	Blue Shield 65 Plus (HMO)	01	01		1			H0504	017	0	2012	San Bernardino County (Partial)		2		2			2						www.blueshieldca.com	https://www.blueshieldca.com/medicarepartdplans/formulary/	www.blueshieldca.com	(800)-776-4466		(800)-776-4466		(800)-488-8000		(800)-488-8000		(800)-776-4466		(800)-776-4466		(800)-488-8000		(800)-488-8000		(800)-794-1099		(800)-794-1099		(888)-595-0000		(888)-595-0000		(800)-794-1099		(800)-794-1099		(888)-595-0000		(888)-595-0000		2	2	2
H0504	021	0	1	01	01	H0504_021_0	10	1		08/09/2011	2012.02	08/09/2011 08:35:14 AM Pacific Daylight Time	08/09/2011 09:16:26 AM Pacific Daylight Time	08/05/2011 03:20:22 PM Pacific Daylight Time		08/09/2011 02:28:57 PM Pacific Daylight Time	CALIFORNIA PHYSICIANS' SERVICE	Blue Shield of California	www.blueshieldca.com/findamedicareplan	Blue Shield 65 Plus Choice Plan (HMO)	01	01		1			H0504	021	0	2012	Los Angeles (Partial)/Orange (Partial) Counties CP		2		2			2						www.blueshieldca.com	https://www.blueshieldca.com/medicarepartdplans/formulary/	www.blueshieldca.com	(800)-776-4466		(800)-776-4466		(800)-488-8000		(800)-488-8000		(800)-776-4466		(800)-776-4466		(800)-488-8000		(800)-488-8000		(800)-794-1099		(800)-794-1099		(888)-595-0000		(888)-595-0000		(800)-794-1099		(800)-794-1099		(888)-595-0000		(888)-595-0000		2	2	2
H0504	026	0	1	01	01	H0504_026_0	11	1		08/09/2011	2012.02	08/09/2011 08:39:31 AM Pacific Daylight Time	08/05/2011 04:32:08 PM Pacific Daylight Time	08/05/2011 03:21:55 PM Pacific Daylight Time		08/09/2011 02:32:14 PM Pacific Daylight Time	CALIFORNIA PHYSICIANS' SERVICE	Blue Shield of California	www.blueshieldca.com/findamedicareplan	Blue Shield 65 Plus (HMO)	01	01		1			H0504	026	0	2012	Riverside County (Partial)		2		2			2						www.blueshieldca.com	https://www.blueshieldca.com/medicarepartdplans/formulary/	www.blueshieldca.com	(800)-776-4466		(800)-776-4466		(800)-488-8000		(800)-488-8000		(800)-776-4466		(800)-776-4466		(800)-488-8000		(800)-488-8000		(800)-794-1099		(800)-794-1099		(888)-595-0000		(888)-595-0000		(800)-794-1099		(800)-794-1099		(888)-595-0000		(888)-595-0000		2	2	2
H0504	803	0	1	01	01	H0504_803_0	4	1		05/31/2011	2012.02	05/31/2011 04:29:43 PM Pacific Daylight Time	07/20/2011 05:38:29 PM Pacific Daylight Time			07/21/2011 09:05:54 AM Pacific Daylight Time	CALIFORNIA PHYSICIANS' SERVICE	Blue Shield of California	www.blueshieldca.com	Blue Shield 65 Plus (HMO)	01	01		1			H0504	803	0	2012	MA-PD Employer Group Plan		1		2			2						www.blueshieldca.com	https://www.blueshieldca.com/medicarepartdplans/formulary/	www.blueshieldca.com	(800)-776-4466		(800)-776-4466		(800)-488-8000		(800)-488-8000		(800)-776-4466		(800)-776-4466		(800)-488-8000		(800)-488-8000		(800)-794-1099		(800)-794-1099		(888)-595-0000		(888)-595-0000		(800)-794-1099		(800)-794-1099		(888)-595-0000		(888)-595-0000		1	2	2
H0504	804	0	1	01	01	H0504_804_0	4	1		07/05/2011	2012.02	07/05/2011 05:32:20 PM Pacific Daylight Time	07/20/2011 05:39:39 PM Pacific Daylight Time			07/21/2011 09:09:46 AM Pacific Daylight Time	CALIFORNIA PHYSICIANS' SERVICE	Blue Shield of California	www.blueshieldca.com	Blue Shield 65 Plus (HMO)	01	01		1			H0504	804	0	2012	MA-PD Employer Group Plan		1		2			2						www.blueshieldca.com	https://www.blueshieldca.com/medicarepartdplans/formulary/	www.blueshieldca.com	(800)-776-4466		(800)-776-4466		(800)-488-8000		(800)-488-8000		(800)-776-4466		(800)-776-4466		(800)-488-8000		(800)-488-8000		(800)-794-1099		(800)-794-1099		(888)-595-0000		(888)-595-0000		(800)-794-1099		(800)-794-1099		(888)-595-0000		(888)-595-0000		1	2	2
H0504	805	0	1	01	01	H0504_805_0	5	1		07/05/2011	2012.02	07/05/2011 05:31:56 PM Pacific Daylight Time	07/20/2011 05:41:05 PM Pacific Daylight Time			07/21/2011 09:16:27 AM Pacific Daylight Time	CALIFORNIA PHYSICIANS' SERVICE	Blue Shield of California	www.blueshieldca.com	Blue Shield 65 Plus (HMO)	01	01		1			H0504	805	0	2012	MA-Only Employer Group Plan		1		2			2						www.blueshieldca.com	https://www.blueshieldca.com/medicarepartdplans/formulary/	www.blueshieldca.com	(800)-776-4466		(800)-776-4466		(800)-488-8000		(800)-488-8000										(800)-794-1099		(800)-794-1099		(888)-595-0000		(888)-595-0000										1	2	2
H0523	002	0	1	01	01	H0523_002_0	5	1		07/12/2011	2012.02	07/12/2011 02:29:39 PM Central Daylight Time	08/04/2011 02:17:29 PM Central Daylight Time	08/04/2011 09:31:34 AM Central Daylight Time		08/08/2011 07:54:55 AM Central Daylight Time	AETNA HEALTH OF CALIFORNIA,INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Select Plan (HMO)	01	01		1			H0523	002	0	2012	Los Angeles and Orange Counties		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H0523	022	0	1	01	01	H0523_022_0	5	1		07/12/2011	2012.02	07/12/2011 02:30:55 PM Central Daylight Time	08/04/2011 02:18:25 PM Central Daylight Time	08/04/2011 09:32:04 AM Central Daylight Time		08/08/2011 07:54:55 AM Central Daylight Time	AETNA HEALTH OF CALIFORNIA,INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Select Plan (HMO)	01	01		1			H0523	022	0	2012	Riverside and San Bernardino Counties		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H0523	031	0	1	01	01	H0523_031_0	5	1		07/12/2011	2012.02	07/12/2011 02:32:40 PM Central Daylight Time	08/04/2011 02:19:29 PM Central Daylight Time	08/04/2011 10:30:51 AM Central Daylight Time		08/08/2011 07:54:55 AM Central Daylight Time	AETNA HEALTH OF CALIFORNIA,INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Select Plan (HMO)	01	01		1			H0523	031	0	2012	Kern County		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H0523	032	0	1	01	01	H0523_032_0	5	1		07/12/2011	2012.02	07/12/2011 02:34:18 PM Central Daylight Time	08/04/2011 02:20:27 PM Central Daylight Time	08/04/2011 09:33:02 AM Central Daylight Time		08/08/2011 07:54:55 AM Central Daylight Time	AETNA HEALTH OF CALIFORNIA,INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Select Plan (HMO)	01	01		1			H0523	032	0	2012	Fresno County		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H0523	052	0	1	01	01	H0523_052_0	4	1		07/08/2011	2012.02	07/08/2011 11:15:08 AM Central Daylight Time	08/04/2011 02:21:26 PM Central Daylight Time	08/04/2011 09:34:21 AM Central Daylight Time		08/08/2011 07:54:55 AM Central Daylight Time	AETNA HEALTH OF CALIFORNIA,INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Select Plan (HMO)	01	01		1			H0523	052	0	2012	San Diego County		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H0523	058	0	1	01	01	H0523_058_0	5	1		07/08/2011	2012.02	07/08/2011 11:15:16 AM Central Daylight Time	08/04/2011 02:22:18 PM Central Daylight Time	08/04/2011 09:35:47 AM Central Daylight Time		08/08/2011 07:54:55 AM Central Daylight Time	AETNA HEALTH OF CALIFORNIA,INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Select Plan (HMO)	01	01		1			H0523	058	0	2012	Ventura County		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H0523	801	0	1	01	01	H0523_801_0	1	1		04/22/2011	2012.02	04/22/2011 09:39:50 AM Eastern Daylight Time	06/03/2011 02:11:25 PM Eastern Daylight Time			06/03/2011 03:00:50 PM Eastern Daylight Time	AETNA HEALTH OF CALIFORNIA,INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan (HMO)	01	01		1			H0523	801	0	2012	California		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748										1	1	1
H0523	805	0	1	01	01	H0523_805_0	1	1		04/22/2011	2012.02	04/22/2011 09:40:18 AM Eastern Daylight Time	06/03/2011 02:07:09 PM Eastern Daylight Time			06/03/2011 03:00:50 PM Eastern Daylight Time	AETNA HEALTH OF CALIFORNIA,INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan w/Rx CY (HMO)	01	01		1			H0523	805	0	2012	California		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		1	1	1
H0524	002	0	2	01	01	H0524_002_0	8	1		07/21/2011	2012.02	07/21/2011 04:40:59 PM Pacific Daylight Time	08/05/2011 09:39:02 AM Pacific Daylight Time	08/03/2011 03:20:14 PM Pacific Daylight Time		08/05/2011 03:10:44 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage B Only South (HMO)	01	01		2	1		H0524	002	0	2012	Part B Only Southern California Area		2		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		2	2	2
H0524	003	0	1	01	01	H0524_003_0	8	1		08/04/2011	2012.02	08/04/2011 10:23:28 AM Pacific Daylight Time	08/05/2011 09:40:43 AM Pacific Daylight Time	08/03/2011 03:21:15 PM Pacific Daylight Time		08/05/2011 03:10:44 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage LA, Orange Co. (HMO)	01	01		1			H0524	003	0	2012	Los Angeles and Orange Counties Plan		2		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		2	2	2
H0524	008	0	1	01	01	H0524_008_0	8	1		08/04/2011	2012.02	08/04/2011 10:23:43 AM Pacific Daylight Time	08/05/2011 09:16:40 AM Pacific Daylight Time	08/03/2011 03:04:47 PM Pacific Daylight Time		08/05/2011 03:10:44 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage Solano (HMO)	01	01		1			H0524	008	0	2012	Solano County Plan		2		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		2	2	2
H0524	010	0	2	01	01	H0524_010_0	7	1		08/04/2011	2012.02	08/04/2011 10:23:54 AM Pacific Daylight Time	08/05/2011 09:17:56 AM Pacific Daylight Time	08/03/2011 03:06:04 PM Pacific Daylight Time		08/05/2011 03:10:44 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage B Only North (HMO)	01	01		2	1		H0524	010	0	2012	Part B Only Northern California Area		2		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		2	2	2
H0524	013	0	1	01	01	H0524_013_0	8	1		08/04/2011	2012.02	08/04/2011 10:24:04 AM Pacific Daylight Time	08/05/2011 09:20:25 AM Pacific Daylight Time	08/03/2011 03:07:17 PM Pacific Daylight Time		08/05/2011 03:10:44 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage Sac., Sonoma (HMO)	01	01		1			H0524	013	0	2012	Greater Sacramento and Sonoma County Plan		2		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		2	2	2
H0524	015	0	1	01	01	H0524_015_0	7	1		08/04/2011	2012.02	08/04/2011 10:24:13 AM Pacific Daylight Time	08/05/2011 09:41:50 AM Pacific Daylight Time	08/03/2011 03:23:48 PM Pacific Daylight Time		08/05/2011 03:10:44 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage Inland Empire (HMO)	01	01		1			H0524	015	0	2012	Inland Empire Plan		2		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		2	2	2
H0524	029	0	1	01	01	H0524_029_0	8	1	2	08/04/2011	2012.02	08/04/2011 10:24:28 AM Pacific Daylight Time	08/05/2011 09:42:49 AM Pacific Daylight Time	08/03/2011 03:25:18 PM Pacific Daylight Time		08/05/2011 03:10:44 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Senior Advantage Medicare Medi-Cal Plan South (HMO SNP)	01	01		1			H0524	029	0	2012	Southern California Plan		2		2			1	3		1	3		kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		2	2	2
H0524	030	0	1	01	01	H0524_030_0	10	1	2	08/04/2011	2012.02	08/04/2011 10:24:37 AM Pacific Daylight Time	08/05/2011 09:21:43 AM Pacific Daylight Time	08/03/2011 03:08:32 PM Pacific Daylight Time		08/05/2011 03:10:44 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Senior Advantage Medicare Medi-Cal Plan North (HMO SNP)	01	01		1			H0524	030	0	2012	Northern California Plan		2		2			1	3		1	3		kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		2	2	2
H0524	031	0	1	01	01	H0524_031_0	8	1		08/04/2011	2012.02	08/04/2011 10:24:48 AM Pacific Daylight Time	08/05/2011 09:23:18 AM Pacific Daylight Time	08/03/2011 03:09:36 PM Pacific Daylight Time		08/05/2011 03:10:44 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage Marin San Mateo (HMO)	01	01		1			H0524	031	0	2012	Marin and San Mateo Counties Plan		2		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		2	2	2
H0524	032	0	1	01	01	H0524_032_0	8	1		08/04/2011	2012.02	08/04/2011 10:24:57 AM Pacific Daylight Time	08/05/2011 09:24:18 AM Pacific Daylight Time	08/03/2011 03:10:37 PM Pacific Daylight Time		08/05/2011 03:10:44 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage Alam., SF, Napa (HMO)	01	01		1			H0524	032	0	2012	Alameda, Napa, and SF Counties Plan		2		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		2	2	2
H0524	033	0	1	01	01	H0524_033_0	8	1		08/04/2011	2012.02	08/04/2011 10:25:12 AM Pacific Daylight Time	08/05/2011 09:25:18 AM Pacific Daylight Time	08/03/2011 03:11:44 PM Pacific Daylight Time		08/05/2011 03:10:44 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage Contra Costa (HMO)	01	01		1			H0524	033	0	2012	Contra Costa County Plan		2		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		2	2	2
H0524	034	0	1	01	01	H0524_034_0	7	1		08/04/2011	2012.02	08/04/2011 10:25:27 AM Pacific Daylight Time	08/05/2011 09:43:30 AM Pacific Daylight Time	08/03/2011 03:26:51 PM Pacific Daylight Time		08/05/2011 03:10:44 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage Ventura (HMO)	01	01		1			H0524	034	0	2012	Ventura County Plan		2		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		2	2	2
H0524	035	0	1	01	01	H0524_035_0	7	1		08/04/2011	2012.02	08/04/2011 10:25:41 AM Pacific Daylight Time	08/05/2011 09:44:59 AM Pacific Daylight Time	08/03/2011 03:28:30 PM Pacific Daylight Time		08/05/2011 03:10:44 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage Enhanced Kern (HMO)	01	01		1			H0524	035	0	2012	Kern County Plan - Enhanced		2		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		2	2	2
H0524	036	0	1	01	01	H0524_036_0	7	1		08/04/2011	2012.02	08/04/2011 10:25:54 AM Pacific Daylight Time	08/05/2011 09:46:59 AM Pacific Daylight Time	08/03/2011 03:30:10 PM Pacific Daylight Time		08/05/2011 03:10:44 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage Basic Kern (HMO)	01	01		1			H0524	036	0	2012	Kern County Plan - Basic		2		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		2	2	2
H0524	037	0	1	01	01	H0524_037_0	8	1		08/04/2011	2012.02	08/04/2011 10:26:09 AM Pacific Daylight Time	08/05/2011 09:47:45 AM Pacific Daylight Time	08/03/2011 03:31:23 PM Pacific Daylight Time		08/05/2011 03:10:44 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage San Diego (HMO)	01	01		1			H0524	037	0	2012	San Diego County Plan		2		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		2	2	2
H0524	038	0	1	01	01	H0524_038_0	7	1		08/04/2011	2012.02	08/04/2011 10:26:26 AM Pacific Daylight Time	08/05/2011 09:26:23 AM Pacific Daylight Time	08/03/2011 03:12:48 PM Pacific Daylight Time		08/05/2011 03:10:44 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage Enhanced Fresno (HMO)	01	01		1			H0524	038	0	2012	Greater Fresno Area Plan - Enhanced		2		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		2	2	2
H0524	039	0	1	01	01	H0524_039_0	9	1		08/04/2011	2012.02	08/04/2011 10:26:38 AM Pacific Daylight Time	08/05/2011 09:27:17 AM Pacific Daylight Time	08/03/2011 03:13:51 PM Pacific Daylight Time		08/05/2011 03:10:44 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage Santa Clara (HMO)	01	01		1			H0524	039	0	2012	Santa Clara County Plan		2		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		2	2	2
H0524	040	0	1	01	01	H0524_040_0	8	1		08/04/2011	2012.02	08/04/2011 10:26:50 AM Pacific Daylight Time	08/05/2011 09:28:34 AM Pacific Daylight Time	08/03/2011 03:14:52 PM Pacific Daylight Time		08/05/2011 03:10:44 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage Enhanced Stanis (HMO)	01	01		1			H0524	040	0	2012	Stanislaus County Plan - Enhanced		2		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		2	2	2
H0524	041	0	1	01	01	H0524_041_0	9	1		08/04/2011	2012.02	08/04/2011 10:27:03 AM Pacific Daylight Time	08/05/2011 09:29:52 AM Pacific Daylight Time	08/03/2011 03:15:53 PM Pacific Daylight Time		08/05/2011 03:10:44 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage Basic Stanis (HMO)	01	01		1			H0524	041	0	2012	Stanislaus County Plan - Basic		2		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		2	2	2
H0524	042	0	1	01	01	H0524_042_0	7	1		08/04/2011	2012.02	08/04/2011 10:27:13 AM Pacific Daylight Time	08/05/2011 09:31:48 AM Pacific Daylight Time	08/03/2011 03:16:49 PM Pacific Daylight Time		08/05/2011 03:10:44 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage Enhanced SnJoaq (HMO)	01	01		1			H0524	042	0	2012	San Joaquin County Plan - Enhanced		2		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		2	2	2
H0524	043	0	1	01	01	H0524_043_0	8	1		08/04/2011	2012.02	08/04/2011 10:27:27 AM Pacific Daylight Time	08/05/2011 09:34:08 AM Pacific Daylight Time	08/03/2011 03:17:53 PM Pacific Daylight Time		08/05/2011 03:10:44 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage Basic SnJoaq (HMO)	01	01		1			H0524	043	0	2012	San Joaquin County Plan - Basic		2		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		2	2	2
H0524	046	0	1	01	01	H0524_046_0	7	1		08/04/2011	2012.02	08/04/2011 10:28:51 AM Pacific Daylight Time	08/05/2011 11:46:53 AM Pacific Daylight Time	08/03/2011 03:18:53 PM Pacific Daylight Time		08/05/2011 01:40:00 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage Basic Fresno (HMO)	01	01		1			H0524	046	0	2012	Greater Fresno Area Plan - Basic		2		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		2	2	2
H0524	801	0	1	01	01	H0524_801_0	4	1		07/21/2011	2012.02	07/21/2011 04:44:27 PM Pacific Daylight Time	07/21/2011 12:51:15 PM Pacific Daylight Time			07/22/2011 12:37:20 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage (HMO)	01	01		1			H0524	801	0	2012	Southern California Group Part A B		1		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238										(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054										2	2	2
H0524	802	0	1	01	01	H0524_802_0	4	1		07/21/2011	2012.02	07/21/2011 04:44:36 PM Pacific Daylight Time	07/21/2011 12:40:19 PM Pacific Daylight Time			07/22/2011 12:37:20 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage (HMO)	01	01		1			H0524	802	0	2012	Northern California Group Part A B		1		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238										(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054										2	2	2
H0524	803	0	2	01	01	H0524_803_0	4	1		07/21/2011	2012.02	07/21/2011 04:44:45 PM Pacific Daylight Time	07/21/2011 12:51:54 PM Pacific Daylight Time			07/22/2011 12:37:20 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage (HMO)	01	01		2	1		H0524	803	0	2012	Southern California Group B Only		1		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238										(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054										2	2	2
H0524	804	0	2	01	01	H0524_804_0	4	1		07/21/2011	2012.02	07/21/2011 04:39:33 PM Pacific Daylight Time	07/21/2011 12:41:01 PM Pacific Daylight Time			07/22/2011 12:37:20 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage (HMO)	01	01		2	1		H0524	804	0	2012	Northern California Group B Only		1		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238										(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054										2	2	2
H0524	805	0	1	01	01	H0524_805_0	4	1		07/21/2011	2012.02	07/21/2011 04:39:43 PM Pacific Daylight Time	07/21/2011 12:53:18 PM Pacific Daylight Time			07/22/2011 12:37:20 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage (HMO)	01	01		1			H0524	805	0	2012	Southern California Group Part A B Part D		1		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		2	2	2
H0524	806	0	1	01	01	H0524_806_0	4	1		07/21/2011	2012.02	07/21/2011 04:39:50 PM Pacific Daylight Time	07/21/2011 12:41:39 PM Pacific Daylight Time			07/22/2011 12:37:20 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage (HMO)	01	01		1			H0524	806	0	2012	Northern California Group Part A B Part D		1		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		2	2	2
H0524	807	0	2	01	01	H0524_807_0	4	1		07/21/2011	2012.02	07/21/2011 04:39:58 PM Pacific Daylight Time	07/21/2011 12:53:56 PM Pacific Daylight Time			07/22/2011 12:37:20 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage (HMO)	01	01		2	1		H0524	807	0	2012	Southern California Group Part B only  Part D		1		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		2	2	2
H0524	808	0	2	01	01	H0524_808_0	4	1		07/21/2011	2012.02	07/21/2011 04:40:06 PM Pacific Daylight Time	07/21/2011 12:42:27 PM Pacific Daylight Time			07/22/2011 12:37:20 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage (HMO)	01	01		2	1		H0524	808	0	2012	Northern California Group Part B only Part D		1		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		2	2	2
H0524	809	0	1	01	01	H0524_809_0	4	1		07/21/2011	2012.02	07/21/2011 04:40:15 PM Pacific Daylight Time	07/21/2011 12:54:55 PM Pacific Daylight Time			07/22/2011 12:37:20 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	FEHB Part AB with D (HMO)	01	01		1			H0524	809	0	2012	Southern California Plan		1		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		2	2	2
H0524	810	0	1	01	01	H0524_810_0	5	1		07/21/2011	2012.02	07/21/2011 04:40:23 PM Pacific Daylight Time	07/21/2011 12:43:04 PM Pacific Daylight Time			07/22/2011 12:37:20 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	FEHB Part AB with D (HMO)	01	01		1			H0524	810	0	2012	Northern California Plan		1		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		2	2	2
H0524	811	0	2	01	01	H0524_811_0	4	1		07/21/2011	2012.02	07/21/2011 04:40:30 PM Pacific Daylight Time	07/21/2011 12:55:41 PM Pacific Daylight Time			07/22/2011 12:37:20 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	FEHB Part B Only with D (HMO)	01	01		2	1		H0524	811	0	2012	Southern California Plan		1		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		2	2	2
H0524	812	0	2	01	01	H0524_812_0	4	1		07/21/2011	2012.02	07/21/2011 04:40:39 PM Pacific Daylight Time	07/21/2011 12:43:39 PM Pacific Daylight Time			07/22/2011 12:37:20 PM Pacific Daylight Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	FEHB Part B Only with D (HMO)	01	01		2	1		H0524	812	0	2012	Northern California Plan		1		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-443-0815		(800)-443-0815		(800)-777-1238		(800)-777-1238		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		(800)-777-1370		(800)-777-1370		(888)-758-6054		(888)-758-6054		2	2	2
H0542	001	0	1	20	08	H0542_001_0	1	1		05/23/2011	2012.01	05/23/2011 10:14:28 AM Pacific Daylight Time		05/20/2011 01:58:57 PM Pacific Daylight Time		05/23/2011 10:19:17 AM Pacific Daylight Time	ALTAMED HEALTH SERVICES CORPORATION	AltaMed Senior BuenaCare	www.altamed.org	AltaMed Senior BuenaCare (PACE)	08	20		1			H0542	001	0	2012	Los Angeles County		2		2			2							http://www.altamed.org/	http://www.altamed.org/									(877)-462-2582		(323)-728-0411		(877)-462-2582		(323)-728-0411										(800)-735-2922		(800)-735-2922		(800)-735-2922		(800)-735-2922				
H0542	002	0	1	20	08	H0542_002_0	1	1		05/23/2011	2012.01	05/23/2011 10:15:04 AM Pacific Daylight Time		05/20/2011 01:58:57 PM Pacific Daylight Time		05/23/2011 10:19:17 AM Pacific Daylight Time	ALTAMED HEALTH SERVICES CORPORATION	AltaMed Senior BuenaCare	www.altamed.org	AltaMed Senior BuenaCare (PACE)	08	20		1			H0542	002	0	2012	Los Angeles County		2		2			2							http://www.altamed.org/	http://www.altamed.org/									(877)-462-2582		(323)-728-0411		(877)-462-2582		(323)-728-0411										(800)-735-2922		(323)-728-0411		(800)-735-2922		(800)-735-2922				
H0543	001	0	1	01	01	H0543_001_0	4	1		09/13/2011	2012.02	09/13/2011 01:46:27 PM Central Daylight Time	08/06/2011 08:12:55 PM Central Daylight Time	08/05/2011 01:13:23 PM Central Daylight Time		09/13/2011 02:17:17 PM Central Daylight Time	UNITEDHEALTHCARE OF CALIFORNIA	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons (HMO)	01	01		1			H0543	001	0	2012	Los Angeles County		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0543	004	0	1	01	01	H0543_004_0	3	1		08/08/2011	2012.02	08/08/2011 09:59:33 AM Central Daylight Time	08/06/2011 08:13:31 PM Central Daylight Time	08/05/2011 01:13:40 PM Central Daylight Time		08/09/2011 12:21:14 PM Central Daylight Time	UNITEDHEALTHCARE OF CALIFORNIA	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Premier (HMO)	01	01		1			H0543	004	0	2012	Orange County		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0543	007	0	1	01	01	H0543_007_0	3	1		08/08/2011	2012.02	08/08/2011 10:39:42 AM Central Daylight Time	08/06/2011 08:14:09 PM Central Daylight Time	08/05/2011 01:13:55 PM Central Daylight Time		08/09/2011 12:21:14 PM Central Daylight Time	UNITEDHEALTHCARE OF CALIFORNIA	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 1 (HMO)	01	01		1			H0543	007	0	2012	Riverside, San Bernardino		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0543	013	0	1	01	01	H0543_013_0	4	1		08/08/2011	2012.02	08/08/2011 05:13:27 PM Central Daylight Time	08/08/2011 04:58:54 PM Central Daylight Time	08/05/2011 01:14:10 PM Central Daylight Time		08/09/2011 12:21:14 PM Central Daylight Time	UNITEDHEALTHCARE OF CALIFORNIA	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Value (HMO)	01	01		1			H0543	013	0	2012	San Diego		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0543	019	0	1	01	01	H0543_019_0	3	1		08/08/2011	2012.02	08/08/2011 10:46:27 AM Central Daylight Time	08/06/2011 08:15:14 PM Central Daylight Time	08/05/2011 01:14:26 PM Central Daylight Time		08/09/2011 12:21:14 PM Central Daylight Time	UNITEDHEALTHCARE OF CALIFORNIA	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons (HMO)	01	01		1			H0543	019	0	2012	Kern		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0543	022	0	1	01	01	H0543_022_0	3	1		08/08/2011	2012.02	08/08/2011 11:18:36 AM Central Daylight Time	08/06/2011 08:15:47 PM Central Daylight Time	08/05/2011 01:14:42 PM Central Daylight Time		08/09/2011 12:21:14 PM Central Daylight Time	UNITEDHEALTHCARE OF CALIFORNIA	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons (HMO)	01	01		1			H0543	022	0	2012	Ventura		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0543	028	0	1	01	01	H0543_028_0	3	1		08/09/2011	2012.02	08/09/2011 12:47:27 PM Central Daylight Time	08/06/2011 08:16:21 PM Central Daylight Time	08/05/2011 01:14:57 PM Central Daylight Time		08/09/2011 02:23:47 PM Central Daylight Time	UNITEDHEALTHCARE OF CALIFORNIA	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons (HMO)	01	01		1			H0543	028	0	2012	San Mateo		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0543	029	0	1	01	01	H0543_029_0	4	1		08/09/2011	2012.02	08/09/2011 12:48:15 PM Central Daylight Time	08/08/2011 04:34:13 PM Central Daylight Time	08/05/2011 01:15:14 PM Central Daylight Time		08/09/2011 02:23:47 PM Central Daylight Time	UNITEDHEALTHCARE OF CALIFORNIA	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons (HMO)	01	01		1			H0543	029	0	2012	Santa Clara		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0543	032	0	1	01	01	H0543_032_0	3	1		08/09/2011	2012.02	08/09/2011 12:48:38 PM Central Daylight Time	08/06/2011 08:16:54 PM Central Daylight Time	08/05/2011 01:15:30 PM Central Daylight Time		08/09/2011 02:23:47 PM Central Daylight Time	UNITEDHEALTHCARE OF CALIFORNIA	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons (HMO)	01	01		1			H0543	032	0	2012	Santa Barbara and San Luis Obispo counties		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0543	035	0	1	01	01	H0543_035_0	3	1		08/09/2011	2012.02	08/09/2011 12:48:52 PM Central Daylight Time	08/08/2011 04:34:42 PM Central Daylight Time	08/05/2011 01:15:46 PM Central Daylight Time		08/09/2011 02:23:47 PM Central Daylight Time	UNITEDHEALTHCARE OF CALIFORNIA	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 1 (HMO)	01	01		1			H0543	035	0	2012	Fresno County and Madera County- select zip codes		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0543	036	0	1	01	01	H0543_036_0	3	1		08/09/2011	2012.02	08/09/2011 12:50:14 PM Central Daylight Time	08/06/2011 08:17:27 PM Central Daylight Time	08/05/2011 01:16:02 PM Central Daylight Time		08/09/2011 02:23:47 PM Central Daylight Time	UNITEDHEALTHCARE OF CALIFORNIA	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 1 (HMO)	01	01		1			H0543	036	0	2012	Stanislaus County		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0543	060	0	1	01	01	H0543_060_0	3	1		08/08/2011	2012.02	08/08/2011 05:12:58 PM Central Daylight Time	08/08/2011 04:35:08 PM Central Daylight Time	08/05/2011 01:16:17 PM Central Daylight Time		08/09/2011 12:21:14 PM Central Daylight Time	UNITEDHEALTHCARE OF CALIFORNIA	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Premier (HMO)	01	01		1			H0543	060	0	2012	San Diego		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0543	070	0	1	01	01	H0543_070_0	3	1		08/09/2011	2012.02	08/09/2011 12:51:03 PM Central Daylight Time	08/06/2011 08:18:41 PM Central Daylight Time	08/05/2011 01:16:32 PM Central Daylight Time		08/09/2011 02:23:47 PM Central Daylight Time	UNITEDHEALTHCARE OF CALIFORNIA	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons (HMO)	01	01		1			H0543	070	0	2012	Alameda and Contra Costa counties		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0543	078	0	1	01	01	H0543_078_0	4	1	2	07/22/2011	2012.02	07/22/2011 12:59:03 PM Central Daylight Time	08/06/2011 08:19:17 PM Central Daylight Time	08/05/2011 12:53:21 PM Central Daylight Time		08/09/2011 12:38:08 PM Central Daylight Time	UNITEDHEALTHCARE OF CALIFORNIA	SecureHorizons by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H0543	078	0	2012	Los Angeles County		2		2			1	3		1	2		www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(866)-846-2762		(866)-846-2762		(888)-834-3721		(888)-834-3721		(866)-846-2762		(866)-846-2762		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0543	079	0	1	01	01	H0543_079_0	4	1	2	07/22/2011	2012.02	07/22/2011 12:59:35 PM Central Daylight Time	08/06/2011 08:19:52 PM Central Daylight Time	08/05/2011 12:53:42 PM Central Daylight Time		08/09/2011 12:38:08 PM Central Daylight Time	UNITEDHEALTHCARE OF CALIFORNIA	SecureHorizons by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H0543	079	0	2012	Orange County		2		2			1	3		1	2		www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(866)-846-2762		(866)-846-2762		(888)-834-3721		(888)-834-3721		(866)-846-2762		(866)-846-2762		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0543	081	0	1	01	01	H0543_081_0	4	1	2	07/22/2011	2012.02	07/22/2011 12:59:37 PM Central Daylight Time	08/06/2011 08:20:26 PM Central Daylight Time	08/05/2011 12:54:04 PM Central Daylight Time		08/09/2011 12:38:08 PM Central Daylight Time	UNITEDHEALTHCARE OF CALIFORNIA	SecureHorizons by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H0543	081	0	2012	Riverside and San Bernardino Counties		2		2			1	3		1	2		www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(866)-846-2762		(866)-846-2762		(888)-834-3721		(888)-834-3721		(866)-846-2762		(866)-846-2762		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0543	085	0	1	01	01	H0543_085_0	3	1		08/09/2011	2012.02	08/09/2011 12:53:22 PM Central Daylight Time	08/06/2011 08:21:01 PM Central Daylight Time	08/05/2011 01:16:47 PM Central Daylight Time		08/09/2011 02:23:47 PM Central Daylight Time	UNITEDHEALTHCARE OF CALIFORNIA	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons (HMO)	01	01		1			H0543	085	0	2012	San Francisco		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0543	086	0	1	01	01	H0543_086_0	3	1		07/20/2011	2012.02	07/20/2011 11:30:04 AM Central Daylight Time	08/08/2011 04:35:35 PM Central Daylight Time	08/05/2011 01:17:02 PM Central Daylight Time		08/09/2011 12:38:08 PM Central Daylight Time	UNITEDHEALTHCARE OF CALIFORNIA	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons (HMO)	01	01		1			H0543	086	0	2012	Nevada County		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0543	089	0	1	01	01	H0543_089_0	3	1		08/09/2011	2012.02	08/09/2011 12:54:15 PM Central Daylight Time	08/06/2011 08:21:35 PM Central Daylight Time	08/05/2011 01:17:19 PM Central Daylight Time		08/09/2011 02:29:28 PM Central Daylight Time	UNITEDHEALTHCARE OF CALIFORNIA	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 1 (HMO)	01	01		1			H0543	089	0	2012	Sacramento, Placer, and Yolo counties		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0543	121	0	1	01	01	H0543_121_0	2	1		07/20/2011	2012.02	07/20/2011 11:26:15 AM Central Daylight Time	07/22/2011 03:32:36 PM Central Daylight Time			07/25/2011 12:56:09 PM Central Daylight Time	UNITEDHEALTHCARE OF CALIFORNIA	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Essential (HMO)	01	01		1			H0543	121	0	2012	Kern,LA,Orange,Riverside,San Bernardino,San Diego		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514										(711)		(711)		(711)		(711)										2	2	2
H0543	125	0	1	01	01	H0543_125_0	3	1		08/09/2011	2012.02	08/09/2011 12:54:44 PM Central Daylight Time	08/06/2011 08:22:11 PM Central Daylight Time	08/05/2011 01:17:34 PM Central Daylight Time		08/09/2011 02:29:28 PM Central Daylight Time	UNITEDHEALTHCARE OF CALIFORNIA	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 2 (HMO)	01	01		1			H0543	125	0	2012	Fresno and Madera		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0543	138	0	1	01	01	H0543_138_0	4	1		09/13/2011	2012.02	09/13/2011 01:56:21 PM Central Daylight Time	08/06/2011 08:22:45 PM Central Daylight Time	08/05/2011 01:17:50 PM Central Daylight Time		09/13/2011 02:17:17 PM Central Daylight Time	UNITEDHEALTHCARE OF CALIFORNIA	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 2 (HMO)	01	01		1			H0543	138	0	2012	Orange		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0543	140	0	1	01	01	H0543_140_0	3	1		08/09/2011	2012.02	08/09/2011 12:54:59 PM Central Daylight Time	08/06/2011 08:23:18 PM Central Daylight Time	08/05/2011 01:18:06 PM Central Daylight Time		08/09/2011 02:29:28 PM Central Daylight Time	UNITEDHEALTHCARE OF CALIFORNIA	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons (HMO)	01	01		1			H0543	140	0	2012	Amador, El Dorado, Mendocino,Merced,Shasta,Tulare		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0543	142	0	1	01	01	H0543_142_0	3	1		08/08/2011	2012.02	08/08/2011 11:29:09 AM Central Daylight Time	08/06/2011 08:23:52 PM Central Daylight Time	08/05/2011 01:18:21 PM Central Daylight Time		08/09/2011 12:38:08 PM Central Daylight Time	UNITEDHEALTHCARE OF CALIFORNIA	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons (HMO)	01	01		1			H0543	142	0	2012	Imperial County		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0543	144	0	1	01	01	H0543_144_0	4	1		09/13/2011	2012.02	09/13/2011 01:57:09 PM Central Daylight Time	08/06/2011 08:24:27 PM Central Daylight Time	08/05/2011 01:18:36 PM Central Daylight Time		09/13/2011 02:17:17 PM Central Daylight Time	UNITEDHEALTHCARE OF CALIFORNIA	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 2 (HMO)	01	01		1			H0543	144	0	2012	Riverside and San Bernardino Counties		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0543	145	0	1	01	01	H0543_145_0	3	1		08/08/2011	2012.02	08/08/2011 11:30:10 AM Central Daylight Time	08/06/2011 08:25:02 PM Central Daylight Time	08/05/2011 01:18:52 PM Central Daylight Time		08/09/2011 02:29:28 PM Central Daylight Time	UNITEDHEALTHCARE OF CALIFORNIA	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	Sharp SecureHorizons Plan by UnitedHealthcare (HMO)	01	01		1			H0543	145	0	2012	San Diego		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0543	146	0	1	01	01	H0543_146_0	3	1		08/09/2011	2012.02	08/09/2011 12:55:13 PM Central Daylight Time	08/06/2011 08:25:35 PM Central Daylight Time	08/05/2011 01:19:07 PM Central Daylight Time		08/09/2011 02:29:28 PM Central Daylight Time	UNITEDHEALTHCARE OF CALIFORNIA	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 2 (HMO)	01	01		1			H0543	146	0	2012	Sacramento and Yolo Counties		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0543	147	0	1	01	01	H0543_147_0	4	1		08/09/2011	2012.02	08/09/2011 12:55:37 PM Central Daylight Time	08/06/2011 08:26:10 PM Central Daylight Time	08/05/2011 01:19:24 PM Central Daylight Time		08/09/2011 02:39:21 PM Central Daylight Time	UNITEDHEALTHCARE OF CALIFORNIA	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 2 (HMO)	01	01		1			H0543	147	0	2012	Stanislaus County		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0543	148	0	1	01	01	H0543_148_0	3	1		08/09/2011	2012.02	08/09/2011 12:56:28 PM Central Daylight Time	08/06/2011 08:26:46 PM Central Daylight Time	08/05/2011 01:19:39 PM Central Daylight Time		08/09/2011 02:39:21 PM Central Daylight Time	UNITEDHEALTHCARE OF CALIFORNIA	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 2 (HMO)	01	01		1			H0543	148	0	2012	Sonoma County		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0543	149	0	1	01	01	H0543_149_0	3	1		08/09/2011	2012.02	08/09/2011 12:57:35 PM Central Daylight Time	08/06/2011 08:27:21 PM Central Daylight Time	08/05/2011 01:19:54 PM Central Daylight Time		08/09/2011 02:39:21 PM Central Daylight Time	UNITEDHEALTHCARE OF CALIFORNIA	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 1 (HMO)	01	01		1			H0543	149	0	2012	Sonoma County		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0543	150	0	1	01	01	H0543_150_0	3	1		08/09/2011	2012.02	08/09/2011 12:57:57 PM Central Daylight Time	08/06/2011 08:27:56 PM Central Daylight Time	08/05/2011 01:20:09 PM Central Daylight Time		08/09/2011 02:39:21 PM Central Daylight Time	UNITEDHEALTHCARE OF CALIFORNIA	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 2 (HMO)	01	01		1			H0543	150	0	2012	Placer County		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0543	802	0	1	01	01	H0543_802_0	3	1		07/06/2011	2012.02	07/06/2011 04:36:20 PM Central Daylight Time	06/04/2011 12:06:01 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	UNITEDHEALTHCARE OF CALIFORNIA	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0543	802	0	2012	CA Employer Sponsored Plan Service Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548										(711)		(711)		(711)		(711)										2	2	2
H0543	805	0	1	01	01	H0543_805_0	3	1		07/06/2011	2012.02	07/06/2011 04:36:23 PM Central Daylight Time	06/04/2011 12:04:26 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	UNITEDHEALTHCARE OF CALIFORNIA	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0543	805	0	2012	CA Employer Sponsored Plan Service Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0543	806	0	1	01	01	H0543_806_0	3	1		07/06/2011	2012.02	07/06/2011 04:36:28 PM Central Daylight Time	06/04/2011 12:03:56 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	UNITEDHEALTHCARE OF CALIFORNIA	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0543	806	0	2012	CA Employer Sponsored Plan Service Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0544	002	0	1	01	01	H0544_002_0	9	1		08/08/2011	2012.02	08/08/2011 12:36:39 PM Pacific Daylight Time	08/08/2011 03:35:14 PM Pacific Daylight Time	08/08/2011 01:00:05 PM Pacific Daylight Time		08/08/2011 04:16:07 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	CareMore Health Plan	http://www.caremore.com	CareMore Value Plus (HMO)	01	01		1			H0544	002	0	2012	Los Angeles and Orange Counties (partial)		2	24548	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)-822-6991		(800)-822-6991		(866)-622-2820		(866)-622-2820		(800)-822-6991		(800)-822-6991		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H0544	003	0	1	01	01	H0544_003_0	7	1	2	08/06/2011	2012.02	08/06/2011 10:52:02 AM Pacific Daylight Time	08/08/2011 03:35:23 PM Pacific Daylight Time	08/08/2011 01:00:24 PM Pacific Daylight Time		08/08/2011 04:24:53 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	CareMore Health Plan	http://www.caremore.com	CareMore Connect (HMO SNP)	01	01		1			H0544	003	0	2012	Los Angeles and Orange Counties (partial)		2	387	2			1	3		1	2		www.caremore.com	www.caremore.com	www.caremore.com	(800)-589-3146		(800)-589-3146		(866)-622-2820		(866)-622-2820		(800)-589-3146		(800)-589-3146		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H0544	004	0	1	01	01	H0544_004_0	8	1		08/06/2011	2012.02	08/06/2011 11:12:50 AM Pacific Daylight Time	08/08/2011 03:35:32 PM Pacific Daylight Time	08/08/2011 01:00:26 PM Pacific Daylight Time		08/08/2011 04:24:53 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	CareMore Health Plan	http://www.caremore.com	CareMore Reliance (HMO SNP)	01	01		1			H0544	004	0	2012	Los Angeles and Orange Counties (partial)		2	7412	2			1	4		1		00000010000000000000	www.caremore.com	www.caremore.com	www.caremore.com	(800)-589-3145		(800)-589-3145		(866)-622-2820		(866)-622-2820		(800)-589-3145		(800)-589-3145		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H0544	005	0	1	01	01	H0544_005_0	6	1		08/06/2011	2012.02	08/06/2011 10:41:05 AM Pacific Daylight Time	08/08/2011 03:36:00 PM Pacific Daylight Time	08/08/2011 01:00:29 PM Pacific Daylight Time		08/08/2011 04:24:53 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	CareMore Health Plan	http://www.caremore.com	CareMore Touch (HMO SNP)	01	01		1			H0544	005	0	2012	Los Angeles and Orange Counties (partial)		2	1207	2			1	1	3	1			www.caremore.com	www.caremore.com	www.caremore.com	(800)-589-3147		(800)-589-3147		(866)-622-2820		(866)-622-2820		(800)-589-3147		(800)-589-3147		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H0544	007	0	1	01	01	H0544_007_0	7	1		08/08/2011	2012.02	08/08/2011 12:35:25 PM Pacific Daylight Time	08/08/2011 03:36:10 PM Pacific Daylight Time	08/08/2011 01:00:31 PM Pacific Daylight Time		08/08/2011 04:24:53 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	CareMore Health Plan	http://www.caremore.com	StartSmart with CareMore (HMO)	01	01		1			H0544	007	0	2012	Los Angeles and Orange Counties (partial)		2	760	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)-822-8720		(800)-822-8720		(866)-622-2820		(866)-622-2820		(800)-822-8720		(800)-822-8720		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H0544	008	0	1	01	01	H0544_008_0	8	1		08/06/2011	2012.02	08/06/2011 10:52:48 AM Pacific Daylight Time	08/08/2011 03:36:18 PM Pacific Daylight Time	08/08/2011 01:00:32 PM Pacific Daylight Time		08/08/2011 04:32:14 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	CareMore Health Plan	http://www.caremore.com	CareMore Value Plus (HMO)	01	01		1			H0544	008	0	2012	San Bernardino County (partial)		2	1284	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)-822-6991		(800)-822-6991		(866)-622-2820		(866)-622-2820		(800)-822-6991		(800)-822-6991		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H0544	010	0	1	01	01	H0544_010_0	8	1		08/06/2011	2012.02	08/06/2011 10:53:37 AM Pacific Daylight Time	08/08/2011 03:36:26 PM Pacific Daylight Time	08/08/2011 01:00:36 PM Pacific Daylight Time		08/08/2011 04:32:14 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	CareMore Health Plan	http://www.caremore.com	CareMore Reliance (HMO SNP)	01	01		1			H0544	010	0	2012	San Bernardino County (partial)		2	1234	2			1	4		1		00000010000000000000	www.caremore.com	www.caremore.com	www.caremore.com	(800)-589-3145		(800)-589-3145		(866)-622-2820		(866)-622-2820		(800)-589-3145		(800)-589-3145		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H0544	012	0	1	01	01	H0544_012_0	6	1		08/06/2011	2012.02	08/06/2011 10:56:16 AM Pacific Daylight Time	08/08/2011 03:36:59 PM Pacific Daylight Time	08/08/2011 01:00:36 PM Pacific Daylight Time		08/08/2011 04:32:14 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	CareMore Health Plan	http://www.caremore.com	CareMore Value Plus (HMO)	01	01		1			H0544	012	0	2012	Santa Clara County (partial)		2	2260	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)-822-6991		(800)-822-6991		(866)-622-2820		(866)-622-2820		(800)-822-6991		(800)-822-6991		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H0544	013	0	1	01	01	H0544_013_0	8	1		08/06/2011	2012.02	08/06/2011 11:13:46 AM Pacific Daylight Time	08/08/2011 03:35:42 PM Pacific Daylight Time	08/08/2011 01:00:39 PM Pacific Daylight Time		08/08/2011 04:32:14 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	CareMore Health Plan	http://www.caremore.com	CareMore Heart (HMO SNP)	01	01		1			H0544	013	0	2012	Los Angeles and Orange Counties (partial)		2	2192	2			1	4		1		00000000000000010000	www.caremore.com	www.caremore.com	www.caremore.com	(888)-494-8280		(888)-494-8280		(866)-622-2820		(866)-622-2820		(888)-494-8280		(888)-494-8280		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H0544	014	0	1	01	01	H0544_014_0	7	1		08/06/2011	2012.02	08/06/2011 11:14:19 AM Pacific Daylight Time	08/08/2011 03:35:51 PM Pacific Daylight Time	08/08/2011 01:00:41 PM Pacific Daylight Time		08/08/2011 04:40:16 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	CareMore Health Plan	http://www.caremore.com	CareMore Breathe (HMO SNP)	01	01		1			H0544	014	0	2012	Los Angeles and Orange Counties (partial)		2	1438	2			1	4		1		00000000000100000000	www.caremore.com	www.caremore.com	www.caremore.com	(888)-357-4166		(888)-357-4166		(866)-622-2820		(866)-622-2820		(888)-357-4166		(888)-357-4166		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H0544	015	0	1	01	01	H0544_015_0	6	1		08/06/2011	2012.02	08/06/2011 10:51:22 AM Pacific Daylight Time		08/08/2011 01:00:43 PM Pacific Daylight Time		08/09/2011 09:55:05 AM Pacific Daylight Time	CAREMORE HEALTH PLAN	CareMore Health Plan	http://www.caremore.com	CareMore ESRD (HMO SNP)	01	01		1			H0544	015	0	2012	Los Angeles and Orange Counties (partial)		2	1058	2			1	4		1		00000000100000000000	www.caremore.com	www.caremore.com	www.caremore.com	(888)-357-4177		(888)-357-4177		(866)-622-2820		(866)-622-2820		(888)-357-4177		(888)-357-4177		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H0544	016	0	1	01	01	H0544_016_0	9	1		08/08/2011	2012.02	08/08/2011 12:37:14 PM Pacific Daylight Time	08/08/2011 03:36:51 PM Pacific Daylight Time	08/08/2011 01:00:45 PM Pacific Daylight Time		08/08/2011 04:40:16 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	CareMore Health Plan	http://www.caremore.com	StartSmart with CareMore (HMO)	01	01		1			H0544	016	0	2012	San Bernardino County (partial)		2	25	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)-822-8720		(800)-822-8720		(866)-622-2820		(866)-622-2820		(800)-822-8720		(800)-822-8720		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H0544	019	0	1	01	01	H0544_019_0	7	1		08/06/2011	2012.02	08/06/2011 10:54:00 AM Pacific Daylight Time	08/08/2011 03:36:43 PM Pacific Daylight Time	08/08/2011 01:00:47 PM Pacific Daylight Time		08/08/2011 04:40:16 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	CareMore Health Plan	http://www.caremore.com	CareMore Breathe (HMO SNP)	01	01		1			H0544	019	0	2012	San Bernardino County (partial)		2	349	2			1	4		1		00000000000100000000	www.caremore.com	www.caremore.com	www.caremore.com	(888)-357-4166		(888)-357-4166		(866)-622-2820		(866)-622-2820		(888)-357-4166		(888)-357-4166		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H0544	020	0	1	01	01	H0544_020_0	6	1		08/06/2011	2012.02	08/06/2011 10:55:04 AM Pacific Daylight Time		08/08/2011 01:00:48 PM Pacific Daylight Time		08/09/2011 09:55:05 AM Pacific Daylight Time	CAREMORE HEALTH PLAN	CareMore Health Plan	http://www.caremore.com	CareMore ESRD (HMO SNP)	01	01		1			H0544	020	0	2012	San Bernardino County (partial)		2	52	2			1	4		1		00000000100000000000	www.caremore.com	www.caremore.com	www.caremore.com	(888)-357-4177		(888)-357-4177		(866)-622-2820		(866)-622-2820		(888)-357-4177		(888)-357-4177		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H0544	021	0	1	01	01	H0544_021_0	6	1		08/08/2011	2012.02	08/08/2011 12:37:42 PM Pacific Daylight Time	08/08/2011 03:37:42 PM Pacific Daylight Time	08/08/2011 01:00:52 PM Pacific Daylight Time		08/08/2011 04:40:16 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	CareMore Health Plan	http://www.caremore.com	StartSmart with CareMore (HMO)	01	01		1			H0544	021	0	2012	Santa Clara County (partial)		2	142	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)-822-8720		(800)-822-8720		(866)-622-2820		(866)-622-2820		(800)-822-8720		(800)-822-8720		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H0544	022	0	1	01	01	H0544_022_0	7	1		08/06/2011	2012.02	08/06/2011 10:42:54 AM Pacific Daylight Time	08/08/2011 03:37:33 PM Pacific Daylight Time	08/08/2011 01:00:53 PM Pacific Daylight Time		08/08/2011 04:47:59 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	CareMore Health Plan	http://www.caremore.com	CareMore Touch (HMO SNP)	01	01		1			H0544	022	0	2012	Santa Clara County (partial)		2	91	2			1	1	3	1			www.caremore.com	www.caremore.com	www.caremore.com	(800)-589-3147		(800)-589-3147		(866)-622-2820		(866)-622-2820		(800)-589-3147		(800)-589-3147		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H0544	024	0	1	01	01	H0544_024_0	6	1		08/06/2011	2012.02	08/06/2011 10:58:50 AM Pacific Daylight Time	08/08/2011 03:37:16 PM Pacific Daylight Time	08/08/2011 01:00:56 PM Pacific Daylight Time		08/08/2011 04:47:59 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	CareMore Health Plan	http://www.caremore.com	CareMore Breathe (HMO SNP)	01	01		1			H0544	024	0	2012	Santa Clara County (partial)		2	95	2			1	4		1		00000000000100000000	www.caremore.com	www.caremore.com	www.caremore.com	(888)-357-4166		(888)-357-4166		(866)-622-2820		(866)-622-2820		(888)-357-4166		(888)-357-4166		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H0544	025	0	1	01	01	H0544_025_0	5	1		08/06/2011	2012.02	08/06/2011 10:58:24 AM Pacific Daylight Time	08/08/2011 03:37:25 PM Pacific Daylight Time	08/08/2011 01:00:57 PM Pacific Daylight Time		08/08/2011 04:47:59 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	CareMore Health Plan	http://www.caremore.com	CareMore Diabetes (HMO SNP)	01	01		1			H0544	025	0	2012	Santa Clara County (partial)		2	504	2			1	4		1		00000010000000000000	www.caremore.com	www.caremore.com	www.caremore.com	(888)-357-4187		(888)-357-4187		(866)-622-2820		(866)-622-2820		(888)-357-4187		(888)-357-4187		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H0544	027	0	1	01	01	H0544_027_0	5	1		08/06/2011	2012.02	08/06/2011 11:00:40 AM Pacific Daylight Time	08/08/2011 03:39:22 PM Pacific Daylight Time	08/08/2011 01:01:00 PM Pacific Daylight Time		08/08/2011 04:47:59 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	CareMore Health Plan	http://www.caremore.com	CareMore Value Plus (HMO)	01	01		1			H0544	027	0	2012	Stanislaus County		2	2286	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)-822-6991		(800)-822-6991		(866)-622-2820		(866)-622-2820		(800)-822-6991		(800)-822-6991		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H0544	028	0	1	01	01	H0544_028_0	5	1		08/08/2011	2012.02	08/08/2011 12:38:32 PM Pacific Daylight Time	08/08/2011 03:39:56 PM Pacific Daylight Time	08/08/2011 01:01:02 PM Pacific Daylight Time		08/08/2011 04:55:04 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	CareMore Health Plan	http://www.caremore.com	StartSmart with CareMore (HMO)	01	01		1			H0544	028	0	2012	Stanislaus County		2	149	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)-822-8720		(800)-822-8720		(866)-622-2820		(866)-622-2820		(800)-822-8720		(800)-822-8720		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H0544	031	0	1	01	01	H0544_031_0	5	1		08/06/2011	2012.02	08/06/2011 11:01:49 AM Pacific Daylight Time	08/08/2011 03:39:47 PM Pacific Daylight Time	08/08/2011 01:01:04 PM Pacific Daylight Time		08/08/2011 04:55:04 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	CareMore Health Plan	http://www.caremore.com	CareMore Breathe (HMO SNP)	01	01		1			H0544	031	0	2012	Stanislaus County		2	170	2			1	4		1		00000000000100000000	www.caremore.com	www.caremore.com	www.caremore.com	(888)-357-4166		(888)-357-4166		(866)-622-2820		(866)-622-2820		(888)-357-4166		(888)-357-4166		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H0544	032	0	1	01	01	H0544_032_0	5	1		08/06/2011	2012.02	08/06/2011 11:01:26 AM Pacific Daylight Time	08/08/2011 03:39:30 PM Pacific Daylight Time	08/08/2011 01:01:06 PM Pacific Daylight Time		08/08/2011 04:55:04 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	CareMore Health Plan	http://www.caremore.com	CareMore Diabetes (HMO SNP)	01	01		1			H0544	032	0	2012	Stanislaus County		2	824	2			1	4		1		00000010000000000000	www.caremore.com	www.caremore.com	www.caremore.com	(888)-357-4187		(888)-357-4187		(866)-622-2820		(866)-622-2820		(888)-357-4187		(888)-357-4187		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H0544	034	0	1	01	01	H0544_034_0	6	1		08/06/2011	2012.02	08/06/2011 10:43:30 AM Pacific Daylight Time	08/08/2011 03:40:04 PM Pacific Daylight Time	08/08/2011 01:01:08 PM Pacific Daylight Time		08/08/2011 04:55:04 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	CareMore Health Plan	http://www.caremore.com	CareMore Value Plus (HMO)	01	01		1			H0544	034	0	2012	Riverside (partial)		2	824	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)-822-6991		(800)-822-6991		(866)-622-2820		(866)-622-2820		(800)-822-6991		(800)-822-6991		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H0544	035	0	1	01	01	H0544_035_0	5	1		08/06/2011	2012.02	08/06/2011 11:03:51 AM Pacific Daylight Time	08/08/2011 03:40:13 PM Pacific Daylight Time	08/08/2011 01:01:12 PM Pacific Daylight Time		08/08/2011 05:04:35 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	CareMore Health Plan	http://www.caremore.com	CareMore Diabetes (HMO SNP)	01	01		1			H0544	035	0	2012	Riverside (partial)		2	627	2			1	4		1		00000010000000000000	www.caremore.com	www.caremore.com	www.caremore.com	(888)-357-4187		(888)-357-4187		(866)-622-2820		(866)-622-2820		(888)-357-4187		(888)-357-4187		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H0544	036	0	1	01	01	H0544_036_0	5	1		08/06/2011	2012.02	08/06/2011 11:02:21 AM Pacific Daylight Time	08/08/2011 03:39:39 PM Pacific Daylight Time	08/08/2011 01:01:13 PM Pacific Daylight Time		08/08/2011 05:04:35 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	CareMore Health Plan	caremore.com	CareMore Heart (HMO SNP)	01	01		1			H0544	036	0	2012	Stanislaus County		2	84	2			1	4		1		00000000000000010000	www.caremore.com	www.caremore.com	www.caremore.com	(888)-494-8280		(888)-494-8280		(866)-622-2820		(866)-622-2820		(888)-494-8280		(888)-494-8280		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H0544	037	0	1	01	01	H0544_037_0	5	1		08/06/2011	2012.02	08/06/2011 10:59:25 AM Pacific Daylight Time	08/08/2011 03:37:08 PM Pacific Daylight Time	08/08/2011 01:01:17 PM Pacific Daylight Time		08/08/2011 05:04:35 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	CareMore Health Plan	caremore.com	CareMore Heart (HMO SNP)	01	01		1			H0544	037	0	2012	Santa Clara County (partial)		2	73	2			1	4		1		00000000000000010000	www.caremore.com	www.caremore.com	www.caremore.com	(888)-494-8280		(888)-494-8280		(866)-622-2820		(866)-622-2820		(888)-494-8280		(888)-494-8280		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H0544	038	0	1	01	01	H0544_038_0	6	1		08/06/2011	2012.02	08/06/2011 10:54:34 AM Pacific Daylight Time	08/08/2011 03:36:35 PM Pacific Daylight Time	08/08/2011 01:01:18 PM Pacific Daylight Time		08/08/2011 05:04:35 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	CareMore Health Plan	caremore.com	CareMore Heart (HMO SNP)	01	01		1			H0544	038	0	2012	San Bernardino County (partial)		2	59	2			1	4		1		00000000000000010000	www.caremore.com	www.caremore.com	www.caremore.com	(888)-494-8280		(888)-494-8280		(866)-622-2820		(866)-622-2820		(888)-494-8280		(888)-494-8280		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H0544	039	0	1	01	01	H0544_039_0	5	1		08/08/2011	2012.02	08/08/2011 12:38:19 PM Pacific Daylight Time	08/08/2011 03:41:15 PM Pacific Daylight Time	08/08/2011 01:01:22 PM Pacific Daylight Time		08/08/2011 05:04:35 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	CareMore Health Plan	caremore.com	StartSmart with CareMore (HMO)	01	01		1			H0544	039	0	2012	Riverside (partial county)		2	25	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)-822-8720		(800)-822-8720		(866)-622-2820		(866)-622-2820		(800)-822-8720		(800)-822-8720		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H0544	801	0	1	01	01	H0544_801_0	3	1		05/28/2011	2012.02	05/28/2011 11:09:49 AM Pacific Daylight Time	06/03/2011 12:00:12 PM Pacific Daylight Time			07/22/2011 04:58:08 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	CareMore Health Plan	caremore.com	CareMore EGWP (HMO)	01	01		1			H0544	801	0	2012	California		1	48	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)-822-6991		(800)-822-6991		(866)-622-2820		(866)-622-2820										(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586										1	1	1
H0544	802	0	1	01	01	H0544_802_0	3	1		05/28/2011	2012.02	05/28/2011 11:09:24 AM Pacific Daylight Time	06/03/2011 11:59:54 AM Pacific Daylight Time			07/22/2011 04:58:08 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	CareMore Health Plan	caremore.com	CareMore EGWP MAPD (HMO)	01	01		1			H0544	802	0	2012	California		1	48	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)-822-6991		(800)-822-6991		(866)-622-2820		(866)-622-2820		(800)-822-6991		(800)-822-6991		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		1	1	1
H0544	803	0	1	01	01	H0544_803_0	3	1		05/28/2011	2012.02	05/28/2011 11:13:40 AM Pacific Daylight Time	06/03/2011 12:00:50 PM Pacific Daylight Time			07/22/2011 04:58:08 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	CareMore Health Plan	caremore.com	CareMore EGWP (HMO)	01	01		1			H0544	803	0	2012	California		1	12	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)-822-6991		(800)-822-6991		(866)-622-2820		(866)-622-2820										(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586										1	1	1
H0544	804	0	1	01	01	H0544_804_0	3	1		05/28/2011	2012.02	05/28/2011 11:13:26 AM Pacific Daylight Time	06/03/2011 12:00:31 PM Pacific Daylight Time			07/22/2011 04:58:08 PM Pacific Daylight Time	CAREMORE HEALTH PLAN	CareMore Health Plan	caremore.com	CareMore EGWP MAPD (HMO)	01	01		1			H0544	804	0	2012	California		1	12	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)-822-6991		(800)-822-6991		(866)-622-2820		(866)-622-2820		(800)-822-6991		(800)-822-6991		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		1	1	1
H0545	001	0	1	01	01	H0545_001_0	6	1		08/08/2011	2012.02	08/08/2011 01:51:55 PM Pacific Daylight Time	08/08/2011 07:21:16 AM Pacific Daylight Time	08/04/2011 07:06:28 AM Pacific Daylight Time		08/08/2011 01:54:33 PM Pacific Daylight Time	INTER VALLEY HEALTH PLAN, INC.	Inter Valley Health Plan	www.ivhp.com	Inter Valley Health Plan Service To Seniors (HMO)	01	01		1			H0545	001	0	2012	Los Angeles, San Bernardino and Riverside Counties		2	13000	2			2						http://www.ivhp.com	www.ivhp.com/ivhp/pdfs/formulary.pdf	http://www.ivhp.com	(800)-251-8191		(909)-623-6333		(800)-500-7018		(800)-500-7018		(800)-523-3142		(800)-523-3142		(800)-500-7018		(800)-500-7018		(800)-505-7150		(800)-505-7150		(800)-505-7150		(800)-505-7150		(800)-505-7150		(800)-505-7150		(800)-505-7150		(800)-505-7150		2	2	2
H0545	011	0	1	01	01	H0545_011_0	7	1		08/08/2011	2012.02	08/08/2011 01:52:01 PM Pacific Daylight Time	08/08/2011 07:31:06 AM Pacific Daylight Time	08/04/2011 07:07:32 AM Pacific Daylight Time		08/08/2011 01:54:33 PM Pacific Daylight Time	INTER VALLEY HEALTH PLAN, INC.	Inter Valley Health Plan	www.ivhp.com	Inter Valley Health Plan Total Fit (HMO)	01	01		1			H0545	011	0	2012	Los Angeles, Riverside and San Bernardino Counties		2	3000	2			2						http://www.ivhp.com	www.ivhp.com/ivhp/pdfs/formulary.pdf	http://www.ivhp.com	(800)-251-8191		(909)-623-6333		(800)-500-7018		(800)-500-7018		(800)-523-3142		(800)-523-3142		(800)-500-7018		(800)-500-7018		(800)-505-7150		(800)-505-7150		(800)-505-7150		(800)-505-7150		(800)-505-7150		(800)-505-7150		(800)-505-7150		(800)-505-7150		2	2	2
H0545	012	0	1	01	01	H0545_012_0	5	1		07/23/2011	2012.02	07/23/2011 09:33:16 AM Pacific Daylight Time	08/04/2011 01:49:56 PM Pacific Daylight Time	08/04/2011 11:28:00 AM Pacific Daylight Time		08/04/2011 02:06:10 PM Pacific Daylight Time	INTER VALLEY HEALTH PLAN, INC.	Inter Valley Health Plan	www.ivhp.com	Inter Valley Health Plan Desert Preferred Choice (HMO)	01	01		1			H0545	012	0	2012	Riverside County		2		2			2						http://www.ivhp.com	www.ivhp.com/ivhp/pdfs/formulary.pdf	http://www.ivhp.com	(800)-251-8191		(800)-251-8191		(866)-756-4407		(866)-756-4407		(800)-523-3142		(800)-523-3142		(866)-756-4407		(866)-756-4407		(800)-505-7150		(800)-505-7150		(800)-505-7150		(800)-505-7150		(800)-505-7150		(800)-505-7150		(800)-505-7150		(800)-505-7150		2	2	2
H0545	801	0	1	01	01	H0545_801_0	1	1		04/22/2011	2012.02	04/22/2011 03:16:42 PM Pacific Daylight Time	06/05/2011 08:41:22 AM Pacific Daylight Time			06/05/2011 01:12:48 PM Pacific Daylight Time	INTER VALLEY HEALTH PLAN, INC.	Inter Valley Health Plan	www.ivhp.com	Inter Valley Health Plan Active Plus I (HMO)	01	01		1			H0545	801	0	2012	Los Angeles, Riverside and San Bernardino Counties		1		2			2						http://www.ivhp.com	www.ivhp.com/ivhp/pdfs/formulary.pdf	http://www.ivhp.com	(800)-251-8191		(909)-623-6333		(800)-500-7018		(800)-500-7018		(800)-523-3142		(800)-523-3142		(800)-500-7018		(800)-500-7018		(800)-505-7150		(800)-505-7150		(800)-505-7150		(800)-505-7150		(800)-505-7150		(800)-505-7150		(800)-505-7150		(800)-505-7150		1	1	1
H0545	802	0	1	01	01	H0545_802_0	1	1		04/22/2011	2012.02	04/22/2011 03:17:10 PM Pacific Daylight Time	06/05/2011 08:49:12 AM Pacific Daylight Time			06/05/2011 01:12:48 PM Pacific Daylight Time	INTER VALLEY HEALTH PLAN, INC.	Inter Valley Health Plan	www.ivhp.com	Inter Valley Health Plan Active Plus II (HMO)	01	01		1			H0545	802	0	2012	Los Angeles, Riverside and San Bernardino Counties		1		2			2						http://www.ivhp.com	www.ivhp.com/ivhp/pdfs/formulary.pdf	http://www.ivhp.com	(800)-251-8191		(909)-623-6333		(800)-500-7018		(800)-500-7018		(800)-523-3142		(800)-523-3142		(800)-500-7018		(800)-500-7018		(800)-505-7150		(800)-505-7150		(800)-505-7150		(800)-505-7150		(800)-505-7150		(800)-505-7150		(800)-505-7150		(800)-505-7150		1	1	1
H0562	009	0	1	01	01	H0562_009_0	7	1		07/21/2011	2012.02	07/21/2011 05:52:56 PM Central Daylight Time	08/05/2011 11:44:30 AM Pacific Daylight Time	08/04/2011 02:19:52 PM Pacific Daylight Time		08/08/2011 03:37:27 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA	Health Net of California	www.healthnet.com	Health Net Healthy Heart (HMO)	01	01		1			H0562	009	0	2012	San Francisco County		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	2	2
H0562	011	0	1	01	01	H0562_011_0	6	1		07/21/2011	2012.02	07/21/2011 05:53:24 PM Central Daylight Time	08/05/2011 11:44:52 AM Pacific Daylight Time	08/04/2011 02:17:52 PM Pacific Daylight Time		08/08/2011 03:37:27 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA	Health Net of California	www.healthnet.com	Health Net Healthy Heart (HMO)	01	01		1			H0562	011	0	2012	Contra Costa and Fresno Counties		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	2	2
H0562	012	0	1	01	01	H0562_012_0	6	1		07/21/2011	2012.02	07/21/2011 05:53:53 PM Central Daylight Time	08/05/2011 11:45:10 AM Pacific Daylight Time	08/04/2011 02:14:54 PM Pacific Daylight Time		08/08/2011 03:37:27 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA	Health Net of California	www.healthnet.com	Health Net Healthy Heart (HMO)	01	01		1			H0562	012	0	2012	San Diego county		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	2	2
H0562	017	0	1	01	01	H0562_017_0	6	1		07/21/2011	2012.02	07/21/2011 04:33:30 PM Pacific Daylight Time	08/05/2011 11:45:26 AM Pacific Daylight Time	08/04/2011 02:10:46 PM Pacific Daylight Time		08/08/2011 03:37:27 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA	Health Net of California	www.healthnet.com	Health Net Seniority Plus Ruby (HMO)	01	01		1			H0562	017	0	2012	San Diego, Santa Barbara, Santa Cruz Counties		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	2	2
H0562	036	0	1	01	01	H0562_036_0	6	1		07/21/2011	2012.02	07/21/2011 04:22:13 PM Pacific Daylight Time	08/05/2011 11:45:44 AM Pacific Daylight Time	08/04/2011 02:12:44 PM Pacific Daylight Time		08/08/2011 03:37:27 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA	Health Net of California	www.healthnet.com	Health Net Healthy Heart (HMO)	01	01		1			H0562	036	0	2012	San Joaquin, San Mateo, Solano Counties		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	2	2
H0562	037	0	1	01	01	H0562_037_0	6	1		07/21/2011	2012.02	07/21/2011 04:15:06 PM Pacific Daylight Time	08/05/2011 11:45:58 AM Pacific Daylight Time	08/04/2011 02:51:20 PM Pacific Daylight Time		08/08/2011 03:37:27 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA	Health Net of California	www.healthnet.com	Health Net Healthy Heart (HMO)	01	01		1			H0562	037	0	2012	Santa Clara county		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	2	2
H0562	039	0	1	01	01	H0562_039_0	6	1		07/21/2011	2012.02	07/21/2011 04:15:48 PM Pacific Daylight Time	08/05/2011 11:46:16 AM Pacific Daylight Time	08/04/2011 02:55:46 PM Pacific Daylight Time		08/08/2011 03:37:27 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA	Health Net of California	www.healthnet.com	Health Net Healthy Heart (HMO)	01	01		1			H0562	039	0	2012	Yolo county		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	2	2
H0562	040	0	1	01	01	H0562_040_0	6	1		07/21/2011	2012.02	07/21/2011 04:34:23 PM Pacific Daylight Time	08/05/2011 11:46:32 AM Pacific Daylight Time	08/04/2011 02:43:12 PM Pacific Daylight Time		08/08/2011 03:37:27 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA	Health Net of California	www.healthnet.com	Health Net Seniority Plus Ruby Plan 2 (HMO)	01	01		1			H0562	040	0	2012	San Diego County		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	2	2
H0562	044	0	1	01	01	H0562_044_0	4	1		07/21/2011	2012.02	07/21/2011 05:54:28 PM Central Daylight Time	07/21/2011 09:26:04 AM Pacific Daylight Time			07/21/2011 06:23:52 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA	Health Net of California	www.healthnet.com	Health Net Seniority Plus Green (HMO)	01	01		1			H0562	044	0	2012	Kern, L.A., Orange, Riverside, S.Bern., San Diego		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955										2	2	2
H0562	045	0	1	01	01	H0562_045_0	4	1		07/21/2011	2012.02	07/21/2011 05:54:55 PM Central Daylight Time	07/21/2011 09:26:20 AM Pacific Daylight Time			07/21/2011 06:23:52 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA	Health Net of California	www.healthnet.com	Health Net Seniority Plus Green (HMO)	01	01		1			H0562	045	0	2012	No. CA and Santa Barbara Counties		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955										2	2	2
H0562	053	0	1	01	01	H0562_053_0	6	1		07/21/2011	2012.02	07/21/2011 04:16:32 PM Pacific Daylight Time	08/05/2011 11:47:28 AM Pacific Daylight Time	08/04/2011 02:35:04 PM Pacific Daylight Time		08/08/2011 03:37:27 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA	Health Net of California	www.healthnet.com	Health Net Healthy Heart (HMO)	01	01		1			H0562	053	0	2012	Sonoma, Stanislaus Counties		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	2	2
H0562	055	0	1	01	01	H0562_055_0	4	1	2	07/12/2011	2012.02	07/12/2011 04:58:21 PM Pacific Daylight Time	08/05/2011 03:30:36 PM Pacific Daylight Time	08/04/2011 02:33:34 PM Pacific Daylight Time		08/08/2011 03:40:28 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA	Health Net of California	www.healthnet.com	Health Net Seniority Plus Amber I (HMO SNP)	01	01		1			H0562	055	0	2012	L.A., Kern, Orange, Riverside and San Bernardino		2		2			1	3		1	2		www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-431-9007		(800)-431-9007		(800)-935-6565		(800)-935-6565		(800)-431-9007		(800)-431-9007		(800)-935-6565		(800)-935-6565		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	2	2
H0562	068	0	1	01	01	H0562_068_0	6	1		07/21/2011	2012.02	07/21/2011 05:55:25 PM Central Daylight Time	08/05/2011 11:48:00 AM Pacific Daylight Time	08/04/2011 02:32:04 PM Pacific Daylight Time		08/08/2011 03:37:27 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA	Health Net of California	www.healthnet.com	Health Net Healthy Heart (HMO)	01	01		1			H0562	068	0	2012	Alameda County		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	2	2
H0562	070	0	1	01	01	H0562_070_0	6	1	2	08/11/2011	2012.02	08/11/2011 03:08:12 PM Pacific Daylight Time	08/11/2011 03:59:30 PM Pacific Daylight Time	08/04/2011 02:30:46 PM Pacific Daylight Time		08/12/2011 10:18:51 AM Pacific Daylight Time	HEALTH NET OF CALIFORNIA	Health Net of California	www.healthnet.com	Health Net Seniority Plus Amber II (HMO SNP)	01	01		1			H0562	070	0	2012	Parts of So. Cal., Alameda, Contra Costa, S.F.		2		2			1	3		1	2		www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-431-9007		(800)-431-9007		(800)-935-6565		(800)-935-6565		(800)-431-9007		(800)-431-9007		(800)-935-6565		(800)-935-6565		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	2	2
H0562	079	0	1	01	01	H0562_079_0	6	1		07/21/2011	2012.02	07/21/2011 04:35:03 PM Pacific Daylight Time	08/05/2011 11:48:26 AM Pacific Daylight Time	08/04/2011 02:29:20 PM Pacific Daylight Time		08/08/2011 03:37:27 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA	Health Net of California	www.healthnet.com	Health Net Seniority Plus Ruby (HMO)	01	01		1			H0562	079	0	2012	Kern County, CA		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	2	2
H0562	081	0	1	01	01	H0562_081_0	6	1		07/21/2011	2012.02	07/21/2011 04:17:18 PM Pacific Daylight Time	08/05/2011 11:48:40 AM Pacific Daylight Time	08/04/2011 02:27:50 PM Pacific Daylight Time		08/08/2011 03:37:27 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA	Health Net of California	www.healthnet.com	Health Net Seniority Plus Amber CHF (HMO SNP)	01	01		1			H0562	081	0	2012	Riverside and San Bernardino Counties		2		2			1	4		1		00001000000000000000	www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	2	2
H0562	082	0	1	01	01	H0562_082_0	6	1		07/21/2011	2012.02	07/21/2011 04:18:28 PM Pacific Daylight Time	08/05/2011 11:48:54 AM Pacific Daylight Time	08/04/2011 02:55:34 PM Pacific Daylight Time		08/08/2011 03:37:27 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA	Health Net of California	www.healthnet.com	Health Net Healthy Heart Plan 1 (HMO)	01	01		1			H0562	082	0	2012	LA, Orange, Riverside San Bernardino Counties		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	2	2
H0562	083	0	1	01	01	H0562_083_0	6	1		07/21/2011	2012.02	07/21/2011 04:30:27 PM Pacific Daylight Time	08/05/2011 11:49:10 AM Pacific Daylight Time	08/04/2011 02:54:50 PM Pacific Daylight Time		08/08/2011 03:37:27 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA	Health Net of California	www.healthnet.com	Health Net Seniority Plus Ruby Plan 1 (HMO)	01	01		1			H0562	083	0	2012	LA, Orange Riverside and San Bernardino Counties		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	2	2
H0562	084	0	1	01	01	H0562_084_0	6	1		07/21/2011	2012.02	07/21/2011 04:30:49 PM Pacific Daylight Time	08/05/2011 11:49:24 AM Pacific Daylight Time	08/04/2011 02:53:42 PM Pacific Daylight Time		08/08/2011 03:37:27 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA	Health Net of California	www.healthnet.com	Health Net Healthy Heart Plan 2 (HMO)	01	01		1			H0562	084	0	2012	Placer, Sacramento Counties		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	2	2
H0562	085	0	1	01	01	H0562_085_0	6	1		07/21/2011	2012.02	07/21/2011 04:31:11 PM Pacific Daylight Time	08/05/2011 11:49:38 AM Pacific Daylight Time	08/04/2011 02:53:14 PM Pacific Daylight Time		08/08/2011 03:37:27 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA	Health Net of California	www.healthnet.com	Salud con Health Net Medicare Advantage (HMO)	01	01		1			H0562	085	0	2012	LA, Orange, Riverside and San Bernardino Counties		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	2	2
H0562	086	0	1	01	01	H0562_086_0	6	1		07/21/2011	2012.02	07/21/2011 04:31:43 PM Pacific Daylight Time	08/05/2011 11:49:52 AM Pacific Daylight Time	08/04/2011 02:52:50 PM Pacific Daylight Time		08/08/2011 03:37:27 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA	Health Net of California	www.healthnet.com	Health Net Healthy Heart Plan 2 (HMO)	01	01		1			H0562	086	0	2012	LA, Org, Riverside and San Bernardino, San Diego		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	2	2
H0562	087	0	1	01	01	H0562_087_0	6	1		07/21/2011	2012.02	07/21/2011 04:19:34 PM Pacific Daylight Time	08/05/2011 11:50:06 AM Pacific Daylight Time	08/04/2011 02:52:08 PM Pacific Daylight Time		08/08/2011 03:37:27 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA	Health Net of California	www.healthnet.com	Health Net Healthy Heart Plan 1 (HMO)	01	01		1			H0562	087	0	2012	Placer and Sacramento Counties		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	2	2
H0562	088	0	1	01	01	H0562_088_0	6	1		07/21/2011	2012.02	07/21/2011 05:55:55 PM Central Daylight Time	08/05/2011 11:50:20 AM Pacific Daylight Time	08/04/2011 02:51:56 PM Pacific Daylight Time		08/08/2011 03:37:27 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA	Health Net of California	www.healthnet.com	Health Net Seniority Plus Ruby (HMO)	01	01		1			H0562	088	0	2012	San Joaquin County		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	2	2
H0562	089	0	1	01	01	H0562_089_0	6	1		07/21/2011	2012.02	07/21/2011 04:21:51 PM Pacific Daylight Time	08/05/2011 11:50:32 AM Pacific Daylight Time	08/04/2011 02:51:34 PM Pacific Daylight Time		08/08/2011 03:37:27 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA	Health Net of California	www.healthnet.com	Health Net Seniority Plus Ruby (HMO)	01	01		1			H0562	089	0	2012	Santa Clara County		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	2	2
H0562	801	0	1	01	01	H0562_801_0	2	1		05/31/2011	2012.02	05/31/2011 01:53:27 PM Pacific Daylight Time	06/05/2011 03:07:44 PM Pacific Daylight Time			06/05/2011 03:04:11 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA	Health Net of California	www.healthnet.com	Health Net Seniority Plus Employer (HMO)	01	01		1			H0562	801	0	2012	California		1		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	1	1
H0562	803	0	1	01	01	H0562_803_0	2	1		05/31/2011	2012.02	05/31/2011 01:38:00 PM Pacific Daylight Time	06/05/2011 03:08:04 PM Pacific Daylight Time			06/05/2011 03:04:11 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA	Health Net of California	www.healthnet.com	Health Net Seniority Plus Employer (HMO)	01	01		1			H0562	803	0	2012	California		1		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955										2	1	1
H0562	804	0	1	01	01	H0562_804_0	2	1		05/31/2011	2012.02	05/31/2011 01:38:22 PM Pacific Daylight Time	06/05/2011 03:08:24 PM Pacific Daylight Time			06/05/2011 03:04:11 PM Pacific Daylight Time	HEALTH NET OF CALIFORNIA	Health Net of California	www.healthnet.com	Health Net Seniority Plus Employer (HMO)	01	01		1			H0562	804	0	2012	California		1		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-275-4737		(800)-275-4737		(800)-935-6565		(800)-935-6565		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	1	1
H0564	006	0	1	01	01	H0564_006_0	10	1		08/08/2011	2012.02	08/08/2011 12:27:46 PM Eastern Daylight Time	08/09/2011 10:56:03 AM Eastern Daylight Time	08/08/2011 02:06:02 PM Eastern Daylight Time		08/09/2011 10:59:54 AM Eastern Daylight Time	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca/medicare	Blue Cross Senior Secure Plan I (HMO)	01	01		1			H0564	006	0	2012	Orange and Los Angeles Counties in California		2	3250	2			2							http://www.bluecrosscamedicarerx.com	www.bluecrossca.com	(888)-230-7338		(888)-230-7338		(800)-797-6438		(800)-797-6438		(888)-230-7338		(888)-230-7338		(800)-797-6438		(800)-797-6438		(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894		(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894		2	2	2
H0564	047	0	1	01	01	H0564_047_0	9	1		08/08/2011	2012.02	08/08/2011 12:28:54 PM Eastern Daylight Time	08/09/2011 10:56:13 AM Eastern Daylight Time	08/08/2011 02:06:11 PM Eastern Daylight Time		08/09/2011 10:59:54 AM Eastern Daylight Time	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca/medicare	Blue Cross Senior Secure Plan I (HMO)	01	01		1			H0564	047	0	2012	Select Counties in Southern California		2	7053	2			2							http://www.bluecrosscamedicarerx.com	www.bluecrossca.com	(888)-230-7338		(888)-230-7338		(800)-797-6438		(800)-797-6438		(888)-230-7338		(888)-230-7338		(800)-797-6438		(800)-797-6438		(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894		(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894		2	2	2
H0564	801	0	1	01	01	H0564_801_0	6	1		07/16/2011	2012.02	07/16/2011 12:58:24 PM Pacific Daylight Time	07/22/2011 08:38:53 AM Pacific Daylight Time			07/22/2011 01:55:09 PM Pacific Daylight Time	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca/medicare	Senior Secure (HMO)	01	01		1			H0564	801	0	2012	California, Select Counties		1	1205	2			2							http://www.bluecrosscamedicarerx.com	www.bluecrossca.com	(800)-225-2273		(800)-225-2273		(800)-225-2273		(800)-225-2273		(800)-225-2273		(800)-225-2273		(800)-225-2273		(800)-225-2273		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		2	2	2
H0564	810	0	1	01	01	H0564_810_0	6	1		07/01/2011	2012.02	07/01/2011 10:29:10 AM Pacific Daylight Time	07/22/2011 08:38:53 AM Pacific Daylight Time			07/22/2011 01:55:09 PM Pacific Daylight Time	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca/medicare	Senior Secure (HMO)	01	01		1			H0564	810	0	2012	California, Select Counties		1	50	2			2							http://www.bluecrosscamedicarerx.com	www.bluecrossca.com	(800)-225-2273		(800)-225-2273		(800)-225-2273		(800)-225-2273										(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657										2	2	2
H0564	811	0	1	01	01	H0564_811_0	5	1		06/05/2011	2012.02	06/05/2011 12:48:02 PM Pacific Daylight Time	07/22/2011 08:38:54 AM Pacific Daylight Time			07/22/2011 01:55:09 PM Pacific Daylight Time	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca/medicare	Senior Secure (HMO)	01	01		1			H0564	811	0	2012	CA, Select Counties		1	50	2			2							http://www.bluecrosscamedicarerx.com	www.bluecrossca.com	(800)-225-2273		(800)-225-2273		(800)-225-2273		(800)-225-2273		(800)-225-2273		(800)-225-2273		(800)-225-2273		(800)-225-2273		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		2	2	2
H0571	001	0	1	01	01	H0571_001_0	4	1		07/19/2011	2012.02	07/19/2011 01:14:32 PM Pacific Daylight Time	08/04/2011 03:23:58 PM Pacific Daylight Time	08/03/2011 02:49:34 PM Pacific Daylight Time		08/05/2011 03:17:30 PM Pacific Daylight Time	CHINESE COMMUNITY HEALTH PLAN	Chinese Community Health Plan	cchphmo.com	CCHP Senior Program (HMO)	01	01		1			H0571	001	0	2012	San Francisco County		2	4368	2			2							www.cchphmo.com/drugbenefitseniorprogram.html	www.cchphmo.com/drugbenefitseniorprogram.html	(888)-775-7888		(415)-834-2118		(888)-775-7888		(415)-955-8800		(888)-775-7888		(415)-834-2118		(888)-775-7888		(415)-955-8800		(877)-681-8898		(877)-681-8898		(877)-681-8898		(877)-681-8898		(877)-681-8898		(877)-681-8898		(877)-681-8898		(877)-681-8898		2	2	2
H0571	002	0	2	01	01	H0571_002_0	3	1		07/19/2011	2012.02	07/19/2011 01:14:52 PM Pacific Daylight Time	08/04/2011 03:27:55 PM Pacific Daylight Time	08/03/2011 02:53:25 PM Pacific Daylight Time		08/05/2011 03:17:30 PM Pacific Daylight Time	CHINESE COMMUNITY HEALTH PLAN	Chinese Community Health Plan	cchphmo.com	CCHP Senior Plan B-only Plan (HMO)	01	01		2	2		H0571	002	0	2012	San Francisco County		2	4	2			2							www.cchphmo.com/drugbenefitseniorprogram.html	www.cchphmo.com/drugbenefitseniorprogram.html	(888)-775-7888		(415)-834-2118		(888)-775-7888		(415)-834-2118		(888)-775-7888		(415)-834-2118		(888)-775-7888		(415)-834-2118		(877)-681-8898		(877)-681-8898		(877)-681-8898		(877)-681-8898		(877)-681-8898		(877)-681-8898		(877)-681-8898		(877)-681-8898		2	2	2
H0571	005	0	1	01	01	H0571_005_0	3	1	2	07/19/2011	2012.02	07/19/2011 01:15:08 PM Pacific Daylight Time	08/04/2011 03:29:05 PM Pacific Daylight Time	08/03/2011 02:54:56 PM Pacific Daylight Time		08/05/2011 03:17:30 PM Pacific Daylight Time	CHINESE COMMUNITY HEALTH PLAN	Chinese Community Health Plan	cchphmo.com	CCHP Senior Select Program (HMO SNP)	01	01		1			H0571	005	0	2012	San Francisco County		2	3825	2			1	3		1	3			www.cchphmo.com/drugbenefitseniorprogram.html	www.cchphmo.com/drugbenefitseniorprogram.html	(888)-775-7888		(415)-834-2118		(888)-775-7888		(415)-955-8800		(888)-775-7888		(415)-834-2118		(888)-775-7888		(415)-955-8800		(877)-681-8898		(877)-681-8898		(877)-681-8898		(877)-681-8898		(877)-681-8898		(877)-681-8898		(877)-681-8898		(877)-681-8898		2	2	2
H0571	801	0	1	01	01	H0571_801_0	3	1		07/19/2011	2012.02	07/19/2011 01:15:19 PM Pacific Daylight Time	06/30/2011 01:31:53 PM Pacific Daylight Time			07/19/2011 01:39:28 PM Pacific Daylight Time	CHINESE COMMUNITY HEALTH PLAN	Chinese Community Health Plan	cchphmo.com	CCHP Senior Plan  Employer-Only (HMO)	01	01		1			H0571	801	0	2012	San Francisco County		1	27	2			2							www.cchphmo.com/drugbenefitseniorprogram.html	www.cchphmo.com/drugbenefitseniorprogram.html	(888)-775-7888		(415)-834-2118		(888)-775-7888		(415)-955-8800		(888)-775-7888		(415)-834-2118		(888)-775-7888		(415)-955-8800		(877)-681-8898		(877)-681-8898		(877)-681-8898		(877)-681-8898		(877)-681-8898		(877)-681-8898		(877)-681-8898		(877)-681-8898		2	2	2
H0602	001	0	1	18	06	H0602_001_0	3	1		06/03/2011	2012.01	06/03/2011 01:47:05 PM Mountain Daylight Time				06/06/2011 01:55:40 PM Mountain Daylight Time	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION	Rocky Mountain Health Plans	www.rmhpmedicare.org	Rocky Mountain Standard Plan (Cost)	06	18		1			H0602	001	0	2012	Western Slope Colorado		2	5400	2			2							http://www.rmhpmedicare.org	www.rmhpmedicare.org	(888)-282-1420		(970)-244-7912		(888)-282-1420		(970)-244-7912										(711)		(711)		(711)		(711)										2	2	2
H0602	003	0	1	18	06	H0602_003_0	4	1		08/15/2011	2012.01	08/15/2011 07:34:00 AM Mountain Daylight Time				08/15/2011 08:31:54 AM Mountain Daylight Time	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION	Rocky Mountain Health Plans	www.rmhpmedicare.org	Rocky Mountain Plus Plan (Cost)	06	18		1			H0602	003	0	2012	Colorado		2	50	2			2							http://www.rmhpmedicare.org	www.rmhpmedicare.org	(888)-282-1420		(970)-244-7912		(888)-282-1420		(970)-244-7912										(711)		(711)		(711)		(711)										2	2	2
H0602	007	0	1	18	06	H0602_007_0	5	1		08/15/2011	2012.01	08/15/2011 07:34:46 AM Mountain Daylight Time				08/15/2011 08:31:54 AM Mountain Daylight Time	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION	Rocky Mountain Health Plans	www.rmhpmedicare.org	Rocky Mountain Standard Plan (Cost)	06	18		1			H0602	007	0	2012	Front Range Colorado		2	500	2			2							http://www.rmhpmedicare.org	www.rmhpmedicare.org	(888)-282-1420		(970)-244-7912		(888)-282-1420		(970)-244-7912										(711)		(711)		(711)		(711)										2	2	2
H0602	009	0	1	18	06	H0602_009_0	4	1		08/15/2011	2012.01	08/15/2011 07:35:04 AM Mountain Daylight Time				08/15/2011 08:31:54 AM Mountain Daylight Time	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION	Rocky Mountain Health Plans	www.rmhpmedicare.org	Rocky Mountain Standard Plan (Cost)	06	18		1			H0602	009	0	2012	Denver/Boulder Metro Area		2	500	2			2							http://www.rmhpmedicare.org	www.rmhpmedicare.org	(888)-282-1420		(970)-244-7912		(888)-282-1420		(970)-244-7912										(711)		(711)		(711)		(711)										2	2	2
H0602	017	0	1	18	06	H0602_017_0	3	1		06/06/2011	2012.01	06/06/2011 10:02:31 AM Mountain Daylight Time		06/03/2011 02:27:55 PM Mountain Daylight Time		06/06/2011 01:55:40 PM Mountain Daylight Time	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION	Rocky Mountain Health Plans	www.rmhpmedicare.org	Rocky Mountain Standard Plan + Rx (Cost)	06	18		1			H0602	017	0	2012	Western Slope Colorado		2	5800	2			2							http://www.rmhpmedicare.org	www.rmhpmedicare.org	(888)-282-1420		(970)-244-7912		(888)-282-1420		(970)-244-7912		(888)-282-1420		(970)-244-7912		(888)-282-1420		(970)-244-7912		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0602	019	0	1	18	06	H0602_019_0	6	1		08/15/2011	2012.01	08/15/2011 08:26:40 AM Mountain Daylight Time		08/15/2011 08:53:36 AM Mountain Daylight Time		08/15/2011 09:21:46 AM Mountain Daylight Time	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION	Rocky Mountain Health Plans	www.rmhpmedicare.org	Rocky Mountain Plus Plan + Rx (Cost)	06	18		1			H0602	019	0	2012	Colorado		2	50	2			2							http://www.rmhpmedicare.org	www.rmhpmedicare.org	(888)-282-1420		(970)-244-7912		(888)-282-1420		(970)-244-7912		(888)-282-1420		(970)-244-7912		(888)-282-1420		(970)-244-7912		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0602	020	0	1	18	06	H0602_020_0	6	1		08/15/2011	2012.01	08/15/2011 08:26:58 AM Mountain Daylight Time		08/08/2011 11:05:39 AM Mountain Daylight Time		08/15/2011 09:21:46 AM Mountain Daylight Time	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION	Rocky Mountain Health Plans	www.rmhpmedicare.org	Rocky Mountain Standard Plan + Rx (Cost)	06	18		1			H0602	020	0	2012	Front Range Colorado		2	2300	2			2							http://www.rmhpmedicare.org	www.rmhpmedicare.org	(888)-282-1420		(970)-244-7912		(888)-282-1420		(970)-244-7912		(888)-282-1420		(970)-244-7912		(888)-282-1420		(970)-244-7912		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0602	022	0	1	18	06	H0602_022_0	6	1		08/15/2011	2012.01	08/15/2011 08:27:09 AM Mountain Daylight Time		08/08/2011 11:06:15 AM Mountain Daylight Time		08/15/2011 09:21:46 AM Mountain Daylight Time	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION	Rocky Mountain Health Plans	www.rmhpmedicare.org	Rocky Mountain Standard Plan + Rx (Cost)	06	18		1			H0602	022	0	2012	Denver/Boulder Metro Area		2	2025	2			2							http://www.rmhpmedicare.org	www.rmhpmedicare.org	(888)-282-1420		(970)-244-7912		(888)-282-1420		(970)-244-7912		(888)-282-1420		(970)-244-7912		(888)-282-1420		(970)-244-7912		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0602	026	0	1	18	06	H0602_026_0	1	1		06/06/2011	2012.01	06/06/2011 02:47:17 PM Mountain Daylight Time				06/06/2011 03:25:51 PM Mountain Daylight Time	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION	Rocky Mountain Health Plans	www.rmhpmedicare.org	AB Basic Plan (Cost)	06	18		1			H0602	026	0	2012	Colorado		2	1300	2			2							http://www.rmhpmedicare.org	www.rmhpmedicare.org	(888)-282-1420		(970)-244-7912		(888)-282-1420		(970)-244-7912										(711)		(711)		(711)		(711)										2	2	2
H0602	027	0	1	18	06	H0602_027_0	2	1		06/06/2011	2012.01	06/06/2011 03:17:36 PM Mountain Daylight Time				06/06/2011 03:25:51 PM Mountain Daylight Time	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION	Rocky Mountain Health Plans	www.rmhpmedicare.org	Rocky Mountain Thrifty Plan (Cost)	06	18		1			H0602	027	0	2012	Colorado		2	780	2			2							http://www.rmhpmedicare.org	www.rmhpmedicare.org	(888)-282-1420		(970)-244-7912		(888)-282-1420		(970)-244-7912										(711)		(711)		(711)		(711)										2	2	2
H0602	039	0	1	18	06	H0602_039_0	2	1		06/06/2011	2012.01	06/06/2011 03:17:51 PM Mountain Daylight Time		06/06/2011 01:47:52 PM Mountain Daylight Time		06/06/2011 03:25:51 PM Mountain Daylight Time	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION	Rocky Mountain Health Plans	www.rmhpmedicare.org	Rocky Mountain Thrifty Plan + Rx (Cost)	06	18		1			H0602	039	0	2012	Colorado		2	950	2			2							http://www.rmhpmedicare.org	www.rmhpmedicare.org	(888)-282-1420		(970)-244-7912		(888)-282-1420		(970)-244-7912		(888)-282-1420		(970)-244-7912		(888)-282-1420		(970)-244-7912		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0602	040	0	2	18	06	H0602_040_0	1	1		06/06/2011	2012.01	06/06/2011 08:17:41 PM Mountain Daylight Time				06/06/2011 08:18:52 PM Mountain Daylight Time	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION	Rocky Mountain Health Plans	www.rmhpmedicare.org	B Basic Plan (Cost)	06	18		2	2		H0602	040	0	2012	Colorado		2	5	2			2							http://www.rmhpmedicare.org	www.rmhpmedicare.org	(888)-282-1420		(970)-244-7912		(888)-282-1420		(970)-244-7912										(711)		(711)		(711)		(711)										2	2	2
H0602	041	0	2	18	06	H0602_041_0	3	1		06/03/2011	2012.01	06/03/2011 01:30:58 PM Mountain Daylight Time				06/06/2011 01:55:40 PM Mountain Daylight Time	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION	Rocky Mountain Health Plans	www.rmhpmedicare.org	B Standard Plan (Cost)	06	18		2	2		H0602	041	0	2012	Colorado		2	10	2			2							http://www.rmhpmedicare.org	www.rmhpmedicare.org	(888)-282-1420		(970)-244-7912		(888)-282-1420		(970)-244-7912										(711)		(711)		(711)		(711)										2	2	2
H0602	042	0	1	18	06	H0602_042_0	3	1		06/03/2011	2012.01	06/03/2011 03:33:45 PM Mountain Daylight Time				06/06/2011 01:55:40 PM Mountain Daylight Time	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION	Rocky Mountain Health Plans	www.rmhpmedicare.org	Rocky Mountain Green Plan (Cost)	06	18		1			H0602	042	0	2012	Colorado		2	850	2			2							http://www.rmhpmedicare.org	www.rmhpmedicare.org	(888)-282-1420		(970)-244-7912		(888)-282-1420		(970)-244-7912										(711)		(711)		(711)		(711)										2	2	2
H0602	043	0	1	18	06	H0602_043_0	4	1		06/03/2011	2012.01	06/03/2011 01:43:50 PM Mountain Daylight Time		06/03/2011 04:26:58 PM Mountain Daylight Time		06/06/2011 01:55:40 PM Mountain Daylight Time	ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION	Rocky Mountain Health Plans	https://www.rmhpmedicare.org	Rocky Mountain Green Plan + Rx (Cost)	06	18		1			H0602	043	0	2012	Colorado		2	2100	2			2							http://www.rmhpmedicare.org	www.rmhpmedicare.org	(888)-282-1420		(970)-244-7912		(888)-282-1420		(970)-244-7912		(888)-282-1420		(970)-244-7912		(888)-282-1420		(970)-244-7912		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0602	801	0		18	06	H0602_801_0	2	1		04/20/2011	2012.01						ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION	Rocky Mountain Health Plans	www.rmhpmedicare.org	Group Plus Plan (Cost)	06	18					H0602	801	0	2012	Colorado		1					2							http://www.rmhpmedicare.org	www.rmhpmedicare.org	(888)-282-1420		(970)-244-7912		(888)-282-1420				(888)-282-1420		(970)-244-7912		(888)-282-1420		(970)-244-7912		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)				
H0609	002	0	1	01	01	H0609_002_0	5	1		08/08/2011	2012.02	08/08/2011 11:12:42 AM Central Daylight Time	08/05/2011 04:40:06 PM Central Daylight Time	08/05/2011 01:20:25 PM Central Daylight Time		08/09/2011 01:25:28 PM Central Daylight Time	PACIFICARE OF COLORADO, INC	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 1 (HMO)	01	01		1			H0609	002	0	2012	El Paso, Larimer, and Teller counties		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0609	007	0	1	01	01	H0609_007_0	5	1		08/05/2011	2012.02	08/05/2011 02:53:35 PM Central Daylight Time	08/05/2011 04:41:17 PM Central Daylight Time	08/05/2011 01:20:41 PM Central Daylight Time		08/09/2011 01:25:28 PM Central Daylight Time	PACIFICARE OF COLORADO, INC	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 1 (HMO)	01	01		1			H0609	007	0	2012	Denver Metro area		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0609	012	0	1	01	01	H0609_012_0	5	1		08/05/2011	2012.02	08/05/2011 02:54:45 PM Central Daylight Time	08/05/2011 04:42:22 PM Central Daylight Time	08/05/2011 01:20:55 PM Central Daylight Time		08/09/2011 01:25:28 PM Central Daylight Time	PACIFICARE OF COLORADO, INC	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 2 (HMO)	01	01		1			H0609	012	0	2012	Denver Metro area		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0609	015	0	1	01	01	H0609_015_0	4	1		07/20/2011	2012.02	07/20/2011 01:59:40 PM Central Daylight Time	07/22/2011 02:02:30 PM Central Daylight Time			07/25/2011 01:50:27 PM Central Daylight Time	PACIFICARE OF COLORADO, INC	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Essential (HMO)	01	01		1			H0609	015	0	2012	El Paso, Fremont, Larimer, Pueblo, Teller counties		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514										(711)		(711)		(711)		(711)										2	2	2
H0609	018	0	1	01	01	H0609_018_0	3	1		07/20/2011	2012.02	07/20/2011 01:59:54 PM Central Daylight Time	07/22/2011 02:03:29 PM Central Daylight Time			07/25/2011 01:50:27 PM Central Daylight Time	PACIFICARE OF COLORADO, INC	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Essential (HMO)	01	01		1			H0609	018	0	2012	Denver Metro area		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514										(711)		(711)		(711)		(711)										2	2	2
H0609	020	0	1	01	01	H0609_020_0	5	1		08/05/2011	2012.02	08/05/2011 02:55:57 PM Central Daylight Time	08/05/2011 04:43:33 PM Central Daylight Time	08/05/2011 01:21:10 PM Central Daylight Time		08/09/2011 01:25:28 PM Central Daylight Time	PACIFICARE OF COLORADO, INC	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 2 (HMO)	01	01		1			H0609	020	0	2012	Select counties		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0609	801	0	1	01	01	H0609_801_0	2	1		07/06/2011	2012.02	07/06/2011 04:36:37 PM Central Daylight Time	06/03/2011 02:19:00 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	PACIFICARE OF COLORADO, INC	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0609	801	0	2012	CO Employer Sponsored Plan Service Area		1		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548										(711)		(711)		(711)		(711)										2	2	2
H0609	804	0	1	01	01	H0609_804_0	2	1		07/06/2011	2012.02	07/06/2011 04:36:42 PM Central Daylight Time	06/03/2011 02:19:17 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	PACIFICARE OF COLORADO, INC	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0609	804	0	2012	CO Employer Sponsored Plan Service Area		1		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0609	805	0	1	01	01	H0609_805_0	2	1		07/06/2011	2012.02	07/06/2011 04:36:47 PM Central Daylight Time	06/03/2011 02:19:36 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	PACIFICARE OF COLORADO, INC	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0609	805	0	2012	CO Employer Sponsored Plan Service Area		1		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0609	806	0	2	01	01	H0609_806_0	2	1		07/06/2011	2012.02	07/06/2011 04:24:55 PM Central Daylight Time	06/03/2011 02:19:54 PM Central Daylight Time			07/21/2011 08:26:26 AM Central Daylight Time	PACIFICARE OF COLORADO, INC	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		2	2		H0609	806	0	2012	CO Employer Sponsored Plan Service Area		1		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0613	001	0	1	20	08	H0613_001_0	1	1		05/27/2011	2012.02	05/27/2011 01:44:16 PM Mountain Daylight Time		05/27/2011 11:59:49 AM Mountain Daylight Time		05/27/2011 01:50:27 PM Mountain Daylight Time	TOTAL LONGTERM CARE, INC.	Total Longterm Care, Inc.	totallongtermcare.org	Total Longterm Care - Dual eligibles (PACE)	08	20		1			H0613	001	0	2012	Metropolitan Denver		2		1	1		2							http://www.totallongtermcare.org/services.html	http://www.totallongtermcare.org									(877)-277-6163		(303)-869-4664		(877)-277-6163		(303)-869-4664										(877)-277-6163		(303)-869-4664		(877)-277-6163		(303)-869-4664				
H0613	003	0	1	20	08	H0613_003_0	1	1		05/27/2011	2012.02	05/27/2011 01:45:08 PM Mountain Daylight Time		05/27/2011 11:59:49 AM Mountain Daylight Time		05/27/2011 01:50:27 PM Mountain Daylight Time	TOTAL LONGTERM CARE, INC.	Total Longterm Care, Inc.	totallongtermcare.org	Total Longterm Care - Medicare only (PACE)	08	20		1			H0613	003	0	2012	Metropolitian Denver		2		1	1		2							http://www.totallongtermcare.org/services.html	http://www.totallongtermcare.org									(303)-869-4664		(303)-869-4664		(877)-277-6163		(303)-869-4664										(877)-277-6163		(303)-869-4664		(877)-277-6163		(303)-869-4664				
H0620	002	0	1	04	01	H0620_002_0	3	1		08/09/2011	2012.02	08/09/2011 03:48:04 PM Central Daylight Time	08/09/2011 07:45:16 AM Central Daylight Time	08/05/2011 12:54:25 PM Central Daylight Time		08/09/2011 03:53:30 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	Evercare by UnitedHealthcare	www.EvercareHealthPlans.com	UnitedHealthcare Nursing Home Plan (PPO SNP)	01	04		1			H0620	002	0	2012	Denver and Colorado Springs areas		2		2			1	1	1	1			www.EvercareHealthPlans.com	evercarehealthplans.com/prescription_drug_coverage.jsp	www.PrescriptionSolutions.com	(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0621	006	0	1	01	01	H0621_006_0	8	1		08/09/2011	2012.02	08/09/2011 11:23:31 AM Mountain Daylight Time	08/09/2011 12:29:38 PM Mountain Daylight Time	08/09/2011 12:29:38 PM Mountain Daylight Time		08/09/2011 03:40:08 PM Mountain Daylight Time	COLORADO ACCESS	Colorado Access	www.coaccess.com	Colorado Access Advantage - Plan E (HMO)	01	01		1			H0621	006	0	2012	Denver Metro, El Paso, San Luis Valley, Northeast		2	1038	1	1		2						http://www.coaccess.com/our-medicare-plans	www.coaccess.com/our-medicare-plans	www.coaccess.com/our-medicare-plans	(877)-441-6032		(303)-751-2657		(877)-287-6767		(303)-751-2436		(877)-441-6032		(303)-751-2657		(877)-287-6767		(303)-751-2436		(888)-803-4494		(888)-803-4494		(888)-803-4494		(888)-803-4494		(888)-803-4494		(888)-803-4494		(888)-803-4494		(888)-803-4494		2	2	2
H0621	010	0	1	01	01	H0621_010_0	7	1	2	08/05/2011	2012.02	08/05/2011 09:56:12 AM Mountain Daylight Time	08/09/2011 12:33:17 PM Mountain Daylight Time	08/09/2011 12:33:17 PM Mountain Daylight Time		08/09/2011 03:40:08 PM Mountain Daylight Time	COLORADO ACCESS	Colorado Access	www.coaccess.com	Colorado Access Advantage Dual Plan (HMO SNP)	01	01		1			H0621	010	0	2012	Denver Metro, El Paso, San Luis Valley, Northeast		2	2345	1	1		1	3		1	4		http://www.coaccess.com/our-medicare-plans	www.coaccess.com/our-medicare-plans	www.coaccess.com/our-medicare-plans	(877)-441-6032		(303)-751-2657		(877)-287-6767		(303)-751-2436		(877)-441-6032		(303)-751-2657		(877)-287-6767		(303)-751-2436		(888)-803-4494		(888)-803-4494		(888)-803-4494		(888)-803-4494		(888)-803-4494		(888)-803-4494		(888)-803-4494		(888)-803-4494		2	2	2
H0623	001	0	1	04	01	H0623_001_0	4	1		08/08/2011	2012.02	08/08/2011 11:48:11 AM Eastern Daylight Time	08/05/2011 05:42:02 PM Eastern Daylight Time	08/04/2011 11:07:58 AM Eastern Daylight Time		08/08/2011 04:32:56 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H0623-001 (PPO)	01	04		1			H0623	001	0	2012	Colorado's I-25 Corridor/Grand Junction areas		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0623	009	0	1	04	01	H0623_009_0	2	1		07/05/2011	2012.02	07/05/2011 11:07:56 AM Eastern Daylight Time	06/03/2011 04:15:47 PM Eastern Daylight Time			07/06/2011 03:34:15 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H0623-009 (PPO)	01	04		1			H0623	009	0	2012	Colorado's I-25 Corridor/Grand Junction areas		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H0623	011	0	1	04	01	H0623_011_0	5	1		08/08/2011	2012.02	08/08/2011 11:48:28 AM Eastern Daylight Time	08/05/2011 05:45:56 PM Eastern Daylight Time	08/04/2011 11:08:19 AM Eastern Daylight Time		08/08/2011 04:32:56 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H0623-011 (PPO)	01	04		1			H0623	011	0	2012	Colorado's I-25 Corridor/Grand Junction areas		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0624	001	0	1	01	01	H0624_001_0	7	1	2	07/22/2011	2012.02	07/22/2011 11:45:03 AM Central Daylight Time	08/09/2011 01:58:05 PM Central Daylight Time	08/05/2011 12:54:46 PM Central Daylight Time		08/09/2011 02:22:44 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	Evercare by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H0624	001	0	2012	Denver, Colorado Springs area		2		2			1	3		1	2		www.EvercareHealthPlans.com	evercarehealthplans.com/prescription_drug_coverage.jsp	www.PrescriptionSolutions.com	(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0630	013	0	1	01	01	H0630_013_0	5	1		07/29/2011	2012.02	07/29/2011 03:11:27 PM Mountain Daylight Time	08/04/2011 04:53:44 PM Mountain Daylight Time	08/04/2011 10:59:42 AM Mountain Daylight Time		08/05/2011 01:34:23 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage Core (HMO)	01	01		1			H0630	013	0	2012	Denver Metro Area		2	9315	2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-476-2167		(303)-338-3800		(877)-408-3492		(877)-408-3492		(800)-476-2167		(303)-338-3800		(877)-408-3492		(877)-408-3492		(866)-513-9964		(303)-338-3820		(888)-758-6054		(888)-758-6054		(866)-513-9964		(303)-338-3820		(888)-758-6054		(888)-758-6054		2	2	2
H0630	014	0	1	01	01	H0630_014_0	8	1	2	07/29/2011	2012.02	07/29/2011 03:11:03 PM Mountain Daylight Time	08/05/2011 08:59:02 AM Mountain Daylight Time	08/04/2011 11:05:46 AM Mountain Daylight Time		08/05/2011 01:34:23 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente Senior Advantage	kp.org/medicare	Senior Advantage Medicare Medicaid Plan (HMO SNP)	01	01		1			H0630	014	0	2012	Denver Metro Area		2	2234	2			1	3		1	2		kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-476-2167		(303)-338-3800		(877)-408-3492		(877)-408-3492		(800)-476-2167		(303)-338-3800		(877)-408-3492		(877)-408-3492		(866)-513-9964		(303)-338-3820		(888)-758-6054		(888)-758-6054		(866)-513-9964		(303)-338-3820		(888)-758-6054		(888)-758-6054		2	2	2
H0630	015	0	1	01	01	H0630_015_0	9	1		07/29/2011	2012.02	07/29/2011 03:10:46 PM Mountain Daylight Time	08/04/2011 04:57:10 PM Mountain Daylight Time	08/04/2011 11:09:46 AM Mountain Daylight Time		08/05/2011 01:34:23 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage Silver (HMO)	01	01		1			H0630	015	0	2012	Denver Metro Area		2	28307	2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-476-2167		(303)-338-3800		(877)-408-3492		(877)-408-3492		(800)-476-2167		(303)-338-3800		(877)-408-3492		(877)-408-3492		(866)-513-9964		(303)-338-3820		(888)-758-6054		(888)-758-6054		(866)-513-9964		(303)-338-3820		(888)-758-6054		(888)-758-6054		2	2	2
H0630	016	0	1	01	01	H0630_016_0	5	1		07/29/2011	2012.02	07/29/2011 03:10:00 PM Mountain Daylight Time	08/04/2011 04:58:04 PM Mountain Daylight Time	08/04/2011 11:19:24 AM Mountain Daylight Time		08/05/2011 01:34:23 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage Gold (HMO)	01	01		1			H0630	016	0	2012	Denver Metro Area		2	3409	2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-476-2167		(303)-338-3800		(877)-408-3492		(877)-408-3492		(800)-476-2167		(303)-338-3800		(877)-408-3492		(877)-408-3492		(866)-513-9964		(303)-338-3820		(888)-758-6054		(888)-758-6054		(866)-513-9964		(303)-338-3820		(888)-758-6054		(888)-758-6054		2	2	2
H0630	017	0	1	01	01	H0630_017_0	6	1		07/29/2011	2012.02	07/29/2011 03:09:30 PM Mountain Daylight Time	08/04/2011 05:01:26 PM Mountain Daylight Time	08/04/2011 11:25:34 AM Mountain Daylight Time		08/05/2011 01:34:23 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage Core (HMO)	01	01		1			H0630	017	0	2012	Southern Colorado		2	1962	2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-476-2167		(303)-338-3800		(877)-408-3492		(877)-408-3492		(800)-476-2167		(303)-338-3800		(877)-408-3492		(877)-408-3492		(866)-513-9964		(303)-338-3820		(888)-758-6054		(888)-758-6054		(866)-513-9964		(303)-338-3820		(888)-758-6054		(888)-758-6054		2	2	2
H0630	018	0	1	01	01	H0630_018_0	5	1		07/29/2011	2012.02	07/29/2011 03:09:07 PM Mountain Daylight Time	08/04/2011 05:03:34 PM Mountain Daylight Time	08/04/2011 11:30:44 AM Mountain Daylight Time		08/05/2011 01:34:23 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage Silver (HMO)	01	01		1			H0630	018	0	2012	Southern Colorado		2	842	2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-476-2167		(303)-338-3800		(877)-408-3492		(877)-408-3492		(800)-476-2167		(303)-338-3800		(877)-408-3492		(877)-408-3492		(866)-513-9964		(303)-338-3820		(888)-758-6054		(888)-758-6054		(866)-513-9964		(303)-338-3820		(888)-758-6054		(888)-758-6054		2	2	2
H0630	019	0	1	02	01	H0630_019_0	5	1		07/29/2011	2012.02	07/29/2011 03:08:48 PM Mountain Daylight Time	08/04/2011 04:59:30 PM Mountain Daylight Time	08/04/2011 11:22:14 AM Mountain Daylight Time		08/05/2011 01:34:23 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage Plus Choice (HMO-POS)	01	02		1			H0630	019	0	2012	Denver Metro Area		2	854	2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-476-2167		(303)-338-3800		(877)-408-3492		(877)-408-3492		(800)-476-2167		(303)-338-3800		(877)-408-3492		(877)-408-3492		(866)-513-9964		(303)-338-3820		(888)-758-6054		(888)-758-6054		(866)-513-9964		(303)-338-3820		(888)-758-6054		(888)-758-6054		2	2	2
H0630	805	0	2	01	01	H0630_805_0	4	1		07/29/2011	2012.02	07/29/2011 03:08:22 PM Mountain Daylight Time	07/22/2011 04:25:22 PM Mountain Daylight Time			07/29/2011 04:18:18 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente Senior Advantage	kp.org/medicare	Senior Advantage Group MA-PD_Part B only (HMO)	01	01		2	1		H0630	805	0	2012	Denver Metro Area		1	638	2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-476-2167		(303)-338-3800		(800)-509-7570		(800)-509-7570		(800)-476-2167		(303)-338-3800		(800)-509-7570		(800)-509-7570		(866)-513-9964		(303)-338-3820		(888)-758-6054		(888)-758-6054		(866)-513-9964		(303)-338-3820		(888)-758-6054		(888)-758-6054		2	2	2
H0630	806	0	2	01	01	H0630_806_0	4	1		07/29/2011	2012.02	07/29/2011 03:07:45 PM Mountain Daylight Time	07/22/2011 04:26:42 PM Mountain Daylight Time			07/29/2011 04:18:18 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente Senior Advantage	kp.org/medicare	Senior Advantage Group MA only_Part B only (HMO)	01	01		2	1		H0630	806	0	2012	Denver Metro Area		1	0	2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-476-2167		(303)-338-3800		(800)-509-7570		(800)-509-7570										(866)-513-9964		(303)-338-3820		(888)-758-6054		(888)-758-6054										2	2	2
H0630	807	0	1	01	01	H0630_807_0	4	1		07/29/2011	2012.02	07/29/2011 03:06:58 PM Mountain Daylight Time	07/22/2011 04:27:26 PM Mountain Daylight Time			07/29/2011 04:18:18 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente Senior Advantage	kp.org/medicare	Senior Advantage Group MA-PD (HMO)	01	01		1			H0630	807	0	2012	Denver Metro Area		1	21913	2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-476-2167		(303)-338-3800		(800)-509-7570		(800)-509-7570		(800)-476-2167		(303)-338-3800		(800)-509-7570		(800)-509-7570		(866)-513-9964		(303)-338-3820		(888)-758-6054		(888)-758-6054		(866)-513-9964		(303)-338-3820		(888)-758-6054		(888)-758-6054		2	2	2
H0630	808	0	1	01	01	H0630_808_0	4	1		07/29/2011	2012.02	07/29/2011 03:06:06 PM Mountain Daylight Time	07/22/2011 04:31:18 PM Mountain Daylight Time			07/29/2011 04:18:18 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente Senior Advantage	kp.org/medicare	Senior Adv_Group_MA only (HMO)	01	01		1			H0630	808	0	2012	Denver Metro Area		1	1102	2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-476-2167		(303)-338-3800		(800)-509-7570		(800)-509-7570										(866)-513-9964		(303)-338-3820		(888)-758-6054		(888)-758-6054										2	2	2
H0630	809	0	2	01	01	H0630_809_0	4	1		07/29/2011	2012.02	07/29/2011 03:05:25 PM Mountain Daylight Time	07/22/2011 04:32:22 PM Mountain Daylight Time			07/29/2011 04:18:18 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente Senior Advantage	kp.org/medicare	FEHB B only with D (HMO)	01	01		2	1		H0630	809	0	2012	Denver Metro Area		1	11	2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-476-2167		(303)-338-3800		(800)-509-7570		(800)-509-7570		(800)-476-2167		(303)-338-3800		(800)-509-7570		(800)-509-7570		(866)-513-9964		(303)-338-3820		(888)-758-6054		(888)-758-6054		(866)-513-9964		(303)-338-3820		(888)-758-6054		(888)-758-6054		2	2	2
H0630	810	0	1	01	01	H0630_810_0	4	1		07/29/2011	2012.02	07/29/2011 03:04:58 PM Mountain Daylight Time	07/22/2011 04:33:10 PM Mountain Daylight Time			07/29/2011 04:18:18 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente Senior Advantage	kp.org/medicare	FEHB AB with D (HMO)	01	01		1			H0630	810	0	2012	Denver Metro Area		1	2458	2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-476-2167		(303)-338-3800		(800)-509-7570		(800)-509-7570		(800)-476-2167		(303)-338-3800		(800)-509-7570		(800)-509-7570		(866)-513-9964		(303)-338-3820		(888)-758-6054		(888)-758-6054		(866)-513-9964		(303)-338-3820		(888)-758-6054		(888)-758-6054		2	2	2
H0630	811	0	2	01	01	H0630_811_0	4	1		07/29/2011	2012.02	07/29/2011 03:04:33 PM Mountain Daylight Time	07/22/2011 04:34:56 PM Mountain Daylight Time			07/29/2011 04:18:18 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente Senior Advantage	kp.org/medicare	Senior Advantage Group MA-PD_Part B only (HMO)	01	01		2	1		H0630	811	0	2012	Southern Colorado		1	42	2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-476-2167		(303)-338-3800		(800)-509-7570		(800)-509-7570		(800)-476-2167		(303)-338-3800		(800)-509-7570		(800)-509-7570		(866)-513-9964		(303)-338-3820		(888)-758-6054		(888)-758-6054		(866)-513-9964		(303)-338-3820		(888)-758-6054		(888)-758-6054		2	2	2
H0630	812	0	2	01	01	H0630_812_0	4	1		07/29/2011	2012.02	07/29/2011 03:03:15 PM Mountain Daylight Time	07/22/2011 04:35:42 PM Mountain Daylight Time			07/29/2011 04:18:18 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente Senior Advantage	kp.org/medicare	Senior Advantage Group MA only_Part B only (HMO)	01	01		2	1		H0630	812	0	2012	Southern Colorado		1	0	2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-476-2167		(303)-338-3800		(800)-509-7570		(800)-509-7570										(866)-513-9964		(303)-338-3820		(888)-758-6054		(888)-758-6054										2	2	2
H0630	813	0	1	01	01	H0630_813_0	4	1		07/29/2011	2012.02	07/29/2011 03:02:35 PM Mountain Daylight Time	07/22/2011 04:36:16 PM Mountain Daylight Time			07/29/2011 04:18:18 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente Senior Advantage	kp.org/medicare	Senior Advantage Group MA-PD (HMO)	01	01		1			H0630	813	0	2012	Southern Colorado		1	2511	2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-476-2167		(303)-338-3800		(800)-509-7570		(800)-509-7570		(800)-476-2167		(303)-338-3800		(800)-509-7570		(800)-509-7570		(866)-513-9964		(303)-338-3820		(888)-758-6054		(888)-758-6054		(866)-513-9964		(303)-338-3820		(888)-758-6054		(888)-758-6054		2	2	2
H0630	814	0	1	01	01	H0630_814_0	4	1		07/29/2011	2012.02	07/29/2011 03:00:16 PM Mountain Daylight Time	07/22/2011 04:37:06 PM Mountain Daylight Time			07/29/2011 04:18:18 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente Senior Advantage	kp.org/medicare	Senior Adv Group_MA only (HMO)	01	01		1			H0630	814	0	2012	Southern Colorado		1	3	2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-476-2167		(303)-338-3800		(800)-509-7570		(800)-509-7570										(866)-513-9964		(303)-338-3820		(888)-758-6054		(888)-758-6054										2	2	2
H0630	815	0	2	01	01	H0630_815_0	4	1		07/29/2011	2012.02	07/29/2011 02:58:45 PM Mountain Daylight Time	07/22/2011 04:38:52 PM Mountain Daylight Time			07/29/2011 04:18:18 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente Senior Advantage	kp.org/medicare	FEHB B only with D (HMO)	01	01		2	1		H0630	815	0	2012	Southern Colorado		1	0	2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-476-2167		(303)-338-3800		(800)-509-7570		(800)-509-7570		(800)-476-2167		(303)-338-3800		(800)-509-7570		(800)-509-7570		(866)-513-9964		(303)-338-3820		(888)-758-6054		(888)-758-6054		(866)-513-9964		(303)-338-3820		(888)-758-6054		(888)-758-6054		2	2	2
H0630	816	0	1	01	01	H0630_816_0	4	1		07/29/2011	2012.02	07/29/2011 02:58:11 PM Mountain Daylight Time	07/22/2011 04:39:30 PM Mountain Daylight Time			07/29/2011 04:18:18 PM Mountain Daylight Time	KAISER FOUNDATION HP OF CO	Kaiser Permanente Senior Advantage	kp.org/medicare	FEHB AB with D (HMO)	01	01		1			H0630	816	0	2012	Southern Colorado		1	120	2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-476-2167		(303)-338-3800		(800)-509-7570		(800)-509-7570		(800)-476-2167		(303)-338-3800		(800)-509-7570		(800)-509-7570		(866)-513-9964		(303)-338-3820		(888)-758-6054		(888)-758-6054		(866)-513-9964		(303)-338-3820		(888)-758-6054		(888)-758-6054		2	2	2
H0657	005	0	1	18	06	H0657_005_0	4	2		06/06/2011	2012.02	06/06/2011 08:32:52 PM Mountain Daylight Time				06/06/2011 08:39:58 PM Mountain Daylight Time	COLORADO CHOICE HEALTH PLANS	Colorado Choice Health Plans	www.coloradochoicehp.com	Colorado Choice Silver SV Plan (Cost)	06	18		1			H0657	005	0	2012	The 6 County San Luis Valley Area		2	90	2			2									(800)-475-8466		(719)-589-3696		(800)-475-8466		(719)-589-3696										(800)-659-2656		(800)-659-2656		(800)-659-2656		(800)-659-2656										2	2	2
H0657	006	0	1	18	06	H0657_006_0	4	2		06/06/2011	2012.02	06/06/2011 08:32:24 PM Mountain Daylight Time				06/06/2011 08:39:58 PM Mountain Daylight Time	COLORADO CHOICE HEALTH PLANS	Colorado Choice Health Plans	www.coloradochoicehp.com	Colorado Choice Gold SV Plan (Cost)	06	18		1			H0657	006	0	2012	The 6 County San Luis Valley Area		2	50	2			2									(800)-475-8466		(719)-589-3696		(800)-475-8466		(719)-589-3696										(800)-659-2656		(800)-659-2656		(800)-659-2656		(800)-659-2656										2	2	2
H0657	007	0	1	18	06	H0657_007_0	4	2		06/06/2011	2012.02	06/06/2011 08:32:28 PM Mountain Daylight Time				06/06/2011 08:39:58 PM Mountain Daylight Time	COLORADO CHOICE HEALTH PLANS	Colorado Choice Health Plans	www.coloradochoicehp.com	Colorado Choice Platinum SV Plan (Cost)	06	18		1			H0657	007	0	2012	The 6 County San Luis Valley Area		2	500	2			2									(800)-475-8466		(719)-589-3696		(800)-475-8466		(719)-589-3696										(800)-659-2656		(800)-659-2656		(800)-659-2656		(800)-659-2656										2	2	2
H0657	008	0	1	18	06	H0657_008_0	4	2		06/06/2011	2012.02	06/06/2011 08:32:30 PM Mountain Daylight Time				06/06/2011 08:39:58 PM Mountain Daylight Time	COLORADO CHOICE HEALTH PLANS	Colorado Choice Health Plans	www.coloradochoicehp.com	Colorado Choice Silver Plan (Cost)	06	18		1			H0657	008	0	2012	BEN, CHA, CRO, CUS, FRE, HUE, LAS, OTE, PRO, YUM		2	75	2			2									(800)-475-8466		(719)-589-3696		(800)-475-8466		(719)-589-3696										(800)-659-2656		(800)-659-2656		(800)-659-2656		(800)-659-2656										2	2	2
H0657	009	0	1	18	06	H0657_009_0	4	2		06/06/2011	2012.02	06/06/2011 08:32:34 PM Mountain Daylight Time				06/06/2011 08:39:58 PM Mountain Daylight Time	COLORADO CHOICE HEALTH PLANS	Colorado Choice Health Plans	www.coloradochoicehp.com	Colorado Choice Gold Plan (Cost)	06	18		1			H0657	009	0	2012	BEN, CHA, CRO, CUS, FRE, HUE, LAS, OTE, PRO, YUM		2	15	2			2									(800)-475-8466		(719)-589-3696		(800)-475-8466		(719)-589-3696										(800)-659-2656		(800)-659-2656		(800)-659-2656		(800)-659-2656										2	2	2
H0657	010	0	1	18	06	H0657_010_0	4	2		06/06/2011	2012.02	06/06/2011 08:32:37 PM Mountain Daylight Time				06/06/2011 08:39:58 PM Mountain Daylight Time	COLORADO CHOICE HEALTH PLANS	Colorado Choice Health Plans	www.coloradochoicehp.com	Colorado Choice Platinum Plan (Cost)	06	18		1			H0657	010	0	2012	BEN, CHA, CRO, CUS, FRE, HUE, LAS, OTE, PRO, YUM		2	20	2			2									(800)-475-8466		(719)-589-3696		(800)-475-8466		(719)-589-3696										(800)-659-2656		(800)-659-2656		(800)-659-2656		(800)-659-2656										2	2	2
H0710	001	0	1	04	01	H0710_001_0	5	1		07/22/2011	2012.02	07/22/2011 11:49:32 AM Central Daylight Time	08/29/2011 10:36:21 AM Central Daylight Time	08/05/2011 12:55:07 PM Central Daylight Time		08/29/2011 02:42:33 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.EvercareHealthPlans.com	UnitedHealthcare Nursing Home Plan (PPO SNP)	01	04		1			H0710	001	0	2012	Fairfld, Hrtfrd, Lthfld, New Hvn, Tollnd, Wndham		2		2			1	1	1	1			www.EvercareHealthPlans.com	evercarehealthplans.com/prescription_drug_coverage.jsp	www.PrescriptionSolutions.com	(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0710	002	0	1	04	01	H0710_002_0	4	1	2	07/22/2011	2012.02	07/22/2011 11:47:59 AM Central Daylight Time	08/07/2011 11:48:41 AM Central Daylight Time	08/05/2011 12:55:28 PM Central Daylight Time		08/09/2011 12:05:43 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	Evercare by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Dual Complete (PPO SNP)	01	04		1			H0710	002	0	2012	Frfield, Hrtfrd, Ltchfld, New Hvn, Tollnd, Windham		2		2			1	3		1	2		www.EvercareHealthPlans.com	evercarehealthplans.com/prescription_drug_coverage.jsp	www.PrescriptionSolutions.com	(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0712	001	0	1	02	01	H0712_001_0	8	1		07/21/2011	2012.02	07/21/2011 01:46:32 PM Eastern Daylight Time	08/05/2011 02:04:38 PM Eastern Daylight Time	08/11/2011 11:06:44 AM Eastern Daylight Time		08/11/2011 02:04:00 PM Eastern Daylight Time	WELLCARE OF CONNECTICUT, INC.	WellCare	www.wellcare.com	WellCare Choice (HMO-POS)	01	02		1			H0712	001	0	2012	Fairfield, Hartford, New Haven, Tolland Counties		2		2			2							www.wellcare.com	www.wellcare.com	(866)-579-8006		(866)-579-8006		(877)-232-7119		(877)-232-7119		(866)-579-8006		(866)-579-8006		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H0712	005	0	1	01	01	H0712_005_0	7	1	2	08/04/2011	2012.02	08/04/2011 03:01:49 PM Eastern Daylight Time	08/05/2011 02:04:54 PM Eastern Daylight Time	08/04/2011 05:53:50 PM Eastern Daylight Time		08/08/2011 03:21:23 PM Eastern Daylight Time	WELLCARE OF CONNECTICUT, INC.	WellCare	www.wellcare.com	WellCare Access (HMO SNP)	01	01		1			H0712	005	0	2012	Fairfield, Hartford, New Haven, Tolland Counties		2		2			1	3		1	1			www.wellcare.com	www.wellcare.com	(866)-635-7047		(866)-635-7047		(877)-232-7119		(877)-232-7119		(866)-635-7047		(866)-635-7047		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H0712	019	0	1	01	01	H0712_019_0	8	1		07/21/2011	2012.02	07/21/2011 01:47:10 PM Eastern Daylight Time	08/05/2011 02:05:11 PM Eastern Daylight Time	08/11/2011 11:07:26 AM Eastern Daylight Time		08/11/2011 02:04:00 PM Eastern Daylight Time	WELLCARE OF CONNECTICUT, INC.	WellCare	www.wellcare.com	Wellcare Value (HMO)	01	01		1			H0712	019	0	2012	Fairfield, Hartford, New Haven, Tolland		2		2			2							www.wellcare.com	www.wellcare.com	(866)-579-8006		(866)-579-8006		(877)-232-7119		(877)-232-7119		(866)-579-8006		(866)-579-8006		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H0752	002	0	1	02	01	H0752_002_0	5	1		08/12/2011	2012.02	08/12/2011 02:31:37 PM Central Daylight Time	08/04/2011 06:43:35 PM Central Daylight Time	08/05/2011 12:55:49 PM Central Daylight Time		08/12/2011 02:48:29 PM Central Daylight Time	OXFORD HEALTH PLANS (CT), INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H0752	002	0	2012	New Haven county		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-234-1228		(800)-234-1228		(800)-547-5514		(800)-547-5514		(800)-234-1228		(800)-234-1228		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0752	801	0	1	01	01	H0752_801_0	2	1		07/06/2011	2012.02	07/06/2011 04:36:55 PM Central Daylight Time	06/03/2011 02:41:59 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	OXFORD HEALTH PLANS (CT), INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0752	801	0	2012	CT Employer Sponsored Plan Service Area		1		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0752	802	0	1	01	01	H0752_802_0	2	1		07/06/2011	2012.02	07/06/2011 04:37:00 PM Central Daylight Time	06/03/2011 02:40:31 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	OXFORD HEALTH PLANS (CT), INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0752	802	0	2012	CT Employer Sponsored Plan Service Area		1		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548										(711)		(711)		(711)		(711)										2	2	2
H0752	803	0	1	01	01	H0752_803_0	2	1		07/06/2011	2012.02	07/06/2011 04:37:08 PM Central Daylight Time	06/03/2011 02:39:51 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	OXFORD HEALTH PLANS (CT), INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0752	803	0	2012	CT Employer Sponsored Plan Service Area		1		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0755	030	0	1	01	01	H0755_030_0	7	1		08/04/2011	2012.02	08/04/2011 04:41:29 PM Central Daylight Time	08/05/2011 03:55:27 PM Central Daylight Time	08/05/2011 01:21:25 PM Central Daylight Time		08/09/2011 02:16:58 PM Central Daylight Time	OXFORD HEALTH PLANS (CT), INC.	UnitedHealthcare	www.SecureHorizons.com	UnitedHealthcare MedicareComplete Plan 1 (HMO)	01	01		1			H0755	030	0	2012	Connecticut		2		2			2						www.SecureHorizons.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-711-0646		(800)-711-0646		(866)-329-1675		(866)-329-1675		(800)-711-0646		(800)-711-0646		(866)-329-1675		(866)-329-1675		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0755	031	0	1	01	01	H0755_031_0	6	1		08/08/2011	2012.02	08/08/2011 06:13:15 PM Central Daylight Time	08/05/2011 03:56:27 PM Central Daylight Time	08/05/2011 01:21:41 PM Central Daylight Time		08/09/2011 02:16:58 PM Central Daylight Time	OXFORD HEALTH PLANS (CT), INC.	UnitedHealthcare	www.SecureHorizons.com	UnitedHealthcare MedicareComplete Plan 2 (HMO)	01	01		1			H0755	031	0	2012	Connecticut		2		2			2						www.SecureHorizons.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-711-0646		(800)-711-0646		(866)-329-1675		(866)-329-1675		(800)-711-0646		(800)-711-0646		(866)-329-1675		(866)-329-1675		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H0755	032	0	1	01	01	H0755_032_0	4	1		07/25/2011	2012.02	07/25/2011 08:14:30 AM Central Daylight Time	07/22/2011 01:18:36 PM Central Daylight Time			07/25/2011 01:57:11 PM Central Daylight Time	OXFORD HEALTH PLANS (CT), INC.	UnitedHealthcare	www.SecureHorizons.com	UnitedHealthcare MedicareComplete Essential (HMO)	01	01		1			H0755	032	0	2012	Connecticut		2		2			2						www.SecureHorizons.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-711-0646		(800)-711-0646		(866)-329-1675		(866)-329-1675										(711)		(711)		(711)		(711)										2	2	2
H0755	807	0	1	02	01	H0755_807_0	2	1		07/06/2011	2012.02	07/06/2011 04:20:32 PM Central Daylight Time	06/03/2011 03:00:32 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	OXFORD HEALTH PLANS (CT), INC.	UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO-POS)	01	02		1			H0755	807	0	2012	Select Counties in CT		1		2			2						www.SecureHorizons.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-547-8734		(800)-547-8734		(866)-329-1675		(866)-329-1675		(800)-547-8734		(800)-547-8734		(866)-329-1675		(866)-329-1675		(888)-747-2424		(888)-747-2424		(711)		(711)		(888)-747-2424		(888)-747-2424		(711)		(711)		2	2	2
H0755	808	0	1	02	01	H0755_808_0	2	1		07/06/2011	2012.02	07/06/2011 04:22:19 PM Central Daylight Time	06/03/2011 03:01:04 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	OXFORD HEALTH PLANS (CT), INC.	UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO-POS)	01	02		1			H0755	808	0	2012	Select Counties in CT		1		2			2						www.SecureHorizons.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-547-8734		(800)-547-8734		(866)-329-1675		(866)-329-1675										(888)-747-2424		(888)-747-2424		(711)		(711)										2	2	2
H0755	810	0	1	01	01	H0755_810_0	2	1		07/06/2011	2012.02	07/06/2011 04:37:18 PM Central Daylight Time	06/03/2011 03:01:36 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	OXFORD HEALTH PLANS (CT), INC.	UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0755	810	0	2012	Connecticut		1		2			2						www.SecureHorizons.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-547-8734		(800)-547-8734		(866)-329-1675		(866)-329-1675		(800)-547-8734		(800)-547-8734		(866)-329-1675		(866)-329-1675		(888)-747-2424		(888)-747-2424		(711)		(711)		(888)-747-2424		(888)-747-2424		(711)		(711)		2	2	2
H0755	811	0	1	01	01	H0755_811_0	2	1		07/06/2011	2012.02	07/06/2011 04:37:22 PM Central Daylight Time	06/03/2011 03:02:07 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	OXFORD HEALTH PLANS (CT), INC.	UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0755	811	0	2012	Connecticut		1		2			2						www.SecureHorizons.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-547-8734		(800)-547-8734		(866)-329-1675		(866)-329-1675										(888)-747-2424		(888)-747-2424		(711)		(711)										2	2	2
H0755	812	0	1	01	01	H0755_812_0	2	1		07/06/2011	2012.02	07/06/2011 04:37:26 PM Central Daylight Time	06/03/2011 03:02:37 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	OXFORD HEALTH PLANS (CT), INC.	UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H0755	812	0	2012	Connecticut		1		2			2						www.SecureHorizons.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-547-8734		(800)-547-8734		(866)-329-1675		(866)-329-1675		(800)-547-8734		(800)-547-8734		(866)-329-1675		(866)-329-1675		(888)-747-2424		(888)-747-2424		(711)		(711)		(888)-747-2424		(888)-747-2424		(711)		(711)		2	2	2
H0819	001	0	1	20	08	H0819_001_0	1	1		05/24/2011	2012.01	05/24/2011 07:01:11 PM Eastern Daylight Time		05/24/2011 06:52:30 PM Eastern Daylight Time		05/24/2011 07:06:53 PM Eastern Daylight Time	SENIOR LIFE YORK	York County PACE	http://www.seniorlifeyork.com	Senior LIFE York Dual Eligible (PACE)	08	20		1			H0819	001	0	2012	York County PACE		2	80	2			2							www.seniorlifeyork.com	NA									(877)-998-5433	102	(814)-535-6000	102	(877)-998-5433	102	(814)-535-6000	102									(877)-998-5433		(814)-535-6000		(877)-998-5433		(814)-535-6000				
H0819	002	0	1	20	08	H0819_002_0	2	1		05/19/2011	2012.01	05/19/2011 03:24:03 PM Eastern Daylight Time		05/24/2011 06:52:30 PM Eastern Daylight Time		05/24/2011 07:17:07 PM Eastern Daylight Time	SENIOR LIFE YORK	York County PACE	http://www.seniorlifeyork.com	Senior LIFE York Medicare Only (PACE)	08	20		1			H0819	002	0	2012	York County PACE Medicare Only		2	1	2			2							www.seniorlifeyork.com	NA									(877)-998-5433	102	(814)-535-6000	102	(877)-998-5433	102	(814)-535-6000	102									(877)-998-5433		(814)-535-6000		(877)-998-5433		(814)-535-6000				
H0838	020	0	1	01	01	H0838_020_0	10	1		08/11/2011	2012.02	08/11/2011 05:13:32 PM Eastern Daylight Time	08/11/2011 05:14:33 PM Eastern Daylight Time	08/11/2011 05:14:37 PM Eastern Daylight Time		08/11/2011 07:12:04 PM Eastern Daylight Time	UNIVERSAL CARE, INC.	Brand New Day	www.brandnewdayhmo.com	Brand New Day (HMO SNP)	01	01		1			H0838	020	0	2012	Counties: LA, Orange, Kern, Riverside, San Bernard		2	2000	2			1	4		1		00000000000010000000	www.BrandNewDayHMO.com	www.BrandNewDayHMO.com	www.BrandNewDayHMO.com	(866)-255-4795		(866)-255-4795		(866)-255-4795		(866)-255-4795		(866)-255-4795		(866)-255-4795		(866)-255-4795		(866)-255-4795		(866)-321-5955		(866)-321-5955		(866)-321-5955		(866)-321-5955		(866)-321-5955		(866)-321-5955		(866)-321-5955		(866)-321-5955		2	2	2
H0838	022	0	1	01	01	H0838_022_0	11	1		08/11/2011	2012.02	08/11/2011 03:56:26 PM Eastern Daylight Time	08/11/2011 05:14:35 PM Eastern Daylight Time	08/11/2011 05:14:38 PM Eastern Daylight Time		08/11/2011 07:12:04 PM Eastern Daylight Time	UNIVERSAL CARE, INC.	Brand New Day	www.brandnewdayhmo.com	Brand New Day (HMO)	01	01		1			H0838	022	0	2012	Counties-Kern, LA, Orange, Riverside, San Bernardi		2		2			2						www.BrandNewDayHMO.com	www.BrandNewDayHMO.com	www.BrandNewDayHMO.com	(866)-255-4795		(866)-255-4795		(866)-255-4795		(866)-255-4795		(866)-255-4795		(866)-255-4795		(866)-255-4795		(866)-255-4795		(866)-321-5955		(866)-321-5955		(866)-321-5955		(866)-321-5955		(866)-321-5955		(866)-321-5955		(866)-321-5955		(866)-321-5955		2	2	2
H0838	023	0	1	01	01	H0838_023_0	11	1		08/11/2011	2012.02	08/11/2011 03:54:59 PM Eastern Daylight Time	08/11/2011 05:14:36 PM Eastern Daylight Time	08/11/2011 05:14:39 PM Eastern Daylight Time		08/11/2011 07:12:04 PM Eastern Daylight Time	UNIVERSAL CARE, INC.	Brand New Day	www.brandnewdayhmo.com	Brand New Day HMO Extra Care (HMO)	01	01		1			H0838	023	0	2012	Counties:Kern,L.A, Orange,Riverside,SanBernardino		2	2000	2			2						www.BrandNewDayHMO.com	www.BrandNewDayHMO.com	www.BrandNewDayHMO.com	(866)-255-4795		(866)-255-4795		(866)-255-4795		(866)-255-4795		(866)-255-4795		(866)-255-4795		(866)-255-4795		(866)-255-4795		(866)-321-5955		(866)-321-5955		(866)-321-5955		(866)-321-5955		(866)-321-5955		(866)-321-5955		(866)-321-5955		(866)-321-5955		2	2	2
H0901	004	0	1	01	01	H0901_004_0	4	1		07/08/2011	2012.02	07/08/2011 11:17:09 AM Central Daylight Time	08/04/2011 01:49:03 PM Central Daylight Time	08/04/2011 09:36:17 AM Central Daylight Time		08/08/2011 08:57:36 AM Central Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Standard Plan (HMO)	01	01		1			H0901	004	0	2012	District of Columbia		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H0901	801	0	1	01	01	H0901_801_0	3	1		04/22/2011	2012.02	04/22/2011 09:41:20 AM Eastern Daylight Time	07/19/2011 09:26:39 AM Central Daylight Time			07/19/2011 04:49:36 PM Central Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan (HMO)	01	01		1			H0901	801	0	2012	District of Columbia		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748										1	1	1
H0901	802	0	1	01	01	H0901_802_0	3	1		04/22/2011	2012.02	04/22/2011 09:41:38 AM Eastern Daylight Time	07/19/2011 09:26:39 AM Central Daylight Time			07/19/2011 04:49:36 PM Central Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan w/Rx CY (HMO)	01	01		1			H0901	802	0	2012	District of Columbia		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		1	1	1
H0908	001	0	1	01	01	H0908_001_0	8	1	2	07/29/2011	2012.02	07/29/2011 01:18:14 PM Pacific Daylight Time	08/04/2011 12:35:59 PM Pacific Daylight Time	08/04/2011 12:21:19 PM Pacific Daylight Time		08/05/2011 02:37:22 PM Pacific Daylight Time	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Advantage by Buckeye Community Health Plan	http://advantage.bchpohio.com	Advantage by Buckeye Community Health Plan (HMO SNP)	01	01		1			H0908	001	0	2012	Northwest, northeast, southwest, and eastern Ohio		2	1081	2			1	3		1	3		www.bchpohio.com	www.bchpohio.com	www.bchpohio.com	(866)-389-7690		(866)-389-7690		(866)-389-7690		(866)-389-7690		(866)-389-7690		(866)-389-7690		(866)-389-7690		(866)-389-7690		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		2	1	2
H0913	002	0	1	01	01	H0913_002_0	7	1		07/21/2011	2012.02	07/21/2011 01:47:23 PM Eastern Daylight Time	08/05/2011 02:05:28 PM Eastern Daylight Time	08/04/2011 06:02:53 PM Eastern Daylight Time		08/08/2011 03:21:23 PM Eastern Daylight Time	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	WellCare	www.wellcare.com	WellCare Value (HMO)	01	01		1			H0913	002	0	2012	Essex, Hudson, Middlesex, Passaic, Union Counties		2		2			2							www.wellcare.com	www.wellcare.com	(866)-687-8570		(866)-687-8570		(877)-232-7119		(877)-232-7119		(866)-687-8570		(866)-687-8570		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H0913	003	0	1	01	01	H0913_003_0	8	1	2	08/04/2011	2012.02	08/04/2011 03:03:59 PM Eastern Daylight Time	08/05/2011 02:05:44 PM Eastern Daylight Time	08/04/2011 06:05:53 PM Eastern Daylight Time		08/08/2011 03:21:23 PM Eastern Daylight Time	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	WellCare	www.wellcare.com	WellCare Access (HMO SNP)	01	01		1			H0913	003	0	2012	Essex, Hudson, Middlesex, Passaic, Union Counties		2		2			1	3		1	1			www.wellcare.com	www.wellcare.com	(866)-530-9496		(866)-530-9496		(877)-232-7119		(877)-232-7119		(866)-530-9496		(866)-530-9496		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H0979	021	0	1	09	04	H0979_021_0	5	1		07/13/2011	2012.02	07/13/2011 02:21:13 PM Eastern Daylight Time	07/08/2011 02:08:53 PM Eastern Daylight Time			07/13/2011 03:20:10 PM Eastern Daylight Time	AMERICA'S 1ST CHOICE INSURANCE COMPANY OF NC, INC.	AMERICA'S 1ST CHOICE INSURANCE COMPANY OF NC, INC.	www.Americas1stChoice.com	Presidential (PFFS)	04	09	2	1			H0979	021	0	2012	Select Counties in North Carolina		2	1	2			2							www.americas1stchoice.com	www.americas1stchoice.com	(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947										(800)-735-2962		(800)-735-2962		(800)-735-2962		(800)-735-2962										2		2
H0979	022	0	1	09	04	H0979_022_0	6	1		07/13/2011	2012.02	07/13/2011 02:21:24 PM Eastern Daylight Time	08/05/2011 03:00:21 PM Eastern Daylight Time	08/05/2011 03:00:21 PM Eastern Daylight Time		08/05/2011 04:51:31 PM Eastern Daylight Time	AMERICA'S 1ST CHOICE INSURANCE COMPANY OF NC, INC.	AMERICA'S 1ST CHOICE INSURANCE COMPANY OF NC, INC.	www.Americas1stChoice.com	Presidential Plus (PFFS)	04	09	2	1			H0979	022	0	2012	Select Counties in North Carolina		2	1	2			2							www.americas1stchoice.com	www.americas1stchoice.com	(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947		(800)-735-2962		(800)-735-2962		(800)-735-2962		(800)-735-2962		(800)-735-2962		(800)-735-2962		(800)-735-2962		(800)-735-2962		2		2
H1013	011	0	1	01	01	H1013_011_0	8	1		08/10/2011	2012.02	08/10/2011 06:22:31 PM Eastern Daylight Time	08/08/2011 12:43:56 PM Eastern Daylight Time	08/04/2011 09:09:57 AM Eastern Daylight Time		08/10/2011 07:49:17 PM Eastern Daylight Time	COVENTRY HEALTH PLAN OF FLORIDA, INC	Coventry Health Plan of Florida	http://www.chcflorida.coventry-medicare.com	Coventry Vista Ideal (HMO)	01	01		1			H1013	011	0	2012	Miami-Dade County		2	4182	2			2						http://www.chcflorida.coventry-medicare.com	http://www.chcflorida-formulary.coventry-medicare.com	http://www.ProviderDirectory.coventry-medicare.com	(866)-707-9781		(866)-707-9781		(877)-886-3405		(877)-886-3405		(866)-797-8648		(866)-797-8648		(877)-886-3405		(877)-886-3405		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1013	021	0	1	01	01	H1013_021_0	8	1		08/10/2011	2012.02	08/10/2011 06:22:41 PM Eastern Daylight Time	08/08/2011 12:55:08 PM Eastern Daylight Time	08/04/2011 09:15:23 AM Eastern Daylight Time		08/10/2011 07:49:17 PM Eastern Daylight Time	COVENTRY HEALTH PLAN OF FLORIDA, INC	Coventry Health Plan of Florida	http://www.chcflorida.coventry-medicare.com	Coventry Vista Ideal (HMO)	01	01		1			H1013	021	0	2012	Broward County		2	2928	2			2						http://www.chcflorida.coventry-medicare.com	http://www.chcflorida-formulary.coventry-medicare.com	http://www.ProviderDirectory.coventry-medicare.com	(866)-707-9781		(866)-707-9781		(877)-886-3405		(877)-886-3405		(866)-797-8648		(866)-797-8648		(877)-886-3405		(877)-886-3405		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1013	024	0	1	01	01	H1013_024_0	8	1	2	08/10/2011	2012.02	08/10/2011 06:22:54 PM Eastern Daylight Time	08/08/2011 01:08:05 PM Eastern Daylight Time	08/04/2011 09:23:46 AM Eastern Daylight Time		08/10/2011 07:49:17 PM Eastern Daylight Time	COVENTRY HEALTH PLAN OF FLORIDA, INC	Coventry Health Plan of Florida	http://www.chcflorida.coventry-medicare.com	Coventry Vista Maximum (HMO SNP)	01	01		1			H1013	024	0	2012	Dade and Broward Counties		2	1432	2			1	3		1	2		http://www.chcflorida.coventry-medicare.com	http://www.chcflorida-formulary.coventry-medicare.com	http://www.ProviderDirectory.coventry-medicare.com	(866)-707-9781		(866)-707-9781		(877)-886-3405		(877)-886-3405		(866)-797-8648		(866)-797-8648		(877)-886-3405		(877)-886-3405		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1013	802	0	1	01	01	H1013_802_0	6	1		05/27/2011	2012.02	05/27/2011 09:48:39 PM Eastern Daylight Time	07/20/2011 11:35:46 PM Eastern Daylight Time			07/28/2011 04:56:54 PM Eastern Daylight Time	COVENTRY HEALTH PLAN OF FLORIDA, INC	Coventry Health Plan of Florida	http://www.chcflorida.coventry-medicare.com	Coventry Vista Group Ideal (HMO)	01	01		1			H1013	802	0	2012	Nationwide		1	93	2			2						http://www.chcflorida.coventry-medicare.com	http://www.chcflorida-formulary.coventry-medicare.com	http://www.ProviderDirectory.coventry-medicare.com	(866)-707-9781		(866)-707-9781		(877)-886-3405		(877)-886-3405		(866)-797-8648		(866)-797-8648		(877)-886-3405		(877)-886-3405		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H1013	803	0	1	01	01	H1013_803_0	6	1		06/06/2011	2012.02	06/06/2011 07:20:40 PM Eastern Daylight Time	07/21/2011 12:11:24 AM Eastern Daylight Time			07/28/2011 04:56:54 PM Eastern Daylight Time	COVENTRY HEALTH PLAN OF FLORIDA, INC	Coventry Health Plan of Florida	http://www.chcflorida.coventry-medicare.com	Coventry Vista Group Value (HMO)	01	01		1			H1013	803	0	2012	Nationwide		1	93	2			2						http://www.chcflorida.coventry-medicare.com	http://www.chcflorida-formulary.coventry-medicare.com	http://www.ProviderDirectory.coventry-medicare.com	(866)-707-9781		(866)-707-9781		(877)-886-3405		(877)-886-3405										(711)		(711)		(711)		(711)										1	1	1
H1013	805	0	1	01	01	H1013_805_0	6	1		05/27/2011	2012.02	05/27/2011 09:49:39 PM Eastern Daylight Time	07/21/2011 12:33:02 AM Eastern Daylight Time			07/28/2011 04:56:54 PM Eastern Daylight Time	COVENTRY HEALTH PLAN OF FLORIDA, INC	Coventry Health Plan of Florida	http://www.chcflorida.coventry-medicare.com	Coventry Vista Group Choice (HMO)	01	01		1			H1013	805	0	2012	Nationwide		1	93	2			2						http://www.chcflorida.coventry-medicare.com	http://www.chcflorida-formulary.coventry-medicare.com	http://www.ProviderDirectory.coventry-medicare.com	(866)-707-9781		(866)-707-9781		(877)-886-3405		(877)-886-3405		(866)-797-8648		(866)-797-8648		(877)-886-3405		(877)-886-3405		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H1016	001	0	1	01	01	H1016_001_0	7	1		06/30/2011	2012.02	06/30/2011 03:06:46 PM Eastern Daylight Time	08/05/2011 11:45:53 AM Eastern Daylight Time	08/05/2011 11:45:46 AM Eastern Daylight Time		08/05/2011 11:54:46 AM Eastern Daylight Time	AVMED, INC	AvMed Medicare	www.avmed.org	AvMed Medicare Choice (HMO)	01	01		1			H1016	001	0	2012	Miami-Dade and Broward Counties		2	30250	2			2						www.avmed.org	http://www.avmed.org/medicare/drug-list.asp	www.avmed.org	(800)-782-8633		(305)-671-5437	22147	(800)-535-9355		(305)-671-5437	21003	(800)-782-8633		(305)-671-5437	22147	(800)-535-9355		(305)-671-5437	21003	(877)-442-8633		(877)-442-8633		(877)-442-8633		(877)-442-8633		(877)-442-8633		(877)-442-8633		(877)-442-8633		(877)-442-8633		2	2	2
H1016	801	0	1	01	01	H1016_801_0	2	1		05/31/2011	2012.02	05/31/2011 04:04:30 PM Eastern Daylight Time	07/13/2011 12:37:56 PM Eastern Daylight Time			07/13/2011 12:43:03 PM Eastern Daylight Time	AVMED, INC	AvMed Medicare	www.avmed.org	AvMed Employer Group MAPD Plan (HMO)	01	01		1			H1016	801	0	2012	AvMed Florida Employer Group Plan		1	100	2			2						www.avmed.org	http://www.avmed.org/medicare/drug-list.asp	www.avmed.org	(800)-782-8633		(305)-671-5437	22147	(800)-535-9355		(305)-671-5437	21003	(800)-782-8633		(305)-671-5437	22147	(800)-535-9355		(305)-671-5437	21003	(877)-442-8633		(877)-442-8633		(877)-442-8633		(877)-442-8633		(877)-442-8633		(877)-442-8633		(877)-442-8633		(877)-442-8633		1	1	1
H1016	802	0	1	01	01	H1016_802_0	2	1		05/31/2011	2012.02	05/31/2011 04:05:12 PM Eastern Daylight Time	07/13/2011 12:38:23 PM Eastern Daylight Time			07/13/2011 12:43:03 PM Eastern Daylight Time	AVMED, INC	AvMed Medicare	www.avmed.org	AvMed Employer Group MA Only Plan (HMO)	01	01		1			H1016	802	0	2012	AvMed Florida Employer Group Plan		1	100	2			2						www.avmed.org	http://www.avmed.org/medicare/drug-list.asp	www.avmed.org	(800)-782-8633		(305)-671-5437	22147	(800)-535-9355		(305)-671-5437	21003									(877)-442-8633		(877)-442-8633		(877)-442-8633		(877)-442-8633										1	1	1
H1016	803	0	1	01	01	H1016_803_0	2	1		05/31/2011	2012.02	05/31/2011 04:05:51 PM Eastern Daylight Time	07/13/2011 12:38:59 PM Eastern Daylight Time			07/13/2011 12:43:03 PM Eastern Daylight Time	AVMED, INC	AvMed Medicare	www.avmed.org	AvMed Employer Group MAPD Non-CY Plan (HMO)	01	01		1			H1016	803	0	2012	AvMed Florida  Employer Group Plan		1	100	2			2						www.avmed.org	http://www.avmed.org/medicare/drug-list.asp	www.avmed.org	(800)-782-8633		(305)-671-5437	22147	(800)-535-9355		(305)-671-5437	21003	(800)-782-8633		(305)-671-5437	22147	(800)-535-9355		(305)-671-5437	21003	(877)-442-8633		(877)-442-8633		(877)-442-8633		(877)-442-8633		(877)-442-8633		(877)-442-8633		(877)-442-8633		(877)-442-8633		1	1	1
H1016	804	0	1	01	01	H1016_804_0	2	1		05/31/2011	2012.02	05/31/2011 04:06:26 PM Eastern Daylight Time	07/13/2011 12:39:24 PM Eastern Daylight Time			07/13/2011 12:43:03 PM Eastern Daylight Time	AVMED, INC	AvMed Medicare	www.avmed.org	AvMed Employer Group MA Only Non-CY Plan (HMO)	01	01		1			H1016	804	0	2012	AvMed Florida Employer Group Plan		1	100	2			2						www.avmed.org	http://www.avmed.org/medicare/drug-list.asp	www.avmed.org	(800)-782-8633		(305)-671-5437	22147	(800)-535-9355		(305)-671-5437	21003									(877)-442-8633		(877)-442-8633		(877)-442-8633		(877)-442-8633										1	1	1
H1019	001	0	1	01	01	H1019_001_0	5	1		07/08/2011	2012.02	07/08/2011 10:23:42 AM Eastern Daylight Time	08/04/2011 09:57:57 AM Eastern Daylight Time	08/04/2011 11:08:42 AM Eastern Daylight Time		08/08/2011 03:33:33 PM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareOne (HMO)	01	01		1			H1019	001	0	2012	Broward County		2		2			2						www.careplushealthplans.com	http://www.careplushealthplans.com/plans_Rx.asp	http://www.careplushealthplans.com/plans_Rx.asp	(800)-794-5907		(800)-794-5907		(800)-794-4105		(800)-794-4105		(800)-794-5907		(800)-794-5907		(800)-794-4105		(800)-794-4105		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1019	004	0	1	01	01	H1019_004_0	5	1		07/08/2011	2012.02	07/08/2011 10:28:12 AM Eastern Daylight Time	08/04/2011 09:55:21 AM Eastern Daylight Time	08/04/2011 11:09:02 AM Eastern Daylight Time		08/08/2011 03:33:33 PM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareFree (HMO)	01	01		1			H1019	004	0	2012	Broward County		2		2			2						www.careplushealthplans.com	http://www.careplushealthplans.com/plans_Rx.asp	http://www.careplushealthplans.com/plans_Rx.asp	(800)-794-5907		(800)-794-5907		(800)-794-4105		(800)-794-4105		(800)-794-5907		(800)-794-5907		(800)-794-4105		(800)-794-4105		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1019	006	0	1	01	01	H1019_006_0	5	1		07/08/2011	2012.02	07/08/2011 10:28:27 AM Eastern Daylight Time	08/04/2011 09:56:15 AM Eastern Daylight Time	08/04/2011 11:09:22 AM Eastern Daylight Time		08/08/2011 03:33:33 PM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareOne PLUS (HMO)	01	01		1			H1019	006	0	2012	Miami-Dade County		2		2			2						www.careplushealthplans.com	http://www.careplushealthplans.com/plans_Rx.asp	http://www.careplushealthplans.com/plans_Rx.asp	(800)-794-5907		(800)-794-5907		(800)-794-4105		(800)-794-4105		(800)-794-5907		(800)-794-5907		(800)-794-4105		(800)-794-4105		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1019	010	0	1	01	01	H1019_010_0	5	1		07/08/2011	2012.02	07/08/2011 10:31:06 AM Eastern Daylight Time	08/04/2011 09:30:27 AM Eastern Daylight Time	08/04/2011 11:09:42 AM Eastern Daylight Time		08/08/2011 03:33:33 PM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareOne (HMO)	01	01		1			H1019	010	0	2012	Palm Beach County		2		2			2						www.careplushealthplans.com	http://www.careplushealthplans.com/plans_Rx.asp	http://www.careplushealthplans.com/plans_Rx.asp	(800)-794-5907		(800)-794-5907		(800)-794-4105		(800)-794-4105		(800)-794-5907		(800)-794-5907		(800)-794-4105		(800)-794-4105		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1019	014	0	1	01	01	H1019_014_0	6	1		07/08/2011	2012.02	07/08/2011 10:31:22 AM Eastern Daylight Time	08/04/2011 09:30:55 AM Eastern Daylight Time	08/04/2011 11:10:05 AM Eastern Daylight Time		08/08/2011 03:33:33 PM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareOne (HMO)	01	01		1			H1019	014	0	2012	Hillsborough, Pasco, Pinellas and Polk counties		2		2			2						www.careplushealthplans.com	http://www.careplushealthplans.com/plans_Rx.asp	http://www.careplushealthplans.com/plans_Rx.asp	(800)-794-5907		(800)-794-5907		(800)-531-9030		(800)-531-9030		(800)-794-5907		(800)-794-5907		(800)-531-9030		(800)-531-9030		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1019	023	0	1	01	01	H1019_023_0	6	1	2	07/19/2011	2012.02	07/19/2011 02:52:13 PM Eastern Daylight Time	08/04/2011 09:58:26 AM Eastern Daylight Time	08/04/2011 11:10:29 AM Eastern Daylight Time		08/08/2011 03:33:33 PM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareNeeds (HMO SNP)	01	01		1			H1019	023	0	2012	Broward County		2		2			1	3		1	2		www.careplushealthplans.com	http://www.careplushealthplans.com/plans_Rx.asp	http://www.careplushealthplans.com/plans_Rx.asp	(800)-794-5907		(800)-794-5907		(800)-794-4105		(800)-794-4105		(800)-794-5907		(800)-794-5907		(800)-794-4105		(800)-794-4105		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1019	024	0	1	01	01	H1019_024_0	5	1	2	07/08/2011	2012.02	07/08/2011 02:12:55 PM Eastern Daylight Time	08/04/2011 09:59:24 AM Eastern Daylight Time	08/04/2011 11:10:49 AM Eastern Daylight Time		08/08/2011 03:33:33 PM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareNeeds (HMO SNP)	01	01		1			H1019	024	0	2012	Miami-Dade County		2		2			1	3		1	2		www.careplushealthplans.com	http://www.careplushealthplans.com/plans_Rx.asp	http://www.careplushealthplans.com/plans_Rx.asp	(800)-794-5907		(800)-794-5907		(800)-794-4105		(800)-794-4105		(800)-794-5907		(800)-794-5907		(800)-794-4105		(800)-794-4105		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1019	025	0	1	01	01	H1019_025_0	5	1	2	07/08/2011	2012.02	07/08/2011 02:13:19 PM Eastern Daylight Time	08/04/2011 09:31:17 AM Eastern Daylight Time	08/04/2011 11:11:09 AM Eastern Daylight Time		08/08/2011 03:33:33 PM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareNeeds (HMO SNP)	01	01		1			H1019	025	0	2012	Palm Beach County		2		2			1	3		1	2		www.careplushealthplans.com	http://www.careplushealthplans.com/plans_Rx.asp	http://www.careplushealthplans.com/plans_Rx.asp	(800)-794-5907		(800)-794-5907		(800)-794-4105		(800)-794-4105		(800)-794-5907		(800)-794-5907		(800)-794-4105		(800)-794-4105		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1019	026	0	1	01	01	H1019_026_0	5	1	2	07/08/2011	2012.02	07/08/2011 02:13:37 PM Eastern Daylight Time	08/04/2011 09:31:47 AM Eastern Daylight Time	08/04/2011 11:11:33 AM Eastern Daylight Time		08/08/2011 03:33:33 PM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareNeeds (HMO SNP)	01	01		1			H1019	026	0	2012	Hillsborough, Pasco and Pinellas counties		2		2			1	3		1	2		www.careplushealthplans.com	http://www.careplushealthplans.com/plans_Rx.asp	http://www.careplushealthplans.com/plans_Rx.asp	(800)-794-5907		(800)-794-5907		(800)-531-9030		(800)-531-9030		(800)-794-5907		(800)-794-5907		(800)-531-9030		(800)-531-9030		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1019	027	0	1	01	01	H1019_027_0	5	1		07/08/2011	2012.02	07/08/2011 10:33:18 AM Eastern Daylight Time	08/04/2011 09:34:16 AM Eastern Daylight Time	08/04/2011 11:11:53 AM Eastern Daylight Time		08/08/2011 03:33:33 PM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareOne (HMO)	01	01		1			H1019	027	0	2012	Lake, Marion, Orange, Osceola, Seminole and Sumter		2		2			2						www.careplushealthplans.com	http://www.careplushealthplans.com/plans_Rx.asp	http://www.careplushealthplans.com/plans_Rx.asp	(800)-794-5907		(800)-794-5907		(800)-531-9030		(800)-531-9030		(800)-794-5907		(800)-794-5907		(800)-531-9030		(800)-531-9030		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1019	028	0	1	01	01	H1019_028_0	5	1	2	07/08/2011	2012.02	07/08/2011 02:13:57 PM Eastern Daylight Time	08/04/2011 09:35:54 AM Eastern Daylight Time	08/04/2011 11:12:13 AM Eastern Daylight Time		08/08/2011 03:33:33 PM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareNeeds (HMO SNP)	01	01		1			H1019	028	0	2012	Orange, Osceola and Seminole counties		2		2			1	3		1	2		www.careplushealthplans.com	http://www.careplushealthplans.com/plans_Rx.asp	http://www.careplushealthplans.com/plans_Rx.asp	(800)-794-5907		(800)-794-5907		(800)-531-9030		(800)-531-9030		(800)-794-5907		(800)-794-5907		(800)-531-9030		(800)-531-9030		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1019	032	0	1	01	01	H1019_032_0	5	1		07/21/2011	2012.02	07/21/2011 09:06:33 AM Eastern Daylight Time	08/04/2011 09:35:32 AM Eastern Daylight Time	08/04/2011 11:12:40 AM Eastern Daylight Time		08/08/2011 03:33:33 PM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareDirect (HMO SNP)	01	01		1			H1019	032	0	2012	Broward County		2		2			1	4		1		00000010000000000000	www.careplushealthplans.com	http://www.careplushealthplans.com/plans_Rx.asp	http://www.careplushealthplans.com/plans_Rx.asp	(800)-794-5907		(800)-794-5907		(800)-794-4105		(800)-794-4105		(800)-794-5907		(800)-794-5907		(800)-794-4105		(800)-794-4105		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1019	043	0	1	01	01	H1019_043_0	5	1		07/08/2011	2012.02	07/08/2011 10:36:34 AM Eastern Daylight Time	08/04/2011 09:36:47 AM Eastern Daylight Time	08/04/2011 11:13:00 AM Eastern Daylight Time		08/08/2011 03:33:33 PM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareOne (HMO)	01	01		1			H1019	043	0	2012	Treasure Coast Area		2		2			2						www.careplushealthplans.com	http://www.careplushealthplans.com/plans_Rx.asp	http://www.careplushealthplans.com/plans_Rx.asp	(800)-794-5907		(800)-794-5907		(800)-794-4105		(800)-794-4105		(800)-794-5907		(800)-794-5907		(800)-794-4105		(800)-794-4105		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1019	044	0	1	01	01	H1019_044_0	5	1		07/08/2011	2012.02	07/08/2011 10:36:58 AM Eastern Daylight Time	08/04/2011 09:38:26 AM Eastern Daylight Time	08/04/2011 11:13:19 AM Eastern Daylight Time		08/08/2011 03:33:33 PM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareOne (HMO)	01	01		1			H1019	044	0	2012	Charlotte, Lee and Sarasota counties		2		2			2						www.careplushealthplans.com	http://www.careplushealthplans.com/plans_Rx.asp	http://www.careplushealthplans.com/plans_Rx.asp	(800)-794-5907		(800)-794-5907		(866)-838-8239		(866)-838-8239		(800)-794-5907		(800)-794-5907		(866)-838-8239		(866)-838-8239		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1019	045	0	1	01	01	H1019_045_0	5	1	2	07/19/2011	2012.02	07/19/2011 04:01:53 PM Eastern Daylight Time	08/04/2011 09:37:13 AM Eastern Daylight Time	08/04/2011 11:13:40 AM Eastern Daylight Time		08/08/2011 03:33:33 PM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareNeeds PLUS (HMO SNP)	01	01		1			H1019	045	0	2012	Brevard County		2		2			1	3		1	5		www.careplushealthplans.com	http://www.careplushealthplans.com/plans_Rx.asp	http://www.careplushealthplans.com/plans_Rx.asp	(800)-794-5907		(800)-794-5907		(800)-794-4105		(800)-794-4105		(800)-794-5907		(800)-794-5907		(800)-794-4105		(800)-794-4105		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1019	046	0	1	01	01	H1019_046_0	5	1	2	07/19/2011	2012.02	07/19/2011 04:00:48 PM Eastern Daylight Time	08/04/2011 09:42:25 AM Eastern Daylight Time	08/04/2011 11:14:00 AM Eastern Daylight Time		08/08/2011 03:33:33 PM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareNeeds PLUS (HMO SNP)	01	01		1			H1019	046	0	2012	Hillsborough, Pasco, Pinellas and Polk counties		2		2			1	3		1	5		www.careplushealthplans.com	http://www.careplushealthplans.com/plans_Rx.asp	http://www.careplushealthplans.com/plans_Rx.asp	(800)-794-5907		(800)-794-5907		(800)-531-9030		(800)-531-9030		(800)-794-5907		(800)-794-5907		(800)-531-9030		(800)-531-9030		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1019	047	0	1	01	01	H1019_047_0	6	1	2	07/08/2011	2012.02	07/08/2011 02:15:12 PM Eastern Daylight Time	08/04/2011 09:42:50 AM Eastern Daylight Time	08/04/2011 11:14:19 AM Eastern Daylight Time		08/08/2011 03:33:33 PM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareNeeds PLUS (HMO SNP)	01	01		1			H1019	047	0	2012	Broward County		2		2			1	3		1	5		www.careplushealthplans.com	http://www.careplushealthplans.com/plans_Rx.asp	http://www.careplushealthplans.com/plans_Rx.asp	(800)-794-5907		(800)-794-5907		(800)-794-4105		(800)-794-4105		(800)-794-5907		(800)-794-5907		(800)-794-4105		(800)-794-4105		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1019	048	0	1	01	01	H1019_048_0	5	1	2	07/19/2011	2012.02	07/19/2011 03:59:27 PM Eastern Daylight Time	08/04/2011 09:43:13 AM Eastern Daylight Time	08/04/2011 11:14:39 AM Eastern Daylight Time		08/08/2011 03:33:33 PM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareNeeds PLUS (HMO SNP)	01	01		1			H1019	048	0	2012	Miami-Dade County		2		2			1	3		1	5		www.careplushealthplans.com	http://www.careplushealthplans.com/plans_Rx.asp	http://www.careplushealthplans.com/plans_Rx.asp	(800)-794-5907		(800)-794-5907		(800)-794-4105		(800)-794-4105		(800)-794-5907		(800)-794-5907		(800)-794-4105		(800)-794-4105		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1019	049	0	1	01	01	H1019_049_0	5	1	2	07/08/2011	2012.02	07/08/2011 02:15:47 PM Eastern Daylight Time	08/04/2011 09:44:03 AM Eastern Daylight Time	08/04/2011 11:14:58 AM Eastern Daylight Time		08/08/2011 03:33:33 PM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareNeeds PLUS (HMO SNP)	01	01		1			H1019	049	0	2012	Orange, Osceola and Seminole counties		2		2			1	3		1	5		www.careplushealthplans.com	http://www.careplushealthplans.com/plans_Rx.asp	http://www.careplushealthplans.com/plans_Rx.asp	(800)-794-5907		(800)-794-5907		(800)-531-9030		(800)-531-9030		(800)-794-5907		(800)-794-5907		(800)-531-9030		(800)-531-9030		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1019	050	0	1	01	01	H1019_050_0	5	1	2	07/19/2011	2012.02	07/19/2011 04:00:08 PM Eastern Daylight Time	08/04/2011 09:43:36 AM Eastern Daylight Time	08/04/2011 11:15:18 AM Eastern Daylight Time		08/08/2011 03:33:33 PM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareNeeds PLUS (HMO SNP)	01	01		1			H1019	050	0	2012	Palm Beach County		2		2			1	3		1	5		www.careplushealthplans.com	http://www.careplushealthplans.com/plans_Rx.asp	http://www.careplushealthplans.com/plans_Rx.asp	(800)-794-5907		(800)-794-5907		(800)-794-4105		(800)-794-4105		(800)-794-5907		(800)-794-5907		(800)-794-4105		(800)-794-4105		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1019	054	0	1	01	01	H1019_054_0	5	1		07/08/2011	2012.02	07/08/2011 10:38:56 AM Eastern Daylight Time	08/04/2011 09:45:59 AM Eastern Daylight Time	08/04/2011 11:15:42 AM Eastern Daylight Time		08/08/2011 03:33:33 PM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareOne PLUS (HMO)	01	01		1			H1019	054	0	2012	Hillsborough and  Pinellas counties		2		2			2						www.careplushealthplans.com	http://www.careplushealthplans.com/plans_Rx.asp	http://www.careplushealthplans.com/plans_Rx.asp	(800)-794-5907		(800)-794-5907		(800)-531-9030		(800)-531-9030		(800)-794-5907		(800)-794-5907		(800)-531-9030		(800)-531-9030		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1019	055	0	1	01	01	H1019_055_0	5	1		07/08/2011	2012.02	07/08/2011 10:39:11 AM Eastern Daylight Time	08/04/2011 09:47:29 AM Eastern Daylight Time	08/04/2011 11:16:03 AM Eastern Daylight Time		08/08/2011 03:33:33 PM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareOpen (HMO)	01	01		1			H1019	055	0	2012	Palm Beach County		2		2			2						www.careplushealthplans.com	http://www.careplushealthplans.com/plans_Rx.asp	http://www.careplushealthplans.com/plans_Rx.asp	(800)-794-5907		(800)-794-5907		(800)-794-4105		(800)-794-4105		(800)-794-5907		(800)-794-5907		(800)-794-4105		(800)-794-4105		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1019	056	0	1	01	01	H1019_056_0	5	1		07/08/2011	2012.02	07/08/2011 10:39:27 AM Eastern Daylight Time	08/04/2011 09:55:48 AM Eastern Daylight Time	08/04/2011 11:16:23 AM Eastern Daylight Time		08/08/2011 03:33:33 PM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareFree PLUS (HMO)	01	01		1			H1019	056	0	2012	Miami-Dade County		2		2			2						www.careplushealthplans.com	http://www.careplushealthplans.com/plans_Rx.asp	http://www.careplushealthplans.com/plans_Rx.asp	(800)-794-5907		(800)-794-5907		(800)-794-4105		(800)-794-4105		(800)-794-5907		(800)-794-5907		(800)-794-4105		(800)-794-4105		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1019	057	0	1	01	01	H1019_057_0	5	1		07/11/2011	2012.02	07/11/2011 08:58:49 AM Eastern Daylight Time	08/04/2011 09:47:55 AM Eastern Daylight Time	08/04/2011 11:16:43 AM Eastern Daylight Time		08/08/2011 03:33:33 PM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareOne PLUS (HMO)	01	01		1			H1019	057	0	2012	Orange, Osceola and Seminole counties		2		2			2						www.careplushealthplans.com	http://www.careplushealthplans.com/plans_Rx.asp	http://www.careplushealthplans.com/plans_Rx.asp	(800)-794-5907		(800)-794-5907		(800)-531-9030		(800)-531-9030		(800)-794-5907		(800)-794-5907		(800)-531-9030		(800)-531-9030		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1019	059	0	1	01	01	H1019_059_0	6	1		07/21/2011	2012.02	07/21/2011 09:06:10 AM Eastern Daylight Time	08/04/2011 09:52:23 AM Eastern Daylight Time	08/04/2011 11:17:02 AM Eastern Daylight Time		08/08/2011 03:33:33 PM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareDirect (HMO SNP)	01	01		1			H1019	059	0	2012	Hillsborough and Pinellas counties		2		2			1	4		1		00000010000000000000	www.careplushealthplans.com	http://www.careplushealthplans.com/plans_Rx.asp	http://www.careplushealthplans.com/plans_Rx.asp	(800)-794-5907		(800)-794-5907		(800)-531-9030		(800)-531-9030		(800)-794-5907		(800)-794-5907		(800)-531-9030		(800)-531-9030		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1019	060	0	1	01	01	H1019_060_0	7	1		07/11/2011	2012.02	07/11/2011 08:59:18 AM Eastern Daylight Time	08/04/2011 09:53:04 AM Eastern Daylight Time	08/04/2011 11:17:23 AM Eastern Daylight Time		08/08/2011 03:33:33 PM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareFree (HMO)	01	01		1			H1019	060	0	2012	Hillsborough and Pinellas counties		2		2			2						www.careplushealthplans.com	http://www.careplushealthplans.com/plans_Rx.asp	http://www.careplushealthplans.com/plans_Rx.asp	(800)-794-5907		(800)-794-5907		(800)-531-9030		(800)-531-9030		(800)-794-5907		(800)-794-5907		(800)-531-9030		(800)-531-9030		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1019	061	0	1	01	01	H1019_061_0	4	1	2	07/11/2011	2012.02	07/11/2011 08:59:31 AM Eastern Daylight Time	08/04/2011 09:52:02 AM Eastern Daylight Time	08/04/2011 11:17:41 AM Eastern Daylight Time		08/08/2011 03:33:33 PM Eastern Daylight Time	CAREPLUS HEALTH PLANS, INC.	CarePlus Health Plans, Inc.	www.careplushealthplans.com	CareNeeds PLUS (HMO SNP)	01	01		1			H1019	061	0	2012	Lake, Marion and Sumter counties		2		2			1	3		1	5		www.careplushealthplans.com	http://www.careplushealthplans.com/plans_Rx.asp	http://www.careplushealthplans.com/plans_Rx.asp	(800)-794-5907		(800)-794-5907		(800)-531-9030		(800)-531-9030		(800)-794-5907		(800)-794-5907		(800)-531-9030		(800)-531-9030		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1026	001	0	1	01	01	H1026_001_0	7	1		08/08/2011	2012.02	08/08/2011 10:12:59 AM Eastern Daylight Time	08/04/2011 12:16:40 PM Eastern Daylight Time	08/04/2011 09:48:31 AM Eastern Daylight Time		08/09/2011 03:53:54 PM Eastern Daylight Time	HEALTH OPTIONS, INC	Health Options, Inc / Blue Cross Blue Shield of FL	www.BlueMedicareFL.com	BlueMedicare HMO (HMO)	01	01		1			H1026	001	0	2012	Miami-Dade County		2		2			2						www.BlueMedicareFL.com	www.myprime.com	www.myprime.com	(800)-926-6565		(800)-926-6565		(800)-876-2227		(800)-876-2227		(800)-926-6565		(800)-926-6565		(800)-876-2227		(800)-876-2227		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H1026	038	0	1	01	01	H1026_038_0	9	1		08/08/2011	2012.02	08/08/2011 10:14:01 AM Eastern Daylight Time	08/04/2011 12:19:50 PM Eastern Daylight Time	08/04/2011 09:54:19 AM Eastern Daylight Time		08/09/2011 03:53:54 PM Eastern Daylight Time	HEALTH OPTIONS, INC	Health Options, Inc / Blue Cross Blue Shield of FL	www.BlueMedicareFL.com	BlueMedicare HMO (HMO)	01	01		1			H1026	038	0	2012	Hillsb, Palm Bch, Pasco, Pinellas, Polk Counties		2		2			2						www.BlueMedicareFL.com	www.myprime.com	www.myprime.com	(800)-926-6565		(800)-926-6565		(800)-876-2227		(800)-876-2227		(800)-926-6565		(800)-926-6565		(800)-876-2227		(800)-876-2227		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H1026	040	0	1	01	01	H1026_040_0	8	1		08/08/2011	2012.02	08/08/2011 10:14:17 AM Eastern Daylight Time	08/04/2011 12:15:06 PM Eastern Daylight Time	08/04/2011 09:46:14 AM Eastern Daylight Time		08/09/2011 03:53:54 PM Eastern Daylight Time	HEALTH OPTIONS, INC	Health Options, Inc / Blue Cross Blue Shield of FL	www.BlueMedicareFL.com	BlueMedicare HMO (HMO)	01	01		1			H1026	040	0	2012	Broward County		2		2			2						www.BlueMedicareFL.com	www.myprime.com	www.myprime.com	(800)-926-6565		(800)-926-6565		(800)-876-2227		(800)-876-2227		(800)-926-6565		(800)-926-6565		(800)-876-2227		(800)-876-2227		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H1026	801	0	1	01	01	H1026_801_0	4	1		05/31/2011	2012.02	05/31/2011 11:33:34 AM Eastern Daylight Time	06/28/2011 08:32:55 AM Eastern Daylight Time			07/21/2011 02:09:24 PM Eastern Daylight Time	HEALTH OPTIONS, INC	Health Options, Inc / Blue Cross Blue Shield of FL	www.BlueMedicareFL.com	BlueMedicare Group HMO (HMO)	01	01		1			H1026	801	0	2012	State of Florida		1		2			2						www.BlueMedicareFL.com	www.myprime.com	www.myprime.com	(800)-926-6565		(800)-926-6565		(800)-876-2227		(800)-876-2227		(800)-926-6565		(800)-926-6565		(800)-876-2227		(800)-876-2227		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		1	1	1
H1026	802	0	1	01	01	H1026_802_0	3	1		05/31/2011	2012.02	05/31/2011 11:37:13 AM Eastern Daylight Time	06/28/2011 08:33:56 AM Eastern Daylight Time			07/21/2011 02:09:24 PM Eastern Daylight Time	HEALTH OPTIONS, INC	Health Options, Inc / Blue Cross Blue Shield of FL	www.BlueMedicareFL.com	BlueMedicare Group HMO (HMO)	01	01		1			H1026	802	0	2012	State of Florida		1		2			2						www.BlueMedicareFL.com	www.myprime.com	www.myprime.com	(800)-926-6565		(800)-926-6565		(800)-876-2227		(800)-876-2227		(800)-926-6565		(800)-926-6565		(800)-876-2227		(800)-876-2227		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		1	1	1
H1032	002	0	1	02	01	H1032_002_0	6	1		07/21/2011	2012.02	07/21/2011 01:37:56 PM Eastern Daylight Time	08/05/2011 02:06:00 PM Eastern Daylight Time	08/04/2011 06:09:09 PM Eastern Daylight Time		08/08/2011 03:26:25 PM Eastern Daylight Time	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	WellCare Choice (HMO-POS)	01	02		1			H1032	002	0	2012	East Central, Northeast Florida		2		2			2						www.wellcare.com	www.wellcare.com	www.wellcare.com	(888)-888-9355		(888)-888-9355		(877)-232-7119		(877)-232-7119		(888)-888-9355		(888)-888-9355		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H1032	008	0	1	01	01	H1032_008_0	5	1		07/21/2011	2012.02	07/21/2011 01:38:06 PM Eastern Daylight Time	08/05/2011 02:06:16 PM Eastern Daylight Time	08/05/2011 05:45:43 PM Eastern Daylight Time		08/08/2011 03:26:25 PM Eastern Daylight Time	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	WellCare Choice (HMO)	01	01		1			H1032	008	0	2012	Miami-Dade County		2		2			2						www.wellcare.com	www.wellcare.com	www.wellcare.com	(888)-888-9355		(888)-888-9355		(877)-232-7119		(877)-232-7119		(888)-888-9355		(888)-888-9355		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H1032	012	0	1	02	01	H1032_012_0	6	1		07/21/2011	2012.02	07/21/2011 01:38:17 PM Eastern Daylight Time	08/05/2011 02:06:32 PM Eastern Daylight Time	08/04/2011 06:15:49 PM Eastern Daylight Time		08/08/2011 03:26:25 PM Eastern Daylight Time	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	WellCare Choice (HMO-POS)	01	02		1			H1032	012	0	2012	Citrus, Hillsborough, Pasco Counties		2		2			2						www.wellcare.com	www.wellcare.com	www.wellcare.com	(888)-888-9355		(888)-888-9355		(877)-232-7119		(877)-232-7119		(888)-888-9355		(888)-888-9355		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H1032	014	0	1	02	01	H1032_014_0	6	1		07/21/2011	2012.02	07/21/2011 01:38:45 PM Eastern Daylight Time	08/05/2011 02:06:49 PM Eastern Daylight Time	08/04/2011 06:18:42 PM Eastern Daylight Time		08/08/2011 03:26:25 PM Eastern Daylight Time	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	WellCare Choice (HMO-POS)	01	02		1			H1032	014	0	2012	Pinellas County		2		2			2						www.wellcare.com	www.wellcare.com	www.wellcare.com	(888)-888-9355		(888)-888-9355		(877)-232-7119		(877)-232-7119		(888)-888-9355		(888)-888-9355		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H1032	025	0	1	02	01	H1032_025_0	6	1		07/21/2011	2012.02	07/21/2011 01:38:56 PM Eastern Daylight Time	08/05/2011 02:07:06 PM Eastern Daylight Time	08/04/2011 06:23:57 PM Eastern Daylight Time		08/08/2011 03:26:25 PM Eastern Daylight Time	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	WellCare Choice (HMO-POS)	01	02		1			H1032	025	0	2012	Escambia, Okaloosa, Santa Rosa Counties		2		2			2						www.wellcare.com	www.wellcare.com	www.wellcare.com	(888)-888-9355		(888)-888-9355		(877)-232-7119		(877)-232-7119		(888)-888-9355		(888)-888-9355		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H1032	032	0	1	01	01	H1032_032_0	6	1		07/21/2011	2012.02	07/21/2011 01:39:06 PM Eastern Daylight Time	08/05/2011 02:07:23 PM Eastern Daylight Time	08/04/2011 06:26:20 PM Eastern Daylight Time		08/08/2011 03:26:25 PM Eastern Daylight Time	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	WellCare Dividend (HMO)	01	01		1			H1032	032	0	2012	Southeast, Tampa Bay Florida		2		2			2						www.wellcare.com	www.wellcare.com	www.wellcare.com	(888)-888-9355		(888)-888-9355		(877)-232-7119		(877)-232-7119		(888)-888-9355		(888)-888-9355		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H1032	035	0	1	02	01	H1032_035_0	6	1		07/21/2011	2012.02	07/21/2011 01:39:16 PM Eastern Daylight Time	08/05/2011 02:07:40 PM Eastern Daylight Time	08/04/2011 06:27:42 PM Eastern Daylight Time		08/08/2011 03:26:25 PM Eastern Daylight Time	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	WellCare Value (HMO-POS)	01	02		1			H1032	035	0	2012	Hernando, Hillsborough, Pasco, Pinellas Counties		2		2			2						www.wellcare.com	www.wellcare.com	www.wellcare.com	(888)-888-9355		(888)-888-9355		(877)-232-7119		(877)-232-7119		(888)-888-9355		(888)-888-9355		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H1032	037	0	1	01	01	H1032_037_0	6	1		07/21/2011	2012.02	07/21/2011 01:39:27 PM Eastern Daylight Time	07/21/2011 03:24:28 PM Eastern Daylight Time			07/21/2011 03:47:03 PM Eastern Daylight Time	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	WellCare Advance (HMO)	01	01		1			H1032	037	0	2012	East Central Florida		2		2			2						www.wellcare.com	www.wellcare.com	www.wellcare.com	(888)-888-9355		(888)-888-9355		(877)-232-7119		(877)-232-7119										(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272										2	2	2
H1032	040	0	1	01	01	H1032_040_0	6	1		07/21/2011	2012.02	07/21/2011 01:39:38 PM Eastern Daylight Time	08/05/2011 02:08:13 PM Eastern Daylight Time	08/04/2011 06:30:47 PM Eastern Daylight Time		08/08/2011 03:26:25 PM Eastern Daylight Time	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	WellCare Dividend (HMO)	01	01		1			H1032	040	0	2012	Miami-Dade County		2		2			2						www.wellcare.com	www.wellcare.com	www.wellcare.com	(888)-888-9355		(888)-888-9355		(877)-232-7119		(877)-232-7119		(888)-888-9355		(888)-888-9355		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H1032	061	0	1	02	01	H1032_061_0	6	1	2	07/21/2011	2012.02	07/21/2011 01:39:48 PM Eastern Daylight Time	08/05/2011 02:08:29 PM Eastern Daylight Time	08/04/2011 06:34:56 PM Eastern Daylight Time		08/08/2011 03:26:25 PM Eastern Daylight Time	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	WellCare Select (HMO-POS SNP)	01	02		1			H1032	061	0	2012	E. Central, S. Central, NE, SE, Tampa Bay Florida		2		2			1	3		1	2		www.wellcare.com	www.wellcare.com	www.wellcare.com	(866)-637-8041		(866)-637-8041		(877)-232-7119		(877)-232-7119		(866)-637-8041		(866)-637-8041		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H1032	073	0	1	02	01	H1032_073_0	6	1		07/21/2011	2012.02	07/21/2011 01:39:58 PM Eastern Daylight Time	08/05/2011 02:08:46 PM Eastern Daylight Time	08/04/2011 06:38:24 PM Eastern Daylight Time		08/08/2011 03:26:25 PM Eastern Daylight Time	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	WellCare Value (HMO-POS)	01	02		1			H1032	073	0	2012	Broward, Duval, Manatee Counties		2		2			2						www.wellcare.com	www.wellcare.com	www.wellcare.com	(888)-888-9355		(888)-888-9355		(877)-232-7119		(877)-232-7119		(888)-888-9355		(888)-888-9355		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H1032	079	0	1	01	01	H1032_079_0	6	1		07/21/2011	2012.02	07/21/2011 01:40:08 PM Eastern Daylight Time	08/05/2011 02:09:02 PM Eastern Daylight Time	08/04/2011 06:40:19 PM Eastern Daylight Time		08/08/2011 03:26:25 PM Eastern Daylight Time	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	WellCare Value (HMO)	01	01		1			H1032	079	0	2012	Northwest Florida		2		2			2						www.wellcare.com	www.wellcare.com	www.wellcare.com	(888)-888-9355		(888)-888-9355		(877)-232-7119		(877)-232-7119		(888)-888-9355		(888)-888-9355		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H1032	091	0	1	02	01	H1032_091_0	6	1		07/21/2011	2012.02	07/21/2011 01:40:18 PM Eastern Daylight Time	08/05/2011 02:09:18 PM Eastern Daylight Time	08/04/2011 06:42:40 PM Eastern Daylight Time		08/08/2011 03:26:25 PM Eastern Daylight Time	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	WellCare Value (HMO-POS)	01	02		1			H1032	091	0	2012	East Central, North Central, Southeast Florida		2		2			2						www.wellcare.com	www.wellcare.com	www.wellcare.com	(888)-888-9355		(888)-888-9355		(877)-232-7119		(877)-232-7119		(888)-888-9355		(888)-888-9355		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H1032	101	0	1	02	01	H1032_101_0	6	1	2	08/04/2011	2012.02	08/04/2011 03:25:07 PM Eastern Daylight Time	08/05/2011 02:09:35 PM Eastern Daylight Time	08/04/2011 06:45:51 PM Eastern Daylight Time		08/08/2011 03:26:25 PM Eastern Daylight Time	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	WellCare Select (HMO-POS SNP)	01	02		1			H1032	101	0	2012	East Central, South Central, NW, SE Florida		2		2			1	3		1	2		www.wellcare.com	www.wellcare.com	www.wellcare.com	(866)-637-8041		(866)-637-8041		(877)-232-7119		(877)-232-7119		(866)-637-8041		(866)-637-8041		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H1032	124	0	1	01	01	H1032_124_0	6	1	2	07/21/2011	2012.02	07/21/2011 01:40:37 PM Eastern Daylight Time	08/05/2011 02:09:50 PM Eastern Daylight Time	08/04/2011 06:48:21 PM Eastern Daylight Time		08/08/2011 03:26:25 PM Eastern Daylight Time	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	WellCare Access (HMO SNP)	01	01		1			H1032	124	0	2012	E. Central, S. Central, NE, NW, SE, Tampa Bay Fla.		2		2			1	3		1	1		www.wellcare.com	www.wellcare.com	www.wellcare.com	(866)-637-8041		(866)-637-8041		(877)-232-7119		(877)-232-7119		(866)-637-8041		(866)-637-8041		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H1032	131	0	1	01	01	H1032_131_0	8	1		07/21/2011	2012.02	07/21/2011 01:40:47 PM Eastern Daylight Time	08/05/2011 02:10:06 PM Eastern Daylight Time	08/11/2011 11:08:21 AM Eastern Daylight Time		08/11/2011 02:10:30 PM Eastern Daylight Time	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	WellCare Dividend (HMO)	01	01		1			H1032	131	0	2012	East Central, Southeast, Tampa Bay Florida		2		2			2						www.wellcare.com	www.wellcare.com	www.wellcare.com	(888)-888-9355		(888)-888-9355		(877)-232-7119		(877)-232-7119		(888)-888-9355		(888)-888-9355		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H1032	132	0	1	02	01	H1032_132_0	6	1		07/21/2011	2012.02	07/21/2011 01:40:57 PM Eastern Daylight Time	08/05/2011 02:10:23 PM Eastern Daylight Time	08/04/2011 06:54:54 PM Eastern Daylight Time		08/08/2011 03:26:25 PM Eastern Daylight Time	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	WellCare Value (HMO-POS)	01	02		1			H1032	132	0	2012	Highlands, Polk Counties		2		2			2						www.wellcare.com	www.wellcare.com	www.wellcare.com	(888)-888-9355		(888)-888-9355		(877)-232-7119		(877)-232-7119		(888)-888-9355		(888)-888-9355		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H1032	133	0	1	01	01	H1032_133_0	6	1		07/21/2011	2012.02	07/21/2011 01:41:06 PM Eastern Daylight Time	08/05/2011 02:10:40 PM Eastern Daylight Time	08/04/2011 06:58:07 PM Eastern Daylight Time		08/08/2011 03:26:25 PM Eastern Daylight Time	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	WellCare Essential (HMO)	01	01		1			H1032	133	0	2012	Brevard, Indian River, Marion Counties		2		2			2						www.wellcare.com	www.wellcare.com	www.wellcare.com	(888)-888-9355		(888)-888-9355		(877)-232-7119		(877)-232-7119		(888)-888-9355		(888)-888-9355		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H1032	170	0	1	01	01	H1032_170_0	7	1	2	08/04/2011	2012.02	08/04/2011 03:25:46 PM Eastern Daylight Time	08/05/2011 02:10:57 PM Eastern Daylight Time	08/11/2011 11:08:58 AM Eastern Daylight Time		08/11/2011 02:10:30 PM Eastern Daylight Time	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	WellCare Access (HMO SNP)	01	01		1			H1032	170	0	2012	Miami-Dade County		2		2			1	3		1	1		www.wellcare.com	www.wellcare.com	www.wellcare.com	(866)-637-8041		(866)-637-8041		(877)-232-7119		(877)-232-7119		(866)-637-8041		(866)-637-8041		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H1032	173	0	1	01	01	H1032_173_0	7	1		07/21/2011	2012.02	07/21/2011 01:41:24 PM Eastern Daylight Time	08/05/2011 02:11:14 PM Eastern Daylight Time	08/11/2011 11:09:59 AM Eastern Daylight Time		08/11/2011 02:10:30 PM Eastern Daylight Time	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	WellCare Essential (HMO)	01	01		1			H1032	173	0	2012	Orange, Osceola, Seminole Counties		2		2			2						www.wellcare.com	www.wellcare.com	www.wellcare.com	(888)-888-9355		(888)-888-9355		(877)-232-7119		(877)-232-7119		(888)-888-9355		(888)-888-9355		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H1032	174	0	1	01	01	H1032_174_0	7	1		07/21/2011	2012.02	07/21/2011 01:41:34 PM Eastern Daylight Time	08/05/2011 02:11:31 PM Eastern Daylight Time	08/11/2011 11:10:47 AM Eastern Daylight Time		08/11/2011 02:10:30 PM Eastern Daylight Time	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	WellCare Essential (HMO)	01	01		1			H1032	174	0	2012	Hernando, Pasco Counties		2		2			2						www.wellcare.com	www.wellcare.com	www.wellcare.com	(888)-888-9355		(888)-888-9355		(877)-232-7119		(877)-232-7119		(888)-888-9355		(888)-888-9355		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H1035	002	0	1	02	01	H1035_002_0	7	1		07/29/2011	2012.02	07/29/2011 12:18:08 PM Eastern Daylight Time	08/08/2011 08:32:55 AM Eastern Daylight Time	08/04/2011 12:22:34 PM Eastern Daylight Time		08/08/2011 10:38:48 AM Eastern Daylight Time	FLORIDA HEALTH CARE PLAN, INC.	Florida Health Care Plan, Inc.	http://www.fhcp.com/medicare/overview/overview.htm	FHCP Medvantage Rx Plus (HMO-POS)	01	02		1			H1035	002	0	2012	Volusia and Flagler Counties, FL		2	10760	2			2						http://www.fhcp.com/members/findAProvider/providers.htm	http://www.fhcp.com/medicare/formulary/formulary.htm	http://www.fhcp.com/medicare/pharmacies/overview.htm	(877)-615-4022		(386)-615-4022		(800)-232-0578		(386)-676-7110		(877)-615-4022		(386)-615-4022		(800)-232-0578		(386)-676-7110		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H1035	006	0	1	01	01	H1035_006_0	6	1		07/18/2011	2012.02	07/18/2011 03:58:23 PM Eastern Daylight Time	08/04/2011 01:43:07 PM Eastern Daylight Time	08/04/2011 12:23:58 PM Eastern Daylight Time		08/05/2011 09:34:38 AM Eastern Daylight Time	FLORIDA HEALTH CARE PLAN, INC.	Florida Health Care Plan, Inc.	http://www.fhcp.com/medicare/overview/overview.htm	FHCP Medvantage Rx (HMO)	01	01		1			H1035	006	0	2012	Volusia and Flagler Counties, FL		2	2700	2			2						http://www.fhcp.com/members/findAProvider/providers.htm	http://www.fhcp.com/medicare/formulary/formulary.htm	http://www.fhcp.com/medicare/pharmacies/overview.htm	(877)-615-4022		(386)-615-4022		(800)-232-0578		(386)-676-7110		(877)-615-4022		(386)-615-4022		(800)-232-0578		(386)-676-7110		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H1035	007	0	1	02	01	H1035_007_0	4	1		07/18/2011	2012.02	07/18/2011 03:58:36 PM Eastern Daylight Time	08/04/2011 09:13:02 AM Eastern Daylight Time			08/05/2011 09:36:46 AM Eastern Daylight Time	FLORIDA HEALTH CARE PLAN, INC.	Florida Health Care Plan, Inc.	http://www.fhcp.com/medicare/overview/overview.htm	FHCP Medvantage (HMO-POS)	01	02		1			H1035	007	0	2012	Volusia and Flagler Counties, FL		2	220	2			2						http://www.fhcp.com/members/findAProvider/providers.htm	http://www.fhcp.com/medicare/formulary/formulary.htm	http://www.fhcp.com/medicare/pharmacies/overview.htm	(877)-615-4022		(386)-615-4022		(800)-232-0578		(386)-676-7110										(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771										2	2	2
H1035	801	0	1	01	01	H1035_801_0	3	1		05/06/2011	2012.02	05/06/2011 03:18:26 PM Eastern Daylight Time	08/04/2011 09:14:27 AM Eastern Daylight Time			08/05/2011 09:37:46 AM Eastern Daylight Time	FLORIDA HEALTH CARE PLAN, INC.	Florida Health Care Plan, Inc.	http://fhcp.com/medicare/overview/overview.htm	GRPMED (HMO)	01	01		1			H1035	801	0	2012	Florida		1	500	2			2						http://www.fhcp.com/members/findAProvider/providers.htm	http://www.fhcp.com/medicare/formulary/formulary.htm	http://www.fhcp.com/medicare/pharmacies/overview.htm	(877)-615-4022		(386)-615-4022		(800)-232-0578		(386)-676-7110		(877)-615-4022		(386)-615-4022		(800)-232-0578		(386)-676-7110		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		1	1	1
H1035	802	0	1	01	01	H1035_802_0	3	1		05/06/2011	2012.02	05/06/2011 03:18:41 PM Eastern Daylight Time	08/04/2011 09:16:27 AM Eastern Daylight Time			08/05/2011 09:38:45 AM Eastern Daylight Time	FLORIDA HEALTH CARE PLAN, INC.	Florida Health Care Plan, Inc.	http://fhcp.com/medicare/overview/overview.htm	GRPMED+ (HMO)	01	01		1			H1035	802	0	2012	Florida		1	500	2			2						http://www.fhcp.com/members/findAProvider/providers.htm	http://www.fhcp.com/medicare/formulary/formulary.htm	http://www.fhcp.com/medicare/pharmacies/overview.htm	(877)-615-4022		(386)-615-4022		(800)-232-0578		(386)-676-7110		(877)-615-4022		(386)-615-4022		(800)-232-0578		(386)-676-7110		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		1	1	1
H1036	025	0	1	01	01	H1036_025_0	6	1		07/06/2011	2012.02	07/06/2011 11:14:48 AM Eastern Daylight Time	08/04/2011 09:32:12 AM Eastern Daylight Time	08/04/2011 11:18:02 AM Eastern Daylight Time		08/08/2011 03:03:05 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-025 (HMO)	01	01		1			H1036	025	0	2012	Hillsborough County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	040	0	1	01	01	H1036_040_0	6	1		07/06/2011	2012.02	07/06/2011 11:15:12 AM Eastern Daylight Time	08/04/2011 09:32:37 AM Eastern Daylight Time	08/04/2011 11:18:21 AM Eastern Daylight Time		08/08/2011 03:03:05 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-040 (HMO)	01	01		1			H1036	040	0	2012	Pasco County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	044	0	1	01	01	H1036_044_0	6	1		07/06/2011	2012.02	07/06/2011 11:15:34 AM Eastern Daylight Time	08/04/2011 09:58:55 AM Eastern Daylight Time	08/04/2011 11:18:41 AM Eastern Daylight Time		08/08/2011 03:03:05 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-044 (HMO)	01	01		1			H1036	044	0	2012	Flagler and Volusia counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	052	0	1	01	01	H1036_052_0	7	1		07/06/2011	2012.02	07/06/2011 11:15:59 AM Eastern Daylight Time	08/04/2011 09:33:01 AM Eastern Daylight Time	08/04/2011 11:19:01 AM Eastern Daylight Time		08/08/2011 03:03:05 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-052 (HMO)	01	01		1			H1036	052	0	2012	Pinellas County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	053	0	1	01	01	H1036_053_0	6	1		07/06/2011	2012.02	07/06/2011 05:17:08 PM Eastern Daylight Time	05/31/2011 01:15:02 PM Eastern Daylight Time			07/11/2011 11:22:57 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-053A (HMO)	01	01		1			H1036	053	0	2012	Broward County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H1036	054	0	1	01	01	H1036_054_0	7	1		07/06/2011	2012.02	07/06/2011 05:17:56 PM Eastern Daylight Time	08/04/2011 09:39:57 AM Eastern Daylight Time	08/04/2011 11:19:21 AM Eastern Daylight Time		08/08/2011 03:38:00 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-054C (HMO)	01	01		1			H1036	054	0	2012	Miami-Dade County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	056	0	1	01	01	H1036_056_0	4	1		07/06/2011	2012.02	07/06/2011 11:17:38 AM Eastern Daylight Time	07/06/2011 10:13:55 AM Eastern Daylight Time			07/25/2011 03:15:14 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-056 (HMO)	01	01		1			H1036	056	0	2012	Flagler and Volusia counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H1036	062	0	1	01	01	H1036_062_0	6	1		07/08/2011	2012.02	07/08/2011 09:05:59 AM Eastern Daylight Time	08/04/2011 09:59:53 AM Eastern Daylight Time	08/04/2011 11:19:46 AM Eastern Daylight Time		08/08/2011 03:38:00 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-062C (HMO)	01	01		1			H1036	062	0	2012	Palm Beach County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	063	0	1	01	01	H1036_063_0	4	1		07/08/2011	2012.02	07/08/2011 09:07:11 AM Eastern Daylight Time	05/31/2011 01:18:00 PM Eastern Daylight Time			07/11/2011 11:32:46 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-063A (HMO)	01	01		1			H1036	063	0	2012	Palm Beach County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H1036	065	0	1	01	01	H1036_065_0	6	1		07/06/2011	2012.02	07/06/2011 05:20:05 PM Eastern Daylight Time	08/04/2011 09:57:07 AM Eastern Daylight Time	08/04/2011 11:20:05 AM Eastern Daylight Time		08/08/2011 03:38:00 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-065C (HMO)	01	01		1			H1036	065	0	2012	Broward County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	067	0	1	01	01	H1036_067_0	9	1		07/06/2011	2012.02	07/06/2011 11:18:02 AM Eastern Daylight Time	08/04/2011 09:33:29 AM Eastern Daylight Time	08/04/2011 11:20:26 AM Eastern Daylight Time		08/08/2011 03:03:05 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-067 (HMO)	01	01		1			H1036	067	0	2012	Hernando County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	068	0	1	01	01	H1036_068_0	8	1		07/20/2011	2012.02	07/20/2011 10:23:30 AM Eastern Daylight Time	08/04/2011 09:41:07 AM Eastern Daylight Time	08/04/2011 11:20:45 AM Eastern Daylight Time		08/08/2011 03:03:05 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-068 (HMO)	01	01		1			H1036	068	0	2012	St Johns, Putnam, Clay Counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	074	0	1	01	01	H1036_074_0	8	1		07/06/2011	2012.02	07/06/2011 11:18:55 AM Eastern Daylight Time	08/04/2011 09:33:54 AM Eastern Daylight Time	08/04/2011 11:21:04 AM Eastern Daylight Time		08/08/2011 03:03:05 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-074 (HMO)	01	01		1			H1036	074	0	2012	Manatee County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	077	0	1	01	01	H1036_077_0	6	1	2	07/20/2011	2012.02	07/20/2011 11:26:34 AM Eastern Daylight Time	08/04/2011 09:41:32 AM Eastern Daylight Time	08/04/2011 11:21:22 AM Eastern Daylight Time		08/08/2011 03:38:00 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H1036-077A (HMO SNP)	01	01		1			H1036	077	0	2012	Miami-Dade County		2		2			1	3		1	2		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	081	0	1	01	01	H1036_081_0	6	1		07/06/2011	2012.02	07/06/2011 11:19:29 AM Eastern Daylight Time	08/04/2011 09:56:41 AM Eastern Daylight Time	08/04/2011 11:21:41 AM Eastern Daylight Time		08/08/2011 03:03:05 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-081D (HMO)	01	01		1			H1036	081	0	2012	Baker, Duval, Nassau and counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	102	0	1	01	01	H1036_102_0	4	1	2	07/20/2011	2012.02	07/20/2011 09:14:04 AM Eastern Daylight Time	08/04/2011 09:29:39 AM Eastern Daylight Time	08/04/2011 11:22:03 AM Eastern Daylight Time		08/08/2011 03:03:05 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H1036-102 (HMO SNP)	01	01		1			H1036	102	0	2012	Tampa Metro Area		2		2			1	3		1	2		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	103	0	1	01	01	H1036_103_0	5	1	2	07/20/2011	2012.02	07/20/2011 08:54:56 AM Eastern Daylight Time	08/04/2011 09:57:32 AM Eastern Daylight Time	08/04/2011 11:22:22 AM Eastern Daylight Time		08/08/2011 03:38:00 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H1036-103A (HMO SNP)	01	01		1			H1036	103	0	2012	Broward County		2		2			1	3		1	2		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	104	0	1	01	01	H1036_104_0	4	1	2	07/20/2011	2012.02	07/20/2011 09:00:55 AM Eastern Daylight Time	08/04/2011 09:30:02 AM Eastern Daylight Time	08/04/2011 11:22:45 AM Eastern Daylight Time		08/08/2011 03:38:00 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H1036-104A (HMO SNP)	01	01		1			H1036	104	0	2012	Palm Beach County		2		2			1	3		1	2		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	119	0	1	01	01	H1036_119_0	5	1		07/06/2011	2012.02	07/06/2011 11:20:22 AM Eastern Daylight Time	05/31/2011 01:06:56 PM Eastern Daylight Time			07/11/2011 11:07:50 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-119 (HMO)	01	01		1			H1036	119	0	2012	Tampa Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H1036	121	0	1	01	01	H1036_121_0	6	1		07/20/2011	2012.02	07/20/2011 09:02:13 AM Eastern Daylight Time	08/04/2011 09:35:06 AM Eastern Daylight Time	08/04/2011 11:23:04 AM Eastern Daylight Time		08/08/2011 03:38:00 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DB H1036-121C (HMO SNP)	01	01		1			H1036	121	0	2012	Broward County		2		2			1	4		1		00000010000000000000	www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	130	0	1	01	01	H1036_130_0	5	1		07/20/2011	2012.02	07/20/2011 09:02:43 AM Eastern Daylight Time	08/04/2011 09:36:21 AM Eastern Daylight Time	08/04/2011 11:23:23 AM Eastern Daylight Time		08/08/2011 03:38:00 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DB H1036-130C (HMO SNP)	01	01		1			H1036	130	0	2012	Palm Beach County		2		2			1	4		1		00000010000000000000	www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	136	0	1	01	01	H1036_136_0	7	1		07/06/2011	2012.02	07/06/2011 10:55:13 AM Eastern Daylight Time	08/05/2011 03:57:52 PM Eastern Daylight Time	08/04/2011 11:23:46 AM Eastern Daylight Time		08/08/2011 03:43:52 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-136 (HMO)	01	01		1			H1036	136	0	2012	Jackson Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	137	0	1	02	01	H1036_137_0	6	1		07/07/2011	2012.02	07/07/2011 01:26:09 PM Eastern Daylight Time	05/27/2011 03:24:04 PM Eastern Daylight Time	08/04/2011 11:24:07 AM Eastern Daylight Time		08/08/2011 03:57:47 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-137 (HMO-POS)	01	02		1			H1036	137	0	2012	Charlotte Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	138	0	1	02	01	H1036_138_0	7	1		07/07/2011	2012.02	07/07/2011 01:26:30 PM Eastern Daylight Time	08/05/2011 09:09:31 AM Eastern Daylight Time	08/04/2011 11:24:26 AM Eastern Daylight Time		08/08/2011 03:57:47 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-138 (HMO-POS)	01	02		1			H1036	138	0	2012	Greensboro / Winston-Salem Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	140	0	1	01	01	H1036_140_0	9	1		07/08/2011	2012.02	07/08/2011 08:59:41 AM Eastern Daylight Time	08/04/2011 09:45:12 AM Eastern Daylight Time	08/04/2011 11:24:44 AM Eastern Daylight Time		08/08/2011 03:03:05 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-140 (HMO)	01	01		1			H1036	140	0	2012	Citrus County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	141	0	1	01	01	H1036_141_0	8	1		07/06/2011	2012.02	07/06/2011 11:21:23 AM Eastern Daylight Time	08/04/2011 09:46:48 AM Eastern Daylight Time	08/04/2011 11:25:04 AM Eastern Daylight Time		08/08/2011 03:03:05 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-141 (HMO)	01	01		1			H1036	141	0	2012	Tampa Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	143	0	1	01	01	H1036_143_0	5	1		07/06/2011	2012.02	07/06/2011 11:21:51 AM Eastern Daylight Time	08/04/2011 09:45:36 AM Eastern Daylight Time	08/04/2011 11:25:23 AM Eastern Daylight Time		08/08/2011 03:03:05 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-143 (HMO)	01	01		1			H1036	143	0	2012	Escambia, Santa Rosa and counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	144	0	1	01	01	H1036_144_0	3	1		07/06/2011	2012.02	07/06/2011 11:22:12 AM Eastern Daylight Time	06/03/2011 10:02:28 AM Eastern Daylight Time			07/08/2011 03:54:46 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-144 (HMO)	01	01		1			H1036	144	0	2012	Escambia, Santa Rosa and counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H1036	146	0	1	01	01	H1036_146_0	8	1		07/11/2011	2012.02	07/11/2011 04:33:37 PM Eastern Daylight Time	08/04/2011 09:47:09 AM Eastern Daylight Time	08/04/2011 11:25:41 AM Eastern Daylight Time		08/08/2011 03:46:52 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-146 (HMO)	01	01		1			H1036	146	0	2012	Orange, Osceola, Seminole and counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	149	0	1	02	01	H1036_149_0	6	1		07/07/2011	2012.02	07/07/2011 06:29:36 AM Eastern Daylight Time	08/04/2011 03:22:51 PM Eastern Daylight Time	08/04/2011 11:26:00 AM Eastern Daylight Time		08/08/2011 05:00:54 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-149 (HMO-POS)	01	02		1			H1036	149	0	2012	Clackamas, Multnomah and Washington counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	151	0	1	01	01	H1036_151_0	5	1		07/06/2011	2012.02	07/06/2011 10:56:54 AM Eastern Daylight Time	08/05/2011 03:58:45 PM Eastern Daylight Time	08/04/2011 11:26:19 AM Eastern Daylight Time		08/08/2011 03:43:52 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-151 (HMO)	01	01		1			H1036	151	0	2012	Jackson Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	152	0	1	01	01	H1036_152_0	4	1	2	07/20/2011	2012.02	07/20/2011 09:03:12 AM Eastern Daylight Time	08/04/2011 09:50:31 AM Eastern Daylight Time	08/04/2011 11:26:38 AM Eastern Daylight Time		08/08/2011 03:38:00 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H1036-152 (HMO SNP)	01	01		1			H1036	152	0	2012	Palm Beach County		2		2			1	3		1	5		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	153	0	1	01	01	H1036_153_0	5	1		07/08/2011	2012.02	07/08/2011 09:15:55 AM Eastern Daylight Time	08/04/2011 03:34:45 PM Eastern Daylight Time	08/04/2011 11:26:56 AM Eastern Daylight Time		08/08/2011 05:33:16 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-153 (HMO)	01	01		1			H1036	153	0	2012	Clackamas, Multnomah and Washington counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	154	0	1	01	01	H1036_154_0	5	1	2	07/20/2011	2012.02	07/20/2011 09:15:27 AM Eastern Daylight Time	08/04/2011 09:48:18 AM Eastern Daylight Time	08/04/2011 11:27:15 AM Eastern Daylight Time		08/08/2011 03:46:52 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H1036-154 (HMO SNP)	01	01		1			H1036	154	0	2012	Flagler and Volusia counties		2		2			1	3		1	5		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	156	0	1	01	01	H1036_156_0	7	1		07/20/2011	2012.02	07/20/2011 09:15:55 AM Eastern Daylight Time	08/04/2011 09:48:41 AM Eastern Daylight Time	08/04/2011 11:27:33 AM Eastern Daylight Time		08/08/2011 03:46:52 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DB H1036-156 (HMO SNP)	01	01		1			H1036	156	0	2012	Flagler and Volusia counties		2		2			1	4		1		00000010000000000000	www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	157	0	1	01	01	H1036_157_0	8	1		07/06/2011	2012.02	07/06/2011 11:25:32 AM Eastern Daylight Time	08/04/2011 09:53:27 AM Eastern Daylight Time	08/04/2011 11:28:04 AM Eastern Daylight Time		08/08/2011 03:46:52 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-157 (HMO)	01	01		1			H1036	157	0	2012	Volusia County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	159	0	1	01	01	H1036_159_0	5	1	2	07/20/2011	2012.02	07/20/2011 09:16:27 AM Eastern Daylight Time	08/04/2011 09:49:07 AM Eastern Daylight Time	08/04/2011 11:28:22 AM Eastern Daylight Time		08/08/2011 03:52:16 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H1036-159 (HMO SNP)	01	01		1			H1036	159	0	2012	Orange, Osceola and Seminole counties		2		2			1	3		1	5		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	160	0	1	01	01	H1036_160_0	6	1		07/20/2011	2012.02	07/20/2011 09:17:01 AM Eastern Daylight Time	08/04/2011 09:51:17 AM Eastern Daylight Time	08/04/2011 11:28:54 AM Eastern Daylight Time		08/08/2011 03:52:16 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DB H1036-160 (HMO SNP)	01	01		1			H1036	160	0	2012	Pinellas, Hillsborough and Pasco counties		2		2			1	4		1		00000010000000000000	www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	161	0	1	01	01	H1036_161_0	5	1	2	07/20/2011	2012.02	07/20/2011 09:17:38 AM Eastern Daylight Time	08/04/2011 09:50:54 AM Eastern Daylight Time	08/04/2011 11:29:13 AM Eastern Daylight Time		08/08/2011 03:52:16 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H1036-161 (HMO SNP)	01	01		1			H1036	161	0	2012	Tampa Metro Area		2		2			1	3		1	5		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	162	0	1	01	01	H1036_162_0	6	1	2	07/20/2011	2012.02	07/20/2011 11:36:45 AM Eastern Daylight Time	08/04/2011 09:49:28 AM Eastern Daylight Time	08/04/2011 11:29:32 AM Eastern Daylight Time		08/08/2011 03:38:00 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H1036-162 (HMO SNP)	01	01		1			H1036	162	0	2012	Broward County		2		2			1	3		1	5		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	163	0	1	01	01	H1036_163_0	6	1	2	07/20/2011	2012.02	07/20/2011 08:56:45 AM Eastern Daylight Time	08/04/2011 09:49:51 AM Eastern Daylight Time	08/04/2011 11:29:50 AM Eastern Daylight Time		08/08/2011 03:38:00 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H1036-163 (HMO SNP)	01	01		1			H1036	163	0	2012	Miami-Dade County		2		2			1	3		1	5		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	164	0	1	01	01	H1036_164_0	5	1		07/08/2011	2012.02	07/08/2011 12:01:12 PM Eastern Daylight Time	08/04/2011 09:50:10 AM Eastern Daylight Time	08/04/2011 11:30:10 AM Eastern Daylight Time		08/08/2011 03:38:00 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-164 (HMO)	01	01		1			H1036	164	0	2012	Miami-Dade County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	167	0	1	01	01	H1036_167_0	5	1	2	07/15/2011	2012.02	07/15/2011 09:11:16 AM Eastern Daylight Time	06/01/2011 10:06:14 AM Eastern Daylight Time	08/04/2011 11:30:29 AM Eastern Daylight Time		08/08/2011 03:57:47 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H1036-167 (HMO SNP)	01	01		1			H1036	167	0	2012	Charlotte Metro Area		2		2			1	3		1	5		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	168	0	1	01	01	H1036_168_0	5	1	2	07/15/2011	2012.02	07/15/2011 09:11:38 AM Eastern Daylight Time	05/27/2011 03:33:12 PM Eastern Daylight Time	08/04/2011 11:30:58 AM Eastern Daylight Time		08/08/2011 03:57:47 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H1036-168 (HMO SNP)	01	01		1			H1036	168	0	2012	Greensboro / Winston-Salem Metro Area		2		2			1	3		1	5		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	169	0	1	01	01	H1036_169_0	4	1	2	08/08/2011	2012.02	08/08/2011 03:08:24 PM Eastern Daylight Time	08/05/2011 04:25:03 PM Eastern Daylight Time	08/04/2011 11:31:16 AM Eastern Daylight Time		08/08/2011 03:43:52 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H1036-169 (HMO SNP)	01	01		1			H1036	169	0	2012	Jackson County		2	300	2			1	3		1	5		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	170	0	1	01	01	H1036_170_0	4	1	2	07/06/2011	2012.02	07/06/2011 02:28:16 PM Eastern Daylight Time	08/05/2011 04:01:02 PM Eastern Daylight Time	08/04/2011 11:31:35 AM Eastern Daylight Time		08/08/2011 03:43:52 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H1036-170 (HMO SNP)	01	01		1			H1036	170	0	2012	Jackson Metro Area		2	300	2			1	3		1	5		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	171	0	1	01	01	H1036_171_0	6	1		07/06/2011	2012.02	07/06/2011 11:00:21 AM Eastern Daylight Time	08/05/2011 04:01:34 PM Eastern Daylight Time	08/04/2011 11:31:54 AM Eastern Daylight Time		08/08/2011 03:43:52 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-171 (HMO)	01	01		1			H1036	171	0	2012	Jackson County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	173	0	1	02	01	H1036_173_0	7	1		07/06/2011	2012.02	07/06/2011 11:01:55 AM Eastern Daylight Time	08/05/2011 04:03:52 PM Eastern Daylight Time	08/04/2011 11:32:12 AM Eastern Daylight Time		08/08/2011 03:43:52 PM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1036-173 (HMO-POS)	01	02		1			H1036	173	0	2012	Jackson County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1036	801	0	1	01	01	H1036_801_0	2	1		07/05/2011	2012.02	07/06/2011 08:15:35 AM Eastern Daylight Time	05/27/2011 03:18:32 PM Eastern Daylight Time			07/06/2011 11:29:15 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H1036	801	0	2012	Select counties in Florida		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H1036	806	0	1	01	01	H1036_806_0	2	1		07/05/2011	2012.02	07/06/2011 08:15:41 AM Eastern Daylight Time	05/27/2011 03:46:35 PM Eastern Daylight Time			07/06/2011 11:29:15 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H1036	806	0	2012	Select counties in Florida		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
H1036	807	0	1	01	01	H1036_807_0	2	1		07/05/2011	2012.02	07/06/2011 08:15:46 AM Eastern Daylight Time	05/27/2011 03:47:32 PM Eastern Daylight Time			07/06/2011 11:29:15 AM Eastern Daylight Time	HUMANA MEDICAL PLAN, INC.	Humana Medical Plan, Inc.	www.humana-medicare.com	Humana Employer Sponsored Non-CY (HMO)	01	01		1			H1036	807	0	2012	Select counties in Florida		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H1043	001	0	1	20	08	H1043_001_0	1	1		05/23/2011	2012.02	05/23/2011 04:03:22 PM Eastern Daylight Time		05/23/2011 11:24:42 AM Eastern Daylight Time		05/23/2011 04:04:08 PM Eastern Daylight Time	FLORIDA PACE CENTERS, INC.	Florida Pace Centers, Inc.	www.floridapace.org	Florida PACE Centers, Inc. (PACE)	08	20		1			H1043	001	0	2012	Florida PACE Centers, Inc.		2		2			2							www.noformulary.com	www.floridapace.org									(305)-262-7842		(305)-751-7223		(305)-262-7842		(305)-751-7223										(305)-262-7842		(305)-751-7223		(305)-262-7842		(305)-751-7223				
H1043	002	0	1	20	08	H1043_002_0	1	1		05/23/2011	2012.02	05/23/2011 03:58:30 PM Eastern Daylight Time		05/23/2011 11:24:42 AM Eastern Daylight Time		05/23/2011 04:04:08 PM Eastern Daylight Time	FLORIDA PACE CENTERS, INC.	Florida Pace Centers, Inc.	www.floridapace.org	Florida PACE Centers, Inc (PACE)	08	20		1			H1043	002	0	2012	Florida PACE Centers, Inc.		2		2			2							www.noformulary.com	www.floridapace.org									(305)-262-7842		(305)-751-7223		(305)-262-7842		(305)-751-7223										(305)-262-7842		(305)-751-7223		(305)-262-7842		(305)-751-7223				
H1045	001	0	1	02	01	H1045_001_0	8	1		08/05/2011	2012.02	08/05/2011 02:33:11 PM Eastern Daylight Time	08/10/2011 05:24:37 PM Eastern Daylight Time	08/10/2011 05:24:36 PM Eastern Daylight Time		08/10/2011 05:49:55 PM Eastern Daylight Time	PREFERRED CARE PARTNERS INC.	Preferred Care Partners, Inc.	www.mypreferredcare.com	Preferred Choice Dade (HMO-POS)	01	02		1			H1045	001	0	2012	Miami-Dade County		2	20431	2			2						mypreferredcare.com	mypreferredcare.com/mydrugs	mypreferredcare.com/mypharmacy	(866)-231-7201		(305)-670-8446		(877)-485-5597		(877)-485-5597		(866)-231-7201		(305)-670-8446		(877)-485-5597		(877)-485-5597		(800)-406-8076		(800)-406-8076		(877)-447-6035		(877)-447-6035		(800)-406-8076		(800)-406-8076		(877)-447-6035		(877)-447-6035		2	2	2
H1045	005	0	1	01	01	H1045_005_0	5	1		07/06/2011	2012.02	07/06/2011 11:27:04 AM Eastern Daylight Time	08/08/2011 09:49:36 AM Eastern Daylight Time	08/08/2011 09:49:36 AM Eastern Daylight Time		08/09/2011 02:40:09 PM Eastern Daylight Time	PREFERRED CARE PARTNERS INC.	Preferred Care Partners, Inc.	www.mypreferredcare.com	Preferred Choice Broward (HMO)	01	01		1			H1045	005	0	2012	Broward County		2	2327	2			2						mypreferredcare.com	mypreferredcare.com/mydrugs	mypreferredcare.com/mypharmacy	(866)-231-7201		(305)-670-8446		(877)-485-5597		(877)-485-5597		(866)-231-7201		(305)-670-8446		(877)-485-5597		(877)-485-5597		(800)-406-8076		(800)-406-8076		(877)-447-6035		(877)-447-6035		(800)-406-8076		(800)-406-8076		(877)-447-6035		(877)-447-6035		2	2	2
H1045	012	0	1	02	01	H1045_012_0	8	1	2	07/06/2011	2012.02	07/06/2011 11:27:15 AM Eastern Daylight Time	08/10/2011 05:24:37 PM Eastern Daylight Time	08/10/2011 05:24:36 PM Eastern Daylight Time		08/10/2011 05:49:55 PM Eastern Daylight Time	PREFERRED CARE PARTNERS INC.	Preferred Care Partners, Inc.	www.mypreferredcare.com	Preferred Medicare Assist (HMO-POS SNP)	01	02		1			H1045	012	0	2012	Miami-Dade and Broward Counties		2	1118	2			1	3		1	2		mypreferredcare.com	mypreferredcare.com/mydrugs	mypreferredcare.com/mypharmacy	(866)-231-7201		(305)-670-8446		(877)-485-5597		(877)-485-5597		(866)-231-7201		(305)-670-8446		(877)-485-5597		(877)-485-5597		(800)-406-8076		(800)-406-8076		(877)-447-6035		(877)-447-6035		(800)-406-8076		(800)-406-8076		(877)-447-6035		(877)-447-6035		2	2	2
H1045	016	0	1	01	01	H1045_016_0	5	1		07/06/2011	2012.02	07/06/2011 11:27:22 AM Eastern Daylight Time	08/08/2011 09:49:36 AM Eastern Daylight Time	08/08/2011 09:49:35 AM Eastern Daylight Time		08/09/2011 02:40:09 PM Eastern Daylight Time	PREFERRED CARE PARTNERS INC.	Preferred Care Partners, Inc.	www.mypreferredcare.com	Preferred Complete Care (HMO)	01	01		1			H1045	016	0	2012	Miami-Dade County		2	3870	2			2						mypreferredcare.com	mypreferredcare.com/mydrugs	mypreferredcare.com/mypharmacy	(866)-231-7201		(305)-670-8446		(877)-485-5597		(877)-485-5597		(866)-231-7201		(305)-670-8446		(877)-485-5597		(877)-485-5597		(800)-406-8076		(800)-406-8076		(877)-447-6035		(877)-447-6035		(800)-406-8076		(800)-406-8076		(877)-447-6035		(877)-447-6035		2	2	2
H1045	018	0	1	01	01	H1045_018_0	5	1		07/06/2011	2012.02	07/06/2011 11:27:47 AM Eastern Daylight Time	08/08/2011 09:49:35 AM Eastern Daylight Time	08/08/2011 09:49:35 AM Eastern Daylight Time		08/09/2011 02:40:09 PM Eastern Daylight Time	PREFERRED CARE PARTNERS INC.	Preferred Care Partners, Inc.	www.mypreferredcare.com	Preferred Special Care Miami-Dade (HMO SNP)	01	01		1			H1045	018	0	2012	Miami-Dade County		2	1012	2			1	4		1		00000000000000000010	mypreferredcare.com	mypreferredcare.com/mydrugs	mypreferredcare.com/mypharmacy	(866)-231-7201		(305)-670-8446		(877)-485-5597		(877)-485-5597		(866)-231-7201		(305)-670-8446		(877)-485-5597		(877)-485-5597		(800)-406-8076		(800)-406-8076		(877)-447-6035		(877)-447-6035		(800)-406-8076		(800)-406-8076		(877)-447-6035		(877)-447-6035		2	2	2
H1045	019	0	1	01	01	H1045_019_0	6	1		07/06/2011	2012.02	07/06/2011 11:27:56 AM Eastern Daylight Time	08/08/2011 09:49:35 AM Eastern Daylight Time	08/08/2011 09:49:35 AM Eastern Daylight Time		08/09/2011 02:40:09 PM Eastern Daylight Time	PREFERRED CARE PARTNERS INC.	Preferred Care Partners, Inc.	www.mypreferredcare.com	Preferred Gold Option (HMO)	01	01		1			H1045	019	0	2012	Central and South Florida Counties		2	30155	2			2						mypreferredcare.com	mypreferredcare.com/mydrugs	mypreferredcare.com/mypharmacy	(866)-231-7201		(305)-670-8446		(877)-485-5597		(877)-485-5597		(866)-231-7201		(305)-670-8446		(877)-485-5597		(877)-485-5597		(800)-406-8076		(800)-406-8076		(877)-447-6035		(877)-447-6035		(800)-406-8076		(800)-406-8076		(877)-447-6035		(877)-447-6035		2	2	2
H1045	020	0	1	02	01	H1045_020_0	5	1		07/08/2011	2012.02	07/08/2011 01:44:23 PM Eastern Daylight Time	08/08/2011 09:49:34 AM Eastern Daylight Time	08/08/2011 09:49:34 AM Eastern Daylight Time		08/09/2011 02:40:09 PM Eastern Daylight Time	PREFERRED CARE PARTNERS INC.	Preferred Care Partners, Inc.	mypreferredcare.com	Preferred Premium Advantage Miami-Dade (HMO-POS)	01	02		1			H1045	020	0	2012	Miami-Dade County		2	500	2			2						mypreferredcare.com	mypreferredcare.com/mydrugs	mypreferredcare.com/mypharmacy	(866)-231-7201		(305)-670-8446		(877)-485-5597		(877)-485-5597		(866)-231-7201		(305)-670-8446		(877)-485-5597		(877)-485-5597		(800)-406-8076		(800)-406-8076		(877)-447-6035		(877)-447-6035		(800)-406-8076		(800)-406-8076		(877)-447-6035		(877)-447-6035		2	2	2
H1045	022	0	1	01	01	H1045_022_0	5	1		07/06/2011	2012.02	07/06/2011 11:28:13 AM Eastern Daylight Time	08/08/2011 09:49:34 AM Eastern Daylight Time	08/08/2011 09:49:34 AM Eastern Daylight Time		08/09/2011 02:40:09 PM Eastern Daylight Time	PREFERRED CARE PARTNERS INC.	Preferred Care Partners, Inc.	mypreferredcare.com	Preferred Select Care (HMO SNP)	01	01		1			H1045	022	0	2012	Central Florida and Broward Counties		2	2081	2			1	4		1		00000000000000000010	mypreferredcare.com	mypreferredcare.com/mydrugs	mypreferredcare.com/mypharmacy	(866)-231-7201		(305)-670-8446		(877)-485-5597		(877)-485-5597		(866)-231-7201		(305)-670-8446		(877)-485-5597		(877)-485-5597		(800)-406-8076		(800)-406-8076		(877)-447-6035		(877)-447-6035		(800)-406-8076		(800)-406-8076		(877)-447-6035		(877)-447-6035		2	2	2
H1076	003	0	1	01	01	H1076_003_0	8	1		08/10/2011	2012.02	08/10/2011 06:43:25 PM Eastern Daylight Time	08/08/2011 01:44:38 PM Eastern Daylight Time	08/04/2011 09:28:59 AM Eastern Daylight Time		08/10/2011 07:49:17 PM Eastern Daylight Time	COVENTRY HEALTH CARE OF FLORIDA, INC	Coventry Health Care of Florida	http://www.chcflorida.coventry-medicare.com	Coventry Vista Prime (HMO)	01	01		1			H1076	003	0	2012	Broward County		2	281	2			2						http://www.chcflorida.coventry-medicare.com	http://www.chcflorida-formulary.coventry-medicare.com	http://www.ProviderDirectory.coventry-medicare.com	(866)-707-9781		(866)-707-9781		(877)-886-3405		(877)-886-3405		(866)-797-8648		(866)-797-8648		(877)-886-3405		(877)-886-3405		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1076	010	0	1	01	01	H1076_010_0	7	1		08/10/2011	2012.02	08/10/2011 06:44:24 PM Eastern Daylight Time	07/11/2011 12:25:17 PM Eastern Daylight Time			08/10/2011 07:49:17 PM Eastern Daylight Time	COVENTRY HEALTH CARE OF FLORIDA, INC	Coventry Health Care of Florida	http://www.chcflorida.coventry-medicare.com	Coventry Vista Value (HMO)	01	01		1			H1076	010	0	2012	Broward, Miami-Dade and Palm Beach counties		2	462	2			2						http://www.chcflorida.coventry-medicare.com	http://www.chcflorida-formulary.coventry-medicare.com	http://www.ProviderDirectory.coventry-medicare.com	(866)-707-9781		(866)-707-9781		(877)-886-3405		(877)-886-3405										(711)		(711)		(711)		(711)										2	2	2
H1076	011	0	1	01	01	H1076_011_0	7	1	2	08/10/2011	2012.02	08/10/2011 06:40:53 PM Eastern Daylight Time	08/08/2011 01:29:39 PM Eastern Daylight Time	08/04/2011 09:34:29 AM Eastern Daylight Time		08/10/2011 07:49:17 PM Eastern Daylight Time	COVENTRY HEALTH CARE OF FLORIDA, INC	Coventry Health Care of Florida	http://www.chcflorida.coventry-medicare.com	Coventry Vista Maximum Choice (HMO SNP)	01	01		1			H1076	011	0	2012	Broward, Miami-Dade and Palm Beach counties		2	2912	2			1	3		1	2		http://www.chcflorida.coventry-medicare.com	http://www.chcflorida-formulary.coventry-medicare.com	http://www.ProviderDirectory.coventry-medicare.com	(866)-707-9781		(866)-707-9781		(877)-886-3405		(877)-886-3405		(866)-797-8648		(866)-797-8648		(877)-886-3405		(877)-886-3405		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1076	016	0	1	01	01	H1076_016_0	7	1		08/10/2011	2012.02	08/10/2011 06:43:38 PM Eastern Daylight Time	08/08/2011 01:42:39 PM Eastern Daylight Time	08/04/2011 09:39:51 AM Eastern Daylight Time		08/10/2011 07:49:17 PM Eastern Daylight Time	COVENTRY HEALTH CARE OF FLORIDA, INC	Coventry Health Care of Florida	http://www.chcflorida.coventry-medicare.com	Coventry Vista Prime (HMO)	01	01		1			H1076	016	0	2012	Palm Beach County		2	380	2			2						http://www.chcflorida.coventry-medicare.com	http://www.chcflorida-formulary.coventry-medicare.com	http://www.ProviderDirectory.coventry-medicare.com	(866)-707-9781		(866)-707-9781		(877)-886-3405		(877)-886-3405		(866)-797-8648		(866)-797-8648		(877)-886-3405		(877)-886-3405		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1076	802	0	1	01	01	H1076_802_0	6	1		05/27/2011	2012.02	05/27/2011 09:50:40 PM Eastern Daylight Time	07/21/2011 12:55:19 AM Eastern Daylight Time			08/11/2011 04:16:25 PM Eastern Daylight Time	COVENTRY HEALTH CARE OF FLORIDA, INC	Coventry Health Care of Florida	http://www.chcflorida.coventry-medicare.com	Coventry Vista Group Prime (HMO)	01	01		1			H1076	802	0	2012	Nationwide		1	93	2			2						http://www.chcflorida.coventry-medicare.com	http://www.chcflorida-formulary.coventry-medicare.com	http://www.ProviderDirectory.coventry-medicare.com	(866)-707-9781		(866)-707-9781		(877)-886-3405		(877)-886-3405		(866)-797-8648		(866)-797-8648		(877)-886-3405		(877)-886-3405		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H1076	803	0	1	01	01	H1076_803_0	6	1		05/27/2011	2012.02	05/27/2011 09:51:29 PM Eastern Daylight Time	07/21/2011 01:25:53 AM Eastern Daylight Time			08/11/2011 04:16:25 PM Eastern Daylight Time	COVENTRY HEALTH CARE OF FLORIDA, INC	Coventry Health Care of Florida	http://www.chcflorida.coventry-medicare.com	Coventry Vista Group Prime Value (HMO)	01	01		1			H1076	803	0	2012	Nationwide		1	93	2			2						http://www.chcflorida.coventry-medicare.com	http://www.chcflorida-formulary.coventry-medicare.com	http://www.ProviderDirectory.coventry-medicare.com	(866)-707-9781		(866)-707-9781		(877)-886-3405		(877)-886-3405										(711)		(711)		(711)		(711)										1	1	1
H1076	805	0	1	01	01	H1076_805_0	6	1		05/27/2011	2012.02	05/27/2011 09:52:00 PM Eastern Daylight Time	07/21/2011 01:47:39 AM Eastern Daylight Time			08/11/2011 04:16:25 PM Eastern Daylight Time	COVENTRY HEALTH CARE OF FLORIDA, INC	Coventry Health Care of Florida	http://www.chcflorida.coventry-medicare.com	Coventry Vista Group Prime Choice (HMO)	01	01		1			H1076	805	0	2012	Nationwide		1	93	2			2						http://www.chcflorida.coventry-medicare.com	http://www.chcflorida-formulary.coventry-medicare.com	http://www.ProviderDirectory.coventry-medicare.com	(866)-707-9781		(866)-707-9781		(877)-886-3405		(877)-886-3405		(866)-797-8648		(866)-797-8648		(877)-886-3405		(877)-886-3405		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H1080	004	0	1	02	01	H1080_004_0	4	1		08/04/2011	2012.02	08/04/2011 08:09:52 PM Central Daylight Time	08/08/2011 10:46:03 AM Central Daylight Time	08/05/2011 01:21:55 PM Central Daylight Time		08/09/2011 11:01:12 AM Central Daylight Time	UNITEDHEALTHCARE OF FLORIDA, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus Plan 1 (HMO-POS)	01	02		1			H1080	004	0	2012	Select Counties in Florida		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1080	036	0	1	01	01	H1080_036_0	4	1	2	07/22/2011	2012.02	07/22/2011 11:49:13 AM Central Daylight Time	08/05/2011 10:52:43 AM Central Daylight Time	08/05/2011 12:56:10 PM Central Daylight Time		08/09/2011 12:05:43 PM Central Daylight Time	UNITEDHEALTHCARE OF FLORIDA, INC.	SecureHorizons by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Dual Complete LP (HMO SNP)	01	01		1			H1080	036	0	2012	Tampa area Counties		2		2			1	3		1	2		www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1080	042	0	1	02	01	H1080_042_0	4	1		08/04/2011	2012.02	08/04/2011 08:11:35 PM Central Daylight Time	08/05/2011 10:54:24 AM Central Daylight Time	08/05/2011 01:22:11 PM Central Daylight Time		08/09/2011 11:01:12 AM Central Daylight Time	UNITEDHEALTHCARE OF FLORIDA, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H1080	042	0	2012	St. Lucie FL		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1080	043	0	1	01	01	H1080_043_0	4	1		08/04/2011	2012.02	08/04/2011 08:12:24 PM Central Daylight Time	08/05/2011 10:55:57 AM Central Daylight Time	08/05/2011 01:22:26 PM Central Daylight Time		08/09/2011 11:01:12 AM Central Daylight Time	UNITEDHEALTHCARE OF FLORIDA, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H1080	043	0	2012	Brevard, Orange, Osceola, and Seminole counties		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1080	044	0	1	01	01	H1080_044_0	4	1		08/04/2011	2012.02	08/04/2011 08:13:12 PM Central Daylight Time	08/05/2011 10:57:36 AM Central Daylight Time	08/05/2011 01:22:40 PM Central Daylight Time		08/09/2011 11:01:12 AM Central Daylight Time	UNITEDHEALTHCARE OF FLORIDA, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H1080	044	0	2012	Lake County		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1080	801	0	1	01	01	H1080_801_0	2	1		07/06/2011	2012.02	07/06/2011 04:37:33 PM Central Daylight Time	06/03/2011 03:14:43 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	UNITEDHEALTHCARE OF FLORIDA, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H1080	801	0	2012	Select Counties in Florida		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1080	804	0	1	01	01	H1080_804_0	2	1		07/06/2011	2012.02	07/06/2011 04:37:38 PM Central Daylight Time	06/03/2011 03:15:00 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	UNITEDHEALTHCARE OF FLORIDA, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H1080	804	0	2012	Select Counties in Florida		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548										(711)		(711)		(711)		(711)										2	2	2
H1080	807	0	1	01	01	H1080_807_0	2	1		07/06/2011	2012.02	07/06/2011 04:37:43 PM Central Daylight Time	06/03/2011 03:15:19 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	UNITEDHEALTHCARE OF FLORIDA, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H1080	807	0	2012	Select Counties in Florida		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1080	808	0	2	01	01	H1080_808_0	2	1		07/06/2011	2012.02	07/06/2011 04:37:47 PM Central Daylight Time	06/03/2011 03:15:37 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	UNITEDHEALTHCARE OF FLORIDA, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		2	2		H1080	808	0	2012	Select Counties in Florida		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1099	001	0	1	02	01	H1099_001_0	12	1		07/28/2011	2012.02	07/28/2011 12:47:19 PM Eastern Daylight Time	08/04/2011 05:44:08 PM Eastern Daylight Time	08/04/2011 05:44:06 PM Eastern Daylight Time		08/05/2011 11:30:20 AM Eastern Daylight Time	HEALTH FIRST HEALTH PLANS, INC.	Health First Medicare Plans	www.HealthFirstHealthPlans.org	Health First Classic Plan (HMO-POS)	01	02		1			H1099	001	0	2012	All Brevard and Indian River Zip 32957/32958/32978		2	133000	2			2						www.HealthFirstHealthPlans.org	http://www.health-first.org/health_plans/	www.sxc.com	(800)-716-7737		(321)-434-5665		(800)-716-7737		(321)-434-5665		(800)-716-7737		(321)-434-5665		(800)-716-7737		(321)-434-5665		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H1099	006	0	1	01	01	H1099_006_0	6	1		08/05/2011	2012.02	08/05/2011 11:47:29 AM Eastern Daylight Time	08/04/2011 05:44:08 PM Eastern Daylight Time	08/04/2011 05:44:08 PM Eastern Daylight Time		08/05/2011 11:49:17 AM Eastern Daylight Time	HEALTH FIRST HEALTH PLANS, INC.	Health First Medicare Plans	www.HealthFirstHealthPlans.org	Health First Value Plan (HMO)	01	01		1			H1099	006	0	2012	All Brevard and Indian River Zip 32957/32958/32978		2	59000	2			2						www.HealthFirstHealthPlans.org	http://www.health-first.org/health_plans/	www.sxc.com	(800)-716-7737		(321)-434-5665		(800)-716-7737		(321)-434-5665		(800)-716-7737		(321)-434-5665		(800)-716-7737		(321)-434-5665		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H1099	009	0	1	01	01	H1099_009_0	4	1		07/21/2011	2012.02	07/21/2011 08:34:46 AM Eastern Daylight Time	07/11/2011 10:02:40 PM Eastern Daylight Time			07/21/2011 10:06:11 AM Eastern Daylight Time	HEALTH FIRST HEALTH PLANS, INC.	Health First Medicare Plans	www.HealthFirstHealthPlans.org	Health First Secure Plan (HMO)	01	01		1			H1099	009	0	2012	All Brevard and Indian River Zip 32957/32958/32978		2	2500	2			2						www.HealthFirstHealthPlans.org	http://www.health-first.org/health_plans/	www.sxc.com	(800)-716-7737		(321)-434-5665		(800)-716-7737		(321)-434-5665										(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771										2	2	2
H1099	014	0	1	01	01	H1099_014_0	5	1		08/05/2011	2012.02	08/05/2011 10:39:43 AM Eastern Daylight Time	08/04/2011 05:44:08 PM Eastern Daylight Time	08/04/2011 05:44:08 PM Eastern Daylight Time		08/05/2011 12:21:20 PM Eastern Daylight Time	HEALTH FIRST HEALTH PLANS, INC.	Health First Medicare Plans	www.HealthFirstHealthPlans.org	Health First Rewards Plan (HMO)	01	01		1			H1099	014	0	2012	All Brevard and Indian River Zip 32957/32958/32978		2	76000	2			2						www.HealthFirstHealthPlans.org	http://www.health-first.org/health_plans/	www.sxc.com	(800)-716-7737		(321)-434-5665		(800)-716-7737		(321)-434-5665		(800)-716-7737		(321)-434-5665		(800)-716-7737		(321)-434-5665		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H1099	802	0	1	01	01	H1099_802_0	3	1		06/02/2011	2012.02	06/02/2011 07:36:44 AM Eastern Daylight Time	07/20/2011 11:35:44 AM Eastern Daylight Time			07/20/2011 06:01:20 PM Eastern Daylight Time	HEALTH FIRST HEALTH PLANS, INC.	Health First Medicare Plans	www.HealthFirstHealthPlans.org	HEALTH FIRST EMPLOYER GROUP PLUS (HMO)	01	01		1			H1099	802	0	2012	All Brevard and Indian River Zip 32957/32958/32978		1	9000	2			2						www.HealthFirstHealthPlans.org	http://www.health-first.org/health_plans/	www.sxc.com	(800)-716-7737		(321)-434-5665		(800)-716-7737		(321)-434-5665		(800)-716-7737		(321)-434-5665		(800)-716-7737		(321)-434-5665		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		1	1	1
H1099	803	0	1	01	01	H1099_803_0	3	1		06/02/2011	2012.02	06/02/2011 09:19:28 AM Eastern Daylight Time	07/20/2011 11:35:44 AM Eastern Daylight Time			07/20/2011 08:45:16 PM Eastern Daylight Time	HEALTH FIRST HEALTH PLANS, INC.	Health First Medicare Plans	www.HealthFirstHealthPlans.org	HEALTH FIRST EMPLOYER GROUP BASIC (HMO)	01	01		1			H1099	803	0	2012	All Brevard and Indian River Zip 32957/32958/32978		1	4000	2			2						www.HealthFirstHealthPlans.org	http://www.health-first.org/health_plans/	www.sxc.com	(800)-716-7737		(321)-434-5665		(800)-716-7737		(321)-434-5665										(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771										1	1	1
H1099	804	0	1	02	01	H1099_804_0	3	1		06/02/2011	2012.02	06/02/2011 06:48:55 AM Eastern Daylight Time	07/20/2011 11:35:44 AM Eastern Daylight Time			07/20/2011 08:50:01 PM Eastern Daylight Time	HEALTH FIRST HEALTH PLANS, INC.	Health First Medicare Plans	www.HealthFirstHealthPlans.org	HEALTH FIRST EMPLOYER GROUP POS (HMO-POS)	01	02		1			H1099	804	0	2012	All Brevard and Indian River Zip 32957/32958/32978		1	1000	2			2						www.HealthFirstHealthPlans.org	http://www.health-first.org/health_plans/	www.sxc.com	(800)-716-7737		(321)-434-5665		(800)-716-7737		(321)-434-5665		(800)-716-7737		(321)-434-5665		(800)-716-7737		(321)-434-5665		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		1	1	1
H1108	001	0	1	04	01	H1108_001_0	3	1		07/22/2011	2012.02	07/22/2011 11:51:01 AM Central Daylight Time	08/05/2011 10:59:38 AM Central Daylight Time	08/05/2011 12:56:32 PM Central Daylight Time		08/09/2011 03:53:30 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	Evercare by UnitedHealthcare	www.EvercareHealthPlans.com	UnitedHealthcare Nursing Home Plan (PPO SNP)	01	04		1			H1108	001	0	2012	Atlanta and Macon Metro Areas		2		2			1	1	1	1			www.EvercareHealthPlans.com	EvercareHealthPlans.com/prescription_drug_coverage.jsp	www.PrescriptionSolutions.com	(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1108	002	0	1	04	01	H1108_002_0	4	1	2	07/22/2011	2012.02	07/22/2011 11:50:36 AM Central Daylight Time	08/05/2011 11:01:05 AM Central Daylight Time	08/05/2011 12:56:55 PM Central Daylight Time		08/09/2011 12:05:43 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	Evercare by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Dual Complete (PPO SNP)	01	04		1			H1108	002	0	2012	Atlanta and Macon Metro Areas		2		2			1	3		1	2		www.EvercareHealthPlans.com	EvercareHealthPlans.com/prescription_drug_coverage.jsp	www.PrescriptionSolutions.com	(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1109	001	0	1	01	01	H1109_001_0	5	1		07/12/2011	2012.02	07/12/2011 02:36:42 PM Central Daylight Time	08/04/2011 12:57:24 PM Central Daylight Time	08/04/2011 09:38:14 AM Central Daylight Time		08/08/2011 08:57:36 AM Central Daylight Time	AETNA HEALTH INC.(GEORGIA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (HMO)	01	01		1			H1109	001	0	2012	Atlanta and Surrounding Counties		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H1109	003	0	1	01	01	H1109_003_0	5	1		07/12/2011	2012.02	07/12/2011 02:39:00 PM Central Daylight Time	08/04/2011 01:01:56 PM Central Daylight Time	08/04/2011 09:39:12 AM Central Daylight Time		08/08/2011 08:57:36 AM Central Daylight Time	AETNA HEALTH INC.(GEORGIA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (HMO)	01	01		1			H1109	003	0	2012	Atlanta and Surrounding Counties		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H1109	801	0	1	01	01	H1109_801_0	2	1		04/22/2011	2012.02	04/22/2011 09:42:08 AM Eastern Daylight Time	06/01/2011 03:37:53 PM Eastern Daylight Time			06/03/2011 06:19:28 PM Eastern Daylight Time	AETNA HEALTH INC.(GEORGIA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan (HMO)	01	01		1			H1109	801	0	2012	Georgia		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748										1	1	1
H1109	802	0	1	01	01	H1109_802_0	2	1		04/22/2011	2012.02	04/22/2011 09:42:37 AM Eastern Daylight Time	06/01/2011 03:44:50 PM Eastern Daylight Time			06/03/2011 06:19:28 PM Eastern Daylight Time	AETNA HEALTH INC.(GEORGIA)	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan w/Rx CY (HMO)	01	01		1			H1109	802	0	2012	Georgia		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		1	1	1
H1110	001	0	1	04	01	H1110_001_0	4	1		08/04/2011	2012.02	08/04/2011 05:43:45 PM Central Daylight Time	08/04/2011 01:05:28 PM Central Daylight Time	08/04/2011 09:39:38 AM Central Daylight Time		08/08/2011 08:57:36 AM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Standard Plan (PPO)	01	04		1			H1110	001	0	2012	Atlanta and Surrounding Counties		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H1110	801	0	1	04	01	H1110_801_0	2	1		06/02/2011	2012.02	06/02/2011 05:21:30 PM Eastern Daylight Time	06/01/2011 02:22:59 PM Eastern Daylight Time			06/03/2011 06:19:28 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan (PPO)	01	04		1			H1110	801	0	2012	National		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748										1	1	1
H1110	802	0	1	04	01	H1110_802_0	2	1		06/02/2011	2012.02	06/02/2011 05:21:43 PM Eastern Daylight Time	06/01/2011 02:38:07 PM Eastern Daylight Time			06/03/2011 06:19:28 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan w/Rx CY (PPO)	01	04		1			H1110	802	0	2012	National		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		1	1	1
H1110	805	0	2	04	01	H1110_805_0	2	1		06/02/2011	2012.02	06/02/2011 05:21:51 PM Eastern Daylight Time	06/01/2011 03:13:08 PM Eastern Daylight Time			06/03/2011 06:19:28 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Part B Only Plan (PPO)	01	04		2	2		H1110	805	0	2012	National		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748										1	1	1
H1110	806	0	2	04	01	H1110_806_0	2	1		06/02/2011	2012.02	06/02/2011 05:22:02 PM Eastern Daylight Time	06/03/2011 07:58:35 AM Eastern Daylight Time			06/03/2011 06:19:28 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Part B Only Plan w/Rx CY (PPO)	01	04		2	2		H1110	806	0	2012	National		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		1	1	1
H1111	002	0	1	02	01	H1111_002_0	6	1		08/08/2011	2012.02	08/08/2011 11:13:57 AM Central Daylight Time	08/05/2011 11:02:25 AM Central Daylight Time	08/05/2011 01:22:55 PM Central Daylight Time		08/09/2011 01:25:28 PM Central Daylight Time	UNITEDHEALTHCARE OF GEORGIA, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H1111	002	0	2012	Columbia, Harris, Muscogee and Richmond Counties		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1111	004	0	1	02	01	H1111_004_0	5	1	2	07/22/2011	2012.02	07/22/2011 11:53:09 AM Central Daylight Time	08/05/2011 11:03:40 AM Central Daylight Time	08/05/2011 12:57:17 PM Central Daylight Time		08/09/2011 12:05:43 PM Central Daylight Time	UNITEDHEALTHCARE OF GEORGIA, INC.	SecureHorizons by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Dual Complete (HMO-POS SNP)	01	02		1			H1111	004	0	2012	Columbia, Harris, Muscogee and Richmond Counties		2		2			1	3		1	2		www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1111	006	0	1	01	01	H1111_006_0	5	1		08/08/2011	2012.02	08/08/2011 11:13:40 AM Central Daylight Time	08/05/2011 11:05:03 AM Central Daylight Time	08/05/2011 01:23:11 PM Central Daylight Time		08/09/2011 01:25:28 PM Central Daylight Time	UNITEDHEALTHCARE OF GEORGIA, INC.	SecureHorizons by UnitedHealthcare	www.UHCDualComplete.com	AARP MedicareComplete (HMO)	01	01		1			H1111	006	0	2012	Cherokee County		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1111	801	0	1	01	01	H1111_801_0	2	1		07/06/2011	2012.02	07/06/2011 04:37:53 PM Central Daylight Time	06/03/2011 02:58:50 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	UNITEDHEALTHCARE OF GEORGIA, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H1111	801	0	2012	GA Employer Sponsored Plan Service Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1111	804	0	1	01	01	H1111_804_0	2	1		07/06/2011	2012.02	07/06/2011 04:37:57 PM Central Daylight Time	06/03/2011 02:59:23 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	UNITEDHEALTHCARE OF GEORGIA, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H1111	804	0	2012	GA Employer Sponsored Plan Service Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548										(711)		(711)		(711)		(711)										2	2	2
H1111	805	0	1	01	01	H1111_805_0	2	1		07/06/2011	2012.02	07/06/2011 04:38:00 PM Central Daylight Time	06/03/2011 02:59:58 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	UNITEDHEALTHCARE OF GEORGIA, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H1111	805	0	2012	GA Employer Sponsored Plan Service Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1111	807	0	2	01	01	H1111_807_0	2	1		07/06/2011	2012.02	07/06/2011 04:38:07 PM Central Daylight Time	06/03/2011 03:00:30 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	UNITEDHEALTHCARE OF GEORGIA, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		2	2		H1111	807	0	2012	GA Employer Sponsored Plan Service Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1112	006	0	1	01	01	H1112_006_0	8	1	2	07/21/2011	2012.02	07/21/2011 03:49:28 PM Eastern Daylight Time	08/05/2011 02:11:48 PM Eastern Daylight Time	08/04/2011 07:12:04 PM Eastern Daylight Time		08/08/2011 03:50:28 PM Eastern Daylight Time	WELLCARE OF GEORGIA, INC.	WellCare	www.wellcare.com	WellCare Access (HMO SNP)	01	01		1			H1112	006	0	2012	Atlanta, Augusta, Columbus, Savannah Metro Areas		2		2			1	3		1	1		www.wellcare.com	www.wellcare.com	www.wellcare.com	(866)-482-3361		(866)-482-3361		(877)-232-7119		(877)-232-7119		(866)-482-3361		(866)-482-3361		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H1112	027	0	1	02	01	H1112_027_0	7	1		07/21/2011	2012.02	07/21/2011 01:33:10 PM Eastern Daylight Time	08/05/2011 02:12:05 PM Eastern Daylight Time	08/04/2011 07:14:31 PM Eastern Daylight Time		08/08/2011 03:50:28 PM Eastern Daylight Time	WELLCARE OF GEORGIA, INC.	WellCare	www.wellcare.com	WellCare Value (HMO-POS)	01	02		1			H1112	027	0	2012	Atlanta, Augusta, Columbus, Savannah Metro Areas		2		2			2						www.wellcare.com	www.wellcare.com	www.wellcare.com	(866)-334-7730		(866)-334-7730		(877)-232-7119		(877)-232-7119		(866)-334-7730		(866)-334-7730		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H1170	002	0	1	01	01	H1170_002_0	7	1		08/09/2011	2012.02	08/09/2011 12:23:50 PM Eastern Daylight Time	08/05/2011 10:21:33 AM Eastern Daylight Time	08/05/2011 01:43:46 PM Eastern Daylight Time		08/09/2011 01:22:52 PM Eastern Daylight Time	KAISER FOUNDATION HP OF GA, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage Enhanced (HMO)	01	01		1			H1170	002	0	2012	Atlanta Metro Area		2		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-232-4404		(800)-232-4404		(877)-408-3493		(877)-408-3493		(800)-232-4404		(800)-232-4404		(877)-408-3493		(877)-408-3493		(800)-255-0056		(800)-255-0056		(888)-758-6054		(888)-758-6054		(800)-255-0056		(800)-255-0056		(888)-758-6054		(888)-758-6054		2	2	2
H1170	008	0	1	01	01	H1170_008_0	7	1	2	08/03/2011	2012.02	08/03/2011 02:23:38 PM Eastern Daylight Time	08/05/2011 10:29:44 AM Eastern Daylight Time	08/05/2011 01:42:35 PM Eastern Daylight Time		08/05/2011 02:42:41 PM Eastern Daylight Time	KAISER FOUNDATION HP OF GA, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Senior Advantage Medicare Medicaid Plan (HMO SNP)	01	01		1			H1170	008	0	2012	Atlanta Metro Area		2		2			1	3		1	2		kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-232-4404		(800)-232-4404		(877)-408-3493		(877)-408-3493		(800)-232-4404		(800)-232-4404		(877)-408-3493		(877)-408-3493		(800)-255-0056		(800)-255-0056		(888)-758-6054		(888)-758-6054		(800)-255-0056		(800)-255-0056		(888)-758-6054		(888)-758-6054		2	2	2
H1170	009	0	1	01	01	H1170_009_0	7	1		08/09/2011	2012.02	08/09/2011 12:57:54 PM Eastern Daylight Time	08/05/2011 10:27:02 AM Eastern Daylight Time	08/05/2011 01:44:58 PM Eastern Daylight Time		08/09/2011 01:22:52 PM Eastern Daylight Time	KAISER FOUNDATION HP OF GA, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage Basic (HMO)	01	01		1			H1170	009	0	2012	Atlanta Metro Area		2		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-232-4404		(800)-232-4404		(877)-408-3493		(877)-408-3493		(800)-232-4404		(800)-232-4404		(877)-408-3493		(877)-408-3493		(800)-255-0056		(800)-255-0056		(888)-758-6054		(888)-758-6054		(800)-255-0056		(800)-255-0056		(888)-758-6054		(888)-758-6054		2	2	2
H1170	801	0	1	01	01	H1170_801_0	6	1		07/27/2011	2012.02	07/27/2011 03:25:15 PM Eastern Daylight Time	07/21/2011 11:01:52 AM Eastern Daylight Time			07/27/2011 03:31:17 PM Eastern Daylight Time	KAISER FOUNDATION HP OF GA, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Employer Group Plan (HMO)	01	01		1			H1170	801	0	2012	Atlanta Metro Area		1		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-232-4404		(800)-232-4404		(800)-232-4404		(800)-232-4404										(800)-255-0056		(800)-255-0056		(800)-255-0056		(800)-255-0056										2	2	2
H1170	802	0	1	01	01	H1170_802_0	6	1		07/27/2011	2012.02	07/27/2011 03:25:25 PM Eastern Daylight Time	07/21/2011 11:44:04 AM Eastern Daylight Time			07/27/2011 03:31:17 PM Eastern Daylight Time	KAISER FOUNDATION HP OF GA, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Employer Group With Part D (HMO)	01	01		1			H1170	802	0	2012	Atlanta Metro Area		1		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-232-4404		(800)-232-4404		(800)-232-4404		(800)-232-4404		(800)-232-4404		(800)-232-4404		(800)-232-4404		(800)-232-4404		(800)-255-0056		(800)-255-0056		(800)-255-0056		(800)-255-0056		(800)-255-0056		(800)-255-0056		(800)-255-0056		(800)-255-0056		2	2	2
H1170	805	0	1	01	01	H1170_805_0	6	1		07/27/2011	2012.02	07/27/2011 03:25:40 PM Eastern Daylight Time	07/21/2011 11:21:02 AM Eastern Daylight Time			07/27/2011 03:31:17 PM Eastern Daylight Time	KAISER FOUNDATION HP OF GA, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	FEHB Part AB  with D (HMO)	01	01		1			H1170	805	0	2012	Atlanta Metro Area		1		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-232-4404		(800)-232-4404		(800)-232-4404		(800)-232-4404		(800)-232-4404		(800)-232-4404		(800)-232-4404		(800)-232-4404		(800)-255-0056		(800)-255-0056		(800)-255-0056		(800)-255-0056		(800)-255-0056		(800)-255-0056		(800)-255-0056		(800)-255-0056		2	2	2
H1216	001	0	1	02	01	H1216_001_0	7	1		07/21/2011	2012.02	07/21/2011 01:47:44 PM Eastern Daylight Time	08/05/2011 02:12:21 PM Eastern Daylight Time	08/04/2011 07:18:49 PM Eastern Daylight Time		08/08/2011 03:21:23 PM Eastern Daylight Time	HARMONY HEALTH PLAN OF ILLINOIS, INC.	WellCare	www.wellcare.com	WellCare Value (HMO-POS)	01	02		1			H1216	001	0	2012	St. Charles, St. Louis, St. Louis City Counties		2		2			2							www.wellcare.com	www.wellcare.com	(866)-687-8994		(866)-687-8994		(877)-232-7119		(877)-232-7119		(866)-687-8994		(866)-687-8994		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H1216	003	0	1	01	01	H1216_003_0	8	1	2	07/21/2011	2012.02	07/21/2011 01:47:55 PM Eastern Daylight Time	08/05/2011 02:12:38 PM Eastern Daylight Time	08/04/2011 07:21:43 PM Eastern Daylight Time		08/08/2011 03:21:23 PM Eastern Daylight Time	HARMONY HEALTH PLAN OF ILLINOIS, INC.	WellCare	www.wellcare.com	WellCare Access (HMO SNP)	01	01		1			H1216	003	0	2012	St. Charles, St. Louis, St. Louis City Counties		2		2			1	3		1	1			www.wellcare.com	www.wellcare.com	(866)-635-7049		(866)-635-7049		(877)-232-7119		(877)-232-7119		(866)-635-7049		(866)-635-7049		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H1230	001	0	1	01	01	H1230_001_0	10	1		08/02/2011	2012.02	08/02/2011 12:03:53 PM Hawaiian Standard Time	08/05/2011 10:46:16 AM Hawaiian Standard Time	08/05/2011 10:29:15 AM Hawaiian Standard Time		08/09/2011 07:54:25 AM Hawaiian Standard Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage Enhanced (HMO)	01	01		1			H1230	001	0	2012	Islands of Oahu, Maui and Hawaii except for 3 ZIPs		2		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-805-2739		(800)-805-2739		(877)-408-3494		(877)-408-3494		(800)-805-2739		(800)-805-2739		(877)-408-3494		(877)-408-3494		(877)-447-5990		(877)-447-5990		(888)-758-6054		(888)-758-6054		(877)-447-5990		(877)-447-5990		(888)-758-6054		(888)-758-6054		2	2	2
H1230	003	0	1	01	01	H1230_003_0	11	1		07/26/2011	2012.02	07/26/2011 10:32:24 AM Hawaiian Standard Time	08/05/2011 10:49:04 AM Hawaiian Standard Time	08/05/2011 10:32:41 AM Hawaiian Standard Time		08/09/2011 07:54:25 AM Hawaiian Standard Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage Basic (HMO)	01	01		1			H1230	003	0	2012	Islands of Oahu and Maui		2		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-805-2739		(800)-805-2739		(877)-408-3494		(877)-408-3494		(800)-805-2739		(800)-805-2739		(877)-408-3494		(877)-408-3494		(877)-447-5990		(877)-447-5990		(888)-758-6054		(888)-758-6054		(877)-447-5990		(877)-447-5990		(888)-758-6054		(888)-758-6054		2	2	2
H1230	005	0	1	01	01	H1230_005_0	10	1		07/26/2011	2012.02	07/26/2011 10:32:46 AM Hawaiian Standard Time	08/05/2011 10:51:25 AM Hawaiian Standard Time	08/05/2011 10:35:55 AM Hawaiian Standard Time		08/09/2011 07:54:25 AM Hawaiian Standard Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Senior Advantage Essential (HMO)	01	01		1			H1230	005	0	2012	Island of Hawaii except for 3 ZIPs		2		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-805-2739		(800)-805-2739		(877)-408-3494		(877)-408-3494		(800)-805-2739		(800)-805-2739		(877)-408-3494		(877)-408-3494		(877)-447-5990		(877)-447-5990		(888)-758-6054		(888)-758-6054		(877)-447-5990		(877)-447-5990		(888)-758-6054		(888)-758-6054		2	2	2
H1230	801	0	1	01	01	H1230_801_0	7	1		07/28/2011	2012.02	07/28/2011 10:55:52 AM Hawaiian Standard Time	07/20/2011 07:39:48 PM Hawaiian Standard Time			07/28/2011 10:56:09 AM Hawaiian Standard Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Employer Group MA only (HMO)	01	01		1			H1230	801	0	2012	Islands of Oahu, Maui and Hawaii except for 3 ZIPs		1		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-805-2739		(800)-805-2739		(800)-805-2739		(800)-805-2739										(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990										2	2	2
H1230	802	0	2	01	01	H1230_802_0	6	1		07/26/2011	2012.02	07/26/2011 10:46:01 AM Hawaiian Standard Time	07/20/2011 07:33:14 PM Hawaiian Standard Time			07/26/2011 12:30:23 PM Hawaiian Standard Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Employer Group MA only Part B (HMO)	01	01		2	1		H1230	802	0	2012	Islands of Oahu, Maui and Hawaii except for 3 ZIPs		1		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-805-2739		(800)-805-2739		(800)-805-2739		(800)-805-2739										(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990										2	2	2
H1230	803	0	1	01	01	H1230_803_0	7	1		07/28/2011	2012.02	07/28/2011 10:14:53 AM Hawaiian Standard Time	07/20/2011 07:40:24 PM Hawaiian Standard Time			07/28/2011 10:56:09 AM Hawaiian Standard Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Employer Group MA-PD (HMO)	01	01		1			H1230	803	0	2012	Islands of Oahu, Maui and Hawaii except for 3 ZIPs		1		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-805-2739		(800)-805-2739		(800)-805-2739		(800)-805-2739		(800)-805-2739		(800)-805-2739		(800)-805-2739		(800)-805-2739		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		2	2	2
H1230	804	0	2	01	01	H1230_804_0	6	1		07/26/2011	2012.02	07/26/2011 10:46:39 AM Hawaiian Standard Time	07/20/2011 07:41:22 PM Hawaiian Standard Time			07/26/2011 12:30:23 PM Hawaiian Standard Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	Kaiser Permanente Employer Group MA-PD Part B (HMO)	01	01		2	1		H1230	804	0	2012	Islands of Oahu, Maui and Hawaii except for 3 ZIPs		1		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-805-2739		(800)-805-2739		(800)-805-2739		(800)-805-2739		(800)-805-2739		(800)-805-2739		(800)-805-2739		(800)-805-2739		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		2	2	2
H1230	805	0	1	01	01	H1230_805_0	7	1		07/28/2011	2012.02	07/28/2011 10:18:33 AM Hawaiian Standard Time	07/20/2011 07:42:12 PM Hawaiian Standard Time			07/28/2011 10:56:09 AM Hawaiian Standard Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	FEHB AB with D (HMO)	01	01		1			H1230	805	0	2012	Islands of Oahu, Maui and Hawaii except for 3 ZIPs		1		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-805-2739		(800)-805-2739		(800)-805-2739		(800)-805-2739		(800)-805-2739		(800)-805-2739		(800)-805-2739		(800)-805-2739		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		2	2	2
H1230	806	0	2	01	01	H1230_806_0	6	1		07/26/2011	2012.02	07/26/2011 10:49:20 AM Hawaiian Standard Time	07/20/2011 07:44:41 PM Hawaiian Standard Time			07/26/2011 12:30:23 PM Hawaiian Standard Time	KAISER FOUNDATION HP, INC.	Kaiser Permanente Senior Advantage	kp.org/medicare	FEHB B only with D (HMO)	01	01		2	1		H1230	806	0	2012	Islands of Oahu, Maui and Hawaii except for 3 ZIPs		1		2			2						kp.org/medicare	www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-805-2739		(800)-805-2739		(800)-805-2739		(800)-805-2739		(800)-805-2739		(800)-805-2739		(800)-805-2739		(800)-805-2739		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		2	2	2
H1234	001	0	1	20	08	H1234_001_0	1	1		05/23/2011	2012.01	05/23/2011 11:01:27 AM Eastern Daylight Time		05/20/2011 03:49:24 PM Eastern Daylight Time		05/23/2011 11:05:26 AM Eastern Daylight Time	LIFE ST. FRANCIS	LIFE St. Francis	www.stfrancismedical.org	SFMC-Dual (PACE)	08	20		1			H1234	001	0	2012	Mercer County and portions of Burlington County		2		2			2							www.stfrancismedical.org	www.carekinesis.com									(609)-599-5433		(609)-599-5433		(609)-599-5433		(609)-599-5433										(609)-599-5433		(609)-599-5433		(609)-599-5433		(609)-599-5433				
H1234	002	0	1	20	08	H1234_002_0	1	1		05/23/2011	2012.01	05/23/2011 11:02:07 AM Eastern Daylight Time		05/20/2011 03:49:24 PM Eastern Daylight Time		05/23/2011 11:05:26 AM Eastern Daylight Time	LIFE ST. FRANCIS	LIFE St. Francis	www.stfrancismedical.org	SFMC-Medicare only (PACE)	08	20		1			H1234	002	0	2012	Mercer County and portions of Burlington County		2		2			2							www.stfrancismedical.org	www.carekinesis.com									(609)-599-5433		(609)-599-5433		(609)-599-5433		(609)-599-5433										(609)-599-5433		(609)-599-5433		(609)-599-5433		(609)-599-5433				
H1251	001	0	1	18	06	H1251_001_0	3	1		08/18/2011	2012.02	08/18/2011 11:46:46 AM Hawaiian Standard Time				08/18/2011 03:37:32 PM Hawaiian Standard Time	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	HMSA's 65C Plus	www.hmsa.com	65C Plus Basic Option (Cost)	06	18		1			H1251	001	0	2012	State of Hawaii		2	1000	2			2							www.hmsa.com	www.hmsa.com	(800)-776-4672		(808)-948-6000		(800)-620-4672		(808)-948-5555										(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222										2	2	2
H1251	002	0	1	18	06	H1251_002_0	3	1		08/18/2011	2012.02	08/18/2011 11:52:30 AM Hawaiian Standard Time				08/18/2011 03:40:54 PM Hawaiian Standard Time	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	HMSA's 65C Plus	www.hmsa.com	65C Plus High Option (Cost)	06	18		1			H1251	002	0	2012	State of Hawaii		2	5000	2			2							www.hmsa.com	www.hmsa.com	(800)-776-4672		(808)-948-6000		(800)-620-4672		(808)-948-5555										(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222										2	2	2
H1251	003	0	1	18	06	H1251_003_0	6	1		08/18/2011	2012.02	08/18/2011 11:29:19 AM Hawaiian Standard Time		08/09/2011 12:45:12 PM Hawaiian Standard Time		08/18/2011 03:43:51 PM Hawaiian Standard Time	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	HMSA's 65C Plus	www.hmsa.com	65C Plus Basic Option BRx (Cost)	06	18		1			H1251	003	0	2012	State of Hawaii		2	3000	2			2							www.hmsa.com	www.hmsa.com	(800)-776-4672		(808)-948-6000		(800)-620-4672		(808)-948-5555		(800)-776-4672		(808)-948-6000		(800)-620-4672		(808)-948-5555		(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222		2	2	2
H1251	004	0	1	18	06	H1251_004_0	6	1		08/18/2011	2012.02	08/18/2011 11:36:34 AM Hawaiian Standard Time		08/09/2011 12:45:03 PM Hawaiian Standard Time		08/18/2011 03:46:11 PM Hawaiian Standard Time	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	HMSA's 65C Plus	www.hmsa.com	65C Plus High Option SRx (Cost)	06	18		1			H1251	004	0	2012	State of Hawaii		2	10000	2			2							www.hmsa.com	www.hmsa.com	(800)-776-4672		(808)-948-6000		(800)-620-4672		(808)-948-5555		(800)-776-4672		(808)-948-6000		(800)-620-4672		(808)-948-5555		(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222		2	2	2
H1264	004	0	1	02	01	H1264_004_0	7	1		07/21/2011	2012.02	07/21/2011 01:33:32 PM Eastern Daylight Time	08/05/2011 02:12:56 PM Eastern Daylight Time	08/04/2011 07:23:39 PM Eastern Daylight Time		08/08/2011 03:50:28 PM Eastern Daylight Time	WELLCARE OF TEXAS, INC.	WellCare	www.wellcare.com	WellCare Value (HMO-POS)	01	02		1			H1264	004	0	2012	Houston, Dallas, San Antonio Metro Areas		2		2			2						www.wellcare.com	www.wellcare.com	www.wellcare.com	(866)-687-8878		(866)-687-8878		(877)-232-7119		(877)-232-7119		(866)-687-8878		(866)-687-8878		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H1264	007	0	1	01	01	H1264_007_0	8	1	2	07/21/2011	2012.02	07/21/2011 01:33:47 PM Eastern Daylight Time	08/05/2011 02:13:12 PM Eastern Daylight Time	08/04/2011 07:27:50 PM Eastern Daylight Time		08/08/2011 03:50:28 PM Eastern Daylight Time	WELLCARE OF TEXAS, INC.	WellCare	www.wellcare.com	WellCare Access (HMO SNP)	01	01		1			H1264	007	0	2012	Houston, Dallas, San Antonio Metro Areas		2		2			1	3		1	1		www.wellcare.com	www.wellcare.com	www.wellcare.com	(866)-530-9495		(866)-530-9495		(877)-232-7119		(877)-232-7119		(866)-530-9495		(866)-530-9495		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H1264	008	0	1	01	01	H1264_008_0	7	1		07/21/2011	2012.02	07/21/2011 01:34:01 PM Eastern Daylight Time	08/05/2011 02:13:31 PM Eastern Daylight Time	08/04/2011 07:30:28 PM Eastern Daylight Time		08/08/2011 03:50:28 PM Eastern Daylight Time	WELLCARE OF TEXAS, INC.	WellCare	www.wellcare.com	WellCare Dividend (HMO)	01	01		1			H1264	008	0	2012	Houston Metro Area		2		2			2						www.wellcare.com	www.wellcare.com	www.wellcare.com	(866)-687-8878		(866)-687-8878		(877)-232-7119		(877)-232-7119		(866)-687-8878		(866)-687-8878		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H1264	014	0	1	01	01	H1264_014_0	7	1		07/21/2011	2012.02	07/21/2011 01:34:22 PM Eastern Daylight Time	08/05/2011 02:13:48 PM Eastern Daylight Time	08/04/2011 07:34:37 PM Eastern Daylight Time		08/08/2011 03:50:28 PM Eastern Daylight Time	WELLCARE OF TEXAS, INC.	WellCare	www.wellcare.com	WellCare Dividend (HMO)	01	01		1			H1264	014	0	2012	Dallas, San Antonio Metro Areas		2		2			2						www.wellcare.com	www.wellcare.com	www.wellcare.com	(866)-687-8878		(866)-687-8878		(877)-232-7119		(877)-232-7119		(866)-687-8878		(866)-687-8878		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H1286	002	0	1	02	01	H1286_002_0	4	1		08/09/2011	2012.02	08/09/2011 09:06:06 AM Central Daylight Time	08/05/2011 10:11:42 AM Central Daylight Time	08/05/2011 01:23:27 PM Central Daylight Time		08/09/2011 01:10:07 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H1286	002	0	2012	Spokane County		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1286	003	0	1	02	01	H1286_003_0	3	1		07/20/2011	2012.02	07/20/2011 02:27:08 PM Central Daylight Time	07/22/2011 01:07:14 PM Central Daylight Time			07/25/2011 01:32:03 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus Essential (HMO-POS)	01	02		1			H1286	003	0	2012	Spokane County		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514										(711)		(711)		(711)		(711)										2	2	2
H1286	008	0	1	02	01	H1286_008_0	5	1		08/08/2011	2012.02	08/08/2011 09:20:59 AM Central Daylight Time	08/05/2011 10:12:15 AM Central Daylight Time	08/05/2011 01:23:43 PM Central Daylight Time		08/09/2011 01:10:07 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H1286	008	0	2012	Skagit and Whatcom Counties		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1286	804	0	1	02	01	H1286_804_0	2	1		07/06/2011	2012.02	07/06/2011 04:38:20 PM Central Daylight Time	06/03/2011 02:17:35 PM Central Daylight Time			07/14/2011 09:19:14 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO-POS)	01	02		1			H1286	804	0	2012	Select counties in OR/WA		1		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548										(711)		(711)		(711)		(711)										2	2	2
H1291	001	0	1	09	04	H1291_001_0	7	1		07/07/2011	2012.02	07/07/2011 04:42:03 PM Eastern Daylight Time	06/01/2011 09:20:08 AM Eastern Daylight Time	08/04/2011 11:32:33 AM Eastern Daylight Time		08/08/2011 06:51:08 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	Humana Gold Choice H1291-001 (PFFS)	04	09	1	1			H1291	001	0	2012	Select Counties in New York		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1291	003	0	1	09	04	H1291_003_0	2	1		07/07/2011	2012.02	07/07/2011 04:42:54 PM Eastern Daylight Time	05/27/2011 02:18:20 PM Eastern Daylight Time			07/11/2011 03:30:25 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	Humana Gold Choice H1291-003 (PFFS)	04	09	1	1			H1291	003	0	2012	Select Counties in New York		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H1291	007	0	1	09	04	H1291_007_0	6	1		07/07/2011	2012.02	07/07/2011 04:43:41 PM Eastern Daylight Time	08/05/2011 10:48:04 PM Eastern Daylight Time	08/04/2011 11:32:53 AM Eastern Daylight Time		08/08/2011 06:51:08 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	Humana Gold Choice H1291-007 (PFFS)	04	09	1	1			H1291	007	0	2012	Select Counties in New York		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1302	001	0	1	04	01	H1302_001_0	10	1		08/08/2011	2012.02	08/08/2011 10:58:28 AM Mountain Daylight Time	08/08/2011 03:55:27 PM Mountain Daylight Time	08/08/2011 03:55:38 PM Mountain Daylight Time		08/08/2011 06:05:59 PM Mountain Daylight Time	BLUE CROSS OF IDAHO HLTH SERVICES INC	Blue Cross of Idaho	www.bcidaho.com/medicare	Secure Blue (PPO)	01	04		1			H1302	001	0	2012	Select Counties in Idaho		2	11521	2			2						www.bcidaho.com/medicare	bcidaho.com/ma_formulary	bcidaho.com/ma_formulary	(888)-494-2583		(208)-395-8200		(888)-492-2583		(208)-387-6673		(888)-494-2583		(208)-395-8200		(888)-492-2583		(208)-387-6673		(800)-377-1363		(800)-377-1363		(800)-377-1363		(800)-377-1363		(800)-377-1363		(800)-377-1363		(800)-377-1363		(800)-377-1363		2	2	2
H1302	004	0	1	04	01	H1302_004_0	5	1		06/29/2011	2012.02	06/29/2011 02:12:45 PM Mountain Daylight Time	07/07/2011 12:45:52 PM Mountain Daylight Time			07/18/2011 05:17:15 PM Mountain Daylight Time	BLUE CROSS OF IDAHO HLTH SERVICES INC	Blue Cross of Idaho	www.bcidaho.com/medicare	Secure Blue (PPO)	01	04		1			H1302	004	0	2012	Select Counties in Idaho		2	682	2			2						www.bcidaho.com/medicare	bcidaho.com/ma_formulary	bcidaho.com/ma_formulary	(888)-494-2583		(208)-395-8200		(888)-492-2583		(208)-387-6673										(800)-377-1363		(800)-377-1363		(800)-377-1363		(800)-377-1363										2	2	2
H1303	001	0	1	04	01	H1303_001_0	4	1		08/05/2011	2012.02	08/05/2011 08:11:27 AM Central Daylight Time	08/05/2011 10:12:57 AM Central Daylight Time	08/05/2011 01:23:58 PM Central Daylight Time		08/09/2011 01:10:07 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice (PPO)	01	04		1			H1303	001	0	2012	Ada and Canyon counties		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1304	001	0	1	04	01	H1304_001_0	8	1		07/20/2011	2012.02	07/20/2011 09:53:39 AM Mountain Daylight Time	08/09/2011 06:33:17 PM Pacific Daylight Time			08/09/2011 06:40:39 PM Pacific Daylight Time	REGENCE BLUE SHIELD OF IDAHO	Regence BlueShield Of Idaho	www.regence.com/medicare	Regence MedAdvantage Basic (PPO)	01	04		1			H1304	001	0	2012	Select Counties in Idaho/Asotin Co, WA		2		2			2						www.regence.com/medicare	www.regence.com/ID/products/medicare	www.regence.com/ID/products/medicare	(800)-541-8981		(800)-541-8981		(800)-505-6765		(800)-505-6765										(711)		(711)		(711)		(711)										2	2	2
H1304	002	0	1	04	01	H1304_002_0	8	1		07/20/2011	2012.02	07/20/2011 09:54:27 AM Mountain Daylight Time	08/09/2011 11:31:31 AM Pacific Daylight Time	08/09/2011 08:01:46 AM Pacific Daylight Time		08/09/2011 03:49:07 PM Pacific Daylight Time	REGENCE BLUE SHIELD OF IDAHO	Regence BlueShield Of Idaho	www.regence.com/medicare	Regence MedAdvantage + Rx Classic (PPO)	01	04		1			H1304	002	0	2012	Select Counties in Idaho/Asotin Co, WA		2		2			2						www.regence.com/medicare	www.regence.com/ID/products/medicare	www.regence.com/ID/products/medicare	(800)-541-8981		(800)-541-8981		(800)-505-6765		(800)-505-6765		(800)-541-8981		(800)-541-8981		(800)-505-6765		(800)-505-6765		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1304	004	0	1	04	01	H1304_004_0	7	1		07/20/2011	2012.02	07/20/2011 09:55:32 AM Mountain Daylight Time	08/09/2011 11:18:59 AM Pacific Daylight Time	08/09/2011 08:03:18 AM Pacific Daylight Time		08/09/2011 03:54:37 PM Pacific Daylight Time	REGENCE BLUE SHIELD OF IDAHO	Regence BlueShield Of Idaho	www.regence.com/medicare	Regence MedAdvantage + Rx Enhanced (PPO)	01	04		1			H1304	004	0	2012	Select Counties in Idaho/Asotin Co, WA		2		2			2						www.regence.com/medicare	www.regence.com/ID/products/medicare	www.regence.com/ID/products/medicare	(800)-541-8981		(800)-541-8981		(800)-505-6765		(800)-505-6765		(800)-541-8981		(800)-541-8981		(800)-505-6765		(800)-505-6765		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1304	803	0	1	04	01	H1304_803_0	7	1		05/26/2011	2012.02	05/26/2011 01:22:07 PM Mountain Daylight Time	08/09/2011 06:09:18 PM Pacific Daylight Time			08/09/2011 06:21:17 PM Pacific Daylight Time	REGENCE BLUE SHIELD OF IDAHO	Regence BlueShield Of Idaho	www.regence.com/medicare	Regence MedAdvantage (PPO)	01	04		1			H1304	803	0	2012	Nationwide except territories		1		2			2						www.regence.com/medicare	www.regence.com/ID/products/medicare	www.regence.com/ID/products/medicare	(888)-319-8904		(888)-319-8904		(800)-505-6765		(800)-505-6765										(711)		(711)		(711)		(711)										2	2	2
H1304	804	0	1	04	01	H1304_804_0	7	1		05/26/2011	2012.02	05/26/2011 01:28:42 PM Mountain Daylight Time	08/09/2011 06:10:50 PM Pacific Daylight Time			08/09/2011 06:23:19 PM Pacific Daylight Time	REGENCE BLUE SHIELD OF IDAHO	Regence BlueShield Of Idaho	www.regence.com/medicare	Regence MedAdvantage + Rx (PPO)	01	04		1			H1304	804	0	2012	Nationwide except territories		1		2			2						www.regence.com/medicare	www.regence.com/ID/products/medicare	www.regence.com/ID/products/medicare	(888)-319-8904		(888)-319-8904		(800)-505-6765		(800)-505-6765		(888)-319-8904		(888)-319-8904		(800)-505-6765		(800)-505-6765		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1310	001	0	1	20	08	H1310_001_0	1	1		05/26/2011	2012.02	05/26/2011 12:16:37 PM Eastern Daylight Time		05/20/2011 04:54:15 PM Eastern Daylight Time		05/26/2011 12:19:33 PM Eastern Daylight Time	COMPREHENSIVE SENIOR CARE CORPORATION	CentraCare	www.mycentracare.com	CentraCare Dual (PACE)	08	20		1			H1310	001	0	2012	Calhoun County		2		2			2							mycentracare.com	mycentracare.com									(877)-284-4071		(269)-441-9305		(877)-284-4071		(269)-441-9300										(800)-649-3777		(269)-441-9328		(800)-649-3777		(269)-441-9328				
H1310	003	0	1	20	08	H1310_003_0	1	1		05/26/2011	2012.02	05/26/2011 12:17:11 PM Eastern Daylight Time		05/20/2011 04:54:15 PM Eastern Daylight Time		05/26/2011 12:19:33 PM Eastern Daylight Time	COMPREHENSIVE SENIOR CARE CORPORATION	CentraCare	www.mycentracare.com	CentraCare Medicare-only (PACE)	08	20		1			H1310	003	0	2012	Calhoun County		2		2			2							mycentracare.com	mycentracare.com									(877)-284-4071		(269)-441-9305		(877)-284-4071		(269)-441-9300										(800)-649-3777		(269)-441-9328		(800)-649-3777		(269)-441-9328				
H1350	001	0	1	01	01	H1350_001_0	10	1		08/08/2011	2012.02	08/08/2011 10:59:29 AM Mountain Daylight Time	08/08/2011 03:56:15 PM Mountain Daylight Time	08/08/2011 03:56:21 PM Mountain Daylight Time		08/08/2011 06:05:59 PM Mountain Daylight Time	BLUE CROSS OF IDAHO HEALTH SERVICES, INC	Blue Cross of Idaho	www.bcidaho.com/medicare	True Blue Rx Option I (HMO)	01	01		1			H1350	001	0	2012	Select Counties in Idaho		2	15252	2			2						bcidaho.com/medicare	bcidaho.com/ma_formulary	bcidaho.com/ma_formulary	(888)-494-2583		(208)-395-8200		(888)-492-2583		(208)-387-6673		(888)-494-2583		(208)-395-8200		(888)-492-2583		(208)-387-6673		(800)-377-1363		(800)-377-1363		(800)-377-1363		(800)-377-1363		(800)-377-1363		(800)-377-1363		(800)-377-1363		(800)-377-1363		2	2	2
H1350	006	0	1	01	01	H1350_006_0	5	1		07/19/2011	2012.02	07/19/2011 05:35:44 PM Mountain Daylight Time	07/06/2011 04:28:18 PM Mountain Daylight Time			07/20/2011 11:42:02 AM Mountain Daylight Time	BLUE CROSS OF IDAHO HEALTH SERVICES, INC	Blue Cross of Idaho	www.bcidaho.com/medicare	True Blue (HMO)	01	01		1			H1350	006	0	2012	Select Counties in Idaho		2	3935	2			2						bcidaho.com/medicare	bcidaho.com/ma_formulary	bcidaho.com/ma_formulary	(888)-494-2583		(208)-395-8200		(888)-492-2583		(208)-387-6673										(800)-377-1363		(800)-377-1363		(800)-377-1363		(800)-377-1363										2	2	2
H1350	009	0	1	01	01	H1350_009_0	9	1	2	07/27/2011	2012.02	07/27/2011 02:47:02 PM Mountain Daylight Time	08/09/2011 11:47:04 AM Mountain Daylight Time	08/09/2011 11:47:10 AM Mountain Daylight Time		08/09/2011 12:39:15 PM Mountain Daylight Time	BLUE CROSS OF IDAHO HEALTH SERVICES, INC	Blue Cross of Idaho	www.bcidaho.com/medicare	True Blue Special Needs Plan (HMO SNP)	01	01		1			H1350	009	0	2012	Select Counties in Idaho		2	646	2			1	3		1	5		bcidaho.com/medicare	bcidaho.com/ma_formulary	bcidaho.com/ma_formulary	(888)-494-2583		(208)-395-8200		(888)-492-2583		(208)-387-6673		(888)-494-2583		(208)-395-8200		(888)-492-2583		(208)-387-6673		(800)-377-1363		(800)-377-1363		(800)-377-1363		(800)-377-1363		(800)-377-1363		(800)-377-1363		(800)-377-1363		(800)-377-1363		2	2	2
H1350	010	0	1	01	01	H1350_010_0	7	1		08/08/2011	2012.02	08/08/2011 05:58:41 PM Mountain Daylight Time	08/08/2011 03:56:28 PM Mountain Daylight Time	08/08/2011 03:56:35 PM Mountain Daylight Time		08/08/2011 06:05:59 PM Mountain Daylight Time	BLUE CROSS OF IDAHO HEALTH SERVICES, INC	Blue Cross of Idaho	www.bcidaho.com/medicare	True Blue Rx Option II (HMO)	01	01		1			H1350	010	0	2012	Select Counties in Idaho		2	655	2			2						bcidaho.com/medicare	bcidaho.com/ma_formulary	bcidaho.com/ma_formulary	(888)-494-2583		(208)-395-8200		(888)-492-2583		(208)-387-6673		(888)-494-2583		(208)-395-8200		(888)-492-2583		(208)-387-6673		(800)-377-1363		(800)-377-1363		(800)-377-1363		(800)-377-1363		(800)-377-1363		(800)-377-1363		(800)-377-1363		(800)-377-1363		2	2	2
H1350	011	0	1	01	01	H1350_011_0	9	1		08/08/2011	2012.02	08/08/2011 05:57:05 PM Mountain Daylight Time	08/08/2011 03:56:45 PM Mountain Daylight Time	08/08/2011 03:56:51 PM Mountain Daylight Time		08/08/2011 06:05:59 PM Mountain Daylight Time	BLUE CROSS OF IDAHO HEALTH SERVICES, INC	Blue Cross of Idaho	www.bcidaho.com/medicare	True Blue Freedom (HMO)	01	01		1			H1350	011	0	2012	Select Counties in Idaho		2	3000	2			2						bcidaho.com/medicare	bcidaho.com/ma_formulary	bcidaho.com/ma_formulary	(888)-494-2583		(208)-395-8200		(888)-492-2583		(208)-387-6673		(888)-494-2583		(208)-395-8200		(888)-492-2583		(208)-387-6673		(800)-377-1363		(800)-377-1363		(800)-377-1363		(800)-377-1363		(800)-377-1363		(800)-377-1363		(800)-377-1363		(800)-377-1363		2	2	2
H1355	001	0	1	04	01	H1355_001_0	10	1		07/18/2011	2012.02	07/18/2011 03:20:34 PM Eastern Daylight Time	08/08/2011 08:55:26 AM Central Daylight Time	08/04/2011 04:45:45 PM Central Daylight Time		08/09/2011 04:46:11 PM Central Daylight Time	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	Bravo Freedom (PPO)	01	04		1			H1355	001	0	2012	Select Texas Counties		2		2			2						www.mybravohealth.com	www.mybravohealth.com/formulary	www.mybravohealth.com	(800)-291-0396		(800)-291-0396		(888)-318-2827		(888)-318-2827		(800)-291-0396		(800)-291-0396		(888)-318-2827		(888)-318-2827		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1355	002	0	1	04	01	H1355_002_0	8	1		08/05/2011	2012.02	08/05/2011 03:13:55 PM Eastern Daylight Time	08/08/2011 08:56:20 AM Central Daylight Time	08/04/2011 04:46:30 PM Central Daylight Time		08/09/2011 04:46:11 PM Central Daylight Time	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	Bravo Traditions (PPO SNP)	01	04		1			H1355	002	0	2012	Select Tx Counties		2		2			1	1	1	1			www.mybravohealth.com	www.mybravohealth.com/formulary	www.mybravohealth.com	(800)-291-0396		(800)-291-0396		(888)-318-2827		(888)-318-2827		(800)-291-0396		(800)-291-0396		(888)-318-2827		(888)-318-2827		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1355	801	0	1	04	01	H1355_801_0	4	1		06/27/2011	2012.02	06/27/2011 10:36:29 AM Eastern Daylight Time	05/30/2011 01:27:01 PM Central Daylight Time			07/05/2011 03:22:22 PM Central Daylight Time	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	EGWP (CY) (PPO)	01	04		1			H1355	801	0	2012	Nationwide		1		2			2						www.mybravohealth.com	www.mybravohealth.com/formulary	www.mybravohealth.com	(800)-291-0396		(800)-291-0396		(888)-318-2827		(888)-318-2827		(800)-291-0396		(800)-291-0396		(888)-318-2827		(888)-318-2827		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1355	802	0	1	04	01	H1355_802_0	4	1		06/27/2011	2012.02	06/27/2011 10:37:05 AM Eastern Daylight Time	05/30/2011 01:28:10 PM Central Daylight Time			07/05/2011 03:22:22 PM Central Daylight Time	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	EGWP (non-CY) (PPO)	01	04		1			H1355	802	0	2012	Nationwide		1		2			2						www.mybravohealth.com	www.mybravohealth.com/formulary	www.mybravohealth.com	(800)-291-0396		(800)-291-0396		(888)-318-2827		(888)-318-2827		(800)-291-0396		(800)-291-0396		(888)-318-2827		(888)-318-2827		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1357	001	0	1	20	08	H1357_001_0	1	1		02/23/2012	2012.02	02/23/2012 07:36:05 AM Mountain Standard Time		02/08/2012 03:12:19 PM Mountain Standard Time		02/23/2012 08:00:41 AM Mountain Standard Time	CAROLINA SENIORCARE	Carolina SeniorCare	www.uchas.org	Carolina SeniorCare (PACE)	08	20		1			H1357	001	0	2012	Carolina SeniorCare		2		2			2							www.uchas.org	www.uchas.org									(800)-000-0000		(828)-465-8017		(800)-000-0000		(828)-465-8017										(800)-000-0000		(828)-465-8017		(800)-000-0000		(828)-465-8017				
H1357	002	0	1	20	08	H1357_002_0	1	1		02/23/2012	2012.02	02/23/2012 07:36:22 AM Mountain Standard Time		02/08/2012 03:12:19 PM Mountain Standard Time		02/23/2012 08:00:41 AM Mountain Standard Time	CAROLINA SENIORCARE	Carolina SeniorCare	www.uchas.org	Carolina SeniorCare (PACE)	08	20		1			H1357	002	0	2012	Carolina SeniorCare		2		2			2							www.uchas.org	www.uchas.org									(800)-000-0000		(828)-465-8017		(800)-000-0000		(828)-465-8017										(800)-000-0000		(828)-465-8017		(800)-000-0000		(828)-465-8017				
H1365	001	0	1	04	01	H1365_001_0	7	1		08/08/2011	2012.02	08/08/2011 10:54:27 AM Eastern Daylight Time	08/07/2011 01:05:46 PM Eastern Daylight Time	08/07/2011 01:05:46 PM Eastern Daylight Time		08/08/2011 11:14:10 AM Eastern Daylight Time	MARTIN'S POINT GENERATIONS, LLC	Martin's Point Generations Advantage	www.martinspoint.org/medicare	Martin's Point Generations Advantage Select (PPO)	01	04		1			H1365	001	0	2012	Counties: Andr,Cumb,Frk,Knx,Linc,Oxf, Sag,Wald,Yrk		2		2			2						http://www.martinspoint.org/medicare	www.martinspoint.org/medicare	www.martinspoint.org/medicare	(866)-544-7504		(866)-544-7504		(888)-640-4423		(888)-640-4423		(888)-640-4423		(888)-640-4423		(888)-640-4423		(888)-640-4423		(866)-544-7503		(866)-544-7503		(866)-544-7502		(866)-544-7502		(866)-544-7502		(866)-544-7502		(866)-544-7502		(866)-544-7502		2	2	2
H1365	002	0	1	04	01	H1365_002_0	6	1		08/08/2011	2012.02	08/08/2011 10:55:21 AM Eastern Daylight Time	08/07/2011 01:05:45 PM Eastern Daylight Time	08/07/2011 01:05:46 PM Eastern Daylight Time		08/08/2011 11:19:53 AM Eastern Daylight Time	MARTIN'S POINT GENERATIONS, LLC	Martin's Point Generations Advantage	www.martinspoint.org/medicare	Martin's Point Generations Advantage Select (PPO)	01	04		1			H1365	002	0	2012	Counties: Aroos, Hanc,Kenn,Penob,Pisc, Som,Wash		2		2			2						http://www.martinspoint.org/medicare	www.martinspoint.org/medicare	www.martinspoint.org/medicare	(866)-544-7504		(866)-544-7504		(888)-640-4423		(888)-640-4423		(866)-544-7504		(866)-544-7504		(888)-640-4423		(888)-640-4423		(866)-544-7503		(866)-544-7503		(866)-544-7502		(866)-544-7502		(866)-544-7503		(866)-544-7503		(866)-544-7502		(866)-544-7502		2	2	2
H1365	802	0	1	04	01	H1365_802_0	2	1		05/29/2011	2012.02	05/29/2011 01:39:12 PM Eastern Daylight Time	06/06/2011 03:40:29 PM Eastern Daylight Time			06/06/2011 03:55:21 PM Eastern Daylight Time	MARTIN'S POINT GENERATIONS, LLC	Martin's Point Generations Advantage	www.martinspoint.org/medicare	Martin's Point Generations Advantage Select Group (PPO)	01	04		1			H1365	802	0	2012	State of Maine		1		2			2						http://www.martinspoint.org/medicare	www.martinspoint.org/medicare	www.martinspoint.org/medicare	(866)-544-7504		(866)-544-7504		(888)-640-4423		(888)-640-4423		(866)-544-7504		(866)-544-7504		(888)-640-4423		(888)-640-4423		(866)-544-7503		(866)-544-7503		(866)-544-7502		(866)-544-7502		(866)-544-7503		(866)-544-7503		(866)-544-7502		(866)-544-7502		1	1	1
H1406	013	0	1	01	01	H1406_013_0	6	1		07/06/2011	2012.02	07/06/2011 09:09:18 AM Eastern Daylight Time	08/04/2011 02:25:41 PM Eastern Daylight Time	08/04/2011 11:33:11 AM Eastern Daylight Time		08/08/2011 02:43:31 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1406-013 (HMO)	01	01		1			H1406	013	0	2012	Chicago Illinois		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1406	022	0	1	01	01	H1406_022_0	5	1		07/08/2011	2012.02	07/08/2011 08:02:49 AM Eastern Daylight Time	08/04/2011 02:39:12 PM Eastern Daylight Time	08/04/2011 11:33:32 AM Eastern Daylight Time		08/08/2011 02:43:31 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1406-022 (HMO)	01	01		1			H1406	022	0	2012	Select Counties in Illinois		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1406	025	0	1	01	01	H1406_025_0	4	1		07/06/2011	2012.02	07/06/2011 09:11:24 AM Eastern Daylight Time	08/04/2011 02:27:54 PM Eastern Daylight Time	08/04/2011 11:33:58 AM Eastern Daylight Time		08/08/2011 02:51:42 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1406-025 (HMO)	01	01		1			H1406	025	0	2012	LaSalle County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1406	026	0	1	01	01	H1406_026_0	5	1		07/06/2011	2012.02	07/06/2011 09:13:16 AM Eastern Daylight Time	08/04/2011 02:28:48 PM Eastern Daylight Time	08/04/2011 11:34:17 AM Eastern Daylight Time		08/08/2011 02:51:42 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1406-026 (HMO)	01	01		1			H1406	026	0	2012	Select Counties in Illinois		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1406	027	0	1	01	01	H1406_027_0	4	1		07/06/2011	2012.02	07/06/2011 09:14:05 AM Eastern Daylight Time	08/04/2011 02:38:21 PM Eastern Daylight Time	08/04/2011 11:34:37 AM Eastern Daylight Time		08/08/2011 02:56:28 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H1406-027 (HMO)	01	01		1			H1406	027	0	2012	Madison County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1406	801	0	1	01	01	H1406_801_0	3	1		07/05/2011	2012.02	07/06/2011 08:15:50 AM Eastern Daylight Time	07/19/2011 09:50:34 AM Eastern Daylight Time			07/22/2011 12:21:38 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H1406	801	0	2012	Select counties in Chicago metro area		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H1406	802	0	1	01	01	H1406_802_0	3	1		07/05/2011	2012.02	07/06/2011 08:15:56 AM Eastern Daylight Time	07/19/2011 09:56:33 AM Eastern Daylight Time			07/22/2011 12:21:38 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H1406	802	0	2012	Select counties in Chicago metro area		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
H1406	803	0	1	01	01	H1406_803_0	3	1		07/05/2011	2012.02	07/06/2011 08:16:00 AM Eastern Daylight Time	07/19/2011 09:58:23 AM Eastern Daylight Time			07/22/2011 12:21:38 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Employer Sponsored Non-CY (HMO)	01	01		1			H1406	803	0	2012	Select counties in Chicago metro area		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H1415	005	0	1	01	01	H1415_005_0	7	1	2	08/05/2011	2012.02	08/05/2011 03:44:01 PM Central Daylight Time	07/21/2011 10:58:06 PM Central Daylight Time	08/04/2011 05:31:41 PM Central Daylight Time		08/09/2011 04:56:32 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	HealthSpring, Inc.	www.healthspring.com	TotalCare (HMO SNP)	01	01		1			H1415	005	0	2012	Cook, DuPage, Kane,  and Will		2		2			1	3		1	2			www.healthspring.com	www.healthspring.com	(888)-588-4827		(888)-588-4827		(888)-886-1993		(888)-886-1993		(800)-331-6293		(800)-331-6293		(888)-886-1993		(888)-886-1993		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230		2	2	2
H1415	013	0	1	01	01	H1415_013_0	3	1		07/28/2011	2012.02	07/28/2011 02:28:06 PM Central Daylight Time	05/27/2011 04:50:21 PM Central Daylight Time			07/28/2011 06:06:50 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	HealthSpring, Inc.	www.healthspring.com	HealthyAdvantage (HMO)	01	01		1			H1415	013	0	2012	Cook, DuPage, Kane, and Will		2		2			2							www.healthspring.com	www.healthspring.com	(888)-588-4827		(888)-588-4827		(888)-886-1993		(888)-886-1993										(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565										2	2	2
H1415	021	0	1	02	01	H1415_021_0	9	1		08/05/2011	2012.02	08/05/2011 03:45:18 PM Central Daylight Time	08/05/2011 02:39:10 PM Central Daylight Time	08/04/2011 05:32:27 PM Central Daylight Time		08/08/2011 06:14:25 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	HealthSpring, Inc.	www.healthspring.com	HealthyAdvantage Preferred (HMO-POS)	01	02		1			H1415	021	0	2012	Cook, DuPage, Kane, and Will		2		2			2							www.healthspring.com	www.healthspring.com	(888)-588-4827		(888)-588-4827		(888)-886-1993		(888)-886-1993		(800)-331-6293		(800)-331-6293		(888)-886-1993		(888)-886-1993		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230		2	2	2
H1415	024	0	1	01	01	H1415_024_0	5	1		08/05/2011	2012.02	08/05/2011 03:46:39 PM Central Daylight Time	08/05/2011 02:41:55 PM Central Daylight Time	08/04/2011 05:33:14 PM Central Daylight Time		08/08/2011 07:14:27 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	HealthSpring, Inc.	www.healthspring.com	HealthyAdvantage Primary Plan (HMO)	01	01		1			H1415	024	0	2012	Cook, DuPage, Kane, and Will		2		2			2							www.healthspring.com	www.healthspring.com	(888)-588-4827		(888)-588-4827		(888)-886-1993		(888)-886-1993		(800)-331-6293		(800)-331-6293		(888)-886-1993		(888)-886-1993		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230		2	2	2
H1415	802	0	1	01	01	H1415_802_0	3	1		06/01/2011	2012.02	06/01/2011 12:44:41 PM Central Daylight Time	06/03/2011 12:11:39 PM Central Daylight Time			06/06/2011 02:58:32 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	HealthSpring, Inc.	www.healthspring.com	Retiree Advantage (HMO)	01	01		1			H1415	802	0	2012	Illinois		1	159	2			2							www.healthspring.com	www.healthspring.com	(888)-588-4827		(888)-588-4827		(888)-886-1993		(888)-886-1993										(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565										1	1	1
H1415	804	0	1	01	01	H1415_804_0	3	1		06/01/2011	2012.02	06/01/2011 12:45:58 PM Central Daylight Time	06/06/2011 02:20:33 PM Central Daylight Time			06/06/2011 02:58:32 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	HealthSpring, Inc.	www.healthspring.com	Retiree Advantage Preferred (HMO)	01	01		1			H1415	804	0	2012	Illinois		1	159	2			2							www.healthspring.com	www.healthspring.com	(888)-588-4827		(888)-588-4827		(888)-886-1993		(888)-886-1993		(800)-331-6293		(800)-331-6293		(888)-299-3582		(888)-299-3582		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230		1	1	1
H1416	007	0	1	01	01	H1416_007_0	8	1	2	07/21/2011	2012.02	07/21/2011 01:34:36 PM Eastern Daylight Time	08/05/2011 02:14:05 PM Eastern Daylight Time	08/04/2011 07:38:35 PM Eastern Daylight Time		08/08/2011 03:50:28 PM Eastern Daylight Time	HARMONY HEALTH PLAN OF ILLINOIS, INC.	WellCare	www.wellcare.com	WellCare Access (HMO SNP)	01	01		1			H1416	007	0	2012	Chicago, St. Louis Areas and Champaign, Verm, Doug		2		2			1	3		1	1			www.wellcare.com	www.wellcare.com	(866)-439-1190		(866)-439-1190		(877)-232-7119		(877)-232-7119		(866)-439-1190		(866)-439-1190		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H1416	009	0	1	02	01	H1416_009_0	8	1		07/21/2011	2012.02	07/21/2011 01:34:49 PM Eastern Daylight Time	08/05/2011 02:14:22 PM Eastern Daylight Time	08/11/2011 11:11:33 AM Eastern Daylight Time		08/11/2011 02:04:30 PM Eastern Daylight Time	HARMONY HEALTH PLAN OF ILLINOIS, INC.	WellCare	www.wellcare.com	WellCare Value (HMO-POS)	01	02		1			H1416	009	0	2012	Chicago, St. Louis Areas and Champaign, Verm, Doug		2		2			2							www.wellcare.com	www.wellcare.com	(866)-334-6876		(866)-334-6876		(877)-232-7119		(877)-232-7119		(866)-334-6876		(866)-334-6876		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H1416	019	0	1	01	01	H1416_019_0	9	1		07/21/2011	2012.02	07/21/2011 01:35:02 PM Eastern Daylight Time	08/05/2011 02:14:39 PM Eastern Daylight Time	08/11/2011 11:12:40 AM Eastern Daylight Time		08/11/2011 02:04:30 PM Eastern Daylight Time	HARMONY HEALTH PLAN OF ILLINOIS, INC.	WellCare	www.wellcare.com	WellCare Rx (HMO)	01	01		1			H1416	019	0	2012	Chicago, St. Louis Areas and Champaign, Verm, Doug		2		2			2							www.wellcare.com	www.wellcare.com	(866)-334-6876		(866)-334-6876		(877)-232-7119		(877)-232-7119		(866)-334-6876		(866)-334-6876		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H1417	001	0	1	04	01	H1417_001_0	7	1		07/11/2011	2012.02	07/11/2011 05:45:26 PM Central Daylight Time	06/01/2011 11:18:26 AM Central Daylight Time			07/12/2011 11:05:09 AM Central Daylight Time	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medical Plans	www.healthalliancemedicare.org	Health Alliance Medicare PPO10 (PPO)	01	04		1			H1417	001	0	2012	Central Illinois		2	310	2			2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-965-4022										(866)-883-8551		(866)-883-8551		(866)-883-8551		(866)-883-8551										2	2	2
H1417	002	0	1	04	01	H1417_002_0	11	1		07/18/2011	2012.02	07/18/2011 03:37:51 PM Central Daylight Time	08/05/2011 01:08:24 PM Central Daylight Time	08/05/2011 09:25:52 AM Central Daylight Time		08/10/2011 10:56:34 AM Central Daylight Time	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medical Plans	www.healthalliancemedicare.org	Health Alliance Medicare PPO10 Rx (PPO)	01	04		1			H1417	002	0	2012	Central Illinois		2	3872	2			2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-526-0844		(800)-526-0844		(800)-526-0844		(800)-526-0844		(800)-526-0844		(800)-526-0844		(800)-526-0844		(800)-526-0844		2	2	2
H1417	003	0	1	04	01	H1417_003_0	8	1		07/18/2011	2012.02	07/18/2011 03:38:10 PM Central Daylight Time	06/01/2011 11:20:42 AM Central Daylight Time			07/18/2011 03:44:30 PM Central Daylight Time	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medical Plans	www.healthalliancemedicare.org	Health Alliance Medicare PPO30 (PPO)	01	04		1			H1417	003	0	2012	Central Illinois		2	109	2			2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-965-4022										(866)-883-8551		(866)-883-8551		(866)-883-8551		(866)-883-8551										2	2	2
H1417	004	0	1	04	01	H1417_004_0	12	1		07/18/2011	2012.02	07/18/2011 03:41:25 PM Central Daylight Time	08/05/2011 11:05:20 AM Central Daylight Time	08/05/2011 09:25:26 AM Central Daylight Time		08/10/2011 10:56:34 AM Central Daylight Time	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medical Plans	www.healthalliancemedicare.org	Health Alliance Medicare PPO30 Rx (PPO)	01	04		1			H1417	004	0	2012	Central Illinois		2	970	2			2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-526-0844		(800)-526-0844		(800)-526-0844		(800)-526-0844		(800)-526-0844		(800)-526-0844		(800)-526-0844		(800)-526-0844		2	2	2
H1417	801	0	1	04	01	H1417_801_0	4	1		05/23/2011	2012.02	05/23/2011 04:49:46 PM Central Daylight Time	06/03/2011 12:59:56 PM Central Daylight Time			06/05/2011 04:54:59 PM Central Daylight Time	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medical Plans	www.healthalliancemedicare.org	Medicare Employer PPO (PPO)	01	04		1			H1417	801	0	2012	Illinois		1	12	1	1		2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-965-4022										(866)-883-8551		(866)-883-8551		(866)-883-8551		(866)-883-8551										1	1	1
H1417	802	0	1	04	01	H1417_802_0	4	1		05/23/2011	2012.02	05/23/2011 04:50:12 PM Central Daylight Time	06/03/2011 12:59:26 PM Central Daylight Time			06/05/2011 04:54:59 PM Central Daylight Time	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medical Plans	www.healthalliancemedicare.org	Medicare Employer PPO Rx (PPO)	01	04		1			H1417	802	0	2012	Illinois		1	1111	1	1		2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-965-4022		(866)-883-8551		(866)-883-8551		(866)-883-8551		(866)-883-8551		(866)-883-8551		(866)-883-8551		(866)-883-8551		(866)-883-8551		1	1	1
H1418	002	0	1	04	01	H1418_002_0	5	1		07/06/2011	2012.02	07/06/2011 01:21:27 PM Eastern Daylight Time	08/04/2011 02:26:46 PM Eastern Daylight Time	08/04/2011 11:34:54 AM Eastern Daylight Time		08/08/2011 02:56:28 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H1418-002 (PPO)	01	04		1			H1418	002	0	2012	Select Counties in Illinois		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1418	007	0	1	04	01	H1418_007_0	5	1		07/07/2011	2012.02	07/07/2011 01:05:49 PM Eastern Daylight Time	08/04/2011 02:13:47 PM Eastern Daylight Time	08/04/2011 11:35:11 AM Eastern Daylight Time		08/08/2011 03:00:19 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H1418-007 (PPO)	01	04		1			H1418	007	0	2012	Select Counties in Illinois		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1418	008	0	1	04	01	H1418_008_0	8	1		07/07/2011	2012.02	07/07/2011 02:30:58 PM Eastern Daylight Time	08/05/2011 11:29:06 AM Eastern Daylight Time	08/04/2011 11:35:40 AM Eastern Daylight Time		08/09/2011 10:58:20 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H1418-008 (PPO)	01	04		1			H1418	008	0	2012	Scott County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1418	009	0	1	04	01	H1418_009_0	5	1		07/07/2011	2012.02	07/07/2011 02:31:13 PM Eastern Daylight Time	05/27/2011 03:14:47 PM Eastern Daylight Time			07/07/2011 03:43:58 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H1418-009 (PPO)	01	04		1			H1418	009	0	2012	Scott County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H1418	016	0	1	04	01	H1418_016_0	5	1		07/06/2011	2012.02	07/06/2011 01:22:35 PM Eastern Daylight Time	08/04/2011 02:29:48 PM Eastern Daylight Time	08/04/2011 11:35:59 AM Eastern Daylight Time		08/08/2011 03:00:19 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H1418-016 (PPO)	01	04		1			H1418	016	0	2012	Massac and Union counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1419	001	0	1	01	01	H1419_001_0	4	1		07/08/2011	2012.02	07/08/2011 11:21:57 AM Central Daylight Time	08/04/2011 12:15:13 PM Central Daylight Time	08/04/2011 09:40:08 AM Central Daylight Time		08/08/2011 08:23:16 AM Central Daylight Time	AETNA HEALTH,  INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (HMO)	01	01		1			H1419	001	0	2012	Cook County		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H1419	801	0	1	01	01	H1419_801_0	2	1		04/22/2011	2012.02	04/22/2011 09:50:38 AM Eastern Daylight Time	06/01/2011 04:38:13 PM Eastern Daylight Time			06/03/2011 06:19:28 PM Eastern Daylight Time	AETNA HEALTH,  INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan (HMO)	01	01		1			H1419	801	0	2012	Illinois		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748										1	1	1
H1419	802	0	1	01	01	H1419_802_0	2	1		04/22/2011	2012.02	04/22/2011 09:51:03 AM Eastern Daylight Time	06/01/2011 04:41:29 PM Eastern Daylight Time			06/03/2011 06:19:28 PM Eastern Daylight Time	AETNA HEALTH,  INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan w/Rx CY (HMO)	01	01		1			H1419	802	0	2012	Illinois		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		1	1	1
H1463	001	0	1	01	01	H1463_001_0	6	1		07/18/2011	2012.02	07/18/2011 12:45:30 PM Central Daylight Time	06/01/2011 11:25:26 AM Central Daylight Time			07/18/2011 03:31:38 PM Central Daylight Time	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medical Plans	www.healthalliancemedicare.org	Health Alliance Medicare HMO20 (HMO)	01	01		1			H1463	001	0	2012	East Central Illinois		2	1220	2			2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-965-4022										(866)-883-8551		(866)-883-8551		(866)-883-8551		(866)-883-8551										2	2	2
H1463	003	0	1	01	01	H1463_003_0	9	1		06/29/2011	2012.02	06/29/2011 05:32:16 PM Central Daylight Time	08/05/2011 10:07:52 AM Central Daylight Time	08/05/2011 09:26:00 AM Central Daylight Time		08/10/2011 10:56:34 AM Central Daylight Time	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medical Plans	www.healthalliancemedicare.org	Health Alliance Medicare HMO20 Rx (HMO)	01	01		1			H1463	003	0	2012	East Central Illinois		2	4615	2			2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-526-0844		(800)-526-0844		(800)-526-0844		(800)-526-0844		(800)-526-0844		(800)-526-0844		(800)-526-0844		(800)-526-0844		2	2	2
H1463	801	0	1	01	01	H1463_801_0	4	1		05/23/2011	2012.02	05/23/2011 04:50:36 PM Central Daylight Time	06/03/2011 12:58:58 PM Central Daylight Time			06/05/2011 04:54:59 PM Central Daylight Time	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medical Plans	www.healthalliancemedicare.org	Medicare Employer HMO (HMO)	01	01		1			H1463	801	0	2012	Illinois		1	27	1	1		2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-965-4022										(866)-883-8551		(866)-883-8551		(866)-883-8551		(866)-883-8551										1	1	1
H1463	802	0	1	01	01	H1463_802_0	4	1		05/23/2011	2012.02	05/23/2011 04:50:46 PM Central Daylight Time	06/03/2011 01:00:26 PM Central Daylight Time			06/05/2011 04:54:59 PM Central Daylight Time	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medical Plans	www.healthalliancemedicare.org	Medicare Employer HMO Rx (HMO)	01	01		1			H1463	802	0	2012	Illinois		1	209	1	1		2						www.healthalliancemedicare.org	www.healthalliancemedicare.org	www.healthalliancemedicare.org	(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-965-4022		(866)-883-8551		(866)-883-8551		(866)-883-8551		(866)-883-8551		(866)-883-8551		(866)-883-8551		(866)-883-8551		(866)-883-8551		1	1	1
H1468	007	0	1	01	01	H1468_007_0	4	1		07/06/2011	2012.02	07/06/2011 01:22:55 PM Eastern Daylight Time	08/04/2011 02:19:13 PM Eastern Daylight Time	08/04/2011 11:36:17 AM Eastern Daylight Time		08/08/2011 03:04:56 PM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana-medicare.com	Humana Gold Plus H1468-007 (HMO)	01	01		1			H1468	007	0	2012	Select Counties in Illinois		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1468	802	0	1	01	01	H1468_802_0	4	1		07/06/2011	2012.02	07/06/2011 08:34:38 AM Eastern Daylight Time	05/27/2011 05:56:10 PM Eastern Daylight Time			07/06/2011 11:11:17 AM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H1468	802	0	2012	Select counties in Peoria metro area		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H1468	803	0	1	01	01	H1468_803_0	4	1		07/06/2011	2012.02	07/06/2011 08:36:42 AM Eastern Daylight Time	05/27/2011 05:57:12 PM Eastern Daylight Time			07/06/2011 11:11:17 AM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H1468	803	0	2012	Select counties in Peoria metro area		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
H1468	804	0	1	01	01	H1468_804_0	4	1		07/06/2011	2012.02	07/06/2011 08:39:49 AM Eastern Daylight Time	05/27/2011 05:58:07 PM Eastern Daylight Time			07/06/2011 11:11:17 AM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana-medicare.com	Humana Employer Sponsored Non-CY (HMO)	01	01		1			H1468	804	0	2012	Select counties in Peoria metro area		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H1500	001	0	1	20	08	H1500_001_0	1	1		05/27/2011	2012.02	05/27/2011 10:42:38 AM Central Daylight Time		05/26/2011 02:59:02 PM Central Daylight Time		05/27/2011 10:43:06 AM Central Daylight Time	LIFE ST. JOSEPH OF THE PINES, INC.	LIFE St. Joseph of the Pines	www.sjp.org	LIFE St. Joseph of the Pines (PACE)	08	20		1			H1500	001	0	2012	LIFE St. Joseph of the Pines		2		2			2							www.sjp.org	www.sjp.org									(800)-246-1000		(910)-246-1000		(800)-246-1000		(910)-246-1000										(800)-246-1000		(910)-246-1000		(800)-246-1000		(910)-246-1000				
H1500	002	0	1	20	08	H1500_002_0	1	1		05/27/2011	2012.02	05/27/2011 10:42:33 AM Central Daylight Time		05/26/2011 02:59:02 PM Central Daylight Time		05/27/2011 10:43:06 AM Central Daylight Time	LIFE ST. JOSEPH OF THE PINES, INC.	LIFE St. Joseph of the Pines	www.sjp.org	LIFE St. Joseph of the Pines (PACE)	08	20		1			H1500	002	0	2012	LIFE St. Joseph of the Pines		2		2			2							www.sjp.org	www.sjp.org									(800)-246-1000		(910)-246-1000		(800)-246-1000		(910)-246-1000										(800)-246-1000		(910)-246-1000		(800)-246-1000		(910)-246-1000				
H1509	001	0	1	04	01	H1509_001_0	5	1		08/04/2011	2012.02	08/04/2011 03:08:17 PM Central Daylight Time	08/04/2011 10:04:55 PM Central Daylight Time	08/05/2011 01:24:13 PM Central Daylight Time		08/09/2011 12:05:43 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice (PPO)	01	04		1			H1509	001	0	2012	Northern Indiana		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1509	004	0	1	04	01	H1509_004_0	4	1	2	07/22/2011	2012.02	07/22/2011 11:54:40 AM Central Daylight Time	08/04/2011 10:05:49 PM Central Daylight Time	08/05/2011 12:57:39 PM Central Daylight Time		08/09/2011 12:05:43 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Dual Complete (PPO SNP)	01	04		1			H1509	004	0	2012	Indianapolis, Fort Wayne, South Bend areas		2		2			1	3		1	2		www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1509	006	0	1	04	01	H1509_006_0	3	1		08/09/2011	2012.02	08/09/2011 11:55:55 AM Central Daylight Time	08/08/2011 11:40:04 AM Central Daylight Time	08/05/2011 12:58:01 PM Central Daylight Time		08/09/2011 03:53:30 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.EvercareHealthPlans.com	UnitedHealthcare Nursing Home Plan (PPO SNP)	01	04		1			H1509	006	0	2012	Indianapolis area		2		2			1	1	1	1			www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1509	007	0	1	04	01	H1509_007_0	4	1		08/04/2011	2012.02	08/04/2011 03:13:05 PM Central Daylight Time	08/04/2011 10:06:26 PM Central Daylight Time	08/05/2011 01:24:29 PM Central Daylight Time		08/09/2011 12:05:43 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice (PPO)	01	04		1			H1509	007	0	2012	Indianapolis area		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1509	009	0	1	04	01	H1509_009_0	4	1		08/04/2011	2012.02	08/04/2011 03:16:13 PM Central Daylight Time	08/04/2011 10:07:12 PM Central Daylight Time	08/05/2011 01:24:44 PM Central Daylight Time		08/09/2011 12:05:43 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice (PPO)	01	04		1			H1509	009	0	2012	Evansville area		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1509	801	0	1	04	01	H1509_801_0	4	1		07/06/2011	2012.02	07/06/2011 04:19:46 PM Central Daylight Time	08/29/2011 10:30:45 AM Central Daylight Time			09/01/2011 10:37:35 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1509	801	0	2012	National Service Area		1		2			2						www.UHCMedicareSolutions.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1509	803	0	1	04	01	H1509_803_0	4	1		07/06/2011	2012.02	07/06/2011 04:38:29 PM Central Daylight Time	08/29/2011 10:32:17 AM Central Daylight Time			09/01/2011 10:37:35 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1509	803	0	2012	National Service Area		1		2			2						www.UHCMedicareSolutions.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506										(711)		(711)		(711)		(711)										2	2	2
H1509	804	0	1	04	01	H1509_804_0	4	1		07/06/2011	2012.02	07/06/2011 04:38:35 PM Central Daylight Time	08/29/2011 10:33:48 AM Central Daylight Time			09/01/2011 10:37:35 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1509	804	0	2012	National Service Area		1		2			2						www.UHCMedicareSolutions.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1509	806	0	2	04	01	H1509_806_0	4	1		07/06/2011	2012.02	07/06/2011 04:38:40 PM Central Daylight Time	08/29/2011 10:35:15 AM Central Daylight Time			09/01/2011 10:37:35 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H1509	806	0	2012	National Service Area		1		2			2						www.UHCMedicareSolutions.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1509	807	0	2	04	01	H1509_807_0	4	1		07/06/2011	2012.02	07/06/2011 04:38:43 PM Central Daylight Time	08/29/2011 10:36:44 AM Central Daylight Time			09/01/2011 10:37:35 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H1509	807	0	2012	National Service Area		1		2			2						www.UHCMedicareSolutions.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506										(711)		(711)		(711)		(711)										2	2	2
H1509	808	0	2	04	01	H1509_808_0	4	1		07/06/2011	2012.02	07/06/2011 04:38:48 PM Central Daylight Time	08/29/2011 10:38:19 AM Central Daylight Time			09/01/2011 10:37:35 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H1509	808	0	2012	National Service Area		1		2			2						www.UHCMedicareSolutions.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1509	809	0	1	04	01	H1509_809_0	3	1		07/06/2011	2012.02	07/06/2011 04:38:53 PM Central Daylight Time	08/29/2011 10:39:37 AM Central Daylight Time			09/01/2011 10:37:35 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1509	809	0	2012	National Service Area		1		2			2						www.UHCMedicareSolutions.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1509	810	0	1	04	01	H1509_810_0	3	1		07/06/2011	2012.02	07/06/2011 04:38:56 PM Central Daylight Time	08/29/2011 10:40:50 AM Central Daylight Time			09/01/2011 10:37:35 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1509	810	0	2012	National Service Area		1		2			2						www.UHCMedicareSolutions.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506										(711)		(711)		(711)		(711)										2	2	2
H1509	811	0	1	04	01	H1509_811_0	3	1		07/06/2011	2012.02	07/06/2011 04:39:03 PM Central Daylight Time	08/29/2011 10:42:06 AM Central Daylight Time			09/01/2011 10:37:35 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1509	811	0	2012	National Service Area		1		2			2						www.UHCMedicareSolutions.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1509	812	0	1	04	01	H1509_812_0	2	1		07/06/2011	2012.02	07/06/2011 04:39:09 PM Central Daylight Time	07/11/2011 11:53:54 AM Central Daylight Time			07/13/2011 01:49:41 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1509	812	0	2012	National Service Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1509	813	0	1	04	01	H1509_813_0	2	1		07/06/2011	2012.02	07/06/2011 04:39:16 PM Central Daylight Time	07/11/2011 11:53:14 AM Central Daylight Time			07/13/2011 01:49:41 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1509	813	0	2012	National Service Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1509	814	0	1	04	01	H1509_814_0	2	1		07/06/2011	2012.02	07/06/2011 04:39:20 PM Central Daylight Time	07/11/2011 11:52:03 AM Central Daylight Time			07/13/2011 01:49:41 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1509	814	0	2012	National Service Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1509	815	0	1	04	01	H1509_815_0	3	1		07/06/2011	2012.02	07/06/2011 04:39:25 PM Central Daylight Time	07/11/2011 11:50:16 AM Central Daylight Time			07/13/2011 01:49:41 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1509	815	0	2012	National Service Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1509	816	0	1	04	01	H1509_816_0	2	1		07/06/2011	2012.02	07/06/2011 04:39:30 PM Central Daylight Time	07/11/2011 11:49:38 AM Central Daylight Time			07/13/2011 01:49:41 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1509	816	0	2012	National Service Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1509	817	0	1	04	01	H1509_817_0	2	1		07/06/2011	2012.02	07/06/2011 04:39:35 PM Central Daylight Time	07/11/2011 11:39:00 AM Central Daylight Time			07/13/2011 01:49:41 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1509	817	0	2012	National Service Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1510	001	0	1	04	01	H1510_001_0	9	1		07/06/2011	2012.02	07/06/2011 11:10:25 AM Eastern Daylight Time	08/05/2011 10:46:07 PM Eastern Daylight Time	08/04/2011 11:36:36 AM Eastern Daylight Time		08/09/2011 10:46:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H1510-001 (PPO)	01	04		1			H1510	001	0	2012	Central Indiana Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1510	004	0	1	04	01	H1510_004_0	13	1		07/06/2011	2012.02	07/06/2011 11:10:00 AM Eastern Daylight Time	08/05/2011 10:39:36 PM Eastern Daylight Time	08/04/2011 11:37:04 AM Eastern Daylight Time		08/09/2011 10:34:10 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H1510-004 (PPO)	01	04		1			H1510	004	0	2012	Evansville Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1510	005	0	1	04	01	H1510_005_0	9	1		07/06/2011	2012.02	07/06/2011 11:25:33 AM Eastern Daylight Time	08/05/2011 10:39:55 PM Eastern Daylight Time	08/04/2011 11:37:22 AM Eastern Daylight Time		08/09/2011 10:29:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H1510-005 (PPO)	01	04		1			H1510	005	0	2012	Northern Indiana Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1510	007	0	1	04	01	H1510_007_0	12	1		07/06/2011	2012.02	07/06/2011 11:26:05 AM Eastern Daylight Time	08/05/2011 10:47:14 PM Eastern Daylight Time	08/04/2011 11:37:42 AM Eastern Daylight Time		08/09/2011 10:29:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H1510-007 (PPO)	01	04		1			H1510	007	0	2012	Brown and Monroe counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1510	008	0	1	04	01	H1510_008_0	9	1		07/06/2011	2012.02	07/06/2011 01:40:39 PM Eastern Daylight Time	08/05/2011 10:47:53 PM Eastern Daylight Time	08/04/2011 11:38:00 AM Eastern Daylight Time		08/09/2011 10:34:10 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H1510-008 (PPO)	01	04		1			H1510	008	0	2012	Southern Indiana Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1510	009	0	1	04	01	H1510_009_0	10	1		07/06/2011	2012.02	07/06/2011 11:26:39 AM Eastern Daylight Time	08/05/2011 10:55:08 PM Eastern Daylight Time	08/04/2011 11:38:20 AM Eastern Daylight Time		08/09/2011 10:34:10 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H1510-009 (PPO)	01	04		1			H1510	009	0	2012	Northeast Indiana Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1517	004	0	1	04	01	H1517_004_0	11	1		08/04/2011	2012.02	08/04/2011 02:58:57 PM Eastern Daylight Time	08/08/2011 11:49:17 PM Eastern Daylight Time	08/08/2011 11:50:44 PM Eastern Daylight Time		08/09/2011 12:02:14 AM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred Core (PPO)	01	04		1			H1517	004	0	2012	St. Louis and Springfield Metro Areas		2	7617	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(800)-467-1199		(800)-467-1199		(800)-797-6427		(800)-797-6427		(800)-467-1199		(800)-467-1199		(800)-797-6427		(800)-797-6427		(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894		(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894		2	2	2
H1517	801	0	1	04	01	H1517_801_0	4	1		07/13/2011	2012.02	07/13/2011 01:42:52 PM Eastern Daylight Time	06/07/2011 12:00:00 AM Eastern Daylight Time			07/13/2011 02:42:41 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred (PPO)	01	04		1			H1517	801	0	2012	Missouri		1	95	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608		(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		2	2	2
H1517	802	0	1	04	01	H1517_802_0	4	1		07/07/2011	2012.02	07/07/2011 03:45:27 PM Eastern Daylight Time	06/07/2011 12:00:02 AM Eastern Daylight Time			07/08/2011 09:20:27 AM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred (PPO)	01	04		1			H1517	802	0	2012	Missouri		1	50	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608										(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754										2	2	2
H1517	803	0	1	04	01	H1517_803_0	4	1		07/07/2011	2012.02	07/07/2011 03:45:44 PM Eastern Daylight Time	06/07/2011 12:00:02 AM Eastern Daylight Time			07/08/2011 09:20:27 AM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred (PPO)	01	04		1			H1517	803	0	2012	Missouri		1	50	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608		(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		2	2	2
H1517	805	0	1	04	01	H1517_805_0	4	1		07/07/2011	2012.02	07/07/2011 03:46:00 PM Eastern Daylight Time	06/07/2011 12:00:03 AM Eastern Daylight Time			07/08/2011 09:20:27 AM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred (PPO)	01	04		1			H1517	805	0	2012	Missouri		1	50	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608										(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754										2	2	2
H1518	001	0	1	20	08	H1518_001_0	1	1		05/24/2011	2012.02	05/24/2011 10:17:42 AM Eastern Daylight Time		05/20/2011 04:04:27 PM Eastern Daylight Time		05/24/2011 10:19:56 AM Eastern Daylight Time	CATHOLIC HEALTH SYSTEM BUFFALO PACE	Catholic Health LIFE	www.chsbuffalo.org/Services/SeniorServices/LIFE	CHS Buffalo - Dual (PACE)	08	20		1			H1518	001	0	2012	CHS Lackawanna  Erie County		2		2			2							www.chsbuffalo.org	www.chsbuffalo.org									(888)-845-0247		(716)-819-5433		(888)-845-0247		(716)-819-5433										(888)-845-0247		(716)-819-5433		(888)-845-0247		(716)-819-5433				
H1518	002	0	1	20	08	H1518_002_0	1	1		05/24/2011	2012.02	05/24/2011 10:18:05 AM Eastern Daylight Time		05/20/2011 04:04:27 PM Eastern Daylight Time		05/24/2011 10:19:56 AM Eastern Daylight Time	CATHOLIC HEALTH SYSTEM BUFFALO PACE	Catholic Health LIFE	www.chsbuffalo.org/Services/SeniorServices/LIFE	CHS Buffalo - Medicare only (PACE)	08	20		1			H1518	002	0	2012	CHS Lackawanna Erie County		2		2			2							www.chsbuffalo.org	www.chsbuffalo.org									(888)-845-0247		(716)-819-5433		(888)-845-0247		(716)-819-5433										(888)-845-0247		(716)-819-5433		(888)-845-0247		(716)-819-5433				
H1537	001	0	1	04	01	H1537_001_0	4	1		07/20/2011	2012.02	07/20/2011 11:07:28 AM Central Daylight Time	08/08/2011 11:13:02 AM Central Daylight Time	08/05/2011 01:24:59 PM Central Daylight Time		08/09/2011 02:16:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	SecureHorizons by UnitedHealthcare	www.securehorizons.com	UnitedHealthcare MedicareComplete Choice (PPO)	01	04		1			H1537	001	0	2012	Madison county		2		2			2						www.securehorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1537	801	0	1	04	01	H1537_801_0	3	1		07/06/2011	2012.02	07/06/2011 04:39:43 PM Central Daylight Time	07/11/2011 12:19:11 PM Central Daylight Time			07/13/2011 01:49:41 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	SecureHorizons by UnitedHealthcare	www.securehorizons.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1537	801	0	2012	Select Counties		1		2			2						www.securehorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1537	802	0	1	04	01	H1537_802_0	3	1		07/06/2011	2012.02	07/06/2011 04:39:48 PM Central Daylight Time	07/11/2011 12:18:24 PM Central Daylight Time			07/13/2011 01:49:41 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	SecureHorizons by UnitedHealthcare	www.securehorizons.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1537	802	0	2012	Select Counties		1		2			2						www.securehorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506										(711)		(711)		(711)		(711)										2	2	2
H1537	803	0	1	04	01	H1537_803_0	3	1		07/06/2011	2012.02	07/06/2011 04:39:53 PM Central Daylight Time	07/11/2011 12:16:22 PM Central Daylight Time			07/13/2011 01:49:41 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	SecureHorizons by UnitedHealthcare	www.securehorizons.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1537	803	0	2012	Select Counties		1		2			2						www.securehorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1537	804	0	2	04	01	H1537_804_0	3	1		07/06/2011	2012.02	07/06/2011 04:39:58 PM Central Daylight Time	07/11/2011 12:15:20 PM Central Daylight Time			07/13/2011 01:49:41 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	SecureHorizons by UnitedHealthcare	www.securehorizons.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H1537	804	0	2012	Select Counties		1		2			2						www.securehorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1537	805	0	2	04	01	H1537_805_0	3	1		07/06/2011	2012.02	07/06/2011 04:40:05 PM Central Daylight Time	07/11/2011 12:14:02 PM Central Daylight Time			07/13/2011 01:49:41 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	SecureHorizons by UnitedHealthcare	www.securehorizons.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H1537	805	0	2012	Select Counties		1		2			2						www.securehorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506										(711)		(711)		(711)		(711)										2	2	2
H1537	806	0	2	04	01	H1537_806_0	3	1		07/06/2011	2012.02	07/06/2011 04:40:11 PM Central Daylight Time	07/11/2011 12:12:40 PM Central Daylight Time			07/13/2011 01:49:41 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	SecureHorizons by UnitedHealthcare	www.securehorizons.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		2	2		H1537	806	0	2012	Select Counties		1		2			2						www.securehorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1537	807	0	1	04	01	H1537_807_0	3	1		07/06/2011	2012.02	07/06/2011 04:40:18 PM Central Daylight Time	07/11/2011 12:11:46 PM Central Daylight Time			07/13/2011 01:49:41 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	SecureHorizons by UnitedHealthcare	www.securehorizons.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1537	807	0	2012	Select Counties		1		2			2						www.securehorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1537	808	0	1	04	01	H1537_808_0	2	1		07/06/2011	2012.02	07/06/2011 04:40:24 PM Central Daylight Time	07/11/2011 12:11:07 PM Central Daylight Time			07/13/2011 01:49:41 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	SecureHorizons by UnitedHealthcare	www.securehorizons.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1537	808	0	2012	Select Counties		1		2			2						www.securehorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506										(711)		(711)		(711)		(711)										2	2	2
H1537	809	0	1	04	01	H1537_809_0	2	1		07/06/2011	2012.02	07/06/2011 04:40:29 PM Central Daylight Time	07/11/2011 12:10:32 PM Central Daylight Time			07/13/2011 01:49:41 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	SecureHorizons by UnitedHealthcare	www.securehorizons.com	UnitedHealthcare Group Medicare Advantage (PPO)	01	04		1			H1537	809	0	2012	Select Counties		1		2			2						www.securehorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(800)-457-8506		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1595	001	0	1	04	01	H1595_001_0	7	1		06/05/2011	2012.02	06/05/2011 09:18:43 PM Central Daylight Time	08/04/2011 01:00:46 PM Central Daylight Time	08/04/2011 11:45:44 AM Central Daylight Time		08/04/2011 01:36:52 PM Central Daylight Time	HEALTHPLUS INSURANCE COMPANY	HealthPlus	www.healthplus.org	HealthPlus MedicarePlus-AdvantagePPO Basic (PPO)	01	04		1			H1595	001	0	2012	10 Mid-Michigan and Southeast Michigan Counties		2	641	2			2						www.healthplus.org	www.healthplus.org/partdformularies.aspx	www.healthplus.org	(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		2	2	2
H1595	002	0	1	04	01	H1595_002_0	7	1		06/05/2011	2012.02	06/05/2011 09:18:53 PM Central Daylight Time	08/04/2011 01:04:08 PM Central Daylight Time	08/04/2011 11:46:13 AM Central Daylight Time		08/04/2011 01:36:52 PM Central Daylight Time	HEALTHPLUS INSURANCE COMPANY	HealthPlus	www.healthplus.org	HealthPlus MedicarePlus-AdvantagePPO Enhanced (PPO)	01	04		1			H1595	002	0	2012	10 Mid-Michigan and Southeast Michigan Counties		2	1255	2			2						www.healthplus.org	www.healthplus.org/partdformularies.aspx	www.healthplus.org	(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		2	2	2
H1595	801	0	1	04	01	H1595_801_0	3	1		06/05/2011	2012.02	06/05/2011 09:19:05 PM Central Daylight Time	07/01/2011 02:45:40 PM Central Daylight Time			07/22/2011 02:03:44 PM Central Daylight Time	HEALTHPLUS INSURANCE COMPANY	HealthPlus	www.healthplus.org	Emp-only - HealthPlus MA-Only (PPO)	01	04		1			H1595	801	0	2012	United States EG Area		1	100	2			2						www.healthplus.org	www.healthplus.org/partdformularies.aspx	www.healthplus.org	(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161										(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070										2	1	1
H1595	802	0	1	04	01	H1595_802_0	3	1		06/05/2011	2012.02	06/05/2011 09:19:12 PM Central Daylight Time	07/01/2011 02:47:33 PM Central Daylight Time			07/22/2011 02:03:44 PM Central Daylight Time	HEALTHPLUS INSURANCE COMPANY	HealthPlus	www.healthplus.org	Emp-only - HealthPlus MA-PD calendar yr. (PPO)	01	04		1			H1595	802	0	2012	United States EG Area		1	100	2			2						www.healthplus.org	www.healthplus.org/partdformularies.aspx	www.healthplus.org	(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		2	1	1
H1595	804	0	1	04	01	H1595_804_0	3	1		06/05/2011	2012.02	06/05/2011 09:19:20 PM Central Daylight Time	07/01/2011 02:48:44 PM Central Daylight Time			07/22/2011 02:03:44 PM Central Daylight Time	HEALTHPLUS INSURANCE COMPANY	HealthPlus	www.healthplus.org	Emp-only - HealthPlus MA-PD non-calendar yr. (PPO)	01	04		1			H1595	804	0	2012	United States EG Area		1		2			2						www.healthplus.org	www.healthplus.org/partdformularies.aspx	www.healthplus.org	(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		2	1	1
H1607	001	0	1	04	01	H1607_001_0	9	1		08/08/2011	2012.02	08/08/2011 11:02:24 AM Eastern Daylight Time	08/08/2011 07:07:17 PM Eastern Daylight Time	08/08/2011 07:09:36 PM Eastern Daylight Time		08/08/2011 07:18:07 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred Standard (PPO)	01	04		1			H1607	001	0	2012	Select Counties in Indiana		2	4720	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(800)-467-1199		(800)-467-1199		(800)-797-6421		(800)-797-6421		(800)-467-1199		(800)-467-1199		(800)-797-6421		(800)-797-6421		(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894		(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894		2	2	2
H1607	004	0	1	04	01	H1607_004_0	9	1		07/21/2011	2012.02	07/21/2011 04:01:25 PM Eastern Daylight Time	08/08/2011 07:07:25 PM Eastern Daylight Time	08/08/2011 07:09:44 PM Eastern Daylight Time		08/08/2011 07:18:07 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred Select (PPO)	01	04		1			H1607	004	0	2012	Select Counties in Indiana		2	1370	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(800)-467-1199		(800)-467-1199		(800)-797-6421		(800)-797-6421		(800)-467-1199		(800)-467-1199		(800)-797-6421		(800)-797-6421		(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894		(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894		2	2	2
H1607	804	0	1	04	01	H1607_804_0	2	1		06/04/2011	2012.02	06/04/2011 01:32:15 PM Eastern Daylight Time	06/07/2011 12:00:03 AM Eastern Daylight Time			06/07/2011 12:20:49 AM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred (PPO)	01	04		1			H1607	804	0	2012	Indiana		1	4319	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608		(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		2	2	2
H1607	805	0	1	04	01	H1607_805_0	2	1		06/04/2011	2012.02	06/04/2011 01:53:02 PM Eastern Daylight Time	06/07/2011 12:00:04 AM Eastern Daylight Time			06/07/2011 12:20:49 AM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred (PPO)	01	04		1			H1607	805	0	2012	Indiana		1	50	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608										(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754										2	2	2
H1607	806	0	1	04	01	H1607_806_0	2	1		06/04/2011	2012.02	06/04/2011 01:53:07 PM Eastern Daylight Time	06/07/2011 12:00:04 AM Eastern Daylight Time			06/07/2011 12:20:49 AM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred (PPO)	01	04		1			H1607	806	0	2012	Indiana		1	50	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608		(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		2	2	2
H1607	807	0	1	04	01	H1607_807_0	2	1		06/04/2011	2012.02	06/04/2011 01:53:13 PM Eastern Daylight Time	06/07/2011 12:00:05 AM Eastern Daylight Time			06/07/2011 12:20:49 AM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred (PPO)	01	04		1			H1607	807	0	2012	Indiana		1	50	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608										(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754										2	2	2
H1608	001	0	1	04	01	H1608_001_0	10	1		08/08/2011	2012.02	08/08/2011 03:21:18 PM Central Daylight Time	08/08/2011 11:08:46 AM Central Daylight Time	08/04/2011 08:45:41 AM Central Daylight Time		08/09/2011 01:48:13 PM Central Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	http://iowa-nebraska.chcadvantra.com	Advantra Platinum (PPO)	01	04		1			H1608	001	0	2012	Partial State of IA, Partial State of SD		2	6358	2			2						http://iowa-nebraska.chcadvantra.com	http://iowa-nebraska.chcadvantra.com	http://www.medcoonline.com	(866)-901-4692		(866)-901-4692		(877)-886-7564		(877)-886-7564		(866)-293-4748		(866)-293-4748		(877)-886-7564		(877)-886-7564		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1608	801	0	1	04	01	H1608_801_0	4	1		05/26/2011	2012.02	05/26/2011 09:36:22 AM Central Daylight Time	07/25/2011 01:25:28 PM Central Daylight Time			07/27/2011 01:20:26 PM Central Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	http://iowa-nebraska.chcadvantra.com	PPO-EmGp/No Rx/Cyear (PPO)	01	04		1			H1608	801	0	2012	Iowa/South Dakota		1	100	2			2						http://iowa-nebraska.chcadvantra.com	http://iowa-nebraska.chcadvantra.com	http://www.medcoonline.com	(866)-901-4692		(866)-901-4692		(877)-886-7564		(877)-886-7564										(711)		(711)		(711)		(711)										1	1	1
H1608	802	0	1	04	01	H1608_802_0	3	1		05/26/2011	2012.02	05/26/2011 09:42:10 AM Central Daylight Time	07/25/2011 01:29:36 PM Central Daylight Time			07/27/2011 01:20:26 PM Central Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	http://iowa-nebraska.chcadvantra.com	PPO-EmGp/Comm4/Cyear (PPO)	01	04		1			H1608	802	0	2012	Iowa/South Dakota		1	100	2			2						http://iowa-nebraska.chcadvantra.com	http://iowa-nebraska.chcadvantra.com	http://www.medcoonline.com	(866)-901-4692		(866)-901-4692		(877)-886-7564		(877)-886-7564		(866)-293-4748		(866)-293-4748		(877)-886-7564		(877)-886-7564		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H1608	803	0	1	04	01	H1608_803_0	3	1		05/26/2011	2012.02	05/26/2011 09:39:01 AM Central Daylight Time	07/25/2011 01:36:07 PM Central Daylight Time			07/27/2011 01:20:26 PM Central Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	http://iowa-nebraska.chcadvantra.com	PPO-EmGp/Comm4/NonCyear (PPO)	01	04		1			H1608	803	0	2012	Iowa/South Dakota		1	100	2			2						http://iowa-nebraska.chcadvantra.com	http://iowa-nebraska.chcadvantra.com	http://www.medcoonline.com	(866)-901-4692		(866)-901-4692		(877)-886-7564		(877)-886-7564		(866)-293-4748		(866)-293-4748		(877)-886-7564		(877)-886-7564		(711)		(711)		(711)		(711)		(800)-716-3231		(800)-716-3231		(711)		(711)		1	1	1
H1609	001	0	1	01	01	H1609_001_0	9	1		08/08/2011	2012.02	08/08/2011 03:21:34 PM Central Daylight Time	08/08/2011 11:11:22 AM Central Daylight Time	08/04/2011 08:51:08 AM Central Daylight Time		08/09/2011 01:50:17 PM Central Daylight Time	COVENTRY HEALTH CARE OF IOWA, INC.	Coventry Health Care	http://iowa-nebraska.chcadvantra.com	Advantra Silver (HMO)	01	01		1			H1609	001	0	2012	Partial State of Iowa		2	4611	2			2						http://iowa-nebraska.chcadvantra.com	http://iowa-nebraska.chcadvantra.com	http://www.medcoonline.com	(866)-901-4692		(866)-901-4692		(877)-886-7564		(877)-886-7564		(866)-294-1211		(866)-294-1211		(877)-886-7564		(877)-886-7564		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1609	801	0	1	01	01	H1609_801_0	2	1		05/26/2011	2012.02	05/26/2011 09:42:46 AM Central Daylight Time	07/25/2011 01:45:32 PM Central Daylight Time			07/27/2011 01:50:41 PM Central Daylight Time	COVENTRY HEALTH CARE OF IOWA, INC.	Coventry Health Care	http://iowa-nebraska.chcadvantra.com	HMO-EmGp/No Rx/Cyear (HMO)	01	01		1			H1609	801	0	2012	Iowa		1	100	2			2						http://iowa-nebraska.chcadvantra.com	http://iowa-nebraska.chcadvantra.com	http://www.medcoonline.com	(866)-901-4692		(866)-901-4692		(877)-886-7564		(877)-886-7564										(711)		(711)		(711)		(711)										1	1	1
H1609	802	0	1	01	01	H1609_802_0	2	1		05/26/2011	2012.02	05/26/2011 09:43:13 AM Central Daylight Time	07/25/2011 02:03:14 PM Central Daylight Time			07/27/2011 01:50:41 PM Central Daylight Time	COVENTRY HEALTH CARE OF IOWA, INC.	Coventry Health Care	http://iowa-nebraska.chcadvantra.com	HMO-EmGp/Comm4/Cyear (HMO)	01	01		1			H1609	802	0	2012	Iowa		1	100	2			2						http://iowa-nebraska.chcadvantra.com	http://iowa-nebraska.chcadvantra.com	http://www.medcoonline.com	(866)-901-4692		(866)-901-4692		(877)-886-7564		(877)-886-7564		(866)-294-1211		(866)-294-1211		(877)-886-7564		(877)-886-7564		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H1609	803	0	1	01	01	H1609_803_0	2	1		05/26/2011	2012.02	05/26/2011 09:43:40 AM Central Daylight Time	07/25/2011 02:09:30 PM Central Daylight Time			07/27/2011 01:50:41 PM Central Daylight Time	COVENTRY HEALTH CARE OF IOWA, INC.	Coventry Health Care	http://iowa-nebraska.chcadvantra.com	HMO-EmGp/Comm4/NonCyear (HMO)	01	01		1			H1609	803	0	2012	Iowa		1	100	2			2						http://iowa-nebraska.chcadvantra.com	http://iowa-nebraska.chcadvantra.com	http://www.medcoonline.com	(866)-901-4692		(866)-901-4692		(877)-886-7564		(877)-886-7564		(866)-294-1211		(866)-294-1211		(877)-886-7564		(877)-886-7564		(711)		(711)		(711)		(711)		(800)-716-3231		(800)-716-3231		(711)		(711)		1	1	1
H1651	001	0	1	18	06	H1651_001_0	4	2		08/04/2011	2012.02	08/04/2011 11:18:48 AM Central Daylight Time				08/04/2011 11:38:05 AM Central Daylight Time	MEDICAL ASSOCIATES HEALTH PLAN, INC.	Medical Associates Health Plan, Inc.	www.mahealthcare.com	Medical Associates SmartPlan (Cost)	06	18		1			H1651	001	0	2012	Northeast Iowa		2	5000	2			2									(866)-821-1365		(563)-584-4885		(800)-747-8900		(563)-556-8070										(800)-735-2943		(800)-735-2943		(800)-735-2943		(800)-735-2943										2	2	2
H1651	002	0	1	18	06	H1651_002_0	3	2		08/04/2011	2012.02	08/04/2011 11:18:52 AM Central Daylight Time				08/04/2011 11:49:07 AM Central Daylight Time	MEDICAL ASSOCIATES HEALTH PLAN, INC.	Medical Associates Health Plan, Inc.	www.mahealthcare.com	Medical Associates Basic Plan (Cost)	06	18		1			H1651	002	0	2012	Northeast Iowa		2	0	2			2									(866)-821-1365		(563)-584-4885		(800)-747-8900		(563)-556-8070										(800)-735-2943		(800)-735-2943		(800)-735-2943		(800)-735-2943										2	2	2
H1651	003	0	1	18	06	H1651_003_0	4	2		08/04/2011	2012.02	08/04/2011 11:18:56 AM Central Daylight Time				08/04/2011 11:49:07 AM Central Daylight Time	MEDICAL ASSOCIATES HEALTH PLAN, INC.	Medical Associates Health Plan, Inc.	www.mahealthcare.com	Medical Associates SmartPlan (Cost)	06	18		1			H1651	003	0	2012	Jo Daviess County		2	1000	2			2									(866)-821-1365		(563)-584-4885		(800)-747-8900		(563)-556-8070										(800)-735-2943		(800)-735-2943		(800)-735-2943		(800)-735-2943										2	2	2
H1651	004	0	1	18	06	H1651_004_0	5	2		08/04/2011	2012.02	08/04/2011 11:19:00 AM Central Daylight Time				08/04/2011 11:49:07 AM Central Daylight Time	MEDICAL ASSOCIATES HEALTH PLAN, INC.	Medical Associates Health Plan, Inc.	www.mahealthcare.com	Medical Associates Community Plan (Cost)	06	18		1			H1651	004	0	2012	Northeast Iowa		2	2250	2			2									(866)-821-1365		(563)-584-4885		(800)-747-8900		(563)-556-8070										(800)-735-2943		(800)-735-2943		(800)-735-2943		(800)-735-2943										2	2	2
H1651	005	0	1	18	06	H1651_005_0	4	2		08/04/2011	2012.02	08/04/2011 11:19:04 AM Central Daylight Time				08/04/2011 11:49:07 AM Central Daylight Time	MEDICAL ASSOCIATES HEALTH PLAN, INC.	Medical Associates Health Plan, Inc.	www.mahealthcare.com	Medical Associates Community Plan (Cost)	06	18		1			H1651	005	0	2012	Jo Daviess County		2	250	2			2									(866)-821-1365		(563)-584-4885		(800)-747-8900		(563)-556-8070										(800)-735-2943		(800)-735-2943		(800)-735-2943		(800)-735-2943										2	2	2
H1651	008	0	1	18	06	H1651_008_0	5	2		08/04/2011	2012.02	08/04/2011 11:19:08 AM Central Daylight Time				08/04/2011 11:49:07 AM Central Daylight Time	MEDICAL ASSOCIATES HEALTH PLAN, INC.	Medical Associates Health Plan, Inc.	www.mahealthcare.com	Medical Associates Freedom Plan (Cost)	06	18		1			H1651	008	0	2012	Northeast Iowa		2	280	2			2									(866)-821-1365		(563)-584-4885		(800)-747-8900		(563)-556-8070										(800)-735-2943		(800)-735-2943		(800)-735-2943		(800)-735-2943										2	2	2
H1651	009	0	1	18	06	H1651_009_0	4	2		08/04/2011	2012.02	08/04/2011 11:19:17 AM Central Daylight Time				08/04/2011 11:49:07 AM Central Daylight Time	MEDICAL ASSOCIATES HEALTH PLAN, INC.	Medical Associates Health Plan, Inc.	www.mahealthcare.com	Medical Associates Freedom Plan (Cost)	06	18		1			H1651	009	0	2012	Jo Daviess County		2	65	2			2									(866)-821-1365		(563)-584-4885		(800)-747-8900		(563)-556-8070										(800)-735-2943		(800)-735-2943		(800)-735-2943		(800)-735-2943										2	2	2
H1659	001	0	1	04	01	H1659_001_0	4	1		07/21/2011	2012.02	07/21/2011 03:26:50 PM Eastern Daylight Time	08/05/2011 01:25:12 PM Eastern Daylight Time	08/05/2011 01:28:42 PM Eastern Daylight Time		08/05/2011 04:01:39 PM Eastern Daylight Time	PIEDMONT COMMUNITY HEALTHCARE, INC.	Piedmont Medicare Advantage	www.pchp.net	Piedmont Select Medicare Option One (PPO)	01	04		1			H1659	001	0	2012	Lynchburg, Counties:AM,AP,BE,CA,CLT,HA,PE,PI		2	750	2			2						www.pchp.net	www.pchp.net	www.pchp.net	(877)-210-1719		(434)-947-3671		(877)-210-1719		(434)-947-3671		(866)-494-9927		(866)-494-9927		(877)-210-1719		(434)-947-3671		(877)-295-1454		(877)-295-1454		(877)-295-1454		(877)-295-1454		(866)-236-1069		(866)-236-1069		(877)-295-1454		(877)-295-1454		2	2	2
H1659	002	0	1	04	01	H1659_002_0	4	1		07/21/2011	2012.02	07/21/2011 01:48:38 PM Eastern Daylight Time	08/05/2011 01:26:02 PM Eastern Daylight Time	08/05/2011 01:29:58 PM Eastern Daylight Time		08/05/2011 04:01:39 PM Eastern Daylight Time	PIEDMONT COMMUNITY HEALTHCARE, INC.	Piedmont Medicare Advantage	www.pchp.net	Piedmont Select Medicare Option Two (PPO)	01	04		1			H1659	002	0	2012	Lynchburg, Counties:AM,AP,BE,CA,CLT,HA,PE,PI		2	750	2			2						www.pchp.net	www.pchp.net	www.pchp.net	(877)-210-1719		(434)-947-3671		(877)-210-1719		(434)-947-3671		(866)-494-9927		(866)-494-9927		(877)-210-1719		(434)-947-3671		(877)-295-1454		(877)-295-1454		(877)-295-1454		(877)-295-1454		(866)-236-1069		(866)-236-1069		(877)-295-1454		(877)-295-1454		2	2	2
H1681	001	0	1	04	01	H1681_001_0	10	1		07/07/2011	2012.02	07/07/2011 12:04:28 PM Eastern Daylight Time	08/05/2011 08:54:08 AM Eastern Daylight Time	08/04/2011 11:38:38 AM Eastern Daylight Time		08/08/2011 03:44:30 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H1681-001 (PPO)	01	04		1			H1681	001	0	2012	Huntsville Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1681	002	0	1	04	01	H1681_002_0	10	1		07/07/2011	2012.02	07/07/2011 12:05:19 PM Eastern Daylight Time	05/27/2011 04:15:33 PM Eastern Daylight Time	08/04/2011 11:38:56 AM Eastern Daylight Time		08/08/2011 03:44:30 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H1681-002 (PPO)	01	04		1			H1681	002	0	2012	Birmingham Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1681	004	0	1	04	01	H1681_004_0	9	1		07/07/2011	2012.02	07/07/2011 12:05:46 PM Eastern Daylight Time	05/27/2011 04:22:48 PM Eastern Daylight Time	08/04/2011 11:39:25 AM Eastern Daylight Time		08/08/2011 03:44:30 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H1681-004 (PPO)	01	04		1			H1681	004	0	2012	Cherokee County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1681	005	0	1	04	01	H1681_005_0	9	1		07/07/2011	2012.02	07/07/2011 12:06:26 PM Eastern Daylight Time	08/05/2011 08:56:27 AM Eastern Daylight Time	08/04/2011 11:39:44 AM Eastern Daylight Time		08/08/2011 03:44:30 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H1681-005 (PPO)	01	04		1			H1681	005	0	2012	Montgomery Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1681	006	0	1	04	01	H1681_006_0	9	1		07/07/2011	2012.02	07/07/2011 12:06:51 PM Eastern Daylight Time	08/05/2011 08:55:43 AM Eastern Daylight Time	08/04/2011 11:40:03 AM Eastern Daylight Time		08/08/2011 03:44:30 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H1681-006 (PPO)	01	04		1			H1681	006	0	2012	Henry and Houston Counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1714	001	0	1	20	08	H1714_001_0	2	1		05/23/2011	2012.02	05/23/2011 10:53:49 AM Central Daylight Time		05/20/2011 04:01:28 PM Central Daylight Time		05/23/2011 04:32:45 PM Central Daylight Time	VIA CHRISTI HEALTHCARE OUTREACH PROGRAM FOR ELDERS	Via Christi HOPE	www.viachristihope.com	Via Christi HOPE (PACE)	08	20		1			H1714	001	0	2012	Via Christi HOPE		2		2			2							www.viachristihope.com	www.viachristihope.com									(316)-858-1111		(316)-858-1111		(316)-858-1111		(316)-858-1111										(316)-858-1111		(316)-858-1111		(316)-858-1111		(316)-858-1111				
H1714	002	0	1	20	08	H1714_002_0	2	1		05/23/2011	2012.02	05/23/2011 10:54:22 AM Central Daylight Time		05/20/2011 04:01:28 PM Central Daylight Time		05/23/2011 04:32:45 PM Central Daylight Time	VIA CHRISTI HEALTHCARE OUTREACH PROGRAM FOR ELDERS	Via Christi HOPE	www.viachristihope.com	Via Christi HOPE (PACE)	08	20		1			H1714	002	0	2012	Sedgwick Co, KS		2		2			2							www.viachristihope.com	www.viachristihope.com									(316)-858-1111		(316)-858-1111		(316)-858-1111		(316)-858-1111										(316)-858-1111		(316)-858-1111		(316)-858-1111		(316)-858-1111				
H1716	001	0	1	04	01	H1716_001_0	5	1		08/08/2011	2012.02	08/08/2011 11:48:44 AM Eastern Daylight Time	08/05/2011 05:43:12 PM Eastern Daylight Time	08/04/2011 11:40:22 AM Eastern Daylight Time		08/08/2011 04:32:56 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H1716-001 (PPO)	01	04		1			H1716	001	0	2012	Kansas City Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1716	002	0	1	04	01	H1716_002_0	5	1		08/08/2011	2012.02	08/08/2011 11:48:53 AM Eastern Daylight Time	08/05/2011 05:41:21 PM Eastern Daylight Time	08/04/2011 11:40:41 AM Eastern Daylight Time		08/08/2011 04:32:56 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H1716-002 (PPO)	01	04		1			H1716	002	0	2012	Wichita area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1716	004	0	1	04	01	H1716_004_0	5	1		08/08/2011	2012.02	08/08/2011 12:32:09 PM Eastern Daylight Time	08/05/2011 05:42:33 PM Eastern Daylight Time	08/04/2011 11:41:09 AM Eastern Daylight Time		08/08/2011 04:32:56 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H1716-004 (PPO)	01	04		1			H1716	004	0	2012	Select Counties in Missouri		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1716	006	0	1	04	01	H1716_006_0	5	1		08/08/2011	2012.02	08/08/2011 11:49:29 AM Eastern Daylight Time	08/05/2011 05:41:10 PM Eastern Daylight Time	08/04/2011 11:41:28 AM Eastern Daylight Time		08/08/2011 04:32:56 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H1716-006 (PPO)	01	04		1			H1716	006	0	2012	St. Louis Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1716	019	0	1	04	01	H1716_019_0	5	1		08/08/2011	2012.02	08/08/2011 11:49:38 AM Eastern Daylight Time	08/05/2011 05:43:39 PM Eastern Daylight Time	08/04/2011 11:41:47 AM Eastern Daylight Time		08/08/2011 04:32:56 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H1716-019 (PPO)	01	04		1			H1716	019	0	2012	St. Charles and St. Louis Counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1716	020	0	1	04	01	H1716_020_0	5	1		08/08/2011	2012.02	08/08/2011 11:49:50 AM Eastern Daylight Time	08/05/2011 05:46:09 PM Eastern Daylight Time	08/04/2011 11:42:07 AM Eastern Daylight Time		08/08/2011 04:32:56 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H1716-020 (PPO)	01	04		1			H1716	020	0	2012	Kansas City Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1717	001	0	1	04	01	H1717_001_0	5	1		08/09/2011	2012.02	08/09/2011 09:09:22 AM Central Daylight Time	08/05/2011 09:55:36 AM Central Daylight Time	08/05/2011 01:25:15 PM Central Daylight Time		08/09/2011 01:25:28 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice Plan 1 (PPO)	01	04		1			H1717	001	0	2012	Sedgwick County		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1717	009	0	1	04	01	H1717_009_0	3	1		08/09/2011	2012.02	08/09/2011 11:56:36 AM Central Daylight Time	08/05/2011 09:55:10 AM Central Daylight Time	08/05/2011 12:58:23 PM Central Daylight Time		08/09/2011 03:53:30 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.EvercareHealthPlans.com	UnitedHealthcare Nursing Home Plan (PPO SNP)	01	04		1			H1717	009	0	2012	Johnson and Wyandotte Counties		2		2			1	1	1	1			www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1777	007	0	1	01	01	H1777_007_0	9	1		07/18/2011	2012.02	07/18/2011 11:00:03 AM Eastern Daylight Time	08/08/2011 01:21:00 PM Eastern Daylight Time	08/08/2011 01:18:00 PM Eastern Daylight Time		08/08/2011 03:03:10 PM Eastern Daylight Time	CATHOLIC SPECIAL NEEDS PLAN, LLC	ArchCare Advantage,HMO	www.archcareadvantage.org	ArchCare Advanage- Institutional SNP - NYC (HMO SNP)	01	01		1			H1777	007	0	2012	NYC boros		2	1400	2			1	1	1	1				www.archcareadvantage.org	www.archcareadvantage.org	(800)-373-3177		(800)-373-3177		(800)-373-3177		(800)-373-3177		(888)-816-7977		(888)-816-7977		(888)-816-7977		(888)-816-7977		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(866)-236-1069		(866)-236-1069		(866)-236-1069		(866)-236-1069		2	2	2
H1777	008	0	1	01	01	H1777_008_0	8	1		07/18/2011	2012.02	07/18/2011 11:00:20 AM Eastern Daylight Time	08/08/2011 01:23:00 PM Eastern Daylight Time	08/08/2011 01:19:00 PM Eastern Daylight Time		08/08/2011 03:03:10 PM Eastern Daylight Time	CATHOLIC SPECIAL NEEDS PLAN, LLC	ArchCare Advantage,HMO	www.archcareadvantage.org	ArchCare  Advantage- Institutional SNP - NonNYC (HMO SNP)	01	01		1			H1777	008	0	2012	Westchester, Orange, Dutchess		2	353	2			1	1	1	1				www.archcareadvantage.org	www.archcareadvantage.org	(800)-373-3177		(800)-373-3177		(800)-373-3177		(800)-373-3177		(888)-816-7977		(888)-816-7977		(888)-816-7977		(888)-816-7977		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(866)-236-1069		(866)-236-1069		(866)-236-1069		(866)-236-1069		2	2	2
H1777	009	0	1	01	01	H1777_009_0	7	1		08/08/2011	2012.02	08/08/2011 02:39:05 PM Eastern Daylight Time	08/08/2011 01:25:00 PM Eastern Daylight Time	08/08/2011 01:16:00 PM Eastern Daylight Time		08/08/2011 02:42:28 PM Eastern Daylight Time	CATHOLIC SPECIAL NEEDS PLAN, LLC	ArchCare Advantage,HMO	www.archcareadvantage.org	ArchCare Advantage- Institutional Equiv SNP - NYC (HMO SNP)	01	01		1			H1777	009	0	2012	NYC boros		2	75	2			1	1	2	1				www.archcareadvantage.org	www.archcareadvantage.org	(800)-373-3177		(800)-373-3177		(800)-373-3177		(800)-373-3177		(888)-816-7977		(888)-816-7977		(888)-816-7977		(888)-816-7977		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(866)-236-1069		(866)-236-1069		(866)-236-1069		(866)-236-1069		2	2	2
H1777	010	0	1	01	01	H1777_010_0	8	1		06/14/2011	2012.02	06/14/2011 09:23:13 AM Eastern Daylight Time	08/08/2011 01:26:00 PM Eastern Daylight Time	08/08/2011 01:17:00 PM Eastern Daylight Time		08/08/2011 03:03:10 PM Eastern Daylight Time	CATHOLIC SPECIAL NEEDS PLAN, LLC	ArchCare Advantage,HMO	www.archcareadvantage.org	ArchCare Advan tage- Instit. Equiv SNP - NonNYC (HMO SNP)	01	01		1			H1777	010	0	2012	Westchester, Dutchess, Orange		2	55	2			1	1	2	1				www.archcareadvantage.org	www.archcareadvantage.org	(800)-373-3177		(800)-373-3177		(800)-373-3177		(800)-373-3177		(888)-816-7977		(888)-816-7977		(888)-816-7977		(888)-816-7977		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(866)-236-1069		(866)-236-1069		(866)-236-1069		(866)-236-1069		2	2	2
H1804	128	0	1	09	04	H1804_128_0	7	1		07/06/2011	2012.02	07/06/2011 04:08:04 PM Eastern Daylight Time	06/05/2011 09:39:03 PM Eastern Daylight Time	08/04/2011 11:42:26 AM Eastern Daylight Time		08/08/2011 04:00:14 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H1804-128 (PFFS)	04	09	2	1			H1804	128	0	2012	Select Counties in Mississippi		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2		2
H1806	001	0	1	04	01	H1806_001_0	9	1		07/01/2011	2012.02	07/01/2011 12:38:12 PM Eastern Daylight Time	05/27/2011 02:26:12 PM Eastern Daylight Time	08/04/2011 11:42:46 AM Eastern Daylight Time		08/08/2011 02:42:11 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H1806-001 (PPO)	01	04		1			H1806	001	0	2012	Louisville Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1806	002	0	1	04	01	H1806_002_0	6	1		07/01/2011	2012.02	07/01/2011 12:37:47 PM Eastern Daylight Time	08/05/2011 10:55:50 PM Eastern Daylight Time	08/04/2011 11:43:05 AM Eastern Daylight Time		08/08/2011 02:42:11 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H1806-002 (PPO)	01	04		1			H1806	002	0	2012	Lexington Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1806	005	0	1	04	01	H1806_005_0	8	1		07/01/2011	2012.02	07/01/2011 12:38:26 PM Eastern Daylight Time	08/05/2011 10:43:32 PM Eastern Daylight Time	08/04/2011 11:43:24 AM Eastern Daylight Time		08/08/2011 02:42:11 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H1806-005 (PPO)	01	04		1			H1806	005	0	2012	Barren and Warren counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1837	001	0	1	01	01	H1837_001_0	9	1		08/04/2011	2012.02	08/04/2011 03:35:40 PM Central Daylight Time	08/04/2011 02:05:22 PM Central Daylight Time	08/04/2011 02:05:49 PM Central Daylight Time		08/04/2011 04:24:56 PM Central Daylight Time	ESSENCE HEALTHCARE, INC.	Essence Healthcare	www.essencehealthcare.com	Essence Advantage (HMO)	01	01		1			H1837	001	0	2012	Central Puget Sound Service Area		2	2968	2			2						www.essencehealthcare.com	www.essencehealthcare.com	www.essencehealthcare.com	(877)-392-3849		(425)-697-8300		(877)-392-3849		(425)-697-8300		(877)-392-3849		(425)-697-8300		(877)-392-3849		(425)-697-8300		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1837	002	0	1	01	01	H1837_002_0	10	1		08/04/2011	2012.02	08/04/2011 03:39:12 PM Central Daylight Time	08/04/2011 02:10:26 PM Central Daylight Time	08/04/2011 02:09:59 PM Central Daylight Time		08/04/2011 04:24:56 PM Central Daylight Time	ESSENCE HEALTHCARE, INC.	Essence Healthcare	www.essencehealthcare.com	Essence Advantage (HMO)	01	01		1			H1837	002	0	2012	North Puget Sound Service Area		2	2094	2			2						www.essencehealthcare.com	www.essencehealthcare.com	www.essencehealthcare.com	(877)-392-3849		(425)-697-8300		(877)-392-3849		(425)-697-8300		(877)-392-3849		(425)-697-8300		(877)-392-3849		(425)-697-8300		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1837	003	0	1	01	01	H1837_003_0	9	1		08/04/2011	2012.02	08/04/2011 03:42:42 PM Central Daylight Time	08/04/2011 02:13:37 PM Central Daylight Time	08/04/2011 02:13:09 PM Central Daylight Time		08/04/2011 04:24:56 PM Central Daylight Time	ESSENCE HEALTHCARE, INC.	Essence Healthcare	www.essencehealthcare.com	Essence Advantage Plus (HMO)	01	01		1			H1837	003	0	2012	Central Puget Sound Service Area		2	576	2			2						www.essencehealthcare.com	www.essencehealthcare.com	www.essencehealthcare.com	(877)-392-3849		(425)-697-8300		(877)-392-3849		(425)-697-8300		(877)-392-3849		(425)-697-8300		(877)-392-3849		(425)-697-8300		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1837	005	0	1	01	01	H1837_005_0	9	1		08/04/2011	2012.02	08/04/2011 03:45:21 PM Central Daylight Time	08/04/2011 02:16:46 PM Central Daylight Time	08/04/2011 02:16:20 PM Central Daylight Time		08/04/2011 04:24:56 PM Central Daylight Time	ESSENCE HEALTHCARE, INC.	Essence Healthcare	www.essencehealthcare.com	Essence Advantage (HMO)	01	01		1			H1837	005	0	2012	Spokane Service Area		2	2941	2			2						www.essencehealthcare.com	www.essencehealthcare.com	www.essencehealthcare.com	(877)-392-3849		(425)-697-8300		(877)-392-3849		(425)-697-8300		(877)-392-3849		(425)-697-8300		(877)-392-3849		(425)-697-8300		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1837	006	0	1	01	01	H1837_006_0	9	1		08/04/2011	2012.02	08/04/2011 03:46:52 PM Central Daylight Time	08/04/2011 02:19:50 PM Central Daylight Time	08/04/2011 02:19:21 PM Central Daylight Time		08/04/2011 04:24:56 PM Central Daylight Time	ESSENCE HEALTHCARE, INC.	Essence Healthcare	www.essencehealthcare.com	Essence Advantage Plus (HMO)	01	01		1			H1837	006	0	2012	Spokane Service Area		2	379	2			2						www.essencehealthcare.com	www.essencehealthcare.com	www.essencehealthcare.com	(877)-392-3849		(425)-697-8300		(877)-392-3849		(425)-697-8300		(877)-392-3849		(425)-697-8300		(877)-392-3849		(425)-697-8300		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1837	801	0	1	01	01	H1837_801_0	7	1		04/26/2011	2012.02	04/26/2011 12:57:12 PM Central Daylight Time	06/02/2011 03:47:00 PM Central Daylight Time			06/02/2011 04:21:29 PM Central Daylight Time	ESSENCE HEALTHCARE, INC.	Essence Healthcare	www.essencehealthcare.com	Essence Advantage Employer Group Plan non-calendar (HMO)	01	01		1			H1837	801	0	2012	North Puget Sound Service Area		1	10	2			2						www.essencehealthcare.com	www.essencehealthcare.com	www.essencehealthcare.com	(877)-392-3849		(425)-697-8300		(877)-392-3849		(425)-697-8300		(877)-392-3849		(425)-697-8300		(877)-392-3849		(425)-697-8300		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H1837	803	0	1	01	01	H1837_803_0	8	1		04/26/2011	2012.02	04/26/2011 12:57:38 PM Central Daylight Time	06/02/2011 03:50:57 PM Central Daylight Time			06/02/2011 04:21:29 PM Central Daylight Time	ESSENCE HEALTHCARE, INC.	Essence Healthcare	www.essencehealthcare.com	Essence Advantage Employer Group Plan (HMO)	01	01		1			H1837	803	0	2012	North Puget Sound Service Area		1	10	2			2						www.essencehealthcare.com	www.essencehealthcare.com	www.essencehealthcare.com	(877)-392-3849		(425)-697-8300		(877)-392-3849		(425)-697-8300		(877)-392-3849		(425)-697-8300		(877)-392-3849		(425)-697-8300		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H1846	001	0	1	04	01	H1846_001_0	7	1		07/21/2011	2012.02	07/21/2011 08:25:47 AM Eastern Daylight Time	08/08/2011 02:24:16 PM Eastern Daylight Time	08/08/2011 02:28:36 PM Eastern Daylight Time		08/09/2011 08:51:18 AM Eastern Daylight Time	MOUNT CARMEL HEALTH INSURANCE COMPANY	MediGold	medigold.com	MediGold Network Choice (PPO)	01	04		1			H1846	001	0	2012	Greater Central Ohio and Dayton Area		2	790	2			2						www.medigold.com	www.medigold.com	www.caremark.com	(800)-240-3851		(614)-546-3110		(800)-964-4525		(800)-964-4525		(800)-240-3851		(614)-546-3110		(800)-964-4525		(800)-964-4525		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1846	003	0	1	04	01	H1846_003_0	7	1		07/24/2011	2012.02	07/24/2011 01:01:45 PM Eastern Daylight Time	08/08/2011 02:23:32 PM Eastern Daylight Time	08/08/2011 02:28:24 PM Eastern Daylight Time		08/09/2011 08:51:18 AM Eastern Daylight Time	MOUNT CARMEL HEALTH INSURANCE COMPANY	MediGold	medigold.com	MediGold Value Choice (PPO)	01	04		1			H1846	003	0	2012	Greater Dayton, Richland and Knox Counties		2	232	2			2						www.medigold.com	www.medigold.com	www.caremark.com	(800)-240-3851		(614)-546-3110		(800)-964-4525		(800)-964-4525		(800)-240-3851		(614)-546-3110		(800)-964-4525		(800)-964-4525		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1846	801	0	1	04	01	H1846_801_0	1	1		05/25/2011	2012.02	05/25/2011 12:16:53 PM Eastern Daylight Time	05/26/2011 05:58:58 PM Eastern Daylight Time			05/27/2011 02:22:52 PM Eastern Daylight Time	MOUNT CARMEL HEALTH INSURANCE COMPANY	MediGold	medigold.com	EGWP MediGold Network Choice (PPO)	01	04		1			H1846	801	0	2012	Greater Central Ohio and Dayton Area		1	2	2			2						www.medigold.com	www.medigold.com	www.caremark.com	(800)-240-3851		(614)-546-3110		(800)-964-4525		(800)-964-4525		(800)-240-3851		(614)-546-3110		(800)-964-4525		(800)-964-4525		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H1846	802	0	1	04	01	H1846_802_0	1	1		05/25/2011	2012.02	05/25/2011 12:16:58 PM Eastern Daylight Time	05/26/2011 05:57:42 PM Eastern Daylight Time			05/27/2011 02:22:52 PM Eastern Daylight Time	MOUNT CARMEL HEALTH INSURANCE COMPANY	MediGold	medigold.com	EGWP MediGold Network Choice Medical Only (PPO)	01	04		1			H1846	802	0	2012	Greater Central Ohio and Dayton Area		1	2	2			2						www.medigold.com	www.medigold.com	www.caremark.com	(800)-240-3851		(614)-546-3110		(800)-964-4525		(800)-964-4525										(711)		(711)		(711)		(711)										1	1	1
H1849	015	0	1	01	01	H1849_015_0	9	1		08/04/2011	2012.02	08/04/2011 02:01:24 PM Eastern Daylight Time	08/08/2011 07:07:33 PM Eastern Daylight Time	08/08/2011 07:09:51 PM Eastern Daylight Time		08/08/2011 07:18:07 PM Eastern Daylight Time	ANTHEM HEALTH PLANS OF KENTUCKY, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Senior Advantage Value (HMO)	01	01		1			H1849	015	0	2012	Select Counties in Kentucky		2	5992	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(800)-467-1199		(800)-467-1199		(800)-797-6406		(800)-797-6406		(800)-467-1199		(800)-467-1199		(800)-797-6406		(800)-797-6406		(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894		(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894		2	2	2
H1849	016	0	1	01	01	H1849_016_0	8	1		08/04/2011	2012.02	08/04/2011 02:01:43 PM Eastern Daylight Time	08/08/2011 07:07:40 PM Eastern Daylight Time	08/08/2011 07:09:57 PM Eastern Daylight Time		08/08/2011 07:18:07 PM Eastern Daylight Time	ANTHEM HEALTH PLANS OF KENTUCKY, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Senior Advantage Complete (HMO)	01	01		1			H1849	016	0	2012	Select Counties in Kentucky		2	2948	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(800)-467-1199		(800)-467-1199		(800)-797-6406		(800)-797-6406		(800)-467-1199		(800)-467-1199		(800)-797-6406		(800)-797-6406		(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894		(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894		2	2	2
H1849	801	0	1	01	01	H1849_801_0	10	1		06/05/2011	2012.02	06/05/2011 12:48:57 PM Pacific Daylight Time	07/22/2011 08:38:54 AM Pacific Daylight Time			07/22/2011 01:55:09 PM Pacific Daylight Time	ANTHEM HEALTH PLANS OF KENTUCKY, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Senior Advantage (HMO)	01	01		1			H1849	801	0	2012	Kentucky		1	1096	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-845-8609		(866)-845-8609		(866)-845-8609		(866)-845-8609		(866)-845-8609		(866)-845-8609		(866)-845-8609		(866)-845-8609		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		2	2	2
H1849	803	0	1	01	01	H1849_803_0	7	1		06/05/2011	2012.02	06/05/2011 12:49:05 PM Pacific Daylight Time	07/22/2011 08:38:55 AM Pacific Daylight Time			07/22/2011 01:55:09 PM Pacific Daylight Time	ANTHEM HEALTH PLANS OF KENTUCKY, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Senior Advantage (HMO)	01	01		1			H1849	803	0	2012	Kentucky		1	50	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-845-8609		(866)-845-8609		(866)-845-8609		(866)-845-8609										(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754										2	2	2
H1849	804	0	1	01	01	H1849_804_0	7	1		06/05/2011	2012.02	06/05/2011 12:49:15 PM Pacific Daylight Time	07/22/2011 08:38:55 AM Pacific Daylight Time			07/22/2011 01:55:09 PM Pacific Daylight Time	ANTHEM HEALTH PLANS OF KENTUCKY, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Senior Advantage (HMO)	01	01		1			H1849	804	0	2012	Kentucky		1	50	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-845-8609		(866)-845-8609		(866)-845-8609		(866)-845-8609		(866)-845-8609		(866)-845-8609		(866)-845-8609		(866)-845-8609		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		2	2	2
H1903	011	0	1	01	01	H1903_011_0	7	1	2	08/04/2011	2012.02	08/04/2011 03:10:22 PM Eastern Daylight Time	08/05/2011 02:14:55 PM Eastern Daylight Time	08/04/2011 07:46:54 PM Eastern Daylight Time		08/08/2011 03:50:28 PM Eastern Daylight Time	WELLCARE OF LOUISIANA, INC.	WellCare	www.wellcare.com	WellCare Access (HMO SNP)	01	01		1			H1903	011	0	2012	Alexandria, NO, BR, Lafayette Metro Areas		2		2			1	3		1	1		www.wellcare.com	www.wellcare.com	www.wellcare.com	(866)-530-9488		(866)-530-9488		(877)-232-7119		(877)-232-7119		(866)-530-9488		(866)-530-9488		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H1903	022	0	1	02	01	H1903_022_0	7	1		07/21/2011	2012.02	07/21/2011 01:35:31 PM Eastern Daylight Time	08/05/2011 02:15:12 PM Eastern Daylight Time	08/04/2011 07:49:48 PM Eastern Daylight Time		08/08/2011 03:50:28 PM Eastern Daylight Time	WELLCARE OF LOUISIANA, INC.	WellCare	www.wellcare.com	WellCare Value (HMO-POS)	01	02		1			H1903	022	0	2012	Alexandria, NO, BR, Lafayette Metro Areas		2		2			2						www.wellcare.com	www.wellcare.com	www.wellcare.com	(866)-804-5926		(866)-804-5926		(877)-232-7119		(877)-232-7119		(866)-804-5926		(866)-804-5926		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H1903	024	0	1	02	01	H1903_024_0	8	1		07/21/2011	2012.02	07/21/2011 01:35:42 PM Eastern Daylight Time	08/05/2011 02:15:28 PM Eastern Daylight Time	08/11/2011 11:13:33 AM Eastern Daylight Time		08/11/2011 02:04:30 PM Eastern Daylight Time	WELLCARE OF LOUISIANA, INC.	WellCare	www.wellcare.com	WellCare Dividend (HMO-POS)	01	02		1			H1903	024	0	2012	Alexandria, NO, BR, Lafayette Metro Areas		2		2			2						www.wellcare.com	www.wellcare.com	www.wellcare.com	(866)-804-5926		(866)-804-5926		(877)-232-7119		(877)-232-7119		(866)-804-5926		(866)-804-5926		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H1904	001	0	1	20	08	H1904_001_0	1	1		05/24/2011	2012.01	05/24/2011 12:19:18 PM Central Daylight Time		05/24/2011 10:25:00 AM Central Daylight Time		05/24/2011 01:16:56 PM Central Daylight Time	PACE GREATER NEW ORLEANS	Pace Greater New Orleans	http://pacegno.org/	PACE GREATER NEW ORLEANS (PACE)	08	20		1			H1904	001	0	2012	PACE GREATER NEW ORLEANS		2		2			2							http://www.pacegno.org	http://www.pacegno.org									(866)-395-8509		(504)-835-0006		(866)-395-8509		(504)-835-0006										(800)-846-5277		(800)-846-5277		(800)-846-5277		(800)-846-5277				
H1904	002	0	1	20	08	H1904_002_0	1	1		05/24/2011	2012.01	05/24/2011 12:11:38 PM Central Daylight Time		05/24/2011 10:25:00 AM Central Daylight Time		05/24/2011 01:16:56 PM Central Daylight Time	PACE GREATER NEW ORLEANS	Pace Greater New Orleans	http://pacegno.org/	PACE GREATER NEW ORLEANS (PACE)	08	20		1			H1904	002	0	2012	PACE GREATER NEW ORLEANS		2		2			2							http://www.pacegno.org	http://www.pacegno.org									(866)-395-8509		(504)-835-0006		(866)-395-8509		(504)-835-0006										(800)-846-5277		(800)-846-5277		(800)-846-5277		(800)-846-5277				
H1906	001	0	1	09	04	H1906_001_0	8	1		07/06/2011	2012.02	07/06/2011 07:08:25 PM Eastern Daylight Time	08/05/2011 04:04:16 PM Eastern Daylight Time	08/04/2011 11:43:47 AM Eastern Daylight Time		08/08/2011 04:00:14 PM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LA, INC.	Humana Health Benefit Plan of LA, Inc.	www.humana-medicare.com	Humana Gold Choice H1906-001 (PFFS)	04	09	2	1			H1906	001	0	2012	Select Parishes in Louisiana		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2		2
H1906	010	0	1	09	04	H1906_010_0	4	1		07/08/2011	2012.02	07/08/2011 04:00:28 PM Eastern Daylight Time	07/07/2011 04:55:22 PM Eastern Daylight Time			07/19/2011 03:43:11 PM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LA, INC.	Humana Health Benefit Plan of LA, Inc.	www.humana-medicare.com	Humana Gold Choice H1906-010 (PFFS)	04	09	2	1			H1906	010	0	2012	Select Parishes in Louisiana		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2		2
H1944	001	0	1	02	01	H1944_001_0	4	1		08/08/2011	2012.02	08/08/2011 09:26:17 AM Central Daylight Time	08/04/2011 07:54:47 PM Central Daylight Time	08/05/2011 01:25:31 PM Central Daylight Time		08/09/2011 02:16:58 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H1944	001	0	2012	Middlesex and Suffolk counties		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1951	001	0	1	01	01	H1951_001_0	7	1		07/06/2011	2012.02	07/06/2011 04:09:06 PM Eastern Daylight Time	08/05/2011 03:56:59 PM Eastern Daylight Time	08/04/2011 11:44:06 AM Eastern Daylight Time		08/08/2011 04:00:14 PM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana Inc	www.humana-medicare.com	Humana Gold Plus H1951-001 (HMO)	01	01		1			H1951	001	0	2012	New Orleans Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1951	005	0	1	01	01	H1951_005_0	6	1		07/06/2011	2012.02	07/06/2011 04:09:28 PM Eastern Daylight Time	08/05/2011 03:54:12 PM Eastern Daylight Time	08/04/2011 11:44:24 AM Eastern Daylight Time		08/08/2011 04:00:14 PM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana Inc	www.humana-medicare.com	Humana Gold Plus H1951-005 (HMO)	01	01		1			H1951	005	0	2012	Select parishes in Louisiana		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1951	013	0	1	01	01	H1951_013_0	7	1		07/07/2011	2012.02	07/07/2011 09:34:03 AM Eastern Daylight Time	08/05/2011 04:05:05 PM Eastern Daylight Time	08/04/2011 11:44:55 AM Eastern Daylight Time		08/08/2011 04:00:14 PM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana Inc	www.humana-medicare.com	Humana Gold Plus H1951-013 (HMO)	01	01		1			H1951	013	0	2012	Select parishes in Louisiana		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1951	017	0	1	01	01	H1951_017_0	8	1	2	08/08/2011	2012.02	08/08/2011 12:25:57 PM Eastern Daylight Time	08/05/2011 04:42:46 PM Eastern Daylight Time	08/04/2011 11:45:13 AM Eastern Daylight Time		08/08/2011 04:00:14 PM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana Inc	www.humana-medicare.com	Humana Gold Plus SNP-DE H1951-017 (HMO SNP)	01	01		1			H1951	017	0	2012	New Orleans Area		2		2			1	3		1	2		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1951	019	0	1	01	01	H1951_019_0	5	1	2	08/08/2011	2012.02	08/08/2011 12:27:49 PM Eastern Daylight Time	08/05/2011 03:53:37 PM Eastern Daylight Time	08/04/2011 11:45:31 AM Eastern Daylight Time		08/08/2011 04:00:14 PM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana Inc	www.humana-medicare.com	Humana Gold Plus SNP-DE H1951-019 (HMO SNP)	01	01		1			H1951	019	0	2012	Baton Rouge Area		2		2			1	3		1	2		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1951	024	0	1	01	01	H1951_024_0	6	1		07/06/2011	2012.02	07/06/2011 02:58:24 PM Eastern Daylight Time	08/05/2011 03:58:19 PM Eastern Daylight Time	08/04/2011 11:45:47 AM Eastern Daylight Time		08/08/2011 04:00:14 PM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana Inc	www.humana-medicare.com	Humana Gold Plus H1951-024 (HMO)	01	01		1			H1951	024	0	2012	Tangipahoa Parish		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1951	025	0	1	01	01	H1951_025_0	6	1		07/06/2011	2012.02	07/06/2011 10:28:20 AM Eastern Daylight Time	08/05/2011 03:59:13 PM Eastern Daylight Time	08/04/2011 11:46:06 AM Eastern Daylight Time		08/08/2011 04:00:14 PM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana Inc	www.humana-medicare.com	Humana Gold Plus H1951-025 (HMO)	01	01		1			H1951	025	0	2012	Select Louisiana Parishes		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1951	028	0	1	01	01	H1951_028_0	6	1		07/06/2011	2012.02	07/06/2011 04:11:34 PM Eastern Daylight Time	06/05/2011 09:34:35 PM Eastern Daylight Time	08/04/2011 11:46:27 AM Eastern Daylight Time		08/08/2011 04:00:14 PM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana Inc	www.humana-medicare.com	Humana Gold Plus H1951-028 (HMO)	01	01		1			H1951	028	0	2012	Washington and St. Tammany Parishes		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1951	030	0	1	01	01	H1951_030_0	4	1		07/07/2011	2012.02	07/07/2011 12:43:59 PM Eastern Daylight Time	06/05/2011 09:33:25 PM Eastern Daylight Time			07/07/2011 02:29:43 PM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana Inc	www.humana-medicare.com	Humana Gold Plus H1951-030 (HMO)	01	01		1			H1951	030	0	2012	Baton Rouge Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H1951	032	0	1	01	01	H1951_032_0	4	1	2	07/06/2011	2012.02	07/06/2011 04:26:08 PM Eastern Daylight Time	08/05/2011 04:03:28 PM Eastern Daylight Time	08/04/2011 11:46:55 AM Eastern Daylight Time		08/08/2011 04:00:14 PM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana Inc	www.humana-medicare.com	Humana Gold Plus SNP-DE H1951-032 (HMO SNP)	01	01		1			H1951	032	0	2012	Baton Rouge Area		2		2			1	3		1	5		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1951	033	0	1	01	01	H1951_033_0	4	1	2	07/06/2011	2012.02	07/06/2011 04:13:30 PM Eastern Daylight Time	08/05/2011 04:02:56 PM Eastern Daylight Time	08/04/2011 11:47:15 AM Eastern Daylight Time		08/08/2011 04:00:14 PM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana Inc	www.humana-medicare.com	Humana Gold Plus SNP-DE H1951-033 (HMO SNP)	01	01		1			H1951	033	0	2012	New Orleans Area		2		2			1	3		1	5		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1951	034	0	1	01	01	H1951_034_0	4	1	2	07/06/2011	2012.02	07/06/2011 04:12:51 PM Eastern Daylight Time	08/05/2011 04:02:29 PM Eastern Daylight Time	08/04/2011 11:47:33 AM Eastern Daylight Time		08/08/2011 04:00:14 PM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana Inc	www.humana-medicare.com	Humana Gold Plus SNP-DE H1951-034 (HMO SNP)	01	01		1			H1951	034	0	2012	Washington and St. Tammany Parishes		2		2			1	3		1	5		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1951	035	0	1	01	01	H1951_035_0	4	1	2	07/06/2011	2012.02	07/06/2011 04:14:06 PM Eastern Daylight Time	08/05/2011 04:00:36 PM Eastern Daylight Time	08/04/2011 11:47:50 AM Eastern Daylight Time		08/08/2011 04:00:14 PM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana Inc	www.humana-medicare.com	Humana Gold Plus SNP-DE H1951-035 (HMO SNP)	01	01		1			H1951	035	0	2012	Select Louisiana Parishes		2		2			1	3		1	5		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1951	801	0	1	01	01	H1951_801_0	5	1		07/06/2011	2012.02	07/06/2011 10:12:46 AM Eastern Daylight Time	05/27/2011 03:19:41 PM Eastern Daylight Time			07/06/2011 10:47:18 AM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana Inc	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H1951	801	0	2012	Select parishes in Louisiana		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H1951	804	0	1	01	01	H1951_804_0	7	1		07/06/2011	2012.02	07/06/2011 10:38:53 AM Eastern Daylight Time	05/28/2011 02:23:56 PM Eastern Daylight Time			07/06/2011 12:03:37 PM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana Inc	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H1951	804	0	2012	Select parishes in Louisiana		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
H1951	805	0	1	01	01	H1951_805_0	7	1		07/06/2011	2012.02	07/06/2011 10:38:56 AM Eastern Daylight Time	05/27/2011 03:51:34 PM Eastern Daylight Time			07/06/2011 12:03:37 PM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of Louisiana Inc	www.humana-medicare.com	Humana Employer Sponsored Non-CY (HMO)	01	01		1			H1951	805	0	2012	Select Louisiana Counties		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H1961	001	0	1	01	01	H1961_001_0	8	1		07/26/2011	2012.02	07/26/2011 03:04:20 PM Central Daylight Time	08/09/2011 09:26:52 AM Central Daylight Time	08/09/2011 09:32:14 AM Central Daylight Time		08/09/2011 09:46:41 AM Central Daylight Time	PEOPLES HEALTH, INC.	Peoples Health	www.peopleshealth.com	Peoples Health Choices 65 (HMO)	01	01		1			H1961	001	0	2012	Metro New Orleans area		2	28906	2			2						www.peopleshealth.com/physicians	www.peopleshealth.com/formulary	www.peopleshealth.com/pharmacies	(800)-631-8443	2	(504)-849-4500	2	(800)-631-8443	1	(504)-849-4500	1	(800)-631-8443	2	(504)-849-4500	2	(800)-631-8443	1	(504)-849-4500	1	(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1961	002	0	1	02	01	H1961_002_0	7	1		07/26/2011	2012.02	07/26/2011 03:04:57 PM Central Daylight Time	08/09/2011 09:29:08 AM Central Daylight Time	08/09/2011 09:33:24 AM Central Daylight Time		08/09/2011 10:01:54 AM Central Daylight Time	PEOPLES HEALTH, INC.	Peoples Health	www.peopleshealth.com	Peoples Health Choices Plus (HMO-POS)	01	02		1			H1961	002	0	2012	Southeast Louisiana		2	11009	2			2						www.peopleshealth.com/physicians	www.peopleshealth.com/formulary	www.peopleshealth.com/pharmacies	(800)-631-8443	2	(504)-849-4500	2	(800)-631-8443	1	(504)-849-4500	1	(800)-631-8443	2	(504)-849-4500	2	(800)-631-8443	1	(504)-849-4500	1	(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1961	003	0	1	01	01	H1961_003_0	7	1	2	08/11/2011	2012.02	08/11/2011 08:56:54 AM Central Daylight Time	08/09/2011 05:52:02 PM Central Daylight Time	08/09/2011 05:54:12 PM Central Daylight Time		08/11/2011 12:00:05 PM Central Daylight Time	PEOPLES HEALTH, INC.	Peoples Health	www.peopleshealth.com	Peoples Health Secure Health (HMO SNP)	01	01		1			H1961	003	0	2012	New Orleans Metro and Southeast Louisiana		2	8118	2			1	3		1	2		www.peopleshealth.com/physicians	www.peopleshealth.com/formulary	www.peopleshealth.com/pharmacies	(800)-631-8443	2	(504)-849-4500	2	(800)-631-8443	1	(504)-849-4500	1	(800)-631-8443	2	(504)-849-4500	2	(800)-631-8443	1	(504)-849-4500	1	(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1961	007	0	1	02	01	H1961_007_0	7	1		07/25/2011	2012.02	07/25/2011 06:09:49 PM Central Daylight Time	08/09/2011 09:31:00 AM Central Daylight Time	08/09/2011 09:35:08 AM Central Daylight Time		08/09/2011 10:14:01 AM Central Daylight Time	PEOPLES HEALTH, INC.	Peoples Health	www.peopleshealth.com	Peoples Health Choices Select (HMO-POS)	01	02		1			H1961	007	0	2012	Tangipahoa and Washington Parishes in Louisiana		2	1137	2			2						www.peopleshealth.com/physicians	www.peopleshealth.com/formulary	www.peopleshealth.com/pharmacies	(800)-631-8443	2	(504)-849-4500	2	(800)-631-8443	1	(504)-849-4500	1	(800)-631-8443	2	(504)-849-4500	2	(800)-631-8443	1	(504)-849-4500	1	(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1961	801	0	1	02	01	H1961_801_0	4	1		07/07/2011	2012.02	07/07/2011 02:52:35 PM Central Daylight Time	07/12/2011 12:15:54 PM Central Daylight Time			07/12/2011 01:26:51 PM Central Daylight Time	PEOPLES HEALTH, INC.	Peoples Health	www.peopleshealth.com	Peoples Health Group Medicare (HMO-POS)	01	02		1			H1961	801	0	2012	Nationwide		1	489	2			2						www.peopleshealth.com/physicians	www.peopleshealth.com/formulary	www.peopleshealth.com/pharmacies	(800)-631-8443	2	(504)-849-4500	2	(800)-631-8443	1	(504)-849-4500	1	(800)-631-8443	2	(504)-849-4500	2	(800)-631-8443	1	(504)-849-4500	1	(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1961	802	0	1	02	01	H1961_802_0	4	1		07/07/2011	2012.02	07/07/2011 02:53:26 PM Central Daylight Time	07/12/2011 12:19:26 PM Central Daylight Time			07/12/2011 01:41:06 PM Central Daylight Time	PEOPLES HEALTH, INC.	Peoples Health	www.peopleshealth.com	Peoples Health Group Medicare (HMO-POS)	01	02		1			H1961	802	0	2012	Nationwide		1	489	2			2						www.peopleshealth.com/physicians	www.peopleshealth.com/formulary	www.peopleshealth.com/pharmacies	(800)-631-8443	2	(504)-849-4500	2	(800)-631-8443	1	(504)-849-4500	1	(800)-631-8443	2	(504)-849-4500	2	(800)-631-8443	1	(504)-849-4500	1	(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1961	803	0	1	01	01	H1961_803_0	4	1		06/02/2011	2012.02	06/02/2011 03:10:18 PM Central Daylight Time	07/12/2011 12:20:54 PM Central Daylight Time			07/12/2011 01:51:55 PM Central Daylight Time	PEOPLES HEALTH, INC.	Peoples Health	www.peopleshealth.com	Peoples Health Group Medicare (HMO)	01	01		1			H1961	803	0	2012	Nationwide		1	150	2			2						www.peopleshealth.com/physicians	www.peopleshealth.com/formulary	www.peopleshealth.com/pharmacies	(800)-631-8443	2	(504)-849-4500	2	(800)-631-8443	1	(504)-849-4500	1	(800)-631-8443	2	(504)-849-4500	2	(800)-631-8443	1	(504)-849-4500	1	(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H1961	804	0	1	01	01	H1961_804_0	4	1		06/02/2011	2012.02	06/02/2011 03:10:31 PM Central Daylight Time	07/12/2011 12:22:52 PM Central Daylight Time			07/12/2011 02:03:45 PM Central Daylight Time	PEOPLES HEALTH, INC.	Peoples Health	www.peopleshealth.com	Peoples Health Group Medicare (HMO)	01	01		1			H1961	804	0	2012	Nationwide		1	150	2			2						www.peopleshealth.com/physicians	www.peopleshealth.com/formulary	www.peopleshealth.com/pharmacies	(800)-631-8443	2	(504)-849-4500	2	(800)-631-8443	1	(504)-849-4500	1	(800)-631-8443	2	(504)-849-4500	2	(800)-631-8443	1	(504)-849-4500	1	(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2001	001	0	1	04	01	H2001_001_0	6	1		08/05/2011	2012.02	08/05/2011 09:50:24 AM Central Daylight Time	08/29/2011 10:38:04 AM Central Daylight Time	08/05/2011 01:26:02 PM Central Daylight Time		08/29/2011 02:19:38 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareComplete.com	AARP MedicareComplete Choice (PPO)	01	04		1			H2001	001	0	2012	Cumberland, Kennebec, Sagadahoc and York Counties		2		2			2						www.AARPMedicareComplete.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	001	0	1	01	01	H2012_001_0	5	1		08/08/2011	2012.02	08/08/2011 11:50:01 AM Eastern Daylight Time	08/05/2011 05:38:17 PM Eastern Daylight Time	08/04/2011 11:48:09 AM Eastern Daylight Time		08/08/2011 04:32:56 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus H2012-001 (HMO)	01	01		1			H2012	001	0	2012	Little Rock/NW Arkansas/River Valley areas		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	002	0	1	01	01	H2012_002_0	7	1		07/06/2011	2012.02	07/06/2011 11:49:48 AM Eastern Daylight Time	08/05/2011 08:54:54 AM Eastern Daylight Time	08/04/2011 11:48:27 AM Eastern Daylight Time		08/08/2011 07:12:40 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus H2012-002 (HMO)	01	01		1			H2012	002	0	2012	Birmingham Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	003	0	1	01	01	H2012_003_0	7	1		07/06/2011	2012.02	07/06/2011 11:01:22 AM Eastern Daylight Time	05/27/2011 04:19:02 PM Eastern Daylight Time	08/04/2011 11:48:46 AM Eastern Daylight Time		08/08/2011 07:12:40 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus H2012-003 (HMO)	01	01		1			H2012	003	0	2012	Baldwin, Clarke, and Mobile Counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	006	0	1	01	01	H2012_006_0	8	1		07/06/2011	2012.02	07/06/2011 04:16:13 PM Eastern Daylight Time	06/01/2011 09:59:00 AM Eastern Daylight Time	08/04/2011 11:49:03 AM Eastern Daylight Time		08/09/2011 08:57:23 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus H2012-006 (HMO)	01	01		1			H2012	006	0	2012	Richland County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	007	0	1	01	01	H2012_007_0	6	1		07/06/2011	2012.02	07/06/2011 04:17:15 PM Eastern Daylight Time	08/05/2011 08:51:04 AM Eastern Daylight Time	08/04/2011 11:49:22 AM Eastern Daylight Time		08/09/2011 08:57:23 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus H2012-007 (HMO)	01	01		1			H2012	007	0	2012	Spartanburg / Greenville Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	008	0	1	01	01	H2012_008_0	8	1		07/06/2011	2012.02	07/06/2011 02:20:00 PM Eastern Daylight Time	08/05/2011 10:43:17 PM Eastern Daylight Time	08/04/2011 11:49:40 AM Eastern Daylight Time		08/08/2011 07:26:35 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus H2012-008 (HMO)	01	01		1			H2012	008	0	2012	Richmond Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	009	0	1	01	01	H2012_009_0	14	1		07/07/2011	2012.02	07/07/2011 12:42:15 PM Eastern Daylight Time	08/05/2011 10:42:59 PM Eastern Daylight Time	08/04/2011 11:50:07 AM Eastern Daylight Time		08/09/2011 10:51:26 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus H2012-009 (HMO)	01	01		1			H2012	009	0	2012	Indianapolis Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	011	0	1	01	01	H2012_011_0	12	1		07/06/2011	2012.02	07/06/2011 11:42:53 AM Eastern Daylight Time	08/05/2011 10:47:02 PM Eastern Daylight Time	08/04/2011 11:50:25 AM Eastern Daylight Time		08/09/2011 10:51:26 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus H2012-011 (HMO)	01	01		1			H2012	011	0	2012	Lexington Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	012	0	1	01	01	H2012_012_0	11	1		07/06/2011	2012.02	07/06/2011 11:43:54 AM Eastern Daylight Time	08/05/2011 10:46:38 PM Eastern Daylight Time	08/04/2011 11:50:44 AM Eastern Daylight Time		08/09/2011 10:51:26 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus H2012-012 (HMO)	01	01		1			H2012	012	0	2012	Louisville Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	013	0	1	01	01	H2012_013_0	7	1		07/06/2011	2012.02	07/06/2011 02:20:38 PM Eastern Daylight Time	08/05/2011 10:46:51 PM Eastern Daylight Time	08/04/2011 11:51:03 AM Eastern Daylight Time		08/08/2011 07:26:35 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus H2012-013 (HMO)	01	01		1			H2012	013	0	2012	Roanoke Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	014	0	1	01	01	H2012_014_0	7	1		07/06/2011	2012.02	07/06/2011 11:02:13 AM Eastern Daylight Time	05/27/2011 04:22:19 PM Eastern Daylight Time	08/04/2011 11:51:21 AM Eastern Daylight Time		08/08/2011 07:12:40 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus H2012-014 (HMO)	01	01		1			H2012	014	0	2012	Limestone and Madison Counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	015	0	1	01	01	H2012_015_0	7	1		07/06/2011	2012.02	07/06/2011 10:26:37 AM Eastern Daylight Time	08/05/2011 08:58:48 AM Eastern Daylight Time	08/04/2011 11:51:40 AM Eastern Daylight Time		08/08/2011 04:28:45 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus H2012-015 (HMO)	01	01		1			H2012	015	0	2012	Select VA Counties in the Tri-Cities Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	016	0	1	01	01	H2012_016_0	7	1		07/06/2011	2012.02	07/06/2011 10:28:52 AM Eastern Daylight Time	08/05/2011 09:01:45 AM Eastern Daylight Time	08/04/2011 11:51:59 AM Eastern Daylight Time		08/08/2011 04:28:45 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus H2012-016 (HMO)	01	01		1			H2012	016	0	2012	Select VA Counties in the Tri-Cities Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	021	0	1	01	01	H2012_021_0	6	1		07/07/2011	2012.02	07/07/2011 02:02:34 PM Eastern Daylight Time	08/05/2011 11:33:42 AM Eastern Daylight Time	08/04/2011 11:52:19 AM Eastern Daylight Time		08/09/2011 10:58:20 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus H2012-021 (HMO)	01	01		1			H2012	021	0	2012	Douglas, Lancaster and Sarpy counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	022	0	1	01	01	H2012_022_0	5	1		07/07/2011	2012.02	07/07/2011 01:24:05 PM Eastern Daylight Time	08/04/2011 03:18:45 PM Eastern Daylight Time	08/04/2011 11:52:38 AM Eastern Daylight Time		08/08/2011 02:56:01 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus H2012-022 (HMO)	01	01		1			H2012	022	0	2012	Ada, Canyon, Gem and Payette counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	023	0	1	01	01	H2012_023_0	5	1		07/07/2011	2012.02	07/07/2011 03:33:40 PM Eastern Daylight Time	08/04/2011 03:18:18 PM Eastern Daylight Time	08/04/2011 11:52:57 AM Eastern Daylight Time		08/08/2011 03:10:25 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus H2012-023 (HMO)	01	01		1			H2012	023	0	2012	Twin Falls County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	026	0	1	01	01	H2012_026_0	7	1		07/06/2011	2012.02	07/06/2011 04:03:50 PM Eastern Daylight Time	08/05/2011 09:00:59 AM Eastern Daylight Time	08/04/2011 11:53:17 AM Eastern Daylight Time		08/08/2011 07:12:40 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus H2012-026 (HMO)	01	01		1			H2012	026	0	2012	Limestone and Madison Counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	027	0	1	01	01	H2012_027_0	9	1		07/06/2011	2012.02	07/06/2011 11:44:40 AM Eastern Daylight Time	08/05/2011 10:52:51 PM Eastern Daylight Time	08/04/2011 11:53:35 AM Eastern Daylight Time		08/08/2011 04:11:23 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus H2012-027 (HMO)	01	01		1			H2012	027	0	2012	Evansville Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	028	0	1	01	01	H2012_028_0	9	1		07/06/2011	2012.02	07/06/2011 11:45:38 AM Eastern Daylight Time	08/05/2011 10:52:37 PM Eastern Daylight Time	08/04/2011 11:53:53 AM Eastern Daylight Time		08/08/2011 04:20:10 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus H2012-028 (HMO)	01	01		1			H2012	028	0	2012	Fort Wayne Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	029	0	1	01	01	H2012_029_0	8	1		07/06/2011	2012.02	07/06/2011 02:21:20 PM Eastern Daylight Time	08/05/2011 10:53:19 PM Eastern Daylight Time	08/04/2011 11:54:13 AM Eastern Daylight Time		08/08/2011 07:26:35 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus H2012-029 (HMO)	01	01		1			H2012	029	0	2012	Tidewater Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	030	0	1	02	01	H2012_030_0	7	1		07/07/2011	2012.02	07/07/2011 03:20:58 PM Eastern Daylight Time	08/04/2011 03:24:31 PM Eastern Daylight Time	08/04/2011 11:54:30 AM Eastern Daylight Time		08/08/2011 03:10:25 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus H2012-030 (HMO-POS)	01	02		1			H2012	030	0	2012	Bonner, Boundary and Kootenai counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	031	0	1	01	01	H2012_031_0	7	1		07/07/2011	2012.02	07/07/2011 12:54:37 PM Eastern Daylight Time	08/04/2011 03:24:59 PM Eastern Daylight Time	08/04/2011 11:54:50 AM Eastern Daylight Time		08/08/2011 03:38:16 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus H2012-031 (HMO)	01	01		1			H2012	031	0	2012	Clark County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	032	0	1	02	01	H2012_032_0	6	1		07/07/2011	2012.02	07/07/2011 12:50:13 PM Eastern Daylight Time	08/04/2011 03:28:53 PM Eastern Daylight Time	08/04/2011 11:55:16 AM Eastern Daylight Time		08/08/2011 03:38:16 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus H2012-032 (HMO-POS)	01	02		1			H2012	032	0	2012	Clark County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	033	0	1	01	01	H2012_033_0	6	1		07/07/2011	2012.02	07/07/2011 11:30:13 AM Eastern Daylight Time	08/04/2011 04:19:02 PM Eastern Daylight Time	08/04/2011 11:55:35 AM Eastern Daylight Time		08/08/2011 03:46:54 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus H2012-033 (HMO)	01	01		1			H2012	033	0	2012	King County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	034	0	1	02	01	H2012_034_0	4	1		07/07/2011	2012.02	07/07/2011 12:45:26 PM Eastern Daylight Time	08/04/2011 03:26:55 PM Eastern Daylight Time	08/04/2011 11:55:49 AM Eastern Daylight Time		08/08/2011 03:46:54 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus H2012-034 (HMO-POS)	01	02		1			H2012	034	0	2012	King County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	035	0	1	01	01	H2012_035_0	5	1		07/07/2011	2012.02	07/07/2011 11:24:22 AM Eastern Daylight Time	08/04/2011 03:25:30 PM Eastern Daylight Time	08/04/2011 11:56:08 AM Eastern Daylight Time		08/08/2011 03:51:29 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus H2012-035 (HMO)	01	01		1			H2012	035	0	2012	Pierce County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	036	0	1	02	01	H2012_036_0	6	1		07/07/2011	2012.02	07/07/2011 12:44:41 PM Eastern Daylight Time	08/04/2011 03:27:21 PM Eastern Daylight Time	08/04/2011 11:56:36 AM Eastern Daylight Time		08/08/2011 03:51:29 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus H2012-036 (HMO-POS)	01	02		1			H2012	036	0	2012	Pierce County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	037	0	1	01	01	H2012_037_0	4	1		07/07/2011	2012.02	07/07/2011 10:59:21 AM Eastern Daylight Time	08/04/2011 03:25:54 PM Eastern Daylight Time	08/04/2011 11:56:54 AM Eastern Daylight Time		08/08/2011 03:59:02 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus H2012-037 (HMO)	01	01		1			H2012	037	0	2012	Snohomish County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	038	0	1	02	01	H2012_038_0	6	1		07/07/2011	2012.02	07/07/2011 11:37:11 AM Eastern Daylight Time	08/04/2011 03:27:59 PM Eastern Daylight Time	08/04/2011 11:57:13 AM Eastern Daylight Time		08/08/2011 03:59:02 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus H2012-038 (HMO-POS)	01	02		1			H2012	038	0	2012	Snohomish County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	039	0	1	01	01	H2012_039_0	6	1		07/07/2011	2012.02	07/07/2011 04:19:20 PM Eastern Daylight Time	08/04/2011 03:26:21 PM Eastern Daylight Time	08/04/2011 11:57:31 AM Eastern Daylight Time		08/08/2011 04:04:14 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus H2012-039 (HMO)	01	01		1			H2012	039	0	2012	Spokane County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	040	0	1	02	01	H2012_040_0	6	1		07/07/2011	2012.02	07/07/2011 11:33:44 AM Eastern Daylight Time	08/04/2011 03:28:27 PM Eastern Daylight Time	08/04/2011 11:57:49 AM Eastern Daylight Time		08/08/2011 04:04:14 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus H2012-040 (HMO-POS)	01	02		1			H2012	040	0	2012	Spokane County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	042	0	1	01	01	H2012_042_0	5	1	2	07/06/2011	2012.02	07/06/2011 02:23:53 PM Eastern Daylight Time	08/05/2011 10:53:31 PM Eastern Daylight Time	08/04/2011 11:58:29 AM Eastern Daylight Time		08/08/2011 07:26:35 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus SNP-DE H2012-042 (HMO SNP)	01	01		1			H2012	042	0	2012	Richmond Metro Area		2		2			1	3		1	5		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	046	0	1	02	01	H2012_046_0	9	1		07/07/2011	2012.02	07/07/2011 05:50:02 PM Eastern Daylight Time	08/05/2011 09:12:53 AM Eastern Daylight Time	08/04/2011 11:58:47 AM Eastern Daylight Time		08/09/2011 08:57:23 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus H2012-046 (HMO-POS)	01	02		1			H2012	046	0	2012	York County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	051	0	1	02	01	H2012_051_0	7	1		07/06/2011	2012.02	07/06/2011 11:04:07 AM Eastern Daylight Time	08/05/2011 09:05:13 AM Eastern Daylight Time	08/04/2011 11:59:06 AM Eastern Daylight Time		08/08/2011 07:12:40 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus H2012-051 (HMO-POS)	01	02		1			H2012	051	0	2012	Baldwin, Clarke, and Mobile Counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	053	0	1	01	01	H2012_053_0	5	1	2	07/20/2011	2012.02	07/20/2011 09:03:55 AM Eastern Daylight Time	08/05/2011 12:33:19 PM Eastern Daylight Time	08/04/2011 11:59:25 AM Eastern Daylight Time		08/09/2011 08:57:23 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus SNP-DE H2012-053 (HMO SNP)	01	01		1			H2012	053	0	2012	Spartanburg / Greenville Metro Area		2		2			1	3		1	5		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	054	0	1	01	01	H2012_054_0	7	1	2	07/06/2011	2012.02	07/06/2011 12:56:39 PM Eastern Daylight Time	08/05/2011 01:13:51 PM Eastern Daylight Time	08/04/2011 11:59:43 AM Eastern Daylight Time		08/08/2011 07:12:40 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Gold Plus SNP-DE H2012-054 (HMO SNP)	01	01		1			H2012	054	0	2012	Tri-Cities		2		2			1	3		1	5		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2012	801	0	1	01	01	H2012_801_0	3	1		07/05/2011	2012.02	07/06/2011 08:16:04 AM Eastern Daylight Time	05/27/2011 03:29:18 PM Eastern Daylight Time			07/06/2011 11:29:15 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H2012	801	0	2012	Multi-State		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H2012	802	0	1	01	01	H2012_802_0	3	1		07/05/2011	2012.02	07/06/2011 08:16:11 AM Eastern Daylight Time	05/27/2011 03:38:33 PM Eastern Daylight Time			07/06/2011 11:29:15 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H2012	802	0	2012	Multi-State		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
H2012	803	0	1	01	01	H2012_803_0	3	1		07/05/2011	2012.02	07/06/2011 08:16:15 AM Eastern Daylight Time	05/27/2011 03:39:34 PM Eastern Daylight Time			07/06/2011 11:29:15 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc	www.humana-medicare.com	Humana Employer Sponsored Non-CY (HMO)	01	01		1			H2012	803	0	2012	Multi-State		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H2029	001	0	1	04	01	H2029_001_0	6	1		08/08/2011	2012.02	08/08/2011 09:05:47 AM Eastern Daylight Time	08/08/2011 10:20:34 AM Eastern Daylight Time	08/04/2011 12:00:03 PM Eastern Daylight Time		08/08/2011 05:34:50 PM Eastern Daylight Time	HUMANA INSURANCE OF PUERTO RICO, INC.	Humana Insurance of Puerto Rico, Inc.	www.humana-medicare.com	HumanaChoice H2029-001 (PPO)	01	04		1			H2029	001	0	2012	Puerto Rico Island Wide		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625		(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2029	002	0	1	04	01	H2029_002_0	6	1		08/08/2011	2012.02	08/08/2011 09:04:56 AM Eastern Daylight Time	08/08/2011 10:22:44 AM Eastern Daylight Time	08/04/2011 12:00:22 PM Eastern Daylight Time		08/08/2011 05:34:50 PM Eastern Daylight Time	HUMANA INSURANCE OF PUERTO RICO, INC.	Humana Insurance of Puerto Rico, Inc.	www.humana-medicare.com	HumanaChoice H2029-002 (PPO)	01	04		1			H2029	002	0	2012	Puerto Rico Island Wide		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625		(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2029	801	0	1	04	01	H2029_801_0	4	1		06/21/2011	2012.02	06/21/2011 08:44:05 AM Eastern Daylight Time	06/02/2011 10:15:02 AM Eastern Daylight Time			06/21/2011 10:54:13 AM Eastern Daylight Time	HUMANA INSURANCE OF PUERTO RICO, INC.	Humana Insurance of Puerto Rico, Inc.	www.humana-medicare.com	Humana Employer Sponsored (PPO)	01	04		1			H2029	801	0	2012	Puerto Rico island wide		1		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625		(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H2029	802	0	1	04	01	H2029_802_0	3	1		06/21/2011	2012.02	06/21/2011 08:54:51 AM Eastern Daylight Time	05/31/2011 09:21:21 AM Eastern Daylight Time			06/21/2011 10:54:13 AM Eastern Daylight Time	HUMANA INSURANCE OF PUERTO RICO, INC.	Humana Insurance of Puerto Rico, Inc.	www.humana-medicare.com	Humana Employer Sponsored (PPO)	01	04		1			H2029	802	0	2012	Puerto Rico island wide		1		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625										(711)		(711)		(711)		(711)										2	1	1
H2029	803	0	1	04	01	H2029_803_0	3	1		06/21/2011	2012.02	06/21/2011 08:55:13 AM Eastern Daylight Time	05/31/2011 09:22:20 AM Eastern Daylight Time			06/21/2011 10:54:13 AM Eastern Daylight Time	HUMANA INSURANCE OF PUERTO RICO, INC.	Humana Insurance of Puerto Rico, Inc.	www.humana-medicare.com	Humana Employer Sponsored Non-CY (PPO)	01	04		1			H2029	803	0	2012	Puerto Rico island wide		1		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625		(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H2029	805	0	2	04	01	H2029_805_0	3	1		06/21/2011	2012.02	06/21/2011 08:50:19 AM Eastern Daylight Time	05/31/2011 10:23:12 AM Eastern Daylight Time			06/21/2011 10:54:13 AM Eastern Daylight Time	HUMANA INSURANCE OF PUERTO RICO, INC.	Humana Insurance of Puerto Rico, Inc.	www.humana-medicare.com	Humana Employer Sponsored (PPO)	01	04		2	2		H2029	805	0	2012	Puerto Rico island wide		1		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625		(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H2029	806	0	2	04	01	H2029_806_0	3	1		06/21/2011	2012.02	06/21/2011 09:12:13 AM Eastern Daylight Time	05/31/2011 10:24:16 AM Eastern Daylight Time			06/21/2011 10:54:13 AM Eastern Daylight Time	HUMANA INSURANCE OF PUERTO RICO, INC.	Humana Insurance of Puerto Rico, Inc.	www.humana-medicare.com	Humana Employer Sponsored (PPO)	01	04		2	2		H2029	806	0	2012	Puerto Rico island wide		1		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625										(711)		(711)		(711)		(711)										2	1	1
H2029	807	0	2	04	01	H2029_807_0	3	1		06/21/2011	2012.02	06/21/2011 09:12:35 AM Eastern Daylight Time	05/31/2011 10:25:27 AM Eastern Daylight Time			06/21/2011 10:54:13 AM Eastern Daylight Time	HUMANA INSURANCE OF PUERTO RICO, INC.	Humana Insurance of Puerto Rico, Inc.	www.humana-medicare.com	Humana Employer Sponsored Non-CY (PPO)	01	04		2	2		H2029	807	0	2012	Puerto Rico island wide		1		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625		(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H2029	808	0	1	04	01	H2029_808_0	4	1		06/21/2011	2012.02	06/21/2011 08:55:34 AM Eastern Daylight Time	07/19/2011 10:40:32 AM Eastern Daylight Time			07/22/2011 06:28:25 PM Eastern Daylight Time	HUMANA INSURANCE OF PUERTO RICO, INC.	Humana Insurance of Puerto Rico, Inc.	www.humana-medicare.com	Humana Employer Sponsored - Walmart (PPO)	01	04		1			H2029	808	0	2012	Puerto Rico island wide		1		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625		(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H2034	001	0	1	01	01	H2034_001_0	6	1	2	08/23/2011	2012.02	08/23/2011 04:04:24 PM Central Daylight Time	08/09/2011 03:11:05 PM Central Daylight Time	08/09/2011 03:11:29 PM Central Daylight Time		08/23/2011 04:12:48 PM Central Daylight Time	COMMUNITY CARE HEALTH PLAN, INC.	Community Care	www.communitycareinc.org	Community Care's  Partnership Program (HMO SNP)	01	01		1			H2034	001	0	2012	Eastern Wisconsin		2	70	2			1	3		1	5		www.communitycareinc.org	www.communitycareinc.org/Assets/Formulary.pdf	www.communitycareinc.org	(866)-992-6600		(414)-385-6600		(866)-992-6600		(414)-385-6600		(866)-992-6600		(414)-385-6600		(866)-992-6600		(414)-385-6600		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		2	1	2
H2034	002	0	1	01	01	H2034_002_0	6	1	2	08/23/2011	2012.02	08/23/2011 04:04:36 PM Central Daylight Time	08/09/2011 03:11:32 PM Central Daylight Time	08/09/2011 03:11:28 PM Central Daylight Time		08/23/2011 04:12:48 PM Central Daylight Time	COMMUNITY CARE HEALTH PLAN, INC.	Community Care	www.communitycareinc.org	Community Care's Partnership Program Disabled (HMO SNP)	01	01		1			H2034	002	0	2012	Eastern Wisconsin		2	82	2			1	3		1	5		www.communitycareinc.org	www.communitycareinc.org/Assets/Formulary.pdf	www.communitycareinc.org	(866)-992-6600		(414)-385-6600		(866)-992-6600		(414)-385-6600		(866)-992-6600		(414)-385-6600		(866)-992-6600		(414)-385-6600		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		2	1	2
H2064	001	0	1	20	08	H2064_001_0	1	1		05/23/2011	2012.01	05/23/2011 01:10:58 PM Eastern Daylight Time		05/23/2011 01:04:19 PM Eastern Daylight Time		05/23/2011 01:13:17 PM Eastern Daylight Time	GEISINGER COMMUNITY HEALTH SERVICES	LIFE Geisinger	www.lifegeisinger.org	LIFE Geisinger (PACE)	08	20		1			H2064	001	0	2012	LIFE Geisinger		2		2			2							www.lifegeisinger.org	www.lifegeisinger.org									(570)-214-9790		(570)-214-9791		(570)-214-9790		(570)-214-9791										(570)-214-9790		(570)-214-9790		(570)-214-9790		(570)-214-9790				
H2064	002	0	1	20	08	H2064_002_0	1	1		05/23/2011	2012.01	05/23/2011 01:11:13 PM Eastern Daylight Time		05/23/2011 01:04:24 PM Eastern Daylight Time		05/23/2011 01:13:17 PM Eastern Daylight Time	GEISINGER COMMUNITY HEALTH SERVICES	LIFE Geisinger	www.lifegeisinger.org	LIFE Geisinger (PACE)	08	20		1			H2064	002	0	2012	LIFE Geisinger		2		2			2							www.lifegeisinger.org	www.lifegeisinger.org									(570)-214-9790		(570)-214-9791		(570)-214-9790		(570)-214-9791										(570)-214-9790		(570)-214-9790		(570)-214-9790		(570)-214-9790				
H2108	001	0	1	01	01	H2108_001_0	8	1	2	08/05/2011	2012.02	08/05/2011 03:01:29 PM Eastern Daylight Time	08/08/2011 08:57:15 AM Central Daylight Time	08/04/2011 04:47:17 PM Central Daylight Time		08/09/2011 04:46:11 PM Central Daylight Time	BRAVO HEALTH MID- ATLANTIC INC.	Bravo Health	www.mybravohealth.com	Bravo Select (HMO SNP)	01	01		1			H2108	001	0	2012	Maryland and Delaware Counties and Wash DC		2		2			1	3		1	2		www.mybravohealth.com	www.mybravohealth.com/formulary	www.mybravohealth.com	(800)-291-0396		(800)-291-0396		(888)-311-4483		(888)-311-4483		(800)-291-0396		(800)-291-0396		(888)-311-4483		(888)-311-4483		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2108	020	0	1	01	01	H2108_020_0	7	1		08/05/2011	2012.02	08/05/2011 03:02:59 PM Eastern Daylight Time	08/08/2011 08:58:04 AM Central Daylight Time	08/04/2011 04:48:19 PM Central Daylight Time		08/09/2011 04:46:11 PM Central Daylight Time	BRAVO HEALTH MID- ATLANTIC INC.	Bravo Health	www.mybravohealth.com	Bravo Traditions (HMO SNP)	01	01		1			H2108	020	0	2012	Maryland, Delaware Counties and Wash DC		2		2			1	1	1	1			www.mybravohealth.com	www.mybravohealth.com/formulary	www.mybravohealth.com	(800)-291-0396		(800)-291-0396		(888)-311-4483		(888)-311-4483		(800)-291-0396		(800)-291-0396		(888)-311-4483		(888)-311-4483		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2108	022	0	1	01	01	H2108_022_0	7	1		07/12/2011	2012.02	07/12/2011 01:44:59 PM Eastern Daylight Time	08/08/2011 08:58:54 AM Central Daylight Time	08/04/2011 04:49:05 PM Central Daylight Time		08/09/2011 04:46:11 PM Central Daylight Time	BRAVO HEALTH MID- ATLANTIC INC.	Bravo Health	www.mybravohealth.com	Bravo Classic (HMO)	01	01		1			H2108	022	0	2012	Maryland and Delaware Counties		2		2			2						www.mybravohealth.com	www.mybravohealth.com/formulary	www.mybravohealth.com	(800)-291-0396		(800)-291-0396		(888)-311-4483		(888)-311-4483		(800)-291-0396		(800)-291-0396		(888)-311-4483		(888)-311-4483		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2108	028	0	1	02	01	H2108_028_0	7	1		08/05/2011	2012.02	08/05/2011 03:05:07 PM Eastern Daylight Time	08/08/2011 08:59:43 AM Central Daylight Time	08/04/2011 04:49:52 PM Central Daylight Time		08/09/2011 04:46:11 PM Central Daylight Time	BRAVO HEALTH MID- ATLANTIC INC.	Bravo Health	www.mybravohealth.com	Bravo Classic Plus (HMO-POS)	01	02		1			H2108	028	0	2012	District of Columbia and Delaware Counties		2		2			2						www.mybravohealth.com	www.mybravohealth.com/formulary	www.mybravohealth.com	(800)-291-0396		(800)-291-0396		(888)-311-4483		(888)-311-4483		(800)-291-0396		(800)-291-0396		(888)-311-4483		(888)-311-4483		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2108	029	0	1	02	01	H2108_029_0	9	1		07/19/2011	2012.02	07/19/2011 10:01:27 AM Eastern Daylight Time	08/08/2011 09:00:32 AM Central Daylight Time	08/04/2011 04:50:42 PM Central Daylight Time		08/09/2011 04:46:11 PM Central Daylight Time	BRAVO HEALTH MID- ATLANTIC INC.	Bravo Health	www.mybravohealth.com	Bravo Achieve Plus (HMO-POS SNP)	01	02		1			H2108	029	0	2012	District of Columbia and Delaware Counties		2		2			1	4		1		00000010000000000000	www.mybravohealth.com	www.mybravohealth.com/formulary	www.mybravohealth.com	(800)-291-0396		(800)-291-0396		(888)-311-4483		(888)-311-4483		(800)-291-0396		(800)-291-0396		(888)-311-4483		(888)-311-4483		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2108	030	0	1	01	01	H2108_030_0	8	1		07/12/2011	2012.02	07/12/2011 01:46:02 PM Eastern Daylight Time	08/08/2011 09:01:22 AM Central Daylight Time	08/04/2011 04:51:30 PM Central Daylight Time		08/09/2011 04:46:11 PM Central Daylight Time	BRAVO HEALTH MID- ATLANTIC INC.	Bravo Health	www.mybravohealth.com	Bravo Achieve (HMO SNP)	01	01		1			H2108	030	0	2012	Maryland and Delaware Counties		2		2			1	4		1		00000010000000000000	www.mybravohealth.com	www.mybravohealth.com/formulary	www.mybravohealth.com	(800)-291-0396		(800)-291-0396		(888)-311-4483		(888)-311-4483		(800)-291-0396		(800)-291-0396		(888)-311-4483		(888)-311-4483		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2109	001	0	1	20	08	H2109_001_0	1	1		05/24/2011	2012.02	05/24/2011 01:41:39 PM Eastern Daylight Time		05/23/2011 09:31:02 AM Eastern Daylight Time		05/24/2011 01:54:52 PM Eastern Daylight Time	JOHNS HOPKINS HEALTH SYSTEM, INC.	Hopkins ElderPlus	http://www.hopkinsbayview.org/hopkinselderplus	The Johns Hopkins Health System Corporation. (PACE)	08	20		1			H2109	001	0	2012	Parts of Baltimore City and County, Maryland		2		2			2							http://www.hopkinsbayview.org/hopkinselderplus	http://www.hopkinsbayview.org/hopkinselderplus									(800)-550-7044		(410)-550-7044		(410)-550-7044		(410)-550-7044										(800)-735-2258		(410)-550-0316		(800)-735-2258		(410)-550-0316				
H2109	002	0	1	20	08	H2109_002_0	1	1		05/24/2011	2012.02	05/24/2011 01:38:19 PM Eastern Daylight Time		05/23/2011 09:31:03 AM Eastern Daylight Time		05/24/2011 01:54:52 PM Eastern Daylight Time	JOHNS HOPKINS HEALTH SYSTEM, INC.	Hopkins ElderPlus	http://www.hopkinsbayview.org/hopkinselderplus	The Johns Hopkins Health System Corporation (PACE)	08	20		1			H2109	002	0	2012	Parts of Baltimore City and County, Maryland		2		2			2							http://www.hopkinsbayview.org/hopkinselderplus	http://www.hopkinsbayview.org/hopkinselderplus									(800)-550-7044		(410)-550-7044		(410)-550-7124		(410)-550-7044										(800)-735-2258		(410)-550-0316		(800)-735-2258		(410)-550-0316				
H2111	001	0	1	04	01	H2111_001_0	4	1		07/22/2011	2012.02	07/22/2011 11:55:37 AM Central Daylight Time	08/04/2011 08:33:39 PM Central Daylight Time	08/05/2011 12:58:45 PM Central Daylight Time		08/09/2011 03:53:30 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	Evercare by UnitedHealthcare	www.EvercareHealthPlans.com	UnitedHealthcare Nursing Home Plan (PPO SNP)	01	04		1			H2111	001	0	2012	Baltimore,East Shore MD,DC,DE, surrounding areas		2		2			1	1	1	1			www.EvercareHealthPlans.com	EvercareHealthPlans.com/prescription_drug_coverage.jsp	www.PrescriptionSolutions.com	(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2111	008	0	1	04	01	H2111_008_0	5	1	2	07/22/2011	2012.02	07/22/2011 11:55:39 AM Central Daylight Time	08/04/2011 08:34:31 PM Central Daylight Time	08/05/2011 12:59:08 PM Central Daylight Time		08/09/2011 12:05:43 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	Evercare by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Dual Complete (PPO SNP)	01	04		1			H2111	008	0	2012	Washington, DC		2		2			1	3		1	2		www.EvercareHealthPlans.com	EvercareHealthPlans.com/prescription_drug_coverage.jsp	www.PrescriptionSolutions.com	(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2112	001	0	1	01	01	H2112_001_0	2	1		07/08/2011	2012.02	07/08/2011 11:18:20 AM Central Daylight Time	07/15/2011 09:41:04 AM Central Daylight Time			07/18/2011 07:31:49 AM Central Daylight Time	AETNA HEALTH, INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Basic Plan (HMO)	01	01		1			H2112	001	0	2012	Baltimore and Surrounding Counties		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748										2	2	2
H2112	007	0	1	01	01	H2112_007_0	4	1		07/08/2011	2012.02	07/08/2011 11:18:29 AM Central Daylight Time	08/04/2011 01:19:24 PM Central Daylight Time	08/04/2011 09:40:41 AM Central Daylight Time		08/08/2011 08:57:36 AM Central Daylight Time	AETNA HEALTH, INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Standard Plan (HMO)	01	01		1			H2112	007	0	2012	Baltimore and Surrounding Counties		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H2112	014	0	1	01	01	H2112_014_0	5	1		07/12/2011	2012.02	07/12/2011 02:40:05 PM Central Daylight Time	08/04/2011 01:26:20 PM Central Daylight Time	08/04/2011 09:42:22 AM Central Daylight Time		08/08/2011 08:57:36 AM Central Daylight Time	AETNA HEALTH, INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (HMO)	01	01		1			H2112	014	0	2012	Baltimore and Surrounding Counties		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H2112	801	0	1	01	01	H2112_801_0	2	1		04/22/2011	2012.02	04/22/2011 09:51:30 AM Eastern Daylight Time	06/02/2011 08:25:42 AM Eastern Daylight Time			06/03/2011 06:19:28 PM Eastern Daylight Time	AETNA HEALTH, INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan (HMO)	01	01		1			H2112	801	0	2012	Maryland		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748										1	1	1
H2112	802	0	1	01	01	H2112_802_0	2	1		04/22/2011	2012.02	04/22/2011 09:51:48 AM Eastern Daylight Time	06/02/2011 08:40:46 AM Eastern Daylight Time			06/03/2011 06:19:28 PM Eastern Daylight Time	AETNA HEALTH, INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan w/Rx CY (HMO)	01	01		1			H2112	802	0	2012	Maryland		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		1	1	1
H2150	002	0	1	18	06	H2150_002_0	7	1		08/04/2011	2012.02	08/04/2011 07:30:42 PM Eastern Daylight Time		08/04/2011 11:30:29 AM Eastern Daylight Time		08/05/2011 10:15:23 AM Eastern Daylight Time	KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente Medicare Plus	kp.org/medicare	Kaiser Permanente Medicare Plus High w/D AB (Cost)	06	18		1			H2150	002	0	2012	DC, MD, VA		2	15309	2			2							www.kp.org/seniorrx	www.kp.org/seniorrx	(888)-777-5536		(888)-777-5536		(877)-408-8607		(877)-408-8607		(888)-777-5536		(888)-777-5536		(877)-408-8607		(877)-408-8607		(866)-513-0008		(866)-513-0008		(888)-758-6054		(888)-758-6054		(866)-513-0008		(866)-513-0008		(888)-758-6054		(888)-758-6054		2	2	2
H2150	009	0	1	18	06	H2150_009_0	6	1		08/04/2011	2012.02	08/04/2011 07:30:56 PM Eastern Daylight Time		08/04/2011 07:03:44 PM Eastern Daylight Time		08/05/2011 10:15:23 AM Eastern Daylight Time	KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente Medicare Plus	kp.org/medicare	Kaiser Permanente Medicare Plus Std w/D AB (Cost)	06	18		1			H2150	009	0	2012	DC, MD, VA		2	8339	2			2							www.kp.org/seniorrx	www.kp.org/seniorrx	(888)-777-5536		(888)-777-5536		(877)-408-8607		(877)-408-8607		(888)-777-5536		(888)-777-5536		(877)-498-8607		(877)-498-8607		(866)-513-0008		(866)-513-0008		(888)-758-6054		(888)-758-6054		(866)-513-0008		(866)-513-0008		(888)-758-6054		(888)-758-6054		2	2	2
H2150	017	0	1	18	06	H2150_017_0	2	1		05/27/2011	2012.02	05/27/2011 01:25:12 PM Eastern Daylight Time				06/05/2011 02:40:54 PM Eastern Daylight Time	KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente Medicare Plus	kp.org/medicare	Kaiser Permanente Medicare Plus Basic no D AB (Cost)	06	18		1			H2150	017	0	2012	DC, MD, VA		2	1084	2			2							www.kp.org/seniorrx	www.kp.org/seniorrx	(888)-777-5536		(888)-777-5536		(877)-408-8607		(877)-408-8607										(866)-513-0008		(866)-513-0008		(888)-758-6054		(888)-758-6054										2	2	2
H2150	021	0	1	18	06	H2150_021_0	3	1		07/19/2011	2012.02	07/19/2011 07:09:31 PM Eastern Daylight Time				07/19/2011 07:19:59 PM Eastern Daylight Time	KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente Medicare Plus	kp.org/medicare	Kaiser Permanente Medicare Plus High w/o D AB (Cost)	06	18		1			H2150	021	0	2012	DC, MD, VA		2	935	2			2							www.kp.org/seniorrx	www.kp.org/seniorrx	(888)-777-5536		(888)-777-5536		(877)-408-8607		(877)-408-8607										(866)-513-0008		(866)-513-0008		(888)-758-6054		(888)-758-6054										2	2	2
H2150	022	0	1	18	06	H2150_022_0	3	1		07/19/2011	2012.02	07/19/2011 07:09:49 PM Eastern Daylight Time				07/19/2011 07:19:59 PM Eastern Daylight Time	KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente Medicare Plus	kp.org/medicare	Kaiser Permanente Medicare Plus Std w/o D AB (Cost)	06	18		1			H2150	022	0	2012	DC, MD, VA		2	976	2			2							www.kp.org/seniorrx	www.kp.org/seniorrx	(888)-777-5536		(888)-777-5536		(877)-408-8607		(877)-408-8607										(866)-513-0008		(866)-513-0008		(888)-758-6054		(888)-758-6054										2	2	2
H2150	029	0	2	18	06	H2150_029_0	6	1		08/04/2011	2012.02	08/04/2011 07:47:14 PM Eastern Daylight Time		08/04/2011 11:34:41 AM Eastern Daylight Time		08/05/2011 10:15:23 AM Eastern Daylight Time	KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente Medicare Plus	kp.org/medicare	Kaiser Permanente Medicare Plus Std Option w/D B (Cost)	06	18		2	1		H2150	029	0	2012	DC, MD, VA		2	53	2			2							www.kp.org/seniorrx	www.kp.org/seniorrx	(888)-777-5536		(888)-777-5536		(877)-408-8607		(877)-408-8607		(888)-777-5536		(888)-777-5536		(877)-408-8607		(877)-408-8607		(866)-513-0008		(866)-513-0008		(888)-758-6054		(888)-758-6054		(866)-513-0008		(866)-513-0008		(888)-758-6054		(888)-758-6054		2	2	2
H2150	030	0	2	18	06	H2150_030_0	2	1		05/27/2011	2012.02	05/27/2011 01:26:02 PM Eastern Daylight Time				06/05/2011 02:40:54 PM Eastern Daylight Time	KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente Medicare Plus	kp.org/medicare	Kaiser Permanente Basic Option no D B (Cost)	06	18		2	1		H2150	030	0	2012	DC, MD, VA		2	3	2			2							www.kp.org/seniorrx	www.kp.org/seniorrx	(888)-777-5536		(888)-777-5536		(877)-408-8607		(877)-408-8607										(866)-513-0008		(866)-513-0008		(888)-758-6054		(888)-758-6054										2	2	2
H2150	801	0		18	06	H2150_801_0	2	1		04/25/2011	2012.02						KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente Medicare Plus	kp.org/medicare	Kaiser Permanente Medicare Plus EGHP w Part D AB (Cost)	06	18					H2150	801	0	2012	DC, MD, VA		1					2							www.kp.org/seniorrx	www.kp.org/seniorrx	(888)-777-5536		(888)-777-5536		(888)-777-5536				(888)-777-5536		(888)-777-5536		(888)-777-5536		(888)-777-5536		(866)-513-0008		(866)-513-0008		(866)-513-0008		(866)-513-0008		(866)-513-0008		(866)-513-0008		(866)-513-0008		(866)-513-0008				
H2150	805	0		18	06	H2150_805_0	2	1		04/18/2011	2012.02						KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente Medicare Plus	kp.org/medicare	Kaiser Permanente Medicare Plus EGHP w/D B Only (Cost)	06	18					H2150	805	0	2012	DC, MD, VA		1					2							www.kp.org/seniorrx	www.kp.org/seniorrx	(888)-777-5536		(888)-777-5536		(888)-777-5536				(888)-777-5536		(888)-777-5536		(888)-777-5536		(888)-777-5536		(866)-513-0008		(866)-513-0008		(866)-513-0008		(866)-513-0008		(866)-513-0008		(866)-513-0008		(866)-513-0008		(866)-513-0008				
H2150	806	0		18	06	H2150_806_0	2	1		04/25/2011	2012.02						KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente Medicare Plus	kp.org/medicare	Kaiser Permanente Medicare Plus FEHB AB with D (Cost)	06	18					H2150	806	0	2012	DC, MD, VA		1					2							www.kp.org/seniorrx	www.kp.org/seniorrx	(888)-777-5536		(888)-777-5536		(888)-777-5536				(888)-777-5536		(888)-777-5536		(888)-777-5536		(888)-777-5536		(866)-513-0008		(866)-513-0008		(866)-513-0008		(866)-513-0008		(866)-513-0008		(866)-513-0008		(866)-513-0008		(866)-513-0008				
H2150	807	0		18	06	H2150_807_0	2	1		04/25/2011	2012.02						KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente Medicare Plus	kp.org/medicare	Kaiser Permanente Medicare Plus FEHB B Only with D (Cost)	06	18					H2150	807	0	2012	DC, MD, VA		1					2							www.kp.org/seniorrx	www.kp.org/seniorrx	(888)-777-5536		(888)-777-5536		(888)-777-5536				(888)-777-5536		(888)-777-5536		(888)-777-5536		(888)-777-5536		(866)-513-0008		(866)-513-0008		(866)-513-0008		(866)-513-0008		(866)-513-0008		(866)-513-0008		(866)-513-0008		(866)-513-0008				
H2161	001	0	1	01	01	H2161_001_0	3	1	2	08/09/2011	2012.02	08/09/2011 03:17:21 PM Eastern Daylight Time	08/09/2011 02:31:00 PM Eastern Daylight Time	08/09/2011 02:31:01 PM Eastern Daylight Time		08/09/2011 03:25:22 PM Eastern Daylight Time	UPPER PENINSULA HEALTH PLAN, INC.	Upper Peninsula Health Plan Plus (HMO SNP)	www.UPHPplus.com	Upper Peninsula Health Plan Plus (HMO SNP)	01	01		1			H2161	001	0	2012	Upper Peninsula of Michigan		2	300	2			1	3		1	4		http://www.UPHPplus.com	uphpplus.com	uphpplus.com	(877)-349-9324		(906)-225-4481		(877)-349-9324		(906)-225-4481		(877)-464-0073		(877)-464-0073		(877)-349-9324		(877)-349-9324		(800)-649-3777		(800)-649-3777		(800)-649-3777		(800)-649-3777		(800)-649-3777		(800)-649-3777		(800)-649-3777		(800)-649-3777		2	2	2
H2165	004	0	1	01	01	H2165_004_0	4	1		07/27/2011	2012.02	07/27/2011 04:12:54 PM Central Daylight Time	05/31/2011 04:55:34 PM Central Daylight Time			07/28/2011 06:06:50 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Life  Health	www.healthspring.com	HealthyAdvantage NGA (HMO)	01	01		1			H2165	004	0	2012	Northwest Georgia		2		2			2						healthspring.com	healthspring.com	healthspring.com	(888)-501-3965		(615)-401-4501		(866)-593-4468		(615)-401-4501										(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565										2	2	2
H2165	005	0	1	01	01	H2165_005_0	6	1		08/05/2011	2012.02	08/05/2011 03:53:25 PM Central Daylight Time	08/05/2011 04:00:28 PM Central Daylight Time	08/04/2011 05:34:00 PM Central Daylight Time		08/08/2011 07:14:27 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Life  Health	www.healthspring.com	HealthyAdvantage Preferred NGA (HMO)	01	01		1			H2165	005	0	2012	Northwest Georgia		2		2			2						healthspring.com	healthspring.com	healthspring.com	(888)-501-3965		(615)-401-4501		(866)-593-4468		(615)-401-4501		(888)-501-3965		(888)-501-3965		(866)-593-4468		(866)-593-4468		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-845-7230		(866)-845-7230		2	2	2
H2165	011	0	1	02	01	H2165_011_0	6	1		08/05/2011	2012.02	08/05/2011 03:53:41 PM Central Daylight Time	06/02/2011 05:06:02 PM Central Daylight Time	08/04/2011 05:34:46 PM Central Daylight Time		08/09/2011 04:56:32 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Life  Health	www.healthspring.com	HealthyAdvantage Premier NGA (HMO-POS)	01	02		1			H2165	011	0	2012	Northwest Georgia		2		2			2						healthspring.com	healthspring.com	healthspring.com	(888)-501-3965		(615)-401-4501		(866)-593-4468		(615)-401-4501		(888)-501-3965		(888)-501-3965		(866)-593-4468		(866)-593-4468		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-845-7230		(866)-845-7230		2	2	2
H2165	013	0	1	01	01	H2165_013_0	6	1		08/05/2011	2012.02	08/05/2011 03:53:57 PM Central Daylight Time	06/02/2011 05:12:22 PM Central Daylight Time	08/04/2011 05:35:29 PM Central Daylight Time		08/09/2011 04:56:32 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Life  Health	healthspring.com	HealthyAdvantage Preferred WVA (HMO)	01	01		1			H2165	013	0	2012	West Virginia		2		2			2						healthspring.com	healthspring.com	healthspring.com	(888)-501-3965		(615)-401-4501		(866)-593-4468		(615)-401-4500		(888)-501-3965		(888)-501-3965		(866)-593-4468		(866)-593-4468		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-845-7230		(866)-845-7230		2	2	2
H2165	014	0	1	01	01	H2165_014_0	4	1		07/27/2011	2012.02	07/27/2011 04:15:36 PM Central Daylight Time	06/02/2011 05:14:18 PM Central Daylight Time			07/28/2011 06:06:50 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Life  Health	healthspring.com	HealthyAdvantage WVA (HMO)	01	01		1			H2165	014	0	2012	West Virginia		2		2			2						healthspring.com	healthspring.com	healthspring.com	(888)-501-3965		(615)-401-4501		(866)-593-4468		(615)-401-4500										(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565										2	2	2
H2165	015	0	1	02	01	H2165_015_0	7	1		08/05/2011	2012.02	08/05/2011 03:54:26 PM Central Daylight Time	06/02/2011 05:16:10 PM Central Daylight Time	08/04/2011 05:36:16 PM Central Daylight Time		08/09/2011 04:56:32 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Life  Health	healthspring.com	HealthyAdvantage Premier WVA (HMO-POS)	01	02		1			H2165	015	0	2012	West Virginia		2		2			2						healthspring.com	healthspring.com	healthspring.com	(888)-501-3965		(615)-401-4501		(866)-593-4468		(615)-401-4500		(888)-501-3965		(888)-501-3965		(866)-593-4468		(866)-593-4468		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-845-7230		(866)-845-7230		2	2	2
H2165	016	0	1	01	01	H2165_016_0	5	1		08/05/2011	2012.02	08/05/2011 03:54:48 PM Central Daylight Time	08/08/2011 09:02:17 AM Central Daylight Time	08/04/2011 05:37:06 PM Central Daylight Time		08/09/2011 04:46:11 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Life  Health	www.healthspring.com	Traditions (HMO SNP)	01	01		1			H2165	016	0	2012	Select West Virginia Counties		2		2			1	1	1	1			healthspring.com	healthspring.com	healthspring.com	(877)-307-9033		(877)-307-9033		(877)-307-9033		(877)-307-9033		(877)-307-9033		(877)-307-9033		(877)-307-9033		(877)-307-9033		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2165	801	0	1	01	01	H2165_801_0	1	1		06/01/2011	2012.02	06/01/2011 12:50:58 PM Central Daylight Time	06/02/2011 05:18:35 PM Central Daylight Time			06/04/2011 09:46:46 AM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Life  Health	healthspring.com	Retiree Advantage (HMO)	01	01		1			H2165	801	0	2012	Retiree Advantage		1		2			2						healthspring.com	healthspring.com	healthspring.com	(888)-501-3965		(615)-401-4501		(866)-593-4468		(615)-401-4500										(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565										1	1	1
H2165	802	0	1	01	01	H2165_802_0	1	1		06/01/2011	2012.02	06/01/2011 12:54:02 PM Central Daylight Time	06/02/2011 05:20:37 PM Central Daylight Time			06/04/2011 09:46:46 AM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Life  Health	healthspring.com	Retiree Advantage Preferred (HMO)	01	01		1			H2165	802	0	2012	Retiree Advantage Preferred		1		2			2						healthspring.com	healthspring.com	healthspring.com	(888)-501-3965		(615)-401-4501		(866)-593-4468		(615)-401-4500		(866)-593-4468		(866)-593-4468		(866)-593-4468		(866)-593-4468		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230		1	1	1
H2174	001	0	1	01	01	H2174_001_0	5	1	2	08/08/2011	2012.02	08/08/2011 12:28:13 PM Pacific Daylight Time	08/08/2011 12:39:44 PM Pacific Daylight Time	08/03/2011 04:26:02 PM Pacific Daylight Time		08/09/2011 12:33:23 PM Pacific Daylight Time	TRILLIUM COMMUNITY HEALTH PLAN	Trillium Advantage	www.TrilliumAdvantage.com	Trillium Advantage Dual (HMO SNP)	01	01		1			H2174	001	0	2012	Lane County		2	3252	2			1	3		1	3		http://www.trilliumadvantage.com	http://www.trilliumchp.com	http://www.trilliumchp.com	(800)-910-3906		(541)-431-1950		(800)-910-3906		(541)-431-1950		(800)-910-3906		(541)-431-1950		(800)-910-3906		(541)-431-1950		(866)-279-9750		(541)-431-1951		(866)-279-9750		(541)-431-1951		(866)-279-9750		(541)-431-1951		(866)-279-9750		(541)-431-1951		2	2	2
H2174	002	0	1	01	01	H2174_002_0	6	1		08/08/2011	2012.02	08/08/2011 12:29:28 PM Pacific Daylight Time	08/08/2011 12:41:16 PM Pacific Daylight Time	08/03/2011 04:28:32 PM Pacific Daylight Time		08/09/2011 12:33:23 PM Pacific Daylight Time	TRILLIUM COMMUNITY HEALTH PLAN	Trillium Advantage	www.TrilliumAdvantage.com	Trillium Advantage Rx Smart Plus (HMO)	01	01		1			H2174	002	0	2012	Lane County		2	553	2			2						http://www.trilliumadvantage.com	http://www.trilliumchp.com	http://www.trilliumchp.com	(800)-910-3906		(541)-431-1950		(800)-910-3906		(541)-431-1950		(800)-910-3906		(541)-431-1950		(800)-910-3906		(541)-431-1950		(866)-279-9750		(541)-431-1951		(866)-279-9750		(541)-431-1951		(866)-279-9750		(541)-431-1951		(866)-279-9750		(541)-431-1951		2	2	2
H2174	003	0	1	01	01	H2174_003_0	6	1		08/08/2011	2012.02	08/08/2011 12:29:34 PM Pacific Daylight Time	08/08/2011 12:42:28 PM Pacific Daylight Time	08/03/2011 04:29:32 PM Pacific Daylight Time		08/09/2011 12:33:23 PM Pacific Daylight Time	TRILLIUM COMMUNITY HEALTH PLAN	Trillium Advantage	www.TrilliumAdvantage.com	Trillium Advantage TLC ISNP (HMO SNP)	01	01		1			H2174	003	0	2012	Lane County		2	133	2			1	1	1	1			http://www.trilliumadvantage.com	http://www.trilliumchp.com	http://www.trilliumchp.com	(800)-910-3906		(541)-431-1950		(800)-910-3906		(541)-431-1950		(800)-910-3906		(541)-431-1950		(800)-910-3906		(541)-431-1950		(866)-279-9750		(541)-431-1951		(866)-279-9750		(541)-431-1951		(866)-279-9750		(541)-431-1951		(866)-279-9750		(541)-431-1951		2	2	2
H2174	004	0	1	01	01	H2174_004_0	3	1		07/27/2011	2012.02	07/27/2011 03:24:12 PM Pacific Daylight Time	06/06/2011 04:33:34 PM Pacific Daylight Time			07/29/2011 10:58:14 AM Pacific Daylight Time	TRILLIUM COMMUNITY HEALTH PLAN	Trillium Advantage	www.TrilliumAdvantage.com	Trillium Advantage (HMO)	01	01		1			H2174	004	0	2012	Lane County		2	107	2			2						http://www.trilliumadvantage.com	http://www.trilliumchp.com	http://www.trilliumchp.com	(800)-910-3906		(541)-431-1950		(800)-910-3906		(541)-431-1950										(866)-279-9750		(541)-431-1951		(866)-279-9750		(541)-431-1951										2	2	2
H2174	005	0	1	01	01	H2174_005_0	6	1		08/08/2011	2012.02	08/08/2011 12:29:55 PM Pacific Daylight Time	08/08/2011 12:45:50 PM Pacific Daylight Time	08/03/2011 04:33:42 PM Pacific Daylight Time		08/09/2011 12:33:23 PM Pacific Daylight Time	TRILLIUM COMMUNITY HEALTH PLAN	Trillium Advantage	www.TrilliumAdvantage.com	Trillium Advantage TLC Community ISNP (HMO SNP)	01	01		1			H2174	005	0	2012	Lane County		2	131	2			1	1	2	1			http://www.trilliumadvantage.com	http://www.trilliumchp.com	http://www.trilliumchp.com	(800)-910-3906		(541)-431-1950		(800)-910-3906		(541)-431-1950		(800)-910-3906		(541)-431-1950		(800)-910-3906		(541)-431-1950		(866)-279-9750		(541)-431-1951		(866)-279-9750		(541)-431-1951		(866)-279-9750		(541)-431-1951		(866)-279-9750		(541)-431-1951		2	2	2
H2174	008	0	1	01	01	H2174_008_0	7	1		08/08/2011	2012.02	08/08/2011 12:30:08 PM Pacific Daylight Time	08/08/2011 12:53:56 PM Pacific Daylight Time	08/03/2011 04:34:44 PM Pacific Daylight Time		08/09/2011 12:33:23 PM Pacific Daylight Time	TRILLIUM COMMUNITY HEALTH PLAN	Trillium Advantage	www.TrilliumAdvantage.com	Trillium Advantage Rx Smart (HMO)	01	01		1			H2174	008	0	2012	Lane County		2	674	2			2						http://www.trilliumadvantage.com	http://www.trilliumchp.com	http://www.trilliumchp.com	(800)-910-3906		(541)-431-1950		(800)-910-3906		(541)-431-1950		(800)-910-3906		(541)-431-1950		(800)-910-3906		(541)-431-1950		(866)-279-9750		(541)-431-1951		(866)-279-9750		(541)-431-1951		(866)-279-9750		(541)-431-1951		(866)-279-9750		(541)-431-1951		2	2	2
H2182	001	0	1	02	01	H2182_001_0	7	1		08/12/2011	2012.02	08/12/2011 01:10:20 PM Central Daylight Time	08/05/2011 11:06:13 AM Central Daylight Time	08/05/2011 01:26:18 PM Central Daylight Time		08/12/2011 01:29:39 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H2182	001	0	2012	Select Counties in GA		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2218	001	0	1	20	08	H2218_001_0	1	1		05/23/2011	2012.02	05/23/2011 01:53:11 PM Eastern Daylight Time		05/20/2011 03:39:52 PM Eastern Daylight Time		05/23/2011 01:55:30 PM Eastern Daylight Time	HARBOR HEALTH SERVICES	Elder Service Plan of Harbor Health Services, Inc	www.elderserviceplan.org	Harbor Health Elder Service Plan, Dual Eligible (PACE)	08	20		1			H2218	001	0	2012	Norfolk and Suffolk Counties		2		2			2							www.elderserviceplan.org	www.elderserviceplan.org									(866)-714-1277		(617)-533-2400		(866)-714-1277		(617)-533-2400										(866)-714-1277		(617)-533-2400		(866)-714-1277		(617)-533-2400				
H2218	002	0	1	20	08	H2218_002_0	1	1		05/23/2011	2012.02	05/23/2011 01:53:25 PM Eastern Daylight Time		05/20/2011 03:39:52 PM Eastern Daylight Time		05/23/2011 01:55:30 PM Eastern Daylight Time	HARBOR HEALTH SERVICES	Elder Service Plan of Harbor Health Services, Inc	www.elderserviceplan.org	Harbor Health Elder Service Plan, Medicare only (PACE)	08	20		1			H2218	002	0	2012	Norfolk and Suffolk Counties		2		2			2							www.elderserviceplan.org	www.elderserviceplan.org									(866)-714-1277		(617)-533-2400		(866)-714-1277		(617)-533-2400										(866)-714-1277		(617)-533-2400		(866)-714-1277		(617)-533-2400				
H2219	001	0	1	20	08	H2219_001_0	1	1		05/25/2011	2012.02	05/25/2011 08:50:55 AM Eastern Daylight Time		06/03/2011 04:16:02 PM Eastern Daylight Time		06/06/2011 01:54:32 PM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan - Summit ElderCare	www.summiteldercare.org	Summit ElderCare (PACE)	08	20		1			H2219	001	0	2012	Summit ElderCare - Worcester, Middlesex Counties		2	845	2			2							Not Applicable	Not Applicable									(800)-698-7566		(508)-852-2026		(800)-698-7566		(508)-368-9690										(800)-439-2370		(800)-439-2370		(800)-889-4106		(800)-889-4106				
H2219	002	0	1	20	08	H2219_002_0	1	1		05/25/2011	2012.02	05/25/2011 08:51:18 AM Eastern Daylight Time		06/03/2011 04:16:02 PM Eastern Daylight Time		06/06/2011 01:54:32 PM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan - Summit ElderCare	www.summiteldercare.org	Summit ElderCare (PACE)	08	20		1			H2219	002	0	2012	Summit ElderCare - Worcester, Middlesex Counties		2	11	2			2							Not Applicable	Not Applicable									(800)-698-7566		(508)-852-2026		(800)-698-7566		(508)-368-9690										(800)-439-2370		(800)-439-2370		(800)-889-4106		(800)-889-4106				
H2220	001	0	1	20	08	H2220_001_0	1	1		05/26/2011	2012.02	05/26/2011 10:01:00 AM Eastern Daylight Time		05/20/2011 04:23:45 PM Eastern Daylight Time		05/26/2011 10:16:49 AM Eastern Daylight Time	UPHAMS CORNER HEALTH COMMITTEE, INC.	Uphams Corner Health Committee, Inc.	www.uphamselderserviceplan.org	Uphams Corner Health Committee (PACE)	08	20		1			H2220	001	0	2012	Upham's Elder Service Plan		2		2			2							http://www.uphamscornerhealthctr.com/	http://www.uphamscornerhealthctr.com/									(617)-288-0970	11	(617)-288-0970	11	(617)-288-0970	16	(617)-288-0970	16									(617)-287-8000	8206	(617)-287-8000	8206	(617)-287-8000	8206	(617)-287-8000	8206			
H2220	002	0	1	20	08	H2220_002_0	1	1		05/26/2011	2012.02	05/26/2011 10:01:13 AM Eastern Daylight Time		05/20/2011 04:23:45 PM Eastern Daylight Time		05/26/2011 10:16:49 AM Eastern Daylight Time	UPHAMS CORNER HEALTH COMMITTEE, INC.	Uphams Corner Health Committee, Inc.	www.uphamselderserviceplan.org	Uphams Corner Health Committee (PACE)	08	20		1			H2220	002	0	2012	Upham's Elder Service Plan		2		2			2							http://www.uphamscornerhealthctr.com/	http://www.uphamscornerhealthctr.com/									(617)-288-0970	11	(617)-288-0970	11	(617)-288-0970	16	(617)-288-0970	16									(617)-287-8000	8206	(617)-287-8000	8206	(617)-287-8000	8206	(617)-287-8000	8206			
H2221	001	0	1	20	08	H2221_001_0	1	1		05/20/2011	2012.01	05/20/2011 11:11:59 AM Eastern Daylight Time		05/20/2011 10:52:34 AM Eastern Daylight Time		05/20/2011 11:15:06 AM Eastern Daylight Time	ELDER SRVC PLN/CAMBRIDGE HEALTH ALLIANCE	Elder Srvc Pln/Cambridge Health Alliance	Challiance.org	Elder Service Plan of the Cambridge Health (PACE)	08	20		1			H2221	001	0	2012	Counties: Middlesex and Suffolk		2		1	1		2							none	none									(617)-575-5850		(617)-575-5850		(617)-575-5850		(617)-575-5850										(617)-575-5850		(617)-575-5850		(617)-575-5850		(617)-575-5850				
H2221	002	0	1	20	08	H2221_002_0	1	1		05/20/2011	2012.01	05/20/2011 11:12:25 AM Eastern Daylight Time		05/20/2011 10:52:34 AM Eastern Daylight Time		05/20/2011 11:15:06 AM Eastern Daylight Time	ELDER SRVC PLN/CAMBRIDGE HEALTH ALLIANCE	Elder Srvc Pln/Cambridge Health Alliance	Challiance.org	Elder Service Plan of the Cambridge Health (PACE)	08	20		1			H2221	002	0	2012	Counties:  Middlesex and Suffolk		2		1	1		2							none	none									(617)-575-5850		(617)-575-5850		(617)-575-5850		(617)-575-5850										(617)-575-5850		(617)-575-5850		(617)-575-5850		(617)-575-5850				
H2222	002	0	1	20	08	H2222_002_0	1	1		05/23/2011	2012.02	05/23/2011 01:13:41 PM Eastern Daylight Time		05/20/2011 03:36:37 PM Eastern Daylight Time		05/23/2011 01:44:24 PM Eastern Daylight Time	ELDER SERVICE PLAN OF THE NORTH SHORE	Elder Service Plan Of The North Shore	www.pacenorthshore.org	Elder Service Plan of the Northshore (PACE)	08	20		1			H2222	002	0	2012	Essex, Middlesex counties		2	700	1	1		2							None	www.eatonapothecary.com									(781)-715-6608	6650	(781)-715-6608	6650	(781)-715-6608	6650	(781)-715-6608	6650									(781)-715-6608		(781)-715-6608		(781)-715-6608		(781)-715-6608	6688			
H2222	003	0	1	20	08	H2222_003_0	1	1		05/23/2011	2012.02	05/23/2011 01:05:31 PM Eastern Daylight Time		05/20/2011 03:36:38 PM Eastern Daylight Time		05/23/2011 01:44:24 PM Eastern Daylight Time	ELDER SERVICE PLAN OF THE NORTH SHORE	Elder Service Plan Of The North Shore	www.pacenorthshore.org	Elder Service Plan of the Northshore (PACE)	08	20		1			H2222	003	0	2012	Essex, Middlesex counties		2	700	1	1		2							None	www.eatonapothecary.com									(781)-715-6608	6650	(781)-715-6608	6650	(781)-715-6608	6650	(781)-715-6608	6650									(781)-715-6608	6650	(781)-715-6608	6650	(781)-715-6608	6650	(781)-715-6608	6650			
H2223	001	0	1	20	08	H2223_001_0	1	1		05/23/2011	2012.02	05/23/2011 12:49:32 PM Eastern Daylight Time		05/20/2011 03:31:22 PM Eastern Daylight Time		05/23/2011 12:50:52 PM Eastern Daylight Time	ELDER SVC PLN/E BOSTON HEALTH CENTER	Elder Svc Pln/E Boston Health Center	www.ebnhc.org	ESP of East Boston Pharmacy Plan--Duals (PACE)	08	20		1			H2223	001	0	2012	Chelsea, Revere, East Boston, Everett, Winthrop MA		2		2			2							www.ebnhc.org	www.ebnhc.org									(617)-569-5800		(617)-569-5800		(617)-569-5800		(617)-569-5800										(617)-569-5800		(617)-569-5800		(617)-569-5800		(617)-569-5800				
H2223	002	0	1	20	08	H2223_002_0	1	1		05/23/2011	2012.02	05/23/2011 12:49:39 PM Eastern Daylight Time		05/20/2011 03:31:22 PM Eastern Daylight Time		05/23/2011 12:50:52 PM Eastern Daylight Time	ELDER SVC PLN/E BOSTON HEALTH CENTER	Elder Svc Pln/E Boston Health Center	www.ebnhc.org	ESP of East Boston Pharmacy Plan--MCR Only (PACE)	08	20		1			H2223	002	0	2012	Chelsea, Revere, East Boston, Everett, Winthrop MA		2		2			2							www.ebnhc.org	www.ebnhc.org									(617)-569-5800		(617)-569-5800		(617)-569-5800		(617)-569-5800										(617)-569-5800		(617)-569-5800		(617)-569-5800		(617)-569-5800				
H2224	001	0	1	01	01	H2224_001_0	6	1	2	08/09/2011	2012.02	08/09/2011 06:51:37 PM Eastern Daylight Time	08/08/2011 04:16:28 PM Eastern Daylight Time	08/08/2011 01:03:46 PM Eastern Daylight Time		08/09/2011 06:55:44 PM Eastern Daylight Time	SENIOR WHOLE HEALTH, LLC	Senior Whole Health	www.seniorwholehealth.com	Senior Whole Health (HMO SNP)	01	01		1			H2224	001	0	2012	Brstl, Essx, Midlsex, Nrfolk, Plymth, Sufolk, Worc		2	8300	2			1	3		1	5		www.seniorwholehealth.com	www.seniorwholehealth.com	www.seniorwholehealth.com	(888)-794-7268		(888)-794-7268		(888)-566-3526		(888)-566-3526		(888)-794-7268		(888)-794-7268		(888)-566-3526		(888)-566-3526		(888)-749-6455		(888)-749-6455		(888)-749-6455		(888)-749-6455		(888)-749-6455		(888)-749-6455		(888)-749-6455		(888)-749-6455		2	2	1
H2225	001	0	1	01	01	H2225_001_0	6	1	2	09/21/2011	2012.02	09/21/2011 03:28:56 PM Eastern Daylight Time	08/08/2011 03:18:55 PM Eastern Daylight Time	08/08/2011 03:19:03 PM Eastern Daylight Time		09/21/2011 03:34:03 PM Eastern Daylight Time	COMMONWEALTH CARE ALLIANCE, INC.	Commonwealth Care Alliance, Inc.	www.commonwealthcare.org	Senior Care Options Program (HMO SNP)	01	01		1			H2225	001	0	2012	ESS, HMD, MID, NOR, PLY and SUF Counties		2	50	2			1	3		1	5		www.commonwealthcare.org	http://www.commonwealthcare.org/pharmacy-program/formularies.html	http://www.commonwealthcare.org/pharmacy-program/index.html	(866)-610-2273		(866)-610-2273		(866)-610-2273		(866)-610-2273		(866)-610-2273		(866)-610-2273		(866)-610-2273		(866)-610-2273		(866)-322-7357		(866)-322-7357		(866)-322-7357		(866)-322-7357		(866)-322-7357		(866)-322-7357		(866)-322-7357		(866)-322-7357		2	2	2
H2226	001	0	1	01	01	H2226_001_0	5	1	2	07/22/2011	2012.02	07/22/2011 11:56:19 AM Central Daylight Time	08/06/2011 12:07:18 PM Central Daylight Time	08/05/2011 12:59:30 PM Central Daylight Time		08/09/2011 12:05:43 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	Evercare by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Senior Care Options (HMO SNP)	01	01		1			H2226	001	0	2012	Boston, Springfield and Worcester Metro Areas		2		2			1	3		1	5		www.EvercareHealthPlans.com	EvercareHealthPlans.com/prescription_drug_coverage.jsp	www.PrescriptionSolutions.com	(888)-867-5511		(888)-867-5511		(888)-834-3721		(888)-834-3721		(888)-867-5511		(888)-867-5511		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2228	001	0	1	04	01	H2228_001_0	3	1		07/22/2011	2012.02	07/22/2011 12:04:35 PM Central Daylight Time	08/06/2011 12:10:59 PM Central Daylight Time	08/05/2011 12:59:53 PM Central Daylight Time		08/09/2011 04:38:46 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	Evercare by UnitedHealthcare	www.EvercareHealthPlans.com	UnitedHealthcare Nursing Home Plan (PPO SNP)	01	04		1			H2228	001	0	2012	Boston, Springfield and Worcester Metro Areas		2		2			1	1	1	1			www.EvercareHealthPlans.com	EvercareHealthPlans.com/prescription_drug_coverage.jsp	www.PrescriptionSolutions.com	(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2228	002	0	1	04	01	H2228_002_0	3	1		07/22/2011	2012.02	07/22/2011 12:05:29 PM Central Daylight Time	08/06/2011 12:14:15 PM Central Daylight Time	08/05/2011 01:00:15 PM Central Daylight Time		08/09/2011 04:38:46 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	Evercare by UnitedHealthcare	www.EvercareHealthPlans.com	UnitedHealthcare Nursing Home Plan (PPO SNP)	01	04		1			H2228	002	0	2012	Bristol, Kent, Providence and Washington Counties		2		2			1	1	1	1			www.EvercareHealthPlans.com	EvercareHealthPlans.com/prescription_drug_coverage.jsp	www.PrescriptionSolutions.com	(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2230	002	0	1	04	01	H2230_002_0	10	1		07/25/2011	2012.02	07/25/2011 02:24:54 PM Eastern Daylight Time	08/04/2011 11:29:00 AM Eastern Daylight Time	08/08/2011 08:52:21 AM Eastern Daylight Time		08/08/2011 09:26:18 AM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF MA HMO BLUE, INC.	Blue Cross Blue Shield of Massachusetts	www.bluecrossma.com/medicare	Medicare PPO Blue PlusRx (PPO)	01	04		1			H2230	002	0	2012	Massachusetts except Berkshire Dukes and Nantucket		2	16400	2			2						www.bcbsma.com	http://www.bluecrossma.com/medicare-options/2011/prescription-benefit-resources/index.html	http://www.bluecrossma.com/medicare-options/2011/prescription-benefit-resources/index.html	(800)-200-4255		(800)-200-4255		(800)-678-2265		(800)-678-2265		(800)-200-4255		(800)-200-4255		(800)-678-2265		(800)-678-2265		(800)-522-1254		(800)-522-1254		(800)-522-1254		(800)-522-1254		(800)-522-1254		(800)-522-1254		(800)-522-1254		(800)-522-1254		2	2	2
H2230	801	0	1	04	01	H2230_801_0	3	1		06/06/2011	2012.02	06/06/2011 03:29:09 PM Eastern Daylight Time	06/06/2011 03:26:00 PM Eastern Daylight Time			06/06/2011 04:07:37 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF MA HMO BLUE, INC.	Blue Cross Blue Shield of Massachusetts	www.bluecrossma.com/medicare	Medicare PPO Blue (PPO)	01	04		1			H2230	801	0	2012	National Network		1	15	2			2						www.bcbsma.com	http://www.bluecrossma.com/medicare-options/2011/prescription-benefit-resources/index.html	http://www.bluecrossma.com/medicare-options/2011/prescription-benefit-resources/index.html	(800)-200-4255		(800)-200-4255		(800)-678-2265		(800)-678-2265		(800)-200-4255		(800)-200-4255		(800)-678-2265		(800)-678-2265		(800)-522-1254		(800)-522-1254		(800)-522-1254		(800)-522-1254		(800)-522-1254		(800)-522-1254		(800)-522-1254		(800)-522-1254		1	1	1
H2230	809	0	1	04	01	H2230_809_0	3	1		06/06/2011	2012.02	06/06/2011 03:35:58 PM Eastern Daylight Time	06/06/2011 03:26:00 PM Eastern Daylight Time			06/06/2011 04:10:53 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF MA HMO BLUE, INC.	Blue Cross Blue Shield of Massachusetts	www.bluecrossma.com/medicare	Medicare PPO Blue (PPO)	01	04		1			H2230	809	0	2012	National Network		1	15	2			2						www.bcbsma.com	http://www.bluecrossma.com/medicare-options/2011/prescription-benefit-resources/index.html	http://www.bluecrossma.com/medicare-options/2011/prescription-benefit-resources/index.html	(800)-200-4255		(800)-200-4255		(800)-678-2265		(800)-678-2265										(800)-522-1254		(800)-522-1254		(800)-522-1254		(800)-522-1254										1	1	1
H2237	001	0	1	01	01	H2237_001_0	3	1	2	08/09/2011	2012.02	08/09/2011 10:59:27 AM Central Daylight Time	08/09/2011 03:23:45 PM Central Daylight Time	08/08/2011 03:34:53 PM Central Daylight Time		08/09/2011 04:31:48 PM Central Daylight Time	INDEPENDENT CARE HEALTH PLAN, INC.	iCare	www.icare-wi.org	iCare Medicare Plan (HMO SNP)	01	01		1			H2237	001	0	2012	iCare Medicare Plan - Eastern Wisconsin		2	4300	2			1	3		1	2		www.icare-wi.org	www.icare-wi.org	www.icare-wi.org	(800)-777-4376		(414)-223-4847		(888)-241-9637		(414)-223-4847		(800)-777-4376		(414)-223-4847		(855)-689-7690		(414)-223-4847		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		2	2	2
H2237	007	0	1	01	01	H2237_007_0	5	1	2	08/09/2011	2012.02	08/09/2011 11:00:05 AM Central Daylight Time	08/09/2011 03:23:09 PM Central Daylight Time	08/08/2011 03:35:24 PM Central Daylight Time		08/09/2011 04:31:48 PM Central Daylight Time	INDEPENDENT CARE HEALTH PLAN, INC.	iCare	www.icare-wi.org	iCare Family Care Partnership (HMO SNP)	01	01		1			H2237	007	0	2012	iCare Family Care Partnership - Southeastern WI		2	120	2			1	3		1	5		www.icare-wi.org	www.icare-wi.org	www.icare-wi.org	(800)-777-4376		(414)-223-4847		(888)-241-9637		(414)-223-4847		(800)-777-4376		(414)-223-4847		(855)-689-7690		(414)-223-4847		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		2	2	2
H2241	001	0	1	01	01	H2241_001_0	5	1		07/13/2011	2012.02	07/13/2011 12:05:12 PM Pacific Daylight Time	08/08/2011 11:26:37 AM Pacific Daylight Time	08/08/2011 11:27:00 AM Pacific Daylight Time		08/08/2011 11:45:49 AM Pacific Daylight Time	GOLDEN STATE MEDICARE HEALTH PLAN	Golden State Medicare Health Plan, Golden (HMO)	www.GoldenStateMHP.com	Golden State Medicare Health Plan, Golden (HMO)	01	01		1			H2241	001	0	2012	Los Angeles and Orange Counties - Partial		2	1000	2			2						http://www.GoldenStateMHP.com/	www.goldenstatemhp.com	www.goldenstatemhp.com	(877)-541-4111		(562)-799-0319		(877)-541-4111		(562)-799-0319		(877)-541-4111		(562)-799-0319		(877)-541-4111		(562)-799-0319		(877)-551-4111		(877)-551-4111		(877)-551-4111		(877)-551-4111		(877)-551-4111		(877)-551-4111		(877)-551-4111		(877)-551-4111		2	2	2
H2256	001	1	1	01	01	H2256_001_1	12	1		08/03/2011	2012.02	08/03/2011 02:37:25 PM Eastern Daylight Time	08/04/2011 03:40:00 PM Eastern Daylight Time	08/04/2011 09:33:00 AM Eastern Daylight Time		08/07/2011 12:36:23 PM Eastern Daylight Time	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan Medicare Preferred	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Prime Rx Plus (HMO)	01	01		1			H2256	001	1	2012	Most of Massachusetts	Counties ESSEX, SUFFOLK, WORCESTER	2		2			2						tuftsmedicarepreferred.org	tuftsmedicarepreferred.org	tuftsmedicarepreferred.org/druglist.php	(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		2	2	2
H2256	001	2	1	01	01	H2256_001_2	11	1		08/03/2011	2012.02	08/03/2011 12:01:26 PM Eastern Daylight Time	08/04/2011 03:41:00 PM Eastern Daylight Time	08/04/2011 09:33:00 AM Eastern Daylight Time		08/07/2011 12:36:23 PM Eastern Daylight Time	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan Medicare Preferred	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Prime Rx Plus (HMO)	01	01		1			H2256	001	2	2012	Most of Massachusetts	Counties BRISTOL, MIDDLESEX, NORFOLK, PLYMOUTH	2		2			2						tuftsmedicarepreferred.org	tuftsmedicarepreferred.org	tuftsmedicarepreferred.org/druglist.php	(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		2	2	2
H2256	001	6	1	01	01	H2256_001_6	12	1		07/25/2011	2012.02	07/25/2011 01:44:21 PM Eastern Daylight Time	08/04/2011 03:41:00 PM Eastern Daylight Time	08/04/2011 09:34:00 AM Eastern Daylight Time		08/07/2011 12:36:23 PM Eastern Daylight Time	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan Medicare Preferred	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Prime Rx Plus (HMO)	01	01		1			H2256	001	6	2012	Most of Massachusetts	Counties HAMPDEN	2		2			2						tuftsmedicarepreferred.org	tuftsmedicarepreferred.org	tuftsmedicarepreferred.org/druglist.php	(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		2	2	2
H2256	001	7	1	01	01	H2256_001_7	11	1		07/18/2011	2012.02	07/18/2011 01:26:41 PM Eastern Daylight Time	08/04/2011 03:41:00 PM Eastern Daylight Time	08/04/2011 09:34:00 AM Eastern Daylight Time		08/07/2011 12:36:23 PM Eastern Daylight Time	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan Medicare Preferred	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Prime Rx Plus (HMO)	01	01		1			H2256	001	7	2012	Most of Massachusetts	County: BARNSTABLE	2		2			2						tuftsmedicarepreferred.org	tuftsmedicarepreferred.org	tuftsmedicarepreferred.org/druglist.php	(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		2	2	2
H2256	001	8	1	01	01	H2256_001_8	11	1		07/18/2011	2012.02	07/18/2011 01:26:42 PM Eastern Daylight Time	08/04/2011 03:41:00 PM Eastern Daylight Time	08/04/2011 09:34:00 AM Eastern Daylight Time		08/07/2011 12:36:23 PM Eastern Daylight Time	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan Medicare Preferred	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Prime Rx Plus (HMO)	01	01		1			H2256	001	8	2012	Most of Massachusetts	County: HAMPSHIRE	2		2			2						tuftsmedicarepreferred.org	tuftsmedicarepreferred.org	tuftsmedicarepreferred.org/druglist.php	(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		2	2	2
H2256	015	1	1	01	01	H2256_015_1	11	1		07/25/2011	2012.02	07/25/2011 01:45:22 PM Eastern Daylight Time	08/04/2011 03:42:00 PM Eastern Daylight Time	08/04/2011 09:35:00 AM Eastern Daylight Time		08/07/2011 12:36:23 PM Eastern Daylight Time	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan Medicare Preferred	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Prime Rx (HMO)	01	01		1			H2256	015	1	2012	Most of Massachusetts	Counties ESSEX, SUFFOLK, WORCESTER	2		2			2						tuftsmedicarepreferred.org	tuftsmedicarepreferred.org	tuftsmedicarepreferred.org/druglist.php	(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		2	2	2
H2256	015	2	1	01	01	H2256_015_2	11	1		07/18/2011	2012.02	07/18/2011 01:26:46 PM Eastern Daylight Time	08/04/2011 03:42:00 PM Eastern Daylight Time	08/04/2011 09:35:00 AM Eastern Daylight Time		08/07/2011 12:36:23 PM Eastern Daylight Time	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan Medicare Preferred	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Prime Rx (HMO)	01	01		1			H2256	015	2	2012	Most of Massachusetts	Counties BRISTOL, MIDDLESEX, NORFOLK, PLYMOUTH	2		2			2						tuftsmedicarepreferred.org	tuftsmedicarepreferred.org	tuftsmedicarepreferred.org/druglist.php	(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		2	2	2
H2256	015	6	1	01	01	H2256_015_6	12	1		07/18/2011	2012.02	07/18/2011 01:26:47 PM Eastern Daylight Time	08/04/2011 03:42:00 PM Eastern Daylight Time	08/04/2011 09:36:00 AM Eastern Daylight Time		08/07/2011 12:36:23 PM Eastern Daylight Time	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan Medicare Preferred	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Prime Rx (HMO)	01	01		1			H2256	015	6	2012	Most of Massachusetts	Counties HAMPDEN	2		2			2						tuftsmedicarepreferred.org	tuftsmedicarepreferred.org	tuftsmedicarepreferred.org/druglist.php	(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		2	2	2
H2256	015	7	1	01	01	H2256_015_7	11	1		07/18/2011	2012.02	07/18/2011 01:26:49 PM Eastern Daylight Time	08/04/2011 03:43:00 PM Eastern Daylight Time	08/04/2011 09:36:00 AM Eastern Daylight Time		08/07/2011 12:36:23 PM Eastern Daylight Time	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan Medicare Preferred	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Prime Rx (HMO)	01	01		1			H2256	015	7	2012	Most of Massachusetts	County: BARNSTABLE	2		2			2						tuftsmedicarepreferred.org	tuftsmedicarepreferred.org	tuftsmedicarepreferred.org/druglist.php	(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		2	2	2
H2256	015	8	1	01	01	H2256_015_8	11	1		07/18/2011	2012.02	07/18/2011 01:26:50 PM Eastern Daylight Time	08/04/2011 03:43:00 PM Eastern Daylight Time	08/04/2011 09:36:00 AM Eastern Daylight Time		08/07/2011 12:36:23 PM Eastern Daylight Time	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan Medicare Preferred	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Prime Rx (HMO)	01	01		1			H2256	015	8	2012	Most of Massachusetts	County: HAMPSHIRE	2		2			2						tuftsmedicarepreferred.org	tuftsmedicarepreferred.org	tuftsmedicarepreferred.org/druglist.php	(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		2	2	2
H2256	016	1	1	01	01	H2256_016_1	10	1		07/18/2011	2012.02	07/18/2011 01:26:55 PM Eastern Daylight Time	06/06/2011 12:42:00 PM Eastern Daylight Time			07/18/2011 04:27:09 PM Eastern Daylight Time	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan Medicare Preferred	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Prime (HMO)	01	01		1			H2256	016	1	2012	Most of Massachusetts	Counties ESSEX, SUFFOLK, WORCESTER	2		2			2						tuftsmedicarepreferred.org	tuftsmedicarepreferred.org	tuftsmedicarepreferred.org/druglist.php	(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835										(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977										2	2	2
H2256	016	2	1	01	01	H2256_016_2	9	1		07/18/2011	2012.02	07/18/2011 01:26:59 PM Eastern Daylight Time	06/06/2011 12:42:00 PM Eastern Daylight Time			07/18/2011 04:27:09 PM Eastern Daylight Time	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan Medicare Preferred	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Prime (HMO)	01	01		1			H2256	016	2	2012	Most of Massachusetts	Counties BRISTOL, MIDDLESEX, NORFOLK, PLYMOUTH	2		2			2						tuftsmedicarepreferred.org	tuftsmedicarepreferred.org	tuftsmedicarepreferred.org/druglist.php	(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835										(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977										2	2	2
H2256	016	6	1	01	01	H2256_016_6	10	1		07/18/2011	2012.02	07/18/2011 01:27:03 PM Eastern Daylight Time	06/06/2011 12:42:00 PM Eastern Daylight Time			07/18/2011 04:27:09 PM Eastern Daylight Time	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan Medicare Preferred	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Prime (HMO)	01	01		1			H2256	016	6	2012	Most of Massachusetts	Counties HAMPDEN	2		2			2						tuftsmedicarepreferred.org	tuftsmedicarepreferred.org	tuftsmedicarepreferred.org/druglist.php	(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835										(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977										2	2	2
H2256	016	7	1	01	01	H2256_016_7	9	1		07/18/2011	2012.02	07/18/2011 01:27:07 PM Eastern Daylight Time	06/06/2011 12:42:00 PM Eastern Daylight Time			07/18/2011 04:27:09 PM Eastern Daylight Time	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan Medicare Preferred	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Prime (HMO)	01	01		1			H2256	016	7	2012	Most of Massachusetts	County: BARNSTABLE	2		2			2						tuftsmedicarepreferred.org	tuftsmedicarepreferred.org	tuftsmedicarepreferred.org/druglist.php	(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835										(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977										2	2	2
H2256	016	8	1	01	01	H2256_016_8	9	1		07/18/2011	2012.02	07/18/2011 01:27:12 PM Eastern Daylight Time	06/06/2011 12:42:00 PM Eastern Daylight Time			07/18/2011 04:27:09 PM Eastern Daylight Time	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan Medicare Preferred	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Prime (HMO)	01	01		1			H2256	016	8	2012	Most of Massachusetts	County: HAMPSHIRE	2		2			2						tuftsmedicarepreferred.org	tuftsmedicarepreferred.org	tuftsmedicarepreferred.org/druglist.php	(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835										(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977										2	2	2
H2256	018	1	1	01	01	H2256_018_1	11	1		07/18/2011	2012.02	07/18/2011 01:27:13 PM Eastern Daylight Time	08/04/2011 03:44:00 PM Eastern Daylight Time	08/04/2011 09:37:00 AM Eastern Daylight Time		08/07/2011 12:36:23 PM Eastern Daylight Time	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan Medicare Preferred	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Value Rx (HMO)	01	01		1			H2256	018	1	2012	Most of Massachusetts	Counties ESSEX, SUFFOLK, WORCESTER	2		2			2						tuftsmedicarepreferred.org	tuftsmedicarepreferred.org	tuftsmedicarepreferred.org/druglist.php	(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		2	2	2
H2256	018	7	1	01	01	H2256_018_7	11	1		08/05/2011	2012.02	08/05/2011 01:41:10 PM Eastern Daylight Time	08/04/2011 03:45:00 PM Eastern Daylight Time	08/04/2011 09:37:00 AM Eastern Daylight Time		08/07/2011 12:36:23 PM Eastern Daylight Time	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan Medicare Preferred	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Value Rx (HMO)	01	01		1			H2256	018	7	2012	Most of Massachusetts	Counties BARN, BRIS, MIDD, NORF, PLYM	2		2			2						tuftsmedicarepreferred.org	tuftsmedicarepreferred.org	tuftsmedicarepreferred.org/druglist.php	(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		2	2	2
H2256	018	8	1	01	01	H2256_018_8	12	1		07/18/2011	2012.02	07/18/2011 01:27:16 PM Eastern Daylight Time	08/04/2011 03:45:00 PM Eastern Daylight Time	08/04/2011 09:37:00 AM Eastern Daylight Time		08/07/2011 12:36:23 PM Eastern Daylight Time	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan Medicare Preferred	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Value Rx (HMO)	01	01		1			H2256	018	8	2012	Most of Massachusetts	Counties HAMPDEN	2		2			2						tuftsmedicarepreferred.org	tuftsmedicarepreferred.org	tuftsmedicarepreferred.org/druglist.php	(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		2	2	2
H2256	018	9	1	01	01	H2256_018_9	11	1		07/18/2011	2012.02	07/18/2011 01:27:18 PM Eastern Daylight Time	08/04/2011 03:45:00 PM Eastern Daylight Time	08/04/2011 09:38:00 AM Eastern Daylight Time		08/07/2011 12:36:23 PM Eastern Daylight Time	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan Medicare Preferred	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Value Rx (HMO)	01	01		1			H2256	018	9	2012	Most of Massachusetts	County: HAMPSHIRE	2		2			2						tuftsmedicarepreferred.org	tuftsmedicarepreferred.org	tuftsmedicarepreferred.org/druglist.php	(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		2	2	2
H2256	019	1	1	01	01	H2256_019_1	8	1		07/18/2011	2012.02	07/18/2011 01:27:22 PM Eastern Daylight Time	06/06/2011 12:42:00 PM Eastern Daylight Time			07/18/2011 04:27:09 PM Eastern Daylight Time	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan Medicare Preferred	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Value (HMO)	01	01		1			H2256	019	1	2012	Most of Massachusetts	Counties ESSEX, SUFFOLK, WORCESTER	2		2			2						tuftsmedicarepreferred.org	tuftsmedicarepreferred.org	tuftsmedicarepreferred.org/druglist.php	(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835										(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977										2	2	2
H2256	019	7	1	01	01	H2256_019_7	8	1		07/18/2011	2012.02	07/18/2011 01:27:26 PM Eastern Daylight Time	06/06/2011 12:42:00 PM Eastern Daylight Time			07/18/2011 04:27:09 PM Eastern Daylight Time	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan Medicare Preferred	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Value (HMO)	01	01		1			H2256	019	7	2012	Most of Massachusetts	Counties BARN, BRIS, MIDD, NORF, PLYM	2		2			2						tuftsmedicarepreferred.org	tuftsmedicarepreferred.org	tuftsmedicarepreferred.org/druglist.php	(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835										(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977										2	2	2
H2256	019	8	1	01	01	H2256_019_8	9	1		07/18/2011	2012.02	07/18/2011 01:38:08 PM Eastern Daylight Time	06/06/2011 12:42:00 PM Eastern Daylight Time			07/18/2011 04:27:09 PM Eastern Daylight Time	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan Medicare Preferred	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Value (HMO)	01	01		1			H2256	019	8	2012	Most of Massachusetts	Counties HAMPDEN	2		2			2						tuftsmedicarepreferred.org	tuftsmedicarepreferred.org	tuftsmedicarepreferred.org/druglist.php	(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835										(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977										2	2	2
H2256	019	9	1	01	01	H2256_019_9	8	1		07/18/2011	2012.02	07/18/2011 01:27:35 PM Eastern Daylight Time	06/06/2011 12:42:00 PM Eastern Daylight Time			07/18/2011 04:27:09 PM Eastern Daylight Time	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan Medicare Preferred	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Value (HMO)	01	01		1			H2256	019	9	2012	Most of Massachusetts	County: HAMPSHIRE	2		2			2						tuftsmedicarepreferred.org	tuftsmedicarepreferred.org	tuftsmedicarepreferred.org/druglist.php	(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835										(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977										2	2	2
H2256	026	1	1	01	01	H2256_026_1	10	1		07/21/2011	2012.02	07/21/2011 12:58:44 PM Eastern Daylight Time	08/04/2011 03:47:00 PM Eastern Daylight Time	08/04/2011 09:38:00 AM Eastern Daylight Time		08/07/2011 12:36:23 PM Eastern Daylight Time	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan Medicare Preferred	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Basic Rx (HMO)	01	01		1			H2256	026	1	2012	Most of Massachusetts	counties ESSEX, SUFFOLK, WORCESTER	2		2			2						tuftsmedicarepreferred.org	tuftsmedicarepreferred.org	tuftsmedicarepreferred.org/druglist.php	(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		2	2	2
H2256	026	2	1	01	01	H2256_026_2	10	1		07/18/2011	2012.02	07/18/2011 01:27:38 PM Eastern Daylight Time	08/04/2011 03:47:00 PM Eastern Daylight Time	08/04/2011 09:38:00 AM Eastern Daylight Time		08/07/2011 12:36:23 PM Eastern Daylight Time	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan Medicare Preferred	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Basic Rx (HMO)	01	01		1			H2256	026	2	2012	Most of Massachusetts	counties BARN, BRIS, HMPD, HMPS, MIDD, NORF, PLYM	2		2			2						tuftsmedicarepreferred.org	tuftsmedicarepreferred.org	tuftsmedicarepreferred.org/druglist.php	(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		2	2	2
H2256	027	1	1	01	01	H2256_027_1	8	1		07/18/2011	2012.02	07/18/2011 01:27:42 PM Eastern Daylight Time	06/06/2011 12:42:00 PM Eastern Daylight Time			07/18/2011 04:27:09 PM Eastern Daylight Time	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan Medicare Preferred	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Basic (HMO)	01	01		1			H2256	027	1	2012	Most of Massachusetts	counties ESSEX, SUFFOLK, WORCESTER	2		2			2						tuftsmedicarepreferred.org	tuftsmedicarepreferred.org	tuftsmedicarepreferred.org/druglist.php	(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835										(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977										2	2	2
H2256	027	2	1	01	01	H2256_027_2	8	1		07/18/2011	2012.02	07/18/2011 01:38:39 PM Eastern Daylight Time	06/06/2011 12:42:00 PM Eastern Daylight Time			07/18/2011 04:27:09 PM Eastern Daylight Time	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan Medicare Preferred	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Basic (HMO)	01	01		1			H2256	027	2	2012	Most of Massachusetts	counties BARN, BRIS, HMPD, HMPS, MIDD, NORF, PLYM	2		2			2						tuftsmedicarepreferred.org	tuftsmedicarepreferred.org	tuftsmedicarepreferred.org/druglist.php	(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835										(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977										2	2	2
H2256	801	0	1	01	01	H2256_801_0	7	1		07/11/2011	2012.02	07/11/2011 10:14:45 AM Eastern Daylight Time	06/06/2011 12:42:00 PM Eastern Daylight Time			07/14/2011 09:41:15 AM Eastern Daylight Time	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan Medicare Preferred	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Rx (HMO)	01	01		1			H2256	801	0	2012	Most of Massachusetts		1		2			2						tuftsmedicarepreferred.org	tuftsmedicarepreferred.org	tuftsmedicarepreferred.org/druglist.php	(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		2	1	2
H2256	802	0	1	01	01	H2256_802_0	7	1		07/11/2011	2012.02	07/11/2011 10:15:05 AM Eastern Daylight Time	06/06/2011 12:42:00 PM Eastern Daylight Time			07/14/2011 09:41:15 AM Eastern Daylight Time	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan Medicare Preferred	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO (HMO)	01	01		1			H2256	802	0	2012	Most of Massachusetts		1		2			2						tuftsmedicarepreferred.org	tuftsmedicarepreferred.org	tuftsmedicarepreferred.org/druglist.php	(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835										(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977										2	1	2
H2256	803	0	1	01	01	H2256_803_0	7	1		07/11/2011	2012.02	07/11/2011 10:15:29 AM Eastern Daylight Time	06/06/2011 12:42:00 PM Eastern Daylight Time			07/14/2011 09:41:15 AM Eastern Daylight Time	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan Medicare Preferred	tuftsmedicarepreferred.org	Tufts Medicare Preferred HMO Rx (HMO)	01	01		1			H2256	803	0	2012	Most of Massachusetts		1		2			2						tuftsmedicarepreferred.org	tuftsmedicarepreferred.org	tuftsmedicarepreferred.org/druglist.php	(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977		2	1	2
H2261	005	0	1	01	01	H2261_005_0	8	1		07/19/2011	2012.02	07/19/2011 02:40:32 PM Eastern Daylight Time	08/04/2011 11:30:00 AM Eastern Daylight Time	08/08/2011 08:52:21 AM Eastern Daylight Time		08/08/2011 09:26:59 AM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF MA HMO BLUE, INC.	Blue Cross Blue Shield of Massachusetts	www.bluecrossma.com/medicare	Medicare HMO Blue PlusRx (HMO)	01	01		1			H2261	005	0	2012	Massachusetts except Berkshire Dukes and Nantucket		2	8821	2			2						www.bcbsma.com	http://www.bluecrossma.com/medicare-options/2011/prescription-benefit-resources/index.html	http://www.bluecrossma.com/medicare-options/2011/prescription-benefit-resources/index.html	(800)-200-4255		(800)-200-4255		(800)-678-2265		(800)-678-2265		(800)-200-4255		(800)-200-4255		(800)-678-2265		(800)-678-2265		(800)-522-1254		(800)-522-1254		(800)-522-1254		(800)-522-1254		(800)-522-1254		(800)-522-1254		(800)-522-1254		(800)-522-1254		2	2	2
H2261	019	0	1	01	01	H2261_019_0	8	1		07/19/2011	2012.02	07/19/2011 02:29:31 PM Eastern Daylight Time	08/04/2011 11:31:00 AM Eastern Daylight Time	08/08/2011 08:52:21 AM Eastern Daylight Time		08/08/2011 09:46:45 AM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF MA HMO BLUE, INC.	Blue Cross Blue Shield of Massachusetts	www.bluecrossma.com/medicare	Medicare HMO Blue ValueRx (HMO)	01	01		1			H2261	019	0	2012	Massachusetts except Berkshire Dukes Nantucket		2	420	2			2						www.bcbsma.com	http://www.bluecrossma.com/medicare-options/2011/prescription-benefit-resources/index.html	http://www.bluecrossma.com/medicare-options/2011/prescription-benefit-resources/index.html	(800)-200-4255		(800)-200-4255		(800)-678-2265		(800)-678-2265		(800)-200-4255		(800)-200-4255		(800)-678-2265		(800)-678-2265		(800)-522-1254		(800)-522-1254		(800)-522-1254		(800)-522-1254		(800)-522-1254		(800)-522-1254		(800)-522-1254		(800)-522-1254		2	2	2
H2261	801	0	1	01	01	H2261_801_0	3	1		06/06/2011	2012.02	06/06/2011 03:34:46 PM Eastern Daylight Time	06/06/2011 03:27:00 PM Eastern Daylight Time			06/06/2011 04:09:07 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF MA HMO BLUE, INC.	Blue Cross Blue Shield of Massachusetts	www.bluecrossma.com/medicare	Medicare HMO Blue (HMO)	01	01		1			H2261	801	0	2012	Massachusetts except Berkshire,Dukes and Nantucket		1	2352	2			2						www.bcbsma.com	http://www.bluecrossma.com/medicare-options/2011/prescription-benefit-resources/index.html	http://www.bluecrossma.com/medicare-options/2011/prescription-benefit-resources/index.html	(800)-200-4255		(800)-200-4255		(800)-678-2265		(800)-678-2265		(800)-200-4255		(800)-200-4255		(800)-678-2265		(800)-678-2265		(800)-522-1254		(800)-522-1254		(800)-522-1254		(800)-522-1254		(800)-522-1254		(800)-522-1254		(800)-522-1254		(800)-522-1254		1	1	1
H2261	809	0	1	01	01	H2261_809_0	3	1		06/06/2011	2012.02	06/06/2011 03:36:03 PM Eastern Daylight Time	06/06/2011 03:27:00 PM Eastern Daylight Time			06/06/2011 04:12:25 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF MA HMO BLUE, INC.	Blue Cross Blue Shield of Massachusetts	www.bluecrossma.com/medicare	Medicare HMO Blue (HMO)	01	01		1			H2261	809	0	2012	Massachusetts except Berkshire,Dukes and Nantucket		1	2352	2			2						www.bcbsma.com	http://www.bluecrossma.com/medicare-options/2011/prescription-benefit-resources/index.html	http://www.bluecrossma.com/medicare-options/2011/prescription-benefit-resources/index.html	(800)-200-4255		(800)-200-4255		(800)-678-2265		(800)-678-2265										(800)-522-1254		(800)-522-1254		(800)-522-1254		(800)-522-1254										1	1	1
H2312	004	0	1	01	01	H2312_004_0	7	1		07/14/2011	2012.02	07/14/2011 07:22:37 AM Eastern Daylight Time	08/09/2011 09:29:25 AM Eastern Daylight Time	08/09/2011 09:30:36 AM Eastern Daylight Time		08/09/2011 10:33:23 AM Eastern Daylight Time	HEALTH ALLIANCE PLAN OF MICHIGAN	HAP Senior Plus	www.hap.org/Medicare	HAP Senior Plus - Henry Ford (HMO)	01	01		1			H2312	004	0	2012	Southeastern Michigan (3 Counties)		2		2			2						www.hap.org	www.hap.org/medicare	www.hap.org/medicare	(800)-801-1770		(313)-664-7015		(800)-868-3153		(248)-443-8528		(800)-801-1770		(313)-664-7015		(800)-868-3153		(248)-443-8528		(800)-956-4325		(313)-664-8000		(800)-956-4325		(313)-664-8000		(800)-956-4325		(313)-664-8000		(800)-956-4325		(313)-664-8000		2	2	2
H2312	006	0	1	01	01	H2312_006_0	4	1		06/02/2011	2012.02	06/02/2011 02:09:11 PM Eastern Daylight Time	06/16/2011 05:16:23 PM Eastern Daylight Time			07/14/2011 02:28:03 PM Eastern Daylight Time	HEALTH ALLIANCE PLAN OF MICHIGAN	HAP Senior Plus	www.hap.org/Medicare	HAP Senior Plus - Henry Ford (HMO)	01	01		1			H2312	006	0	2012	Southeastern Michigan (3 Counties)		2		2			2						www.hap.org	www.hap.org/medicare	www.hap.org/medicare	(800)-801-1770		(313)-664-7015		(800)-868-3153		(248)-443-8528										(800)-956-4325		(313)-664-8000		(800)-956-4325		(313)-664-8000										2	2	2
H2312	007	0	1	02	01	H2312_007_0	6	1		07/14/2011	2012.02	07/14/2011 07:22:46 AM Eastern Daylight Time	08/09/2011 09:31:39 AM Eastern Daylight Time	08/09/2011 09:32:09 AM Eastern Daylight Time		08/09/2011 10:33:23 AM Eastern Daylight Time	HEALTH ALLIANCE PLAN OF MICHIGAN	HAP Senior Plus	www.hap.org/Medicare	HAP Senior Plus - Expanded Network (HMO-POS)	01	02		1			H2312	007	0	2012	Southeastern Michigan (9 Counties)		2		2			2						www.hap.org	www.hap.org/medicare	www.hap.org/medicare	(800)-801-1770		(313)-664-7015		(800)-868-3153		(248)-443-8528		(800)-801-1770		(313)-664-7015		(800)-868-3153		(248)-443-8528		(800)-956-4325		(313)-664-8000		(800)-956-4325		(313)-664-8000		(800)-956-4325		(313)-664-8000		(800)-956-4325		(313)-664-8000		2	2	2
H2312	008	0	1	02	01	H2312_008_0	4	1		07/13/2011	2012.02	07/13/2011 03:38:10 PM Eastern Daylight Time	06/16/2011 05:17:19 PM Eastern Daylight Time			07/14/2011 02:28:03 PM Eastern Daylight Time	HEALTH ALLIANCE PLAN OF MICHIGAN	HAP Senior Plus	www.hap.org/Medicare	HAP Senior Plus - Expanded Network (HMO-POS)	01	02		1			H2312	008	0	2012	Southeastern Michigan (9 Counties)		2		2			2						www.hap.org	www.hap.org/medicare	www.hap.org/medicare	(800)-801-1770		(313)-664-7015		(800)-868-3153		(248)-443-8528										(800)-956-4325		(313)-664-8000		(800)-956-4325		(313)-664-8000										2	2	2
H2312	009	0	1	01	01	H2312_009_0	6	1		07/13/2011	2012.02	07/13/2011 03:38:22 PM Eastern Daylight Time	08/09/2011 09:35:01 AM Eastern Daylight Time	08/09/2011 09:35:28 AM Eastern Daylight Time		08/09/2011 10:33:23 AM Eastern Daylight Time	HEALTH ALLIANCE PLAN OF MICHIGAN	HAP Senior Plus	www.hap.org/Medicare	HAP Senior Plus - Henry Ford (HMO)	01	01		1			H2312	009	0	2012	Southeastern Michigan (3 Counties)		2		2			2						www.hap.org	www.hap.org/medicare	www.hap.org/medicare	(800)-801-1770		(313)-664-7015		(800)-868-3153		(248)-443-8528		(800)-801-1770		(313)-664-7015		(800)-868-3153		(248)-443-8528		(800)-956-4325		(313)-664-8000		(800)-956-4325		(313)-664-8000		(800)-956-4325		(313)-664-8000		(800)-956-4325		(313)-664-8000		2	2	2
H2312	010	0	1	02	01	H2312_010_0	6	1		07/13/2011	2012.02	07/13/2011 03:38:44 PM Eastern Daylight Time	08/09/2011 09:36:01 AM Eastern Daylight Time	08/09/2011 09:42:06 AM Eastern Daylight Time		08/09/2011 10:33:23 AM Eastern Daylight Time	HEALTH ALLIANCE PLAN OF MICHIGAN	HAP Senior Plus	www.hap.org/Medicare	HAP Senior Plus - Expanded Network (HMO-POS)	01	02		1			H2312	010	0	2012	Southeastern Michigan (9 Counties)		2		2			2						www.hap.org	www.hap.org/medicare	www.hap.org/medicare	(800)-801-1770		(313)-664-7015		(800)-868-3153		(248)-443-8528		(800)-801-1770		(313)-664-7015		(800)-868-3153		(248)-443-8528		(800)-956-4325		(313)-664-8000		(800)-956-4325		(313)-664-8000		(800)-956-4325		(313)-664-8000		(800)-956-4325		(313)-664-8000		2	2	2
H2312	801	0	1	01	01	H2312_801_0	2	1		04/08/2011	2012.02	04/08/2011 03:47:10 PM Eastern Daylight Time	06/05/2011 12:21:37 PM Eastern Daylight Time			07/14/2011 02:28:03 PM Eastern Daylight Time	HEALTH ALLIANCE PLAN OF MICHIGAN	HAP Senior Plus	www.hap.org/Medicare	HAP Senior Plus - Group Only (HMO)	01	01		1			H2312	801	0	2012	Macomb, Oakland and Wayne Counties		1		2			2						www.hap.org	www.hap.org/medicare	www.hap.org/medicare	(800)-801-1770		(313)-664-7015		(800)-868-3153		(248)-443-8528										(800)-956-4325		(313)-664-8000		(800)-956-4325		(313)-664-8000										1	1	1
H2312	803	0	1	01	01	H2312_803_0	2	1		04/08/2011	2012.02	04/08/2011 03:49:03 PM Eastern Daylight Time	06/05/2011 12:22:02 PM Eastern Daylight Time			07/14/2011 02:28:03 PM Eastern Daylight Time	HEALTH ALLIANCE PLAN OF MICHIGAN	HAP Senior Plus	www.hap.org/Medicare	HAP Senior Plus - Group Only (HMO)	01	01		1			H2312	803	0	2012	Macomb, Oakland and Wayne Counties		1		2			2						www.hap.org	www.hap.org/medicare	www.hap.org/medicare	(800)-801-1770		(313)-664-7015		(800)-868-3153		(248)-443-8528		(800)-801-1770		(313)-664-7015		(800)-868-3153		(248)-443-8528		(800)-956-4325		(313)-664-8000		(800)-956-4325		(313)-664-8000		(800)-956-4325		(313)-664-8000		(800)-956-4325		(313)-664-8000		1	1	1
H2312	805	0	1	01	01	H2312_805_0	2	1		04/08/2011	2012.02	04/08/2011 03:49:26 PM Eastern Daylight Time	06/05/2011 12:22:26 PM Eastern Daylight Time			07/14/2011 02:28:03 PM Eastern Daylight Time	HEALTH ALLIANCE PLAN OF MICHIGAN	HAP Senior Plus	www.hap.org/Medicare	HAP Senior Plus - Group Only (HMO)	01	01		1			H2312	805	0	2012	Southeastern Michigan (9 Counties)		1		2			2						www.hap.org	www.hap.org/medicare	www.hap.org/medicare	(800)-801-1770		(313)-664-7015		(800)-868-3153		(248)-443-8528										(800)-956-4325		(313)-664-8000		(800)-956-4325		(313)-664-8000										1	1	1
H2312	807	0	1	01	01	H2312_807_0	2	1		04/08/2011	2012.02	04/08/2011 03:49:51 PM Eastern Daylight Time	06/05/2011 12:23:06 PM Eastern Daylight Time			07/14/2011 02:28:03 PM Eastern Daylight Time	HEALTH ALLIANCE PLAN OF MICHIGAN	HAP Senior Plus	www.hap.org/Medicare	HAP Senior Plus - Group Only (HMO)	01	01		1			H2312	807	0	2012	Southeastern Michigan (9 Counties)		1		2			2						www.hap.org	www.hap.org/medicare	www.hap.org/medicare	(800)-801-1770		(313)-664-7015		(800)-868-3153		(248)-443-8528		(800)-801-1770		(313)-664-7015		(800)-868-3153		(248)-443-8528		(800)-956-4325		(313)-664-8000		(800)-956-4325		(313)-664-8000		(800)-956-4325		(313)-664-8000		(800)-956-4325		(313)-664-8000		1	1	1
H2318	001	0	1	20	08	H2318_001_0	2	1		06/01/2011	2012.02	06/01/2011 04:27:02 PM Eastern Daylight Time		05/31/2011 04:22:35 PM Eastern Daylight Time		06/01/2011 04:29:04 PM Eastern Daylight Time	HENRY FORD HEALTH SYSTEM	Henry Ford Health System	hfhs.org	Henry Ford Health System-Center for Senior Indepen (PACE)	08	20		1			H2318	001	0	2012	Michigan, Wayne County Area		2		2			2							Milwaukee.PACE@milliman.com	None									(313)-653-2020		(313)-653-2020		(313)-653-2020		(313)-653-2020										(313)-653-2803		(313)-653-2803		(313)-653-2803		(313)-653-2803				
H2318	002	0	1	20	08	H2318_002_0	2	1		06/01/2011	2012.02	06/01/2011 04:27:39 PM Eastern Daylight Time		05/31/2011 04:22:35 PM Eastern Daylight Time		06/01/2011 04:29:04 PM Eastern Daylight Time	HENRY FORD HEALTH SYSTEM	Henry Ford Health System	hfhs.org	Henry Ford Health System-Center for Senior Indepen (PACE)	08	20		1			H2318	002	0	2012	Michigan, Wayne County Area		2		2			2							Milwaukee.PACE@milliman.com	None									(313)-653-2020		(313)-653-2020		(313)-653-2020		(313)-653-2020										(313)-653-2803		(313)-653-2803		(313)-653-2803		(313)-653-2803				
H2320	007	0	1	02	01	H2320_007_0	6	1		07/19/2011	2012.02	07/19/2011 01:08:26 PM Eastern Daylight Time	08/05/2011 11:02:42 AM Eastern Daylight Time	08/05/2011 11:03:08 AM Eastern Daylight Time		08/05/2011 11:08:38 AM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare (HMO-POS)	01	02		1			H2320	007	0	2012	CO: IO, IB, KA, MS, MD, MI, MT, MK, OE, OS, OT, WX		2	937	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2320	008	0	1	02	01	H2320_008_0	5	1		07/19/2011	2012.02	07/19/2011 01:09:41 PM Eastern Daylight Time	08/05/2011 11:02:42 AM Eastern Daylight Time	08/05/2011 11:03:05 AM Eastern Daylight Time		08/05/2011 11:08:38 AM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare (HMO-POS)	01	02		1			H2320	008	0	2012	CO: AN,BZ,CV,CL,CR,GT,HD,IN,LK,LL,LV,MA,ME,MR		2	786	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2320	011	0	1	02	01	H2320_011_0	6	1		07/19/2011	2012.02	07/19/2011 01:10:31 PM Eastern Daylight Time	08/05/2011 11:02:43 AM Eastern Daylight Time	08/05/2011 11:03:05 AM Eastern Daylight Time		08/05/2011 11:08:38 AM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Value (HMO-POS)	01	02		1			H2320	011	0	2012	CO: IO, IB, KA, MS, MD, MI, MT, MK, OE, OS, OT, WX		2	656	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2320	012	0	1	02	01	H2320_012_0	5	1		07/19/2011	2012.02	07/19/2011 01:11:04 PM Eastern Daylight Time	08/05/2011 11:02:43 AM Eastern Daylight Time	08/05/2011 11:03:05 AM Eastern Daylight Time		08/05/2011 11:08:38 AM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Value (HMO-POS)	01	02		1			H2320	012	0	2012	10 NW MI co., 2 central MI co., and 2 SE MI co.		2	429	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2320	013	0	1	02	01	H2320_013_0	5	1		07/19/2011	2012.02	07/19/2011 01:11:41 PM Eastern Daylight Time	08/05/2011 11:02:44 AM Eastern Daylight Time	08/05/2011 11:03:06 AM Eastern Daylight Time		08/05/2011 11:08:38 AM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare (HMO-POS)	01	02		1			H2320	013	0	2012	Counties: AG, BR, KN, LN, NW, OW		2	1602	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2320	015	0	1	02	01	H2320_015_0	5	1		07/19/2011	2012.02	07/19/2011 01:12:20 PM Eastern Daylight Time	08/05/2011 11:02:44 AM Eastern Daylight Time	08/05/2011 11:03:06 AM Eastern Daylight Time		08/05/2011 11:08:38 AM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Value (HMO-POS)	01	02		1			H2320	015	0	2012	Counties: AG, BR, KN, LN, NW, OW		2	868	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2320	016	0	1	02	01	H2320_016_0	5	1		07/19/2011	2012.02	07/19/2011 01:12:57 PM Eastern Daylight Time	08/05/2011 11:02:45 AM Eastern Daylight Time	08/05/2011 11:03:06 AM Eastern Daylight Time		08/05/2011 11:08:38 AM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare (HMO-POS)	01	02		1			H2320	016	0	2012	Counties: EM, GL, GT, JK, KK, RS, SJ, SN, SH		2	332	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2320	018	0	1	02	01	H2320_018_0	5	1		07/19/2011	2012.02	07/19/2011 01:13:33 PM Eastern Daylight Time	08/05/2011 11:02:45 AM Eastern Daylight Time	08/05/2011 11:03:06 AM Eastern Daylight Time		08/05/2011 11:08:38 AM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Value (HMO-POS)	01	02		1			H2320	018	0	2012	Counties: EM, GL, GT, JK, KK, RS, SJ, SN, SH		2	332	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2320	019	0	1	02	01	H2320_019_0	5	1		07/19/2011	2012.02	07/19/2011 01:14:05 PM Eastern Daylight Time	08/05/2011 11:02:46 AM Eastern Daylight Time	08/05/2011 11:03:07 AM Eastern Daylight Time		08/05/2011 11:08:38 AM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare (HMO-POS)	01	02		1			H2320	019	0	2012	Counties: BA, BN, MB, OK, SG, TS, WA, WY		2	151	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2320	021	0	1	02	01	H2320_021_0	5	1		07/19/2011	2012.02	07/19/2011 01:14:41 PM Eastern Daylight Time	08/05/2011 11:02:46 AM Eastern Daylight Time	08/05/2011 11:03:07 AM Eastern Daylight Time		08/05/2011 11:08:38 AM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Value (HMO-POS)	01	02		1			H2320	021	0	2012	Counties: BA, BN, MB, OK, SG, TS, WA, WY		2	151	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2320	802	0	1	02	01	H2320_802_0	3	1		06/03/2011	2012.02	06/03/2011 08:08:19 AM Eastern Daylight Time	07/19/2011 03:28:25 PM Eastern Daylight Time			07/19/2011 03:36:04 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare EG Non-Calendar Year (HMO-POS)	01	02		1			H2320	802	0	2012	State of Michigan		1	67	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2320	803	0	1	02	01	H2320_803_0	2	1		06/03/2011	2012.02	06/03/2011 08:08:30 AM Eastern Daylight Time	07/19/2011 03:28:26 PM Eastern Daylight Time			07/19/2011 03:36:04 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare EG Calendar Year (HMO-POS)	01	02		1			H2320	803	0	2012	State of Michigan		1	305	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2320	804	0	1	01	01	H2320_804_0	2	1		06/03/2011	2012.02	06/03/2011 08:08:38 AM Eastern Daylight Time	07/19/2011 03:28:26 PM Eastern Daylight Time			07/19/2011 03:36:04 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare EG HMO w PD Non-Cal Year (HMO)	01	01		1			H2320	804	0	2012	State of Michigan		1	6	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2320	805	0	1	01	01	H2320_805_0	2	1		06/03/2011	2012.02	06/03/2011 08:08:46 AM Eastern Daylight Time	07/19/2011 03:28:10 PM Eastern Daylight Time			07/19/2011 03:36:04 PM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare EG HMO w PD Cal Year (HMO)	01	01		1			H2320	805	0	2012	State of Michigan		1	2	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2322	001	0	1	04	01	H2322_001_0	7	1		07/13/2011	2012.02	07/13/2011 03:40:21 PM Eastern Daylight Time	08/09/2011 09:42:36 AM Eastern Daylight Time	08/09/2011 09:43:24 AM Eastern Daylight Time		08/09/2011 10:33:23 AM Eastern Daylight Time	ALLIANCE HEALTH AND LIFE INSURANCE, CO	Alliance Medicare PPO	www.hap.org/Medicare	Alliance Medicare PPO (PPO)	01	04		1			H2322	001	0	2012	Southeastern Michigan (9 Counties)		2		2			2						www.hap.org	www.hap.org/medicare	www.hap.org/medicare	(888)-658-2536		(313)-664-9050		(800)-868-3153		(800)-868-3153		(888)-658-2536		(313)-664-9050		(800)-868-3153		(800)-868-3153		(800)-956-4325		(313)-664-8000		(800)-956-4325		(313)-664-8000		(800)-956-4325		(313)-664-8000		(800)-956-4325		(313)-664-8000		2	2	2
H2322	004	0	1	04	01	H2322_004_0	6	1		07/13/2011	2012.02	07/13/2011 03:40:34 PM Eastern Daylight Time	08/09/2011 09:43:51 AM Eastern Daylight Time	08/09/2011 09:44:43 AM Eastern Daylight Time		08/09/2011 10:33:23 AM Eastern Daylight Time	ALLIANCE HEALTH AND LIFE INSURANCE, CO	Alliance Medicare PPO	www.hap.org/Medicare	Alliance Medicare PPO (PPO)	01	04		1			H2322	004	0	2012	Southeastern Michigan (9 Counties)		2		2			2						www.hap.org	www.hap.org/medicare	www.hap.org/medicare	(888)-658-2536		(313)-664-9050		(800)-868-3153		(800)-868-3153		(888)-658-2536		(313)-664-9050		(800)-868-3153		(800)-868-3153		(800)-956-4325		(313)-664-8000		(800)-956-4325		(313)-664-8000		(800)-956-4325		(313)-664-8000		(800)-956-4325		(313)-664-8000		2	2	2
H2322	801	0	1	04	01	H2322_801_0	2	1		04/08/2011	2012.02	04/08/2011 03:50:46 PM Eastern Daylight Time	06/05/2011 12:28:19 PM Eastern Daylight Time			07/14/2011 02:28:03 PM Eastern Daylight Time	ALLIANCE HEALTH AND LIFE INSURANCE, CO	Alliance Medicare PPO	www.hap.org/Medicare	Alliance Medicare PPO - Group Only (PPO)	01	04		1			H2322	801	0	2012	Southeastern Michigan (9 Counties)		1		2			2						www.hap.org	www.hap.org/medicare	www.hap.org/medicare	(888)-658-2536		(313)-664-9050		(800)-868-3153		(800)-868-3153										(800)-956-4325		(313)-664-8000		(800)-956-4325		(313)-664-8000										1	1	1
H2322	803	0	1	04	01	H2322_803_0	2	1		04/08/2011	2012.02	04/08/2011 03:51:14 PM Eastern Daylight Time	06/05/2011 12:28:41 PM Eastern Daylight Time			07/14/2011 02:28:03 PM Eastern Daylight Time	ALLIANCE HEALTH AND LIFE INSURANCE, CO	Alliance Medicare PPO	www.hap.org/Medicare	Alliance Medicare PPO - Group Only (PPO)	01	04		1			H2322	803	0	2012	Southeastern Michigan (9 Counties)		1		2			2						www.hap.org	www.hap.org/medicare	www.hap.org/medicare	(888)-658-2536		(313)-664-9050		(800)-868-3153		(800)-868-3153		(888)-658-2536		(313)-664-9050		(800)-868-3153		(800)-868-3153		(800)-956-4325		(313)-664-8000		(800)-956-4325		(313)-664-8000		(800)-956-4325		(313)-664-8000		(800)-956-4325		(313)-664-8000		1	1	1
H2323	005	0	1	01	01	H2323_005_0	8	1		08/12/2011	2012.02	08/12/2011 03:17:48 PM Central Daylight Time	08/12/2011 03:12:16 PM Central Daylight Time	08/12/2011 03:12:15 PM Central Daylight Time		08/12/2011 04:27:26 PM Central Daylight Time	FIDELIS SECURECARE OF MICHIGAN	Fidelis SecureCare Of Michigan	www.fidelissc.com	Fidelis Secure Comfort (HMO SNP)	01	01		1			H2323	005	0	2012	Selected Michigan Counties		2		2			1	1	1	1			http://www.fidelissc.com/pdfs/MI-ProviderDirectory.pdf	http://www.fidelissc.com/pdfs/2010-Formulary-with-Disclaimers.pdf	http://www.fidelissc.com/pharmacy/index.asp	(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		2	2	2
H2323	006	0	1	01	01	H2323_006_0	7	1		06/21/2011	2012.02	06/21/2011 11:59:47 AM Central Daylight Time	06/06/2011 10:09:15 PM Central Daylight Time	07/22/2011 12:51:00 PM Central Daylight Time		07/23/2011 12:38:50 PM Central Daylight Time	FIDELIS SECURECARE OF MICHIGAN	Fidelis SecureCare Of Michigan	www.fidelissc.com	Fidelis Secure Comfort Plus (HMO SNP)	01	01		1			H2323	006	0	2012	Selected Michigan Counties		2		2			1	1	1	1			http://www.fidelissc.com/pdfs/MI-ProviderDirectory.pdf	http://www.fidelissc.com/pdfs/2010-Formulary-with-Disclaimers.pdf	http://www.fidelissc.com/pharmacy/index.asp	(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		2	2	2
H2323	007	0	1	01	01	H2323_007_0	8	1		07/19/2011	2012.02	07/19/2011 11:45:18 AM Central Daylight Time	06/06/2011 10:09:15 PM Central Daylight Time	07/22/2011 12:51:00 PM Central Daylight Time		07/23/2011 12:38:50 PM Central Daylight Time	FIDELIS SECURECARE OF MICHIGAN	Fidelis SecureCare Of Michigan	www.fidelissc.com	Fidelis Secure Independence (HMO SNP)	01	01		1			H2323	007	0	2012	Selected Michigan Counties		2		2			1	1	2	1			http://www.fidelissc.com/pdfs/MI-ProviderDirectory.pdf	http://www.fidelissc.com/pdfs/2010-Formulary-with-Disclaimers.pdf	http://www.fidelissc.com/pharmacy/index.asp	(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		2	2	2
H2323	011	0	1	01	01	H2323_011_0	8	1		08/12/2011	2012.02	08/12/2011 03:30:05 PM Central Daylight Time	08/12/2011 03:11:15 PM Central Daylight Time	08/12/2011 03:11:16 PM Central Daylight Time		08/12/2011 04:27:26 PM Central Daylight Time	FIDELIS SECURECARE OF MICHIGAN	Fidelis SecureCare Of Michigan	www.fidelissc.com	Fidelis Secure Freedom (HMO SNP)	01	01		1			H2323	011	0	2012	Selected Michigan Counties		2		2			1	1	2	1			http://www.fidelissc.com/pdfs/MI-ProviderDirectory.pdf	http://www.fidelissc.com/pdfs/2010-Formulary-with-Disclaimers.pdf	http://www.fidelissc.com/pharmacy/index.asp	(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		2	2	2
H2323	012	0	1	01	01	H2323_012_0	13	1	2	08/12/2011	2012.02	08/12/2011 03:32:54 PM Central Daylight Time	08/12/2011 03:11:15 PM Central Daylight Time	08/12/2011 03:11:11 PM Central Daylight Time		08/12/2011 04:27:26 PM Central Daylight Time	FIDELIS SECURECARE OF MICHIGAN	Fidelis SecureCare Of Michigan	www.fidelissc.com	Fidelis Secure Liberty (HMO SNP)	01	01		1			H2323	012	0	2012	Metro Detroit Area		2		2			1	3		1	2		http://www.fidelissc.com/pdfs/MI-ProviderDirectory.pdf	http://www.fidelissc.com/pdfs/2010-Formulary-with-Disclaimers.pdf	http://www.fidelissc.com/pharmacy/index.asp	(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		2	2	2
H2323	013	0	1	01	01	H2323_013_0	9	1	2	08/12/2011	2012.02	08/12/2011 03:36:38 PM Central Daylight Time	08/12/2011 03:11:16 PM Central Daylight Time	08/12/2011 03:11:16 PM Central Daylight Time		08/12/2011 04:27:26 PM Central Daylight Time	FIDELIS SECURECARE OF MICHIGAN	Fidelis SecureCare Of Michigan	www.fidelissc.com	Fidelis Secure Liberty Select (HMO SNP)	01	01		1			H2323	013	0	2012	Wayne County		2		2			1	3		1	2		http://www.fidelissc.com/pdfs/MI-ProviderDirectory.pdf	http://www.fidelissc.com/pdfs/2010-Formulary-with-Disclaimers.pdf	http://www.fidelissc.com/pharmacy/index.asp	(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		2	2	2
H2323	014	0	1	01	01	H2323_014_0	8	1		08/12/2011	2012.02	08/12/2011 03:38:40 PM Central Daylight Time	08/12/2011 03:11:21 PM Central Daylight Time	08/12/2011 03:11:18 PM Central Daylight Time		08/12/2011 04:27:26 PM Central Daylight Time	FIDELIS SECURECARE OF MICHIGAN	Fidelis SecureCare Of Michigan	www.fidelissc.com	Fidelis SecureHome (HMO SNP)	01	01		1			H2323	014	0	2012	Wayne County		2		2			1	1	2	1			http://www.fidelissc.com/pdfs/MI-ProviderDirectory.pdf	http://www.fidelissc.com/pdfs/2010-Formulary-with-Disclaimers.pdf	http://www.fidelissc.com/pharmacy/index.asp	(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		2	2	2
H2354	001	0	1	02	01	H2354_001_0	6	1		06/05/2011	2012.02	06/05/2011 09:20:12 PM Central Daylight Time	08/04/2011 01:06:43 PM Central Daylight Time	08/04/2011 11:47:11 AM Central Daylight Time		08/04/2011 01:36:52 PM Central Daylight Time	HEALTHPLUS OF MICHIGAN	HealthPlus of Michigan	www.healthplus.org	HealthPlus MedicarePlus-AdvantageHMO-POS Option 1 (HMO-POS)	01	02		1			H2354	001	0	2012	17 Mid-Michigan and Southeast Michigan Counties		2	1770	2			2						www.healthplus.org	www.healthplus.org/partdformularies.aspx	www.healthplus.org	(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		2	2	2
H2354	013	0	1	02	01	H2354_013_0	6	1		06/05/2011	2012.02	06/05/2011 09:20:19 PM Central Daylight Time	08/04/2011 01:08:50 PM Central Daylight Time	08/04/2011 11:47:40 AM Central Daylight Time		08/04/2011 01:36:52 PM Central Daylight Time	HEALTHPLUS OF MICHIGAN	HealthPlus of Michigan	www.healthplus.org	HealthPlus MedicarePlus-AdvantageHMO-POS Option 2 (HMO-POS)	01	02		1			H2354	013	0	2012	17 Mid-Michigan and Southeast Michigan Counties		2	2300	2			2						www.healthplus.org	www.healthplus.org/partdformularies.aspx	www.healthplus.org	(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		2	2	2
H2354	015	0	1	02	01	H2354_015_0	6	1		06/05/2011	2012.02	06/05/2011 09:20:24 PM Central Daylight Time	08/04/2011 01:11:35 PM Central Daylight Time	08/04/2011 11:46:43 AM Central Daylight Time		08/04/2011 01:36:52 PM Central Daylight Time	HEALTHPLUS OF MICHIGAN	HealthPlus of Michigan	www.healthplus.org	HealthPlus MedicarePlus-AdvantageHMO-POS Option 3 (HMO-POS)	01	02		1			H2354	015	0	2012	17 Mid-Michigan and Southeast Michigan Counties		2	210	2			2						www.healthplus.org	www.healthplus.org/partdformularies.aspx	www.healthplus.org	(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		2	2	2
H2354	801	0	1	01	01	H2354_801_0	3	1		06/05/2011	2012.02	06/05/2011 09:20:35 PM Central Daylight Time	07/21/2011 05:03:45 PM Central Daylight Time			07/22/2011 02:03:44 PM Central Daylight Time	HEALTHPLUS OF MICHIGAN	HealthPlus of Michigan	www.healthplus.org	Emp-only - HealthPlus MA-only (HMO)	01	01		1			H2354	801	0	2012	United States EG Area		1	9500	2			2						www.healthplus.org	www.healthplus.org/partdformularies.aspx	www.healthplus.org	(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161										(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070										2	1	1
H2354	802	0	1	01	01	H2354_802_0	4	1		06/05/2011	2012.02	06/05/2011 09:20:45 PM Central Daylight Time	07/26/2011 02:32:53 PM Central Daylight Time			07/26/2011 02:43:25 PM Central Daylight Time	HEALTHPLUS OF MICHIGAN	HealthPlus of Michigan	www.healthplus.org	Emp-only - HealthPlus MA-PD calendar yr. (HMO)	01	01		1			H2354	802	0	2012	United States EG Area		1	50	2			2						www.healthplus.org	www.healthplus.org/partdformularies.aspx	www.healthplus.org	(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		2	1	1
H2354	805	0	1	01	01	H2354_805_0	3	1		06/05/2011	2012.02	06/05/2011 09:20:54 PM Central Daylight Time	07/01/2011 02:44:32 PM Central Daylight Time			07/22/2011 02:03:44 PM Central Daylight Time	HEALTHPLUS OF MICHIGAN	HealthPlus of Michigan	www.healthplus.org	Emp-only - HealthPlus MA-PD non-calendar yr. (HMO)	01	01		1			H2354	805	0	2012	United States EG Area		1		2			2						www.healthplus.org	www.healthplus.org/partdformularies.aspx	www.healthplus.org	(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-332-9161		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		(800)-992-5070		2	1	1
H2386	001	0	1	20	08	H2386_001_0	1	1		05/23/2011	2012.01	05/23/2011 12:47:32 PM Eastern Daylight Time		05/20/2011 04:14:59 PM Eastern Daylight Time		05/23/2011 01:21:41 PM Eastern Daylight Time	APPALACHIAN AGENCY FOR SENIOR CITIZENS, INC.	Appalachian Agency for Senior Citizens, Inc,	www.aasc.org	AllCARE for Seniors - Duals (PACE)	08	20		1			H2386	001	0	2012	Counties:  Buchanan, Dickenson, Russell, Tazewell		2		2			2							www.aasc.org	www.seniorscript.com									(800)-656-2272	7152	(276)-964-4915	7152	(800)-656-2272	7152	(276)-964-4915	7152									(800)-656-2272	7152	(276)-964-4915	7152	(800)-656-2272	7152	(276)-964-4915	7152			
H2386	002	0	1	20	08	H2386_002_0	1	1		05/23/2011	2012.01	05/23/2011 12:48:25 PM Eastern Daylight Time		05/20/2011 04:14:59 PM Eastern Daylight Time		05/23/2011 01:21:41 PM Eastern Daylight Time	APPALACHIAN AGENCY FOR SENIOR CITIZENS, INC.	Appalachian Agency for Senior Citizens, Inc,	www.aasc.org	AllCARE for Seniors - Medicare only (PACE)	08	20		1			H2386	002	0	2012	Counties:  Buchanan, Dickenson, Russell, Tazewell		2		2			2							www.aasc.org	www.seniorscript.com									(800)-656-2272	7152	(276)-964-4915	7152	(800)-656-2272	7152	(276)-964-4915	7152									(800)-656-2272	7152	(276)-964-4915	7152	(800)-656-2272	7152	(276)-964-4915	7152			
H2406	001	0	1	04	01	H2406_001_0	5	1		08/29/2011	2012.02	08/29/2011 03:14:42 PM Central Daylight Time	08/29/2011 10:39:12 AM Central Daylight Time	08/05/2011 01:00:37 PM Central Daylight Time		08/29/2011 03:44:45 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.EvercareHealthPlans.com	UnitedHealthcare Nursing Home Plan (PPO SNP)	01	04		1			H2406	001	0	2012	Cleveland, Cincinnati and Columbus Areas		2		2			1	1	1	1			www.EvercareHealthPlans.com	EvercareHealthPlans.com/prescription_drug_coverage.jsp	www.PrescriptionSolutions.com	(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2410	016	0	1	09	04	H2410_016_0	5	1		08/09/2011	2012.02	08/09/2011 08:56:41 AM Central Daylight Time	08/05/2011 01:51:13 PM Central Daylight Time	08/05/2011 01:53:02 PM Central Daylight Time		08/09/2011 09:07:43 AM Central Daylight Time	MEDICA HEALTH PLANS	Medica Health Plans	www.medica.com	Medica Advantage Solution Std with Part D Option 1 (PFFS)	04	09	2	1			H2410	016	0	2012	Select Counties in North Dakota and South Dakota		2		2			2							http://www.medica.com/C12/DrugFormularyPartD/default.aspx	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	(800)-234-8755		(952)-992-2300		(800)-906-5432		(952)-992-2345		(800)-234-8755		(952)-992-2300		(800)-906-5432		(952)-992-2345		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		2		2
H2411	801	0	1	04	01	H2411_801_0	2	1		06/06/2011	2012.02	06/06/2011 06:35:25 PM Eastern Daylight Time	06/06/2011 09:24:20 PM Eastern Daylight Time			06/06/2011 11:48:29 PM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.fchp.org	PPO MA Only (PPO)	01	04		1			H2411	801	0	2012	Full Service Area - Employer Groups		1	63	2			2						http://www.fchp.org/FindPhysician/	http://www.fchp.org/Extranet/Seniors/Formulary/	http://www.fchp.org/Extranet/Seniors/PharmacyFinder/	(800)-325-5669		(800)-325-5669		(888)-377-1980		(888)-377-1980										(711)		(711)		(711)		(711)										1	1	1
H2411	803	0	1	04	01	H2411_803_0	2	1		06/06/2011	2012.02	06/06/2011 06:35:30 PM Eastern Daylight Time	06/06/2011 09:24:36 PM Eastern Daylight Time			06/06/2011 11:48:29 PM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.fchp.org	PPO MA RX Coinsurance - Calendar Year (PPO)	01	04		1			H2411	803	0	2012	Full Service Area - Employer Groups		1	129	2			2						http://www.fchp.org/FindPhysician/	http://www.fchp.org/Extranet/Seniors/Formulary/	http://www.fchp.org/Extranet/Seniors/PharmacyFinder/	(800)-325-5669		(800)-325-5669		(888)-377-1980		(888)-377-1980		(800)-325-5669		(800)-325-5669		(888)-377-1980		(888)-377-1980		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H2416	001	0	1	01	01	H2416_001_0	3	1	2	07/22/2011	2012.02	07/22/2011 11:03:14 AM Central Daylight Time	08/08/2011 05:25:09 PM Central Daylight Time	08/08/2011 05:10:34 PM Central Daylight Time		08/08/2011 06:55:59 PM Central Daylight Time	PRIMEWEST HEALTH SYSTEM	PrimeWest Health	www.primewest.org	PrimeWest Senior Health Complete (HMO SNP)	01	01		1			H2416	001	0	2012	Northern, west central, and southwestern Minnesota		2	2729	2			1	3		1	5		www.primewest.org/FindA/Default.aspx	http://www.primewest.org/FindA/Drug.aspx	http://www.primewest.org/FindA/Pharmacy.aspx	(800)-366-2906		(320)-335-5219		(800)-366-2906		(320)-335-5219		(800)-366-2906		(320)-335-5219		(800)-366-2906		(320)-335-5219		(800)-627-3529		(800)-627-3529		(800)-627-3529		(800)-627-3529		(800)-627-3529		(800)-627-3529		(800)-627-3529		(800)-627-3529		2	2	2
H2417	001	0	1	01	01	H2417_001_0	4	1	2	07/22/2011	2012.02	07/22/2011 11:03:46 AM Central Daylight Time	08/08/2011 03:24:07 PM Central Daylight Time	08/08/2011 03:25:24 PM Central Daylight Time		08/08/2011 07:05:11 PM Central Daylight Time	ITASCA MEDICAL CARE	Itasca Medical Care/IMCare Classic	http://www.imcare.org	IMCare Classic (HMO SNP)	01	01		1			H2417	001	0	2012	Itasca County		2	566	2			1	3		1	5		http://www.imcare.org/documents/Combined%20Provider%20Directory%20and%20PCNL%202009.pdf	https://www.advancerx.com/advpcsrx_pmwroot/pmwroot/Formulary/00717/IndexForm.jsp	http://www.caremark.com/wps/portal	(800)-843-9536	2188	(218)-327-6188		(800)-843-9536	2188	(218)-327-6188		(800)-843-9536	2188	(218)-327-6188		(800)-843-9536	2188	(218)-327-6188		(800)-627-3529		(800)-627-3529		(800)-627-3529		(800)-627-3529		(800)-627-3529		(800)-627-3529		(800)-627-3529		(800)-627-3529		2	2	2
H2419	001	0	1	01	01	H2419_001_0	3	1	2	07/21/2011	2012.02	07/21/2011 02:27:46 PM Central Daylight Time	08/04/2011 05:32:08 PM Central Daylight Time	08/04/2011 05:32:08 PM Central Daylight Time		08/08/2011 12:53:52 PM Central Daylight Time	SOUTH COUNTRY HEALTH ALLIANCE	South Country Health Alliance	www.mnscha.org	SeniorCare Complete (HMO SNP)	01	01		1			H2419	001	0	2012	Select Counties in Minnesota		2	2214	1	1		1	3		1	5		www.mnscha.org	https://www.myprime.com	https://www.myprime.com	(866)-567-7242		(866)-567-7242		(866)-567-7242		(866)-567-7242		(866)-567-7242		(866)-567-7242		(866)-567-7242		(866)-567-7242		(877)-824-5611		(877)-824-5611		(877)-824-5611		(877)-824-5611		(877)-824-5611		(877)-824-5611		(877)-824-5611		(877)-824-5611		2	2	2
H2422	002	0	1	01	01	H2422_002_0	9	1	2	08/09/2011	2012.02	08/09/2011 03:54:49 PM Central Daylight Time	08/09/2011 01:04:37 PM Central Daylight Time	08/05/2011 02:56:06 PM Central Daylight Time		08/09/2011 07:23:57 PM Central Daylight Time	HEALTHPARTNERS, INC.	HealthPartners	healthpartners.com/medicare	HealthPartners Minnesota Senior Health Options (HMO SNP)	01	01		1			H2422	002	0	2012	Twin Cities Metropolitian Area		2	2975	2			1	3		1	5		healthpartners.com/medicare	healthpartners.com/medicarerx	healthpartners.com/medicare	(888)-820-4285		(952)-967-7029		(877)-713-8215		(952)-883-5050		(888)-820-4285		(952)-967-7029		(877)-713-8215		(952)-883-5050		(800)-443-0156		(952)-883-6060		(800)-443-0156		(952)-883-6060		(800)-443-0156		(952)-883-6060		(800)-443-0156		(952)-883-6060		2	1	2
H2425	001	0	1	01	01	H2425_001_0	6	1	2	08/08/2011	2012.02	08/08/2011 07:58:22 AM Central Daylight Time	06/02/2011 05:58:00 PM Central Daylight Time	05/31/2011 10:03:10 AM Central Daylight Time		08/08/2011 06:03:53 PM Central Daylight Time	BLUE PLUS	Blue Plus	www.bluecrossmn.com	SecureBlue (HMO SNP)	01	01		1			H2425	001	0	2012	62 Counties within the State of Minnesota		2	9855	2			1	3		1	5		www.bluecrossmn.com	www.bluecrossmn.com	www.bluecrossmn.com	(888)-740-6013		(651)-662-6013		(866)-477-1584		(651)-662-3584		(888)-740-6013		(651)-662-6013		(866)-477-1584		(651)-662-3584		(888)-878-0137		(651)-662-8700		(888)-878-0137		(651)-662-8700		(888)-878-0137		(651)-662-8700		(888)-878-0137		(651)-662-8700		2	1	2
H2450	001	0	1	18	06	H2450_001_0	6	1		08/08/2011	2012.02	08/08/2011 01:33:15 PM Central Daylight Time		08/05/2011 02:05:11 PM Central Daylight Time		08/08/2011 01:47:57 PM Central Daylight Time	MEDICA INSURANCE COMPANY	Medica Insurance Company	www.medica.com	Medica Prime Solution Basic with Part D Option 2 (Cost)	06	18		1			H2450	001	0	2012	All of MN, plus select counties in ND, SD and WI		2	192084	2			2							http://www.medica.com/C12/DrugFormularyPartD/default.aspx	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	(800)-234-8755		(952)-992-2300		(800)-906-5432		(952)-992-2345		(800)-234-8755		(952)-992-2300		(800)-906-5432		(952)-992-2345		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		2	2	2
H2450	002	0	1	18	06	H2450_002_0	6	1		08/09/2011	2012.02	08/09/2011 01:37:49 PM Central Daylight Time		08/05/2011 02:05:58 PM Central Daylight Time		08/09/2011 01:57:08 PM Central Daylight Time	MEDICA INSURANCE COMPANY	Medica Insurance Company	www.medica.com	Medica Prime Solution Enhanced w/Part D Option 2 (Cost)	06	18		1			H2450	002	0	2012	All of MN, plus select counties in ND, SD and WI		2	285717	2			2							http://www.medica.com/C12/DrugFormularyPartD/default.aspx	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	(800)-234-8755		(952)-992-2300		(800)-906-5432		(952)-992-2345		(800)-234-8755		(952)-992-2300		(800)-906-5432		(952)-992-2345		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		2	2	2
H2450	005	0	1	18	06	H2450_005_0	4	1		08/08/2011	2012.02	08/08/2011 01:38:18 PM Central Daylight Time		08/05/2011 02:06:48 PM Central Daylight Time		08/08/2011 01:47:57 PM Central Daylight Time	MEDICA INSURANCE COMPANY	Medica Insurance Company	www.medica.com	Medica Prime Solution Basic with Part D Option 3 (Cost)	06	18		1			H2450	005	0	2012	All of MN, plus select counties in ND, SD and WI		2	4352	2			2							http://www.medica.com/C12/DrugFormularyPartD/default.aspx	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	(800)-234-8755		(952)-992-2300		(800)-906-5432		(952)-992-2345		(800)-234-8755		(952)-992-2300		(800)-906-5432		(952)-992-2345		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		2	2	2
H2450	006	0	1	18	06	H2450_006_0	5	1		08/09/2011	2012.02	08/09/2011 01:40:14 PM Central Daylight Time		08/05/2011 02:07:23 PM Central Daylight Time		08/09/2011 01:57:08 PM Central Daylight Time	MEDICA INSURANCE COMPANY	Medica Insurance Company	www.medica.com	Medica Prime Solution Enhanced w/Part D Option 3 (Cost)	06	18		1			H2450	006	0	2012	All of MN, plus select counties in ND, SD and WI		2	35735	2			2							http://www.medica.com/C12/DrugFormularyPartD/default.aspx	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	(800)-234-8755		(952)-992-2300		(800)-906-5432		(952)-992-2345		(800)-234-8755		(952)-992-2300		(800)-906-5432		(952)-992-2345		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		2	2	2
H2450	007	0	1	18	06	H2450_007_0	3	1		08/08/2011	2012.02	08/08/2011 12:56:56 PM Central Daylight Time		08/05/2011 02:09:43 PM Central Daylight Time		08/08/2011 01:21:40 PM Central Daylight Time	MEDICA INSURANCE COMPANY	Medica Insurance Company	www.medica.com	Medica Prime Solution Thrift with Part D Option 1 (Cost)	06	18		1			H2450	007	0	2012	All of MN, plus select counties in ND, SD and WI		2	18254	2			2							http://www.medica.com/C12/DrugFormularyPartD/default.aspx	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	(800)-234-8755		(952)-992-2300		(800)-906-5432		(952)-992-2345		(800)-234-8755		(952)-992-2300		(800)-906-5432		(952)-992-2345		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		2	2	2
H2450	016	0	1	18	06	H2450_016_0	3	1		08/08/2011	2012.02	08/08/2011 01:37:01 PM Central Daylight Time		08/05/2011 02:10:17 PM Central Daylight Time		08/08/2011 01:47:57 PM Central Daylight Time	MEDICA INSURANCE COMPANY	Medica Insurance Company	www.medica.com	Medica Prime Solution Basic with Part D Option 1 (Cost)	06	18		1			H2450	016	0	2012	All of MN, plus select counties in ND, SD and WI		2	40539	2			2							http://www.medica.com/C12/DrugFormularyPartD/default.aspx	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	(800)-234-8755		(952)-992-2300		(800)-906-5432		(952)-992-2345		(800)-234-8755		(952)-992-2300		(800)-906-5432		(952)-992-2345		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		2	2	2
H2450	017	0	1	18	06	H2450_017_0	3	1		08/09/2011	2012.02	08/09/2011 01:42:47 PM Central Daylight Time		08/05/2011 02:10:53 PM Central Daylight Time		08/09/2011 01:57:08 PM Central Daylight Time	MEDICA INSURANCE COMPANY	Medica Insurance Company	www.medica.com	Medica Prime Solution Enhanced w/Part D Option 1 (Cost)	06	18		1			H2450	017	0	2012	All of MN, plus select counties in ND, SD and WI		2	1933	2			2							http://www.medica.com/C12/DrugFormularyPartD/default.aspx	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	(800)-234-8755		(952)-992-2300		(800)-906-5432		(952)-992-2345		(800)-234-8755		(952)-992-2300		(800)-906-5432		(952)-992-2345		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		2	2	2
H2450	022	0	1	18	06	H2450_022_0	3	1		08/08/2011	2012.02	08/08/2011 12:59:02 PM Central Daylight Time		08/05/2011 02:11:31 PM Central Daylight Time		08/08/2011 01:21:40 PM Central Daylight Time	MEDICA INSURANCE COMPANY	Medica Insurance Company	www.medica.com	Medica Prime Solution Value with Part D Option 1 (Cost)	06	18		1			H2450	022	0	2012	All of MN, plus select counties in ND, SD and WI		2	21700	2			2							http://www.medica.com/C12/DrugFormularyPartD/default.aspx	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	(800)-234-8755		(952)-992-2300		(800)-906-5432		(952)-992-2345		(800)-234-8755		(952)-992-2300		(800)-906-5432		(952)-992-2345		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		2	2	2
H2450	023	0	1	18	06	H2450_023_0	4	1		08/08/2011	2012.02	08/08/2011 01:01:22 PM Central Daylight Time		08/05/2011 02:12:12 PM Central Daylight Time		08/08/2011 01:21:40 PM Central Daylight Time	MEDICA INSURANCE COMPANY	Medica Insurance Company	www.medica.com	Medica Prime Solution Value with Part D Option 2 (Cost)	06	18		1			H2450	023	0	2012	All of MN, plus select counties in ND, SD and WI		2	25885	2			2							http://www.medica.com/C12/DrugFormularyPartD/default.aspx	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	(800)-234-8755		(952)-992-2300		(800)-906-5432		(952)-992-2345		(800)-234-8755		(952)-992-2300		(800)-906-5432		(952)-992-2345		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		2	2	2
H2450	028	0	1	18	06	H2450_028_0	5	1		08/08/2011	2012.02	08/08/2011 01:02:58 PM Central Daylight Time		08/05/2011 02:12:45 PM Central Daylight Time		08/08/2011 01:21:40 PM Central Daylight Time	MEDICA INSURANCE COMPANY	Medica Insurance Company	www.medica.com	Medica Prime Solution Value with Part D Option 3 (Cost)	06	18		1			H2450	028	0	2012	All of MN, plus select counties in ND, SD and WI		2	1368	2			2							http://www.medica.com/C12/DrugFormularyPartD/default.aspx	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	(800)-234-8755		(952)-992-2300		(800)-906-5432		(952)-992-2345		(800)-234-8755		(952)-992-2300		(800)-906-5432		(952)-992-2345		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		2	2	2
H2450	801	0		18	06	H2450_801_0	3	1		06/06/2011	2012.02						MEDICA INSURANCE COMPANY	Medica Insurance Company	www.medica.com	Medica Grp Prime Solution Calendar w/4-tier Part D (Cost)	06	18					H2450	801	0	2012	All of MN, plus select Counties in ND , SD and WI		1					2							http://www.medica.com/C12/DrugFormularyPartD/default.aspx	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	(800)-575-2330		(952)-992-2330		(800)-575-2330				(800)-575-2330		(952)-992-2330		(800)-575-2330		(952)-992-2330		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880				
H2450	802	0		18	06	H2450_802_0	2	1		06/03/2011	2012.02						MEDICA INSURANCE COMPANY	Medica Insurance Company	www.medica.com	Medica Grp Prime Solution Contract w/4-tier Part D (Cost)	06	18					H2450	802	0	2012	All of MN, plus select Counties in ND , SD and WI		1					2							http://www.medica.com/C12/DrugFormularyPartD/default.aspx	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	(800)-575-2330		(952)-992-2330		(800)-575-2330				(800)-575-2330		(952)-992-2330		(800)-575-2330		(952)-992-2330		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880				
H2456	002	0	1	01	01	H2456_002_0	10	1	2	08/12/2011	2012.02	08/12/2011 02:55:03 PM Central Daylight Time	08/12/2011 03:27:22 PM Central Daylight Time	08/12/2011 04:00:57 PM Central Daylight Time		08/12/2011 04:10:00 PM Central Daylight Time	UCARE MINNESOTA	UCare	www.ucare.org	UCare's Minnesota Senior Health Options (HMO SNP)	01	01		1			H2456	002	0	2012	Minneapolis, St. Paul, and Greater Minnesota Area		2		2			1	3		1	5		www.ucare.org	www.ucare.org	www.ucare.org	(866)-280-7202		(612)-676-6868		(800)-707-1711		(612)-676-3554		(866)-280-7202		(612)-676-6868		(800)-707-1711		(612)-676-3554		(800)-688-2534		(612)-676-6810		(800)-688-2534		(612)-676-6810		(800)-688-2534		(612)-676-6810		(800)-688-2534		(612)-676-6810		2	2	2
H2457	002	0	1	01	01	H2457_002_0	2	1	2	06/03/2011	2012.02	06/03/2011 09:48:59 AM Central Daylight Time	08/04/2011 11:04:12 AM Central Daylight Time	08/04/2011 11:05:32 AM Central Daylight Time		08/04/2011 01:36:14 PM Central Daylight Time	METROPOLITAN HEALTH PLAN	Metropolitan Health Plan MSHO	www.hennepin.us/MSHO	MHP MSHO (HMO SNP)	01	01		1			H2457	002	0	2012	Anoka, Carver, Hennepin and Scott counties		2	850	2			1	3		1	5		www.hennepin.us/MSHO	http//www.mhp4life.org	http://www.caremark.com/wps/portal	(888)-562-8000		(888)-562-8000		(888)-562-8000		(888)-562-8000		(888)-562-8000		(888)-562-8000		(888)-562-8000		(888)-562-8000		(800)-627-3529		(800)-627-3529		(800)-627-3529		(800)-627-3529		(800)-627-3529		(800)-627-3529		(800)-627-3529		(800)-627-3529		2	2	2
H2458	002	0	1	01	01	H2458_002_0	4	1	2	08/09/2011	2012.02	08/09/2011 10:53:33 AM Central Daylight Time	08/09/2011 10:18:45 AM Central Daylight Time	08/05/2011 02:13:19 PM Central Daylight Time		08/09/2011 10:58:27 AM Central Daylight Time	MEDICA HEALTH PLANS	Medica Health Plans	www.medica.com	Medica DUAL Solution (HMO SNP)	01	01		1			H2458	002	0	2012	Specific Minnesota Counties		2	112874	2			1	3		1	5		https://www.medica.com/C11/FindADoctor/default.aspx	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	(800)-234-8755		(952)-992-2300		(800)-266-2157		(952)-992-2030		(800)-234-8755		(952)-992-2300		(800)-266-2157		(952)-992-2030		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		2	2	2
H2459	001	0	1	02	01	H2459_001_0	10	1		08/02/2011	2012.02	08/02/2011 10:23:59 AM Central Daylight Time	07/08/2011 08:34:52 AM Central Daylight Time			08/02/2011 10:34:54 AM Central Daylight Time	UCARE MINNESOTA	UCare	www.ucare.org	UCare for Seniors Value (HMO-POS)	01	02		1			H2459	001	0	2012	Minnesota		2		2			2						www.ucare.org	www.ucare.org	www.ucare.org	(877)-523-1515		(612)-676-3600		(877)-523-1518		(612)-676-3500										(800)-688-2534		(612)-676-6810		(800)-688-2534		(612)-676-6810										2	2	2
H2459	002	0	1	02	01	H2459_002_0	11	1		08/03/2011	2012.02	08/03/2011 11:14:04 AM Central Daylight Time	08/03/2011 04:45:48 PM Central Daylight Time	08/08/2011 10:17:43 AM Central Daylight Time		08/08/2011 01:09:47 PM Central Daylight Time	UCARE MINNESOTA	UCare	www.ucare.org	UCare for Seniors Classic (HMO-POS)	01	02		1			H2459	002	0	2012	Minnesota		2		2			2						www.ucare.org	www.ucare.org	www.ucare.org	(877)-523-1515		(612)-676-3600		(877)-523-1518		(612)-676-3500		(877)-523-1515		(612)-676-3600		(877)-523-1518		(612)-676-3500		(800)-688-2534		(612)-676-6810		(800)-688-2534		(612)-676-6810		(800)-688-2534		(612)-676-6810		(800)-688-2534		(612)-676-6810		2	2	2
H2459	013	0	1	02	01	H2459_013_0	11	1		08/02/2011	2012.02	08/02/2011 10:24:24 AM Central Daylight Time	08/03/2011 05:21:05 PM Central Daylight Time	08/08/2011 10:20:21 AM Central Daylight Time		08/08/2011 01:09:47 PM Central Daylight Time	UCARE MINNESOTA	UCare	www.ucare.org	UCare for Seniors Value Plus (HMO-POS)	01	02		1			H2459	013	0	2012	Minnesota		2		2			2						www.ucare.org	www.ucare.org	www.ucare.org	(877)-523-1515		(612)-676-3600		(877)-523-1518		(612)-676-3500		(877)-523-1515		(612)-676-3600		(877)-523-1518		(612)-676-3500		(800)-688-2534		(612)-676-6810		(800)-688-2534		(612)-676-6810		(800)-688-2534		(612)-676-6810		(800)-688-2534		(612)-676-6810		2	2	2
H2459	018	0	1	02	01	H2459_018_0	11	1		08/02/2011	2012.02	08/02/2011 10:24:31 AM Central Daylight Time	08/03/2011 05:26:42 PM Central Daylight Time	08/08/2011 10:35:07 AM Central Daylight Time		08/08/2011 01:09:47 PM Central Daylight Time	UCARE MINNESOTA	UCare	www.ucare.org	UCare for Seniors Standard D (HMO-POS)	01	02		1			H2459	018	0	2012	Minnesota		2		2			2						www.ucare.org	www.ucare.org	www.ucare.org	(877)-523-1515		(612)-676-3600		(877)-523-1518		(612)-676-3500		(877)-523-1515		(612)-676-3600		(877)-523-1518		(612)-676-3500		(800)-688-2534		(612)-676-6810		(800)-688-2534		(612)-676-6810		(800)-688-2534		(612)-676-6810		(800)-688-2534		(612)-676-6810		2	2	2
H2459	801	0	1	02	01	H2459_801_0	6	1		05/24/2011	2012.02	05/24/2011 03:00:23 PM Central Daylight Time	06/06/2011 04:46:05 PM Central Daylight Time			06/06/2011 05:09:03 PM Central Daylight Time	UCARE MINNESOTA	UCare	www.ucare.org	Group UCare for Seniors (HMO-POS)	01	02		1			H2459	801	0	2012	Minnesota and 26 Wisconsin Counties		1		2			2						www.ucare.org	www.ucare.org	www.ucare.org	(877)-447-4385		(612)-676-6840		(877)-598-6574		(612)-676-6900		(877)-447-4385		(612)-676-6840		(877)-598-6574		(612)-676-6900		(800)-688-2534		(612)-676-6810		(800)-688-2534		(612)-676-6810		(800)-688-2534		(612)-676-6810		(800)-688-2534		(612)-676-6810		1	1	1
H2459	804	0	1	02	01	H2459_804_0	8	1		05/12/2011	2012.02	05/12/2011 11:46:01 AM Central Daylight Time	06/06/2011 04:46:52 PM Central Daylight Time			06/06/2011 05:09:03 PM Central Daylight Time	UCARE MINNESOTA	UCare	www.ucare.org	Group UCare for Seniors MA Only (HMO-POS)	01	02		1			H2459	804	0	2012	Minnesota and 26 Wisconsin Counties		1		2			2						www.ucare.org	www.ucare.org	www.ucare.org	(877)-447-4385		(612)-676-6840		(877)-598-6574		(612)-676-6900										(800)-688-2534		(612)-676-6810		(800)-688-2534		(612)-676-6810										1	1	1
H2461	005	0	1	18	06	H2461_005_0	4	2		07/20/2011	2012.02	07/20/2011 03:56:03 PM Central Daylight Time				07/20/2011 04:01:16 PM Central Daylight Time	BLUE CROSS BLUE SHIELD OF MINNESOTA	Blue Cross and Blue Shield of Minnesota	www.bluecrossmn.com	Platinum Blue Core Plan (Cost)	06	18		1			H2461	005	0	2012	State of Minnesota		2	1600	2			2							www.bluecrossmn.com	www.primetherapeutics.com	(866)-340-8654		(651)-662-5654		(877)-662-2583		(651)-662-2583										(888)-878-0137		(651)-662-8700		(866)-582-1158		(866)-582-1158										2	2	2
H2461	006	0	1	18	06	H2461_006_0	4	2		07/20/2011	2012.02	07/20/2011 03:55:52 PM Central Daylight Time				07/20/2011 04:01:16 PM Central Daylight Time	BLUE CROSS BLUE SHIELD OF MINNESOTA	Blue Cross and Blue Shield of Minnesota	www.bluecrossmn.com	Platinum Blue Choice Plan (Cost)	06	18		1			H2461	006	0	2012	State of Minnesota		2	4900	2			2							www.bluecrossmn.com	www.primetherapeutics.com	(866)-340-8654		(651)-662-5654		(877)-662-2583		(651)-662-2583										(888)-878-0137		(651)-662-8700		(866)-582-1158		(866)-582-1158										2	2	2
H2461	007	0	1	18	06	H2461_007_0	4	2		07/20/2011	2012.02	07/20/2011 03:56:09 PM Central Daylight Time				07/20/2011 04:01:16 PM Central Daylight Time	BLUE CROSS BLUE SHIELD OF MINNESOTA	Blue Cross and Blue Shield of Minnesota	www.bluecrossmn.com	Platinum Blue Complete Plan (Cost)	06	18		1			H2461	007	0	2012	State of Minnesota		2	57400	2			2							www.bluecrossmn.com	www.primetherapeutics.com	(866)-340-8654		(651)-662-5654		(877)-662-2583		(651)-662-2583										(888)-878-0137		(651)-662-8700		(866)-582-1158		(866)-582-1158										2	2	2
H2462	004	0	1	18	06	H2462_004_0	5	1		08/09/2011	2012.02	08/09/2011 04:28:22 PM Central Daylight Time				08/09/2011 04:29:32 PM Central Daylight Time	GROUP HEALTH PLAN, INC.	HealthPartners	healthpartners.com/medicare	HealthPartners Freedom Basic (Cost)	06	18		1			H2462	004	0	2012	State of Minnesota		2	100	2			2							healthpartners.com/medicarerx	healthpartners.com/medicare	(800)-233-9645		(952)-883-7979		(800)-247-7015		(952)-883-5601										(800)-443-0156		(952)-883-6060		(800)-443-0156		(952)-883-6060										2	2	2
H2462	007	0	1	18	06	H2462_007_0	3	1		08/09/2011	2012.02	08/09/2011 04:15:37 PM Central Daylight Time				08/09/2011 04:38:17 PM Central Daylight Time	GROUP HEALTH PLAN, INC.	HealthPartners	healthpartners.com/medicare	HealthPartners Freedom Balance (Cost)	06	18		1			H2462	007	0	2012	State of Minnesota		2	683	2			2							healthpartners.com/medicarerx	healthpartners.com/medicare	(800)-233-9645		(952)-883-7979		(800)-247-7015		(952)-883-5601										(800)-443-0156		(952)-883-6060		(800)-443-0156		(952)-883-6060										2	2	2
H2462	008	0	1	18	06	H2462_008_0	5	1		08/09/2011	2012.02	08/09/2011 04:16:44 PM Central Daylight Time		08/05/2011 02:56:07 PM Central Daylight Time		08/09/2011 04:47:39 PM Central Daylight Time	GROUP HEALTH PLAN, INC.	HealthPartners	healthpartners.com/medicare	HealthPartners Freedom Balance with Rx (Cost)	06	18		1			H2462	008	0	2012	State of Minnesota		2		2			2							healthpartners.com/medicarerx	healthpartners.com/medicare	(800)-233-9645		(952)-883-7979		(800)-247-7015		(952)-883-5601		(800)-233-9645		(952)-883-7979		(800)-247-7015		(952)-883-5601		(800)-443-0156		(952)-883-6060		(800)-443-0156		(952)-883-6060		(800)-443-0156		(952)-883-6060		(800)-443-0156		(952)-883-6060		2	2	2
H2462	010	0	1	18	06	H2462_010_0	3	1		08/09/2011	2012.02	08/09/2011 11:42:38 AM Central Daylight Time				08/09/2011 04:53:01 PM Central Daylight Time	GROUP HEALTH PLAN, INC.	HealthPartners	healthpartners.com/medicare	HealthPartners Freedom Ultimate (Cost)	06	18		1			H2462	010	0	2012	State of Minnesota		2	1814	2			2							healthpartners.com/medicarerx	healthpartners.com/medicare	(800)-233-9645		(952)-883-7979		(800)-247-7015		(952)-883-5601										(800)-443-0156		(952)-883-6060		(800)-443-0156		(952)-883-6060										2	2	2
H2462	011	0	1	18	06	H2462_011_0	5	1		08/09/2011	2012.02	08/09/2011 11:46:40 AM Central Daylight Time		08/05/2011 02:56:07 PM Central Daylight Time		08/09/2011 05:07:19 PM Central Daylight Time	GROUP HEALTH PLAN, INC.	HealthPartners	healthpartners.com/medicare	HealthPartners Freedom Ultimate with Rx (Cost)	06	18		1			H2462	011	0	2012	State of Minnesota		2		2			2							healthpartners.com/medicarerx	healthpartners.com/medicare	(800)-233-9645		(952)-883-7979		(800)-247-7015		(952)-883-5601		(800)-233-9645		(952)-883-7979		(800)-247-7015		(952)-883-5601		(800)-443-0156		(952)-883-6060		(800)-443-0156		(952)-883-6060		(800)-443-0156		(952)-883-6060		(800)-443-0156		(952)-883-6060		2	2	2
H2462	012	0	1	18	06	H2462_012_0	7	1		08/09/2011	2012.02	08/09/2011 11:51:17 AM Central Daylight Time		08/05/2011 02:56:08 PM Central Daylight Time		08/09/2011 05:15:36 PM Central Daylight Time	GROUP HEALTH PLAN, INC.	HealthPartners	healthpartners.com/medicare	HealthPartners Freedom Ultimate with Enhanced Rx (Cost)	06	18		1			H2462	012	0	2012	State of Minnesota		2		2			2							healthpartners.com/medicarerx	healthpartners.com/medicare	(800)-233-9645		(952)-883-7979		(800)-247-7015		(952)-883-5601		(800)-233-9645		(952)-883-7979		(800)-247-7015		(952)-883-5601		(800)-443-0156		(952)-883-6060		(800)-443-0156		(952)-883-6060		(800)-443-0156		(952)-883-6060		(800)-443-0156		(952)-883-6060		2	2	2
H2462	015	0	1	18	06	H2462_015_0	2	1		08/09/2011	2012.02	08/09/2011 11:55:20 AM Central Daylight Time				08/09/2011 05:20:45 PM Central Daylight Time	GROUP HEALTH PLAN, INC.	HealthPartners	healthpartners.com/medicare	HealthPartners Wisconsin Freedom Basic (Cost)	06	18		1			H2462	015	0	2012	Western Wisconsin		2	7	2			2							healthpartners.com/medicarerx	healthpartners.com/medicare	(800)-233-9645		(952)-883-7979		(800)-247-7015		(952)-883-5601										(800)-443-0156		(952)-883-6060		(800)-443-0156		(952)-883-6060										2	2	2
H2462	016	0	1	18	06	H2462_016_0	2	1		08/09/2011	2012.02	08/09/2011 12:02:26 PM Central Daylight Time				08/09/2011 05:26:05 PM Central Daylight Time	GROUP HEALTH PLAN, INC.	HealthPartners	healthpartners.com/medicare	HealthPartners Wisconsin Freedom Ultimate (Cost)	06	18		1			H2462	016	0	2012	Western Wisconsin		2		2			2							healthpartners.com/medicarerx	healthpartners.com/medicare	(800)-233-9645		(952)-883-7979		(800)-247-7015		(952)-883-5601										(800)-443-0156		(952)-883-6060		(800)-443-0156		(952)-883-6060										2	2	2
H2462	017	0	1	18	06	H2462_017_0	3	1		08/09/2011	2012.02	08/09/2011 12:07:05 PM Central Daylight Time		08/05/2011 02:56:08 PM Central Daylight Time		08/09/2011 05:31:23 PM Central Daylight Time	GROUP HEALTH PLAN, INC.	HealthPartners	healthpartners.com/medicare	HealthPartners Wisconsin Freedom Ultimate with Rx (Cost)	06	18		1			H2462	017	0	2012	Western Wisconsin		2		2			2							healthpartners.com/medicarerx	healthpartners.com/medicare	(800)-233-9645		(952)-883-7979		(800)-247-7015		(952)-883-5601		(800)-233-9645		(952)-883-7979		(800)-247-7015		(952)-883-5601		(800)-443-0156		(952)-883-6060		(800)-443-0156		(952)-883-6060		(800)-443-0156		(952)-883-6060		(800)-443-0156		(952)-883-6060		2	2	2
H2462	018	0	1	18	06	H2462_018_0	4	1		08/09/2011	2012.02	08/09/2011 12:10:15 PM Central Daylight Time				08/09/2011 05:38:00 PM Central Daylight Time	GROUP HEALTH PLAN, INC.	HealthPartners	healthpartners.com/medicare	HealthPartners Freedom Vital (Cost)	06	18		1			H2462	018	0	2012	State of Minnesota		2	93	2			2							healthpartners.com/medicarerx	healthpartners.com/medicare	(800)-233-9645		(952)-883-7979		(800)-247-7015		(952)-883-5601										(800)-443-0156		(952)-883-6060		(800)-443-0156		(952)-883-6060										2	2	2
H2462	019	0	1	18	06	H2462_019_0	7	1		08/09/2011	2012.02	08/09/2011 12:13:41 PM Central Daylight Time		08/05/2011 02:56:08 PM Central Daylight Time		08/09/2011 05:48:09 PM Central Daylight Time	GROUP HEALTH PLAN, INC.	HealthPartners	healthpartners.com/medicare	HealthPartners Freedom Vital with Rx (Cost)	06	18		1			H2462	019	0	2012	State of Minnesota		2	93	2			2							healthpartners.com/medicarerx	healthpartners.com/medicare	(800)-233-9645		(952)-883-7979		(800)-247-7015		(952)-883-5601		(800)-233-9645		(952)-883-7979		(800)-247-7015		(952)-883-5601		(800)-443-0156		(952)-883-6060		(800)-443-0156		(952)-883-6060		(800)-443-0156		(952)-883-6060		(800)-443-0156		(952)-883-6060		2	2	2
H2462	801	0		18	06	H2462_801_0	1	1		06/03/2011	2012.02						GROUP HEALTH PLAN, INC.	HealthPartners	healthpartners.com/medicare	HealthPartners Freedom Calendar Year (Cost)	06	18					H2462	801	0	2012	State of MN Western Wisconsin		1					2							healthpartners.com/medicarerx	healthpartners.com/medicare	(800)-233-9645		(952)-883-7979		(866)-993-7428				(800)-233-9645		(952)-883-7979		(866)-993-7428		(952)-883-7428		(800)-443-0156		(952)-883-6060		(800)-443-0156		(952)-883-6060		(800)-443-0156		(952)-883-6060		(800)-443-0156		(952)-883-6060				
H2462	802	0		18	06	H2462_802_0	1	1		05/03/2011	2012.02						GROUP HEALTH PLAN, INC.	HealthPartners	healthpartners.com/medicare	HealthPartners Freedom Non-Calendar Year (Cost)	06	18					H2462	802	0	2012	State of MN Western Wisconsin		1					2							healthpartners.com/medicarerx	healthpartners.com/medicare	(800)-233-9645		(952)-883-7979		(866)-993-7428				(800)-233-9645		(952)-883-7979		(866)-993-7428		(952)-883-7428		(800)-443-0156		(952)-883-6060		(800)-443-0156		(952)-883-6060		(800)-443-0156		(952)-883-6060		(800)-443-0156		(952)-883-6060				
H2486	003	0	1	02	01	H2486_003_0	7	1		07/11/2011	2012.02	07/11/2011 08:39:54 AM Eastern Daylight Time	08/04/2011 03:32:06 PM Eastern Daylight Time	08/04/2011 12:00:41 PM Eastern Daylight Time		08/08/2011 04:46:24 PM Eastern Daylight Time	HUMANA MEDICAL PLAN OF UTAH, INC.	Humana Medical Plan of Utah	www.humana-medicare.com	Humana Gold Plus H2486-003 (HMO-POS)	01	02		1			H2486	003	0	2012	Davis, Salt Lake, Utah and Weber counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2486	801	0	1	01	01	H2486_801_0	2	1		07/06/2011	2012.02	07/06/2011 10:55:05 AM Eastern Daylight Time	05/27/2011 03:20:49 PM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA MEDICAL PLAN OF UTAH, INC.	Humana Medical Plan of Utah	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H2486	801	0	2012	Select counties in Utah		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H2486	802	0	1	01	01	H2486_802_0	2	1		07/06/2011	2012.02	07/06/2011 10:55:11 AM Eastern Daylight Time	05/28/2011 07:18:45 AM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA MEDICAL PLAN OF UTAH, INC.	Humana Medical Plan of Utah	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H2486	802	0	2012	Select counties in Utah		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
H2486	803	0	1	01	01	H2486_803_0	2	1		07/06/2011	2012.02	07/06/2011 10:55:15 AM Eastern Daylight Time	05/27/2011 03:55:31 PM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA MEDICAL PLAN OF UTAH, INC.	Humana Medical Plan of Utah	www.humana-medicare.com	Humana Employer Sponsored Non-CY (HMO)	01	01		1			H2486	803	0	2012	Select counties in Utah		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H2491	001	0	1	02	01	H2491_001_0	7	1		08/05/2011	2012.02	08/05/2011 08:53:13 AM Eastern Daylight Time	08/05/2011 02:15:44 PM Eastern Daylight Time	08/05/2011 11:39:37 AM Eastern Daylight Time		08/08/2011 03:50:28 PM Eastern Daylight Time	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	'Ohana Health Plan	www.ohanahealthplan.com	'Ohana Reserve (HMO-POS)	01	02		1			H2491	001	0	2012	Honolulu County		2		2			2						www.ohanahealthplan.com	www.ohanahealthplan.com	www.ohanahealthplan.com	(888)-505-1201		(888)-505-1201		(877)-231-2632		(877)-231-2632		(888)-505-1201		(888)-505-1201		(877)-231-2632		(877)-231-2632		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H2491	002	0	1	02	01	H2491_002_0	7	1		07/21/2011	2012.02	07/21/2011 01:36:06 PM Eastern Daylight Time	08/05/2011 02:16:01 PM Eastern Daylight Time	08/05/2011 11:37:22 AM Eastern Daylight Time		08/08/2011 03:50:28 PM Eastern Daylight Time	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	'Ohana Health Plan	www.ohanahealthplan.com	'Ohana Value (HMO-POS)	01	02		1			H2491	002	0	2012	Hawaii, Honolulu, Kauai, Maui Counties		2		2			2						www.ohanahealthplan.com	www.ohanahealthplan.com	www.ohanahealthplan.com	(888)-505-1201		(888)-505-1201		(877)-231-2632		(877)-231-2632		(888)-505-1201		(888)-505-1201		(877)-231-2632		(877)-231-2632		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H2491	004	0	1	02	01	H2491_004_0	8	1	2	08/04/2011	2012.02	08/04/2011 03:09:26 PM Eastern Daylight Time	08/05/2011 02:16:18 PM Eastern Daylight Time	08/11/2011 11:14:14 AM Eastern Daylight Time		08/11/2011 02:04:30 PM Eastern Daylight Time	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	'Ohana Health Plan	www.ohanahealthplan.com	'Ohana Liberty (HMO-POS SNP)	01	02		1			H2491	004	0	2012	Hawaii, Honolulu, Kauai, Maui Counties		2		2			1	3		1	5		www.ohanahealthplan.com	www.ohanahealthplan.com	www.ohanahealthplan.com	(877)-457-7621		(877)-457-7621		(877)-231-2632		(877)-231-2632		(877)-457-7621		(877)-457-7621		(877)-231-2632		(877)-231-2632		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H2537	001	0	1	20	08	H2537_001_0	1	1		05/24/2011	2012.02	05/24/2011 12:27:50 PM Eastern Daylight Time		05/20/2011 04:14:31 PM Eastern Daylight Time		05/24/2011 12:32:46 PM Eastern Daylight Time	LIFE LUTHERAN	LIFE Lutheran Services, Inc.	www.lifelutheranservices.org	LIFE Lutheran - Dual (PACE)	08	20		1			H2537	001	0	2012	Franklin County		2		2			2							www.lifelutheranservices.org	www.lifelutheranservices.org									(877)-840-8408		(717)-264-5433		(877)-840-8408		(717)-264-5433										(877)-840-8408		(717)-264-5433		(877)-840-8408		(717)-264-5433				
H2537	002	0	1	20	08	H2537_002_0	1	1		05/24/2011	2012.02	05/24/2011 12:30:49 PM Eastern Daylight Time		05/20/2011 04:14:31 PM Eastern Daylight Time		05/24/2011 12:32:46 PM Eastern Daylight Time	LIFE LUTHERAN	LIFE Lutheran Services, Inc.	www.lifelutheranservices.org	LIFE Lutheran - Medicare Only (PACE)	08	20		1			H2537	002	0	2012	Franklin County		2		2			2							www.lifelutheranservices.org	www.lifelutheranservices.org									(877)-543-0000		(717)-264-5433		(877)-840-8408		(717)-264-5433										(877)-840-8408		(717)-264-5433		(877)-840-8408		(717)-264-5433				
H2542	001	0	1	04	01	H2542_001_0	13	1		07/06/2011	2012.02	07/06/2011 01:12:37 PM Eastern Daylight Time	08/05/2011 10:40:19 PM Eastern Daylight Time	08/04/2011 12:01:09 PM Eastern Daylight Time		08/08/2011 07:31:59 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H2542-001 (PPO)	01	04		1			H2542	001	0	2012	Richmond Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2542	002	0	1	04	01	H2542_002_0	10	1		07/06/2011	2012.02	07/06/2011 12:30:10 PM Eastern Daylight Time	08/05/2011 10:40:38 PM Eastern Daylight Time	08/04/2011 12:01:25 PM Eastern Daylight Time		08/08/2011 07:31:59 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H2542-002 (PPO)	01	04		1			H2542	002	0	2012	Tidewater Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2542	003	0	1	04	01	H2542_003_0	9	1		07/06/2011	2012.02	07/06/2011 01:18:27 PM Eastern Daylight Time	08/05/2011 10:47:27 PM Eastern Daylight Time	08/04/2011 12:01:43 PM Eastern Daylight Time		08/08/2011 07:31:59 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H2542-003 (PPO)	01	04		1			H2542	003	0	2012	Northern Virginia Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2542	004	0	1	04	01	H2542_004_0	8	1		08/05/2011	2012.02	08/05/2011 09:50:29 AM Eastern Daylight Time	08/05/2011 10:47:39 PM Eastern Daylight Time	08/04/2011 12:02:02 PM Eastern Daylight Time		08/08/2011 07:31:59 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H2542-004 (PPO)	01	04		1			H2542	004	0	2012	Roanoke Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2542	005	0	1	04	01	H2542_005_0	9	1		07/06/2011	2012.02	07/06/2011 12:54:00 PM Eastern Daylight Time	08/05/2011 10:54:30 PM Eastern Daylight Time	08/04/2011 12:02:20 PM Eastern Daylight Time		08/09/2011 08:23:34 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Reader's Digest Healthy Living Plan (PPO)	01	04		1			H2542	005	0	2012	Richmond Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2542	006	0	1	04	01	H2542_006_0	9	1		07/06/2011	2012.02	07/06/2011 12:58:04 PM Eastern Daylight Time	05/27/2011 02:25:14 PM Eastern Daylight Time	08/04/2011 12:02:39 PM Eastern Daylight Time		08/09/2011 08:30:09 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Reader's Digest Healthy Living Plan (PPO)	01	04		1			H2542	006	0	2012	Tidewater Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2542	007	0	1	04	01	H2542_007_0	10	1		07/06/2011	2012.02	07/06/2011 01:02:47 PM Eastern Daylight Time	08/05/2011 10:54:43 PM Eastern Daylight Time	08/04/2011 12:02:58 PM Eastern Daylight Time		08/09/2011 09:02:13 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Reader's Digest Healthy Living Plan (PPO)	01	04		1			H2542	007	0	2012	Roanoke Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2593	001	0	1	01	01	H2593_001_0	5	1		08/06/2011	2012.02	08/06/2011 10:45:25 AM Pacific Daylight Time	08/08/2011 03:38:40 PM Pacific Daylight Time	08/08/2011 01:01:22 PM Pacific Daylight Time		08/08/2011 05:13:01 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF ARIZONA, INC.	CareMore Health Plan of Arizona, Inc.	http://www.caremore.com	CareMore Value Plus (HMO)	01	01		1			H2593	001	0	2012	Pima County		2	6178	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)-822-6991		(800)-822-6991		(866)-622-2820		(866)-622-2820		(800)-822-6991		(800)-822-6991		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H2593	003	0	1	01	01	H2593_003_0	6	1		08/06/2011	2012.02	08/06/2011 10:44:54 AM Pacific Daylight Time	08/08/2011 03:39:13 PM Pacific Daylight Time	08/08/2011 01:01:27 PM Pacific Daylight Time		08/08/2011 05:13:01 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF ARIZONA, INC.	CareMore Health Plan of Arizona, Inc.	http://www.caremore.com	CareMore Touch (HMO SNP)	01	01		1			H2593	003	0	2012	Pima County		2	418	2			1	1	3	1			www.caremore.com	www.caremore.com	www.caremore.com	(800)-589-3147		(800)-589-3147		(866)-622-2820		(866)-622-2820		(800)-589-3147		(800)-589-3147		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H2593	005	0	1	01	01	H2593_005_0	6	1		08/06/2011	2012.02	08/06/2011 11:04:53 AM Pacific Daylight Time	08/08/2011 03:39:05 PM Pacific Daylight Time	08/08/2011 01:01:27 PM Pacific Daylight Time		08/08/2011 05:13:01 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF ARIZONA, INC.	CareMore Health Plan of Arizona, Inc.	http://www.caremore.com	CareMore Breathe (HMO SNP)	01	01		1			H2593	005	0	2012	Pima County		2	758	2			1	4		1		00000000000100000000	www.caremore.com	www.caremore.com	www.caremore.com	(888)-357-4166		(888)-357-4166		(866)-622-2820		(866)-622-2820		(888)-357-4166		(888)-357-4166		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H2593	006	0	1	01	01	H2593_006_0	6	1		08/06/2011	2012.02	08/06/2011 11:05:06 AM Pacific Daylight Time	08/08/2011 03:38:48 PM Pacific Daylight Time	08/08/2011 01:01:31 PM Pacific Daylight Time		08/08/2011 05:13:01 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF ARIZONA, INC.	CareMore Health Plan of Arizona, Inc.	http://www.caremore.com	CareMore Diabetes (HMO SNP)	01	01		1			H2593	006	0	2012	Pima County		2	2611	2			1	4		1		00000010000000000000	www.caremore.com	www.caremore.com	www.caremore.com	(888)-357-4187		(888)-357-4187		(866)-622-2820		(866)-622-2820		(888)-357-4187		(888)-357-4187		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H2593	007	0	1	01	01	H2593_007_0	6	1		08/06/2011	2012.02	08/06/2011 10:46:03 AM Pacific Daylight Time	08/08/2011 03:40:21 PM Pacific Daylight Time	08/08/2011 01:01:31 PM Pacific Daylight Time		08/08/2011 05:13:01 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF ARIZONA, INC.	CareMore Health Plan of Arizona, Inc.	http://www.caremore.com	CareMore Value Plus (HMO)	01	01		1			H2593	007	0	2012	Maricopa  and Pinal Counties (partial)		2	2221	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)-822-6991		(800)-822-6991		(866)-622-2820		(866)-622-2820		(800)-822-6991		(800)-822-6991		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H2593	009	0	1	01	01	H2593_009_0	6	1		08/06/2011	2012.02	08/06/2011 10:47:05 AM Pacific Daylight Time	08/08/2011 03:40:30 PM Pacific Daylight Time	08/08/2011 01:01:34 PM Pacific Daylight Time		08/08/2011 05:21:59 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF ARIZONA, INC.	CareMore Health Plan of Arizona, Inc.	http://www.caremore.com	CareMore Touch (HMO SNP)	01	01		1			H2593	009	0	2012	Maricopa  and Pinal Counties (partial)		2	397	2			1	1	3	1			www.caremore.com	www.caremore.com	www.caremore.com	(800)-589-3147		(800)-589-3147		(866)-622-2820		(866)-622-2820		(800)-589-3147		(800)-589-3147		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H2593	011	0	1	01	01	H2593_011_0	6	1		08/06/2011	2012.02	08/06/2011 11:07:35 AM Pacific Daylight Time	08/08/2011 03:40:48 PM Pacific Daylight Time	08/08/2011 01:01:36 PM Pacific Daylight Time		08/08/2011 05:21:59 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF ARIZONA, INC.	CareMore Health Plan of Arizona, Inc.	http://www.caremore.com	CareMore Diabetes (HMO SNP)	01	01		1			H2593	011	0	2012	Maricopa and Pinal Counties (partial)		2	1260	2			1	4		1		00000010000000000000	www.caremore.com	www.caremore.com	www.caremore.com	(888)-357-4187		(888)-357-4187		(866)-622-2820		(866)-622-2820		(888)-357-4187		(888)-357-4187		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H2593	013	0	1	01	01	H2593_013_0	6	1		08/06/2011	2012.02	08/06/2011 11:07:27 AM Pacific Daylight Time	08/08/2011 03:38:56 PM Pacific Daylight Time	08/08/2011 01:01:38 PM Pacific Daylight Time		08/08/2011 05:21:59 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF ARIZONA, INC.	CareMore Health Plan of Arizona, Inc.	http://www.caremore.com	CareMore Heart (HMO SNP)	01	01		1			H2593	013	0	2012	Pima County		2	460	2			1	4		1		00000000000000010000	www.caremore.com	www.caremore.com	www.caremore.com	(888)-494-8280		(888)-494-8280		(866)-622-2820		(866)-622-2820		(888)-494-8280		(888)-494-8280		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H2593	014	0	1	01	01	H2593_014_0	6	1		08/06/2011	2012.02	08/06/2011 11:07:11 AM Pacific Daylight Time	08/08/2011 03:40:39 PM Pacific Daylight Time	08/08/2011 01:01:40 PM Pacific Daylight Time		08/08/2011 05:21:59 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF ARIZONA, INC.	CareMore Health Plan of Arizona, Inc.	http://www.caremore.com	CareMore Heart (HMO SNP)	01	01		1			H2593	014	0	2012	Maricopa and Pinal Counties (partial)		2	322	2			1	4		1		00000000000000010000	www.caremore.com	www.caremore.com	www.caremore.com	(888)-494-8280		(888)-494-8280		(866)-622-2820		(866)-622-2820		(888)-494-8280		(888)-494-8280		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H2593	015	0	1	01	01	H2593_015_0	6	1		08/06/2011	2012.02	08/06/2011 11:07:05 AM Pacific Daylight Time	08/08/2011 03:40:56 PM Pacific Daylight Time	08/08/2011 01:01:41 PM Pacific Daylight Time		08/08/2011 05:21:59 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF ARIZONA, INC.	CareMore Health Plan of Arizona, Inc.	caremore.com	CareMore Breathe (HMO SNP)	01	01		1			H2593	015	0	2012	Maricopa and Pinal Counties (partial)		2	96	2			1	4		1		00000000000100000000	www.caremore.com	www.caremore.com	www.caremore.com	(888)-357-4166		(888)-357-4166		(866)-622-2820		(866)-622-2820		(888)-357-4166		(888)-357-4166		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H2593	016	0	1	01	01	H2593_016_0	5	1		08/08/2011	2012.02	08/08/2011 12:38:58 PM Pacific Daylight Time	08/08/2011 03:41:06 PM Pacific Daylight Time	08/08/2011 01:01:45 PM Pacific Daylight Time		08/08/2011 05:21:59 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF ARIZONA, INC.	CareMore Health Plan of Arizona, Inc.	caremore.com	StartSmart with CareMore (HMO)	01	01		1			H2593	016	0	2012	Maricopa and Pinal counties (partial)		2	66	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)-822-8720		(800)-822-8720		(866)-622-2820		(866)-622-2820		(800)-822-8720		(800)-822-8720		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H2593	801	0	1	01	01	H2593_801_0	2	1		05/28/2011	2012.02	05/28/2011 11:18:34 AM Pacific Daylight Time	06/03/2011 12:02:53 PM Pacific Daylight Time			07/22/2011 04:58:08 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF ARIZONA, INC.	CareMore Health Plan of Arizona, Inc.	caremore.com	CareMore EGWP (HMO)	01	01		1			H2593	801	0	2012	Arizona		1	29	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)-822-6991		(800)-822-6991		(866)-622-2820		(866)-622-2820										(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586										1	1	1
H2593	802	0	1	01	01	H2593_802_0	2	1		05/28/2011	2012.02	05/28/2011 11:19:27 AM Pacific Daylight Time	06/03/2011 12:02:33 PM Pacific Daylight Time			07/22/2011 04:58:08 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF ARIZONA, INC.	CareMore Health Plan of Arizona, Inc.	caremore.com	CareMore EGWP MAPD (HMO)	01	01		1			H2593	802	0	2012	Arizona		1	29	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)-822-6991		(800)-822-6991		(866)-622-2820		(866)-622-2820		(800)-822-6991		(800)-822-6991		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		1	1	1
H2593	803	0	1	01	01	H2593_803_0	2	1		05/28/2011	2012.02	05/28/2011 11:19:06 AM Pacific Daylight Time	06/03/2011 12:03:33 PM Pacific Daylight Time			07/22/2011 04:58:08 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF ARIZONA, INC.	CareMore Health Plan of Arizona, Inc.	caremore.com	CareMore EGWP (HMO)	01	01		1			H2593	803	0	2012	Arizona		1	10	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)-822-6991		(800)-822-6991		(866)-622-2820		(866)-622-2820										(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586										1	1	1
H2593	804	0	1	01	01	H2593_804_0	2	1		05/28/2011	2012.02	05/28/2011 11:18:48 AM Pacific Daylight Time	06/03/2011 12:03:12 PM Pacific Daylight Time			07/22/2011 04:58:08 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF ARIZONA, INC.	CareMore Health Plan of Arizona, Inc.	caremore.com	CareMore EGWP MAPD (HMO)	01	01		1			H2593	804	0	2012	Arizona		1	10	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)-822-6991		(800)-822-6991		(866)-622-2820		(866)-622-2820		(800)-822-6991		(800)-822-6991		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		1	1	1
H2609	001	0	1	20	08	H2609_001_0	1	1		05/23/2011	2012.02	05/23/2011 01:14:20 PM Eastern Daylight Time		05/23/2011 11:53:38 AM Eastern Daylight Time		05/23/2011 01:17:28 PM Eastern Daylight Time	ALEXIAN BROTHERS COMMUNITY SERVICES	Alexian Brothers Community Services	rboerner@alexianbrothers.net	Dual Eligibles (PACE)	08	20		1			H2609	001	0	2012	St. Louis City and St. Louis County		2		2			2							None	None									(314)-771-5800	159	(314)-771-5800	159	(314)-771-5800	159	(314)-771-5800	159									(314)-771-5800	159	(314)-771-5800	159	(314)-771-5800	159	(314)-771-5800	159			
H2609	002	0	1	20	08	H2609_002_0	1	1		05/23/2011	2012.02	05/23/2011 01:14:41 PM Eastern Daylight Time		05/23/2011 11:53:38 AM Eastern Daylight Time		05/23/2011 01:17:28 PM Eastern Daylight Time	ALEXIAN BROTHERS COMMUNITY SERVICES	Alexian Brothers Community Services	rboerner@alexianbrothers.net	Medicare Only (PACE)	08	20		1			H2609	002	0	2012	St. Louis City and St. Louis County		2		2			2							None	None									(314)-771-5800	159	(314)-771-5800	159	(314)-771-5800	159	(314)-771-5800	159									(314)-771-5800	159	(314)-771-5800	159	(314)-771-5800	159	(314)-771-5800	159			
H2610	005	0	1	01	01	H2610_005_0	9	1		08/04/2011	2012.02	08/04/2011 03:49:16 PM Central Daylight Time	08/04/2011 02:20:29 PM Central Daylight Time	08/04/2011 02:20:04 PM Central Daylight Time		08/04/2011 04:24:56 PM Central Daylight Time	ESSENCE HEALTHCARE, INC.	Essence Healthcare	www.essencehealthcare.com	Essence Advantage (HMO)	01	01		1			H2610	005	0	2012	St. Louis Metropolitan Area		2	31891	2			2						www.essencehealthcare.com	www.essencehealthcare.com	www.essencehealthcare.com	(866)-597-9560		(314)-209-2700		(866)-597-9560		(314)-209-2700		(866)-597-9560		(314)-209-2700		(866)-597-9560		(314)-209-2700		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2610	006	0	1	01	01	H2610_006_0	10	1		08/04/2011	2012.02	08/04/2011 04:01:32 PM Central Daylight Time	08/04/2011 02:16:50 PM Central Daylight Time	08/04/2011 02:16:24 PM Central Daylight Time		08/04/2011 04:24:56 PM Central Daylight Time	ESSENCE HEALTHCARE, INC.	Essence Healthcare	www.essencehealthcare.com	Essence Advantage Plus (HMO)	01	01		1			H2610	006	0	2012	St. Louis Metropolitan Area		2	1540	2			2						www.essencehealthcare.com	www.essencehealthcare.com	www.essencehealthcare.com	(866)-597-9560		(314)-209-2700		(866)-597-9560		(314)-209-2700		(866)-597-9560		(314)-209-2700		(866)-597-9560		(314)-209-2700		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2610	011	0	1	01	01	H2610_011_0	11	1		08/04/2011	2012.02	08/04/2011 03:53:21 PM Central Daylight Time	08/04/2011 02:12:17 PM Central Daylight Time	08/04/2011 02:11:42 PM Central Daylight Time		08/04/2011 04:24:56 PM Central Daylight Time	ESSENCE HEALTHCARE, INC.	Essence Healthcare	www.essencehealthcare.com	Essence Advantage (HMO)	01	01		1			H2610	011	0	2012	Columbia Metropolitan Area		2	784	2			2						www.essencehealthcare.com	www.essencehealthcare.com	www.essencehealthcare.com	(866)-597-9560		(314)-209-2700		(866)-597-9560		(314)-209-2700		(866)-597-9560		(314)-209-2700		(866)-597-9560		(314)-209-2700		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2610	803	0	1	01	01	H2610_803_0	8	1		04/26/2011	2012.02	04/26/2011 01:09:40 PM Central Daylight Time	07/11/2011 04:03:59 PM Central Daylight Time			07/15/2011 02:12:38 PM Central Daylight Time	ESSENCE HEALTHCARE, INC.	Essence Healthcare	www.essencehealthcare.com	Essence Advantage Employer Group Plan (HMO)	01	01		1			H2610	803	0	2012	St. Louis Metropolitan Area		1	10	2			2						www.essencehealthcare.com	www.essencehealthcare.com	www.essencehealthcare.com	(866)-597-9560		(314)-209-2700		(866)-597-9560		(314)-209-2700		(866)-597-9560		(314)-209-2700		(866)-597-9560		(314)-209-2700		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H2610	804	0	1	01	01	H2610_804_0	8	1		04/26/2011	2012.02	04/26/2011 01:19:30 PM Central Daylight Time	07/11/2011 03:52:24 PM Central Daylight Time			07/15/2011 02:12:38 PM Central Daylight Time	ESSENCE HEALTHCARE, INC.	Essence Healthcare	www.essencehealthcare.com	Essence Advantage Employer Group Plan non-calendar (HMO)	01	01		1			H2610	804	0	2012	St. Louis Metropolitan Area		1	10	2			2						www.essencehealthcare.com	www.essencehealthcare.com	www.essencehealthcare.com	(866)-597-9560		(314)-209-2700		(866)-597-9560		(314)-209-2700		(866)-597-9560		(314)-209-2700		(866)-597-9560		(314)-209-2700		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H2611	001	0	1	04	01	H2611_001_0	11	1		08/19/2011	2012.02	08/19/2011 01:35:47 PM Central Daylight Time	08/08/2011 12:15:02 PM Central Daylight Time	08/05/2011 07:39:14 AM Central Daylight Time		08/19/2011 02:06:23 PM Central Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.advantraplans.com	Advantra (PPO)	01	04		1			H2611	001	0	2012	St. Louis Metro		2	4173	2			2						www.mercyhealthplans.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/formulary/index.htm	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator/index.ht	(800)-919-6459		(314)-810-8300		(877)-886-7563		(877)-886-7563		(800)-919-6459		(314)-810-8300		(877)-886-7563		(877)-886-7563		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2611	008	0	1	04	01	H2611_008_0	11	1		08/19/2011	2012.02	08/19/2011 01:36:17 PM Central Daylight Time	08/08/2011 12:27:50 PM Central Daylight Time	08/05/2011 07:39:02 AM Central Daylight Time		08/19/2011 02:06:23 PM Central Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.kc.chcadvantra.com	Advantra Premier Plus (PPO)	01	04		1			H2611	008	0	2012	NW and Central Arkansas		2		2			2						www.mercyhealthplans.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/formulary/index.htm	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator/index.ht	(866)-875-0189		(866)-875-0189		(800)-330-8449		(417)-837-0200		(866)-875-0189		(866)-875-0189		(800)-330-8449		(417)-837-0200		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2611	018	0	1	04	01	H2611_018_0	11	1		08/19/2011	2012.02	08/19/2011 01:36:48 PM Central Daylight Time	08/08/2011 03:31:56 PM Central Daylight Time	08/05/2011 07:38:50 AM Central Daylight Time		08/19/2011 02:06:23 PM Central Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.kc.chcadvantra.com	Mercy MedicareADVANTAGE (PPO)	01	04		1			H2611	018	0	2012	Southwest Missouri		2		2			2						www.mercyhealthplans.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/formulary/index.htm	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator/index.ht	(866)-875-0189		(417)-836-0429		(800)-330-8449		(417)-837-0200		(800)-481-4466		(417)-837-0266		(800)-330-8449		(417)-837-0200		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2611	807	0	1	04	01	H2611_807_0	3	1		05/20/2011	2012.02	05/20/2011 03:25:14 PM Central Daylight Time	07/22/2011 08:36:56 AM Central Daylight Time			07/27/2011 11:55:11 AM Central Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.advantraplans.com	Emp w Rx CY (PPO)	01	04		1			H2611	807	0	2012	Advantra for Empl (St. L Metro) Rx CY		1	100	2			2						www.mercyhealthplans.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/formulary/index.htm	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator/index.ht	(800)-919-6459		(314)-810-8300		(800)-919-6459		(314)-810-8300		(800)-919-6459		(314)-810-8300		(800)-919-6459		(314)-810-8300		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H2611	809	0	1	04	01	H2611_809_0	3	1		05/03/2011	2012.02	05/03/2011 02:35:38 PM Central Daylight Time	07/22/2011 08:38:30 AM Central Daylight Time			07/27/2011 11:55:11 AM Central Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.kc.chcadvantra.com	Mercy MedicareADVANTAGE for Emp RX CY (PPO)	01	04		1			H2611	809	0	2012	Southwest Missouri		1		2			2						www.mercyhealthplans.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/formulary/index.htm	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator/index.ht	(866)-875-0189		(417)-836-0429		(800)-330-8449		(417)-837-0200		(866)-875-0189		(417)-836-0429		(800)-330-8449		(417)-837-0200		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H2643	001	0	1	01	01	H2643_001_0	7	1	2	08/11/2011	2012.02	08/11/2011 04:39:04 PM Eastern Daylight Time	08/11/2011 04:27:29 PM Eastern Daylight Time	08/04/2011 02:55:48 PM Eastern Daylight Time		08/11/2011 04:39:45 PM Eastern Daylight Time	L. A. CARE HEALTH PLAN	L.A. Care Health Plan Medicare Advantage	www.lacare.org	L.A. Care Health Plan Medicare Advantage (HMO SNP)	01	01		1			H2643	001	0	2012	Los Angeles County		2	2000	2			1	3		1	5		www.lacare.org	www.lacare.org	www.lacare.org	(888)-522-1298		(888)-522-1298		(888)-439-5123		(888)-439-5123		(888)-522-1298		(888)-522-1298		(888)-439-5123		(888)-439-5123		(866)-522-2731		(866)-522-2731		(866)-522-2731		(866)-522-2731		(866)-522-2731		(866)-522-2731		(866)-522-2731		(866)-522-2731		2	2	2
H2649	004	0	1	01	01	H2649_004_0	5	1		08/08/2011	2012.02	08/08/2011 11:50:26 AM Eastern Daylight Time	08/05/2011 05:39:41 PM Eastern Daylight Time	08/04/2011 12:03:22 PM Eastern Daylight Time		08/08/2011 04:32:56 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H2649-004 (HMO)	01	01		1			H2649	004	0	2012	Kansas City Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2649	012	0	1	01	01	H2649_012_0	3	1		07/05/2011	2012.02	07/05/2011 12:12:56 PM Eastern Daylight Time	06/01/2011 01:29:47 PM Eastern Daylight Time			07/07/2011 03:53:53 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H2649-012 (HMO)	01	01		1			H2649	012	0	2012	Kansas City Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H2649	020	0	1	01	01	H2649_020_0	5	1		08/08/2011	2012.02	08/08/2011 11:50:40 AM Eastern Daylight Time	08/05/2011 05:38:29 PM Eastern Daylight Time	08/04/2011 12:03:41 PM Eastern Daylight Time		08/08/2011 04:32:56 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H2649-020 (HMO)	01	01		1			H2649	020	0	2012	Southwest Missouri area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2649	021	0	1	02	01	H2649_021_0	5	1		08/08/2011	2012.02	08/08/2011 11:50:48 AM Eastern Daylight Time	08/05/2011 05:39:29 PM Eastern Daylight Time	08/04/2011 12:04:00 PM Eastern Daylight Time		08/08/2011 04:32:56 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H2649-021 (HMO-POS)	01	02		1			H2649	021	0	2012	Wichita area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2649	022	0	1	01	01	H2649_022_0	6	1		08/08/2011	2012.02	08/08/2011 11:50:56 AM Eastern Daylight Time	08/05/2011 05:38:54 PM Eastern Daylight Time	08/04/2011 12:04:20 PM Eastern Daylight Time		08/08/2011 04:32:56 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H2649-022 (HMO)	01	01		1			H2649	022	0	2012	Mid-Missouri area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2649	023	0	1	01	01	H2649_023_0	5	1		08/08/2011	2012.02	08/08/2011 11:51:04 AM Eastern Daylight Time	08/05/2011 05:38:42 PM Eastern Daylight Time	08/04/2011 12:04:38 PM Eastern Daylight Time		08/08/2011 04:32:56 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H2649-023 (HMO)	01	01		1			H2649	023	0	2012	St. Louis Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2649	024	0	1	01	01	H2649_024_0	5	1		08/08/2011	2012.02	08/08/2011 11:51:32 AM Eastern Daylight Time	08/05/2011 05:39:18 PM Eastern Daylight Time	08/04/2011 12:04:59 PM Eastern Daylight Time		08/08/2011 04:32:56 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Reader's Digest Healthy Living Plan (HMO)	01	01		1			H2649	024	0	2012	Kansas City Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2649	801	0	1	01	01	H2649_801_0	2	1		07/06/2011	2012.02	07/06/2011 10:55:19 AM Eastern Daylight Time	05/27/2011 03:16:11 PM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H2649	801	0	2012	Select counties in Kansas City metro area		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H2649	802	0	1	01	01	H2649_802_0	2	1		07/06/2011	2012.02	07/06/2011 10:55:25 AM Eastern Daylight Time	05/28/2011 02:27:34 PM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H2649	802	0	2012	Select counties in Kansas City metro area		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
H2649	803	0	1	01	01	H2649_803_0	2	1		07/06/2011	2012.02	07/06/2011 10:55:29 AM Eastern Daylight Time	05/27/2011 03:59:24 PM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Employer Sponsored Non-CY (HMO)	01	01		1			H2649	803	0	2012	Select counties in Kansas City metro area		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H2654	004	0	1	01	01	H2654_004_0	4	1		08/08/2011	2012.02	08/08/2011 09:34:30 AM Central Daylight Time	08/08/2011 01:03:27 PM Central Daylight Time	08/05/2011 01:26:34 PM Central Daylight Time		08/09/2011 12:05:43 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDWEST, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H2654	004	0	2012	Select counties in Illinois and Missouri		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2654	010	0	1	02	01	H2654_010_0	5	1		08/04/2011	2012.02	08/04/2011 07:16:29 PM Central Daylight Time	08/05/2011 08:47:58 AM Central Daylight Time	08/05/2011 01:26:48 PM Central Daylight Time		08/09/2011 12:05:43 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDWEST, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H2654	010	0	2012	Springfield, Missouri Area		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2654	013	0	1	02	01	H2654_013_0	4	1		08/05/2011	2012.02	08/05/2011 04:37:47 PM Central Daylight Time	08/08/2011 01:05:09 PM Central Daylight Time	08/05/2011 01:27:04 PM Central Daylight Time		08/09/2011 12:05:43 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDWEST, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus Plan 1 (HMO-POS)	01	02		1			H2654	013	0	2012	Select counties in Illinois and Missouri		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2654	020	0	1	01	01	H2654_020_0	3	1		07/20/2011	2012.02	07/20/2011 12:08:20 PM Central Daylight Time	07/22/2011 01:40:34 PM Central Daylight Time			07/22/2011 04:26:18 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDWEST, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Essential (HMO)	01	01		1			H2654	020	0	2012	Select counties in Illinois and Missouri		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514										(711)		(711)		(711)		(711)										2	2	2
H2654	024	0	1	01	01	H2654_024_0	3	1	2	07/22/2011	2012.02	07/22/2011 11:56:49 AM Central Daylight Time	08/05/2011 08:50:20 AM Central Daylight Time	08/05/2011 01:00:59 PM Central Daylight Time		08/09/2011 12:16:18 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDWEST, INC.	SecureHorizons by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H2654	024	0	2012	St. Louis, MO area		2		2			1	3		1	2		www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2654	029	0	1	02	01	H2654_029_0	4	1		08/05/2011	2012.02	08/05/2011 04:37:03 PM Central Daylight Time	08/08/2011 01:07:15 PM Central Daylight Time	08/05/2011 01:27:19 PM Central Daylight Time		08/09/2011 12:16:18 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDWEST, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H2654	029	0	2012	Select counties in Illinois and Missouri		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2654	031	0	1	01	01	H2654_031_0	4	1	2	07/22/2011	2012.02	07/22/2011 11:57:33 AM Central Daylight Time	08/05/2011 08:52:45 AM Central Daylight Time	08/05/2011 01:27:34 PM Central Daylight Time		08/09/2011 12:16:18 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDWEST, INC.	SecureHorizons by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H2654	031	0	2012	Madison, Monroe and St. Clair counties		2		2			1	3		1	2		www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2654	801	0	1	01	01	H2654_801_0	2	1		07/06/2011	2012.02	07/06/2011 04:43:45 PM Central Daylight Time	06/03/2011 02:24:24 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDWEST, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H2654	801	0	2012	St Louis Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2654	802	0	1	01	01	H2654_802_0	2	1		07/06/2011	2012.02	07/06/2011 04:43:49 PM Central Daylight Time	06/03/2011 02:25:32 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDWEST, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H2654	802	0	2012	St Louis Area Counties		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548										(711)		(711)		(711)		(711)										2	2	2
H2654	803	0	1	01	01	H2654_803_0	2	1		07/06/2011	2012.02	07/06/2011 04:43:54 PM Central Daylight Time	06/03/2011 02:26:43 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDWEST, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H2654	803	0	2012	Springfield Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2654	804	0	1	01	01	H2654_804_0	2	1		07/06/2011	2012.02	07/06/2011 04:43:58 PM Central Daylight Time	06/03/2011 02:27:52 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDWEST, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H2654	804	0	2012	Springfield Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548										(711)		(711)		(711)		(711)										2	2	2
H2654	805	0	1	01	01	H2654_805_0	2	1		07/06/2011	2012.02	07/06/2011 04:44:03 PM Central Daylight Time	06/03/2011 02:29:02 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDWEST, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H2654	805	0	2012	St. Louis Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2654	807	0	1	01	01	H2654_807_0	2	1		07/06/2011	2012.02	07/06/2011 04:44:11 PM Central Daylight Time	06/03/2011 02:30:16 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDWEST, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H2654	807	0	2012	Springfield Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2663	002	0	1	02	01	H2663_002_0	9	1		08/09/2011	2012.02	08/09/2011 01:23:19 PM Central Daylight Time	08/08/2011 11:23:27 AM Central Daylight Time	08/08/2011 04:19:06 PM Central Daylight Time		08/09/2011 01:36:28 PM Central Daylight Time	GROUP HEALTH PLAN, INC.	Group Health Plan, Inc.	www.advantraplans.com	Advantra Option 2 (HMO-POS)	01	02		1			H2663	002	0	2012	St. Louis MO Metro Area		2	4527	2			2						www.ghpmedicare.com	www.ghpmedicare.com	www.ghpmedicare.com	(800)-533-0367		(800)-533-0367		(800)-533-0362		(800)-533-0362		(800)-533-0367		(800)-533-0367		(800)-533-0362		(800)-533-0362		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2663	005	0	1	01	01	H2663_005_0	6	1		08/09/2011	2012.02	08/09/2011 01:23:47 PM Central Daylight Time	08/08/2011 04:20:59 PM Central Daylight Time	08/08/2011 04:19:10 PM Central Daylight Time		08/09/2011 01:36:28 PM Central Daylight Time	GROUP HEALTH PLAN, INC.	Group Health Plan, Inc.	www.advantraplans.com	Gold Advantage Option 1 (HMO)	01	01		1			H2663	005	0	2012	St. Louis MO Metro Area		2	10821	2			2						www.ghpmedicare.com	www.ghpmedicare.com	www.ghpmedicare.com	(800)-533-0367		(800)-533-0367		(800)-533-0362		(800)-533-0362		(800)-533-0367		(800)-533-0367		(800)-533-0362		(800)-533-0362		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2663	006	0	1	01	01	H2663_006_0	6	1		08/09/2011	2012.02	08/09/2011 01:24:29 PM Central Daylight Time	08/08/2011 04:04:30 PM Central Daylight Time	08/08/2011 04:19:14 PM Central Daylight Time		08/09/2011 01:36:28 PM Central Daylight Time	GROUP HEALTH PLAN, INC.	Group Health Plan, Inc.	www.advantraplans.com	Advantra Option 1 (HMO)	01	01		1			H2663	006	0	2012	St. Louis MO Metro Area		2	4739	2			2						www.ghpmedicare.com	www.ghpmedicare.com	www.ghpmedicare.com	(800)-533-0367		(800)-533-0367		(800)-533-0362		(800)-533-0362		(800)-533-0367		(800)-533-0367		(800)-533-0362		(800)-533-0362		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2663	802	0	1	01	01	H2663_802_0	2	1		06/01/2011	2012.02	06/01/2011 03:04:53 PM Central Daylight Time	07/27/2011 11:32:29 AM Central Daylight Time			07/28/2011 08:07:02 AM Central Daylight Time	GROUP HEALTH PLAN, INC.	Group Health Plan, Inc.	www.advantraplans.com	Employer Group Calendar Rx (HMO)	01	01		1			H2663	802	0	2012	St. Louis MO Metro Area - Employer Group		1	3779	2			2						www.ghpmedicare.com	www.ghpmedicare.com	www.ghpmedicare.com	(800)-533-0367		(800)-533-0367		(800)-533-0362		(800)-533-0362		(800)-533-0367		(800)-533-0367		(800)-533-0362		(800)-533-0362		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H2663	804	0	1	01	01	H2663_804_0	2	1		06/01/2011	2012.02	06/01/2011 03:05:11 PM Central Daylight Time	07/28/2011 07:58:06 AM Central Daylight Time			07/28/2011 08:07:02 AM Central Daylight Time	GROUP HEALTH PLAN, INC.	Group Health Plan, Inc.	www.advantraplans.com	Employer Group Non Calendar Rx (HMO)	01	01		1			H2663	804	0	2012	St. Louis MO Metro Area - Employer Group		1	334	2			2						www.ghpmedicare.com	www.ghpmedicare.com	www.ghpmedicare.com	(800)-533-0367		(800)-533-0367		(800)-533-0362		(800)-533-0362		(800)-533-0367		(800)-533-0367		(800)-533-0362		(800)-533-0362		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H2663	805	0	1	01	01	H2663_805_0	2	1		06/01/2011	2012.02	06/01/2011 03:05:35 PM Central Daylight Time	07/27/2011 11:46:30 AM Central Daylight Time			07/28/2011 08:07:02 AM Central Daylight Time	GROUP HEALTH PLAN, INC.	Group Health Plan, Inc.	www.advantraplans.com	Employer Group Calendar No Rx (HMO)	01	01		1			H2663	805	0	2012	St. Louis MO Metro Area - Employer Group		1	72	2			2						www.ghpmedicare.com	www.ghpmedicare.com	www.ghpmedicare.com	(800)-533-0367		(800)-533-0367		(800)-533-0362		(800)-533-0362										(711)		(711)		(711)		(711)										1	1	1
H2667	001	0	1	01	01	H2667_001_0	9	1		08/19/2011	2012.02	08/19/2011 01:37:21 PM Central Daylight Time	08/18/2011 07:37:30 AM Central Daylight Time	08/05/2011 07:38:38 AM Central Daylight Time		08/19/2011 02:06:23 PM Central Daylight Time	GROUP HEALTH PLAN, INC.	Coventry Health Care	www.kc.chcadvantra.com	Mercy MedicareADVANTAGE (HMO)	01	01		1			H2667	001	0	2012	Southwest MO		2		2			2						www.mercyhealthplans.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/formulary/index.htm	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator/index.ht	(800)-481-4466		(417)-837-0266		(800)-330-8449		(417)-837-0200		(800)-481-4466		(417)-837-0266		(800)-330-8449		(417)-837-0200		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2667	003	0	1	01	01	H2667_003_0	8	1		08/19/2011	2012.02	08/19/2011 01:37:48 PM Central Daylight Time	08/08/2011 01:54:46 PM Central Daylight Time	08/05/2011 07:38:24 AM Central Daylight Time		08/19/2011 02:06:23 PM Central Daylight Time	GROUP HEALTH PLAN, INC.	Coventry Health Care	www.advantraplans.com	Gold Advantage Option II (HMO)	01	01		1			H2667	003	0	2012	St. Louis Metro		2	2848	2			2						www.mercyhealthplans.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/formulary/index.htm	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator/index.ht	(800)-280-1602		(314)-214-8040		(877)-886-7563		(877)-886-7563		(800)-280-1602		(314)-214-8040		(877)-886-7563		(877)-886-7563		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2667	012	0	1	01	01	H2667_012_0	3	1		07/18/2011	2012.02	07/18/2011 09:40:55 AM Central Daylight Time	07/22/2011 08:44:36 AM Central Daylight Time			07/27/2011 11:55:11 AM Central Daylight Time	GROUP HEALTH PLAN, INC.	Coventry Health Care	www.kc.chcadvantra.com	Mercy MedicareADVANTAGE (no drug) (HMO)	01	01		1			H2667	012	0	2012	Southwest Missouri		2		2			2						www.mercyhealthplans.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/formulary/index.htm	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator/index.ht	(800)-481-4466		(417)-837-0266		(800)-481-4466		(417)-837-0266										(711)		(711)		(800)-446-1468		(417)-837-0249										2	2	2
H2667	016	0	1	02	01	H2667_016_0	8	1		08/19/2011	2012.02	08/19/2011 01:38:18 PM Central Daylight Time	08/08/2011 02:46:00 PM Central Daylight Time	08/08/2011 03:35:40 PM Central Daylight Time		08/19/2011 02:06:23 PM Central Daylight Time	GROUP HEALTH PLAN, INC.	Coventry Health Care	www.advantraplans.com	Coventry Total Care (HMO-POS)	01	02		1			H2667	016	0	2012	St. Louis Metro		2	750	2			2						www.mercyhealthplans.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/formulary/index.htm	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator/index.ht	(800)-280-1602		(314)-214-8040		(877)-886-7563		(877)-886-7563		(800)-280-1602		(314)-214-8040		(877)-886-7563		(877)-886-7563		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2667	017	0	1	02	01	H2667_017_0	6	1		08/19/2011	2012.02	08/19/2011 01:38:50 PM Central Daylight Time	08/08/2011 02:17:08 PM Central Daylight Time	08/04/2011 09:15:40 AM Central Daylight Time		08/19/2011 02:06:23 PM Central Daylight Time	GROUP HEALTH PLAN, INC.	Coventry Health Care	www.kc.chcadvantra.com	Mercy MedicareADVANTAGE (HMO-POS)	01	02		1			H2667	017	0	2012	Southwest Missouri		2	750	2			2						www.mercyhealthplans.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/formulary/index.htm	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator/index.ht	(800)-481-4466		(417)-837-0266		(800)-330-8449		(417)-837-0200		(800)-481-4466		(417)-837-0266		(800)-330-8449		(417)-837-0200		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2667	803	0	1	01	01	H2667_803_0	3	1		05/03/2011	2012.02	05/03/2011 02:37:32 PM Central Daylight Time	07/22/2011 03:57:12 PM Central Daylight Time			07/27/2011 11:55:11 AM Central Daylight Time	GROUP HEALTH PLAN, INC.	Coventry Health Care	www.kc.chcadvantra.com	Mercy MedicareADVANTAGE for Employers (HMO)	01	01		1			H2667	803	0	2012	Southwest Missouri		1		2			2						www.mercyhealthplans.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/formulary/index.htm	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator/index.ht	(800)-481-4466		(417)-837-0266		(800)-330-8449		(417)-836-0200		(800)-481-4466		(417)-837-0266		(800)-330-8449		(417)-836-0200		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H2667	807	0	1	01	01	H2667_807_0	3	1		05/03/2011	2012.02	05/03/2011 02:38:41 PM Central Daylight Time	07/22/2011 04:00:02 PM Central Daylight Time			07/27/2011 11:55:11 AM Central Daylight Time	GROUP HEALTH PLAN, INC.	Coventry Health Care	www.kc.chcadvantra.com	Mercy MedicareADVANTAGE for Employers RX CY (HMO)	01	01		1			H2667	807	0	2012	Southwest Missouri		1		2			2						www.mercyhealthplans.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/formulary/index.htm	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator/index.ht	(800)-481-4466		(417)-837-0266		(800)-330-8449		(417)-836-0200		(800)-481-4466		(417)-837-0266		(800)-330-8449		(417)-836-0200		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H2667	808	0	1	01	01	H2667_808_0	3	1		05/03/2011	2012.02	05/03/2011 02:39:49 PM Central Daylight Time	07/22/2011 04:01:10 PM Central Daylight Time			07/27/2011 11:55:11 AM Central Daylight Time	GROUP HEALTH PLAN, INC.	Coventry Health Care	www.mercyhealthplans.com	Mercy MedicareADVANTAGE for Emp no RX CY (HMO)	01	01		1			H2667	808	0	2012	Southwest Missouri		1		2			2						www.mercyhealthplans.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/formulary/index.htm	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator/index.ht	(800)-481-4466		(417)-837-0266		(800)-330-8449		(417)-836-0200										(711)		(711)		(711)		(711)										1	1	1
H2667	809	0	1	01	01	H2667_809_0	3	1		07/08/2011	2012.02	07/08/2011 11:21:47 AM Central Daylight Time	07/22/2011 09:23:06 AM Central Daylight Time			07/27/2011 11:55:11 AM Central Daylight Time	GROUP HEALTH PLAN, INC.	Coventry Health Care	www.advantraplans.com	Employers RX CY (HMO)	01	01		1			H2667	809	0	2012	St. Louis Metro		1	100	2			2						www.mercyhealthplans.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/formulary/index.htm	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator/index.ht	(800)-280-1602		(314)-214-8040		(800)-280-1602		(314)-214-8040		(800)-280-1602		(314)-214-8040		(800)-280-1602		(314)-214-8040		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H2667	810	0	1	01	01	H2667_810_0	3	1		05/20/2011	2012.02	05/20/2011 03:24:38 PM Central Daylight Time	07/22/2011 09:24:20 AM Central Daylight Time			07/27/2011 11:55:11 AM Central Daylight Time	GROUP HEALTH PLAN, INC.	Coventry Health Care	www.advantraplans.com	Employer Group CY (HMO)	01	01		1			H2667	810	0	2012	St. Louis Metro		1	100	2			2						www.mercyhealthplans.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/formulary/index.htm	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator/index.ht	(800)-280-1602		(314)-214-8040		(800)-280-1602		(314)-214-8040										(711)		(711)		(711)		(711)										1	1	1
H2672	001	0	1	01	01	H2672_001_0	8	1		08/09/2011	2012.02	08/09/2011 01:17:48 PM Central Daylight Time	08/08/2011 03:47:06 PM Central Daylight Time	08/04/2011 09:21:32 AM Central Daylight Time		08/09/2011 01:28:19 PM Central Daylight Time	COVENTRY HEALTH CARE OF KANSAS, INC.	COVENTRY HEALTH CARE	www.kc.chcadvantra.com	Advantra Advantage (HMO)	01	01		1			H2672	001	0	2012	Kansas City Metro Area		2		2			2						www.ProviderDirectory.coventry-medicare.com	www.KSFormulary.coventry-medicare.com	www.kc.chcadvantra.com	(800)-727-9712		(800)-727-9712		(877)-886-7566		(877)-886-7566		(866)-505-6162		(866)-505-6162		(877)-886-7566		(877)-886-7566		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2672	008	0	1	01	01	H2672_008_0	9	1		08/09/2011	2012.02	08/09/2011 01:22:56 PM Central Daylight Time	08/08/2011 03:49:20 PM Central Daylight Time	08/04/2011 09:29:00 AM Central Daylight Time		08/09/2011 01:28:19 PM Central Daylight Time	COVENTRY HEALTH CARE OF KANSAS, INC.	COVENTRY HEALTH CARE	www.kc.chcadvantra.com	Advantra Advantage (HMO)	01	01		1			H2672	008	0	2012	Wyandotte County		2		2			2						www.ProviderDirectory.coventry-medicare.com	www.KSFormulary.coventry-medicare.com	www.kc.chcadvantra.com	(800)-727-9712		(800)-727-9712		(877)-886-7566		(877)-886-7566		(866)-505-6162		(866)-505-6162		(877)-886-7566		(877)-886-7566		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2672	009	0	1	01	01	H2672_009_0	9	1		08/09/2011	2012.02	08/09/2011 01:20:20 PM Central Daylight Time	08/08/2011 09:39:52 AM Central Daylight Time	08/04/2011 09:37:20 AM Central Daylight Time		08/09/2011 01:28:19 PM Central Daylight Time	COVENTRY HEALTH CARE OF KANSAS, INC.	COVENTRY HEALTH CARE	www.kc.chcadvantra.com	Advantra Total Care (HMO)	01	01		1			H2672	009	0	2012	Sedgwick County		2		2			2						www.ProviderDirectory.coventry-medicare.com	www.KSFormulary.coventry-medicare.com	www.kc.chcadvantra.com	(800)-727-9712		(800)-727-9712		(877)-886-7566		(877)-886-7566		(866)-505-6162		(866)-505-6162		(877)-886-7566		(877)-886-7566		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2672	010	0	1	01	01	H2672_010_0	10	1		08/09/2011	2012.02	08/09/2011 01:20:30 PM Central Daylight Time	08/08/2011 09:50:50 AM Central Daylight Time	08/04/2011 09:43:42 AM Central Daylight Time		08/09/2011 01:28:19 PM Central Daylight Time	COVENTRY HEALTH CARE OF KANSAS, INC.	COVENTRY HEALTH CARE	www.kc.chcadvantra.com	Advantra Total Care (HMO)	01	01		1			H2672	010	0	2012	NW Arkansas		2		2			2						www.ProviderDirectory.coventry-medicare.com	www.KSFormulary.coventry-medicare.com	www.kc.chcadvantra.com	(800)-727-9712		(800)-727-9712		(877)-886-7566		(877)-886-7566		(866)-505-6162		(866)-505-6162		(877)-886-7566		(877)-886-7566		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2672	801	0	1	01	01	H2672_801_0	3	1		06/01/2011	2012.02	06/01/2011 10:23:56 AM Central Daylight Time	07/22/2011 10:19:50 AM Central Daylight Time			07/27/2011 02:31:26 PM Central Daylight Time	COVENTRY HEALTH CARE OF KANSAS, INC.	COVENTRY HEALTH CARE	www.kc.chcadvantra.com	Advantra Employer Group (HMO)	01	01		1			H2672	801	0	2012	Arkansas, Kansas, Missouri		1		2			2						www.ProviderDirectory.coventry-medicare.com	www.KSFormulary.coventry-medicare.com	www.kc.chcadvantra.com	(800)-727-9712		(800)-727-9712		(877)-886-7566		(877)-886-7566		(866)-505-6162		(866)-505-6162		(877)-886-7566		(877)-886-7566		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H2672	802	0	1	01	01	H2672_802_0	3	1		06/01/2011	2012.02	06/01/2011 10:24:08 AM Central Daylight Time	07/22/2011 10:21:30 AM Central Daylight Time			07/27/2011 02:31:26 PM Central Daylight Time	COVENTRY HEALTH CARE OF KANSAS, INC.	COVENTRY HEALTH CARE	www.kc.chcadvantra.com	Advantra Employer Group (HMO)	01	01		1			H2672	802	0	2012	Arkansas, Kansas, Missouri		1		2			2						www.ProviderDirectory.coventry-medicare.com	www.KSFormulary.coventry-medicare.com	www.kc.chcadvantra.com	(800)-727-9712		(800)-727-9712		(877)-886-7566		(877)-886-7566		(866)-505-6162		(866)-505-6162		(877)-886-7566		(877)-886-7566		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H2672	803	0	1	01	01	H2672_803_0	2	1		06/01/2011	2012.02	06/01/2011 10:24:16 AM Central Daylight Time	07/22/2011 10:23:24 AM Central Daylight Time			07/27/2011 02:31:26 PM Central Daylight Time	COVENTRY HEALTH CARE OF KANSAS, INC.	COVENTRY HEALTH CARE	www.kc.chcadvantra.com	Advantra Employer Group (HMO)	01	01		1			H2672	803	0	2012	Arkansas, Kansas, Missouri		1		2			2						www.ProviderDirectory.coventry-medicare.com	www.KSFormulary.coventry-medicare.com	www.kc.chcadvantra.com	(800)-727-9712		(800)-727-9712		(877)-886-7566		(877)-886-7566										(711)		(711)		(711)		(711)										1	1	1
H2699	001	0	1	20	08	H2699_001_0	1	1		05/23/2011	2012.01	05/23/2011 11:36:33 AM Eastern Daylight Time		05/20/2011 03:41:10 PM Eastern Daylight Time		05/23/2011 11:38:42 AM Eastern Daylight Time	LIFE AT HOME, LLC	Life at Home, LLC	www.genesishcc.com	Life at Home LLC (PACE)	08	20		1			H2699	001	0	2012	Chester and Delaware Counties, PA		2		2			2							www.genesishcc.com	www.genesishcc.com									(888)-843-0443		(610)-461-3593		(888)-843-0443		(610)-461-3593										(800)-855-2880		(800)-654-5984		(800)-855-2880		(800)-654-5984				
H2699	002	0	1	20	08	H2699_002_0	1	1		05/23/2011	2012.01	05/23/2011 11:36:52 AM Eastern Daylight Time		05/20/2011 03:41:10 PM Eastern Daylight Time		05/23/2011 11:38:42 AM Eastern Daylight Time	LIFE AT HOME, LLC	Life at Home, LLC	www.genesishcc.com	Life at Home LLC (PACE)	08	20		1			H2699	002	0	2012	Delaware and Chester Counties, PA		2		2			2							www.genesishcc.com	www.genesishcc.com									(888)-843-0443		(610)-461-3593		(888)-843-0443		(610)-461-3593										(800)-855-2880		(800)-654-5984		(800)-855-2880		(800)-654-5984				
H2701	001	0	1	04	01	H2701_001_0	10	1		07/09/2011	2012.02	07/09/2011 04:41:15 PM Mountain Daylight Time	08/06/2011 08:05:45 AM Mountain Daylight Time	08/06/2011 08:05:46 AM Mountain Daylight Time		08/06/2011 08:06:50 AM Mountain Daylight Time	NEW WEST HEALTH SERVICES	New West Health Services	www.newwesthealth.com	New West Medicare Enhanced (PPO)	01	04		1			H2701	001	0	2012	Selected Counties Montana		2	3997	2			2						www.newwesthealth.com	WWW.NEWWESTHEALTH.COM	WWW.EXPRESS-SCRIPTS.COM	(888)-873-8049		(406)-751-3375		(888)-873-8049		(406)-751-3375		(888)-873-8049		(406)-751-3375		(888)-873-8049		(406)-751-3375		(888)-290-3658		(406)-751-3365		(888)-290-3658		(406)-751-3365		(888)-290-3658		(406)-751-3365		(888)-290-3658		(406)-751-3365		2	2	2
H2701	003	0	1	04	01	H2701_003_0	9	1		07/09/2011	2012.02	07/09/2011 04:50:53 PM Mountain Daylight Time	08/06/2011 08:05:48 AM Mountain Daylight Time	08/06/2011 08:05:42 AM Mountain Daylight Time		08/06/2011 08:06:50 AM Mountain Daylight Time	NEW WEST HEALTH SERVICES	New West Health Services	www.newwesthealth.com	New West Medicare (PPO)	01	04		1			H2701	003	0	2012	Selected Counties Montana		2	6698	2			2						www.newwesthealth.com	WWW.NEWWESTHEALTH.COM	WWW.EXPRESS-SCRIPTS.COM	(888)-873-8049		(406)-751-3375		(888)-873-8049		(406)-751-3375		(888)-873-8049		(406)-751-3375		(888)-873-8049		(406)-751-3375		(888)-290-3658		(406)-751-3365		(888)-290-3658		(406)-751-3365		(888)-290-3658		(406)-751-3365		(888)-290-3658		(406)-751-3365		2	2	2
H2701	806	0	1	04	01	H2701_806_0	3	1		06/03/2011	2012.02	06/03/2011 04:18:13 PM Mountain Daylight Time	06/04/2011 11:08:03 AM Mountain Daylight Time			06/04/2011 12:39:39 PM Mountain Daylight Time	NEW WEST HEALTH SERVICES	New West Health Services	www.newwesthealth.com	New West Medicare Group Plus (PPO)	01	04		1			H2701	806	0	2012	National		1	37	2			2						www.newwesthealth.com	WWW.NEWWESTHEALTH.COM	WWW.EXPRESS-SCRIPTS.COM	(888)-873-8049		(406)-751-3375		(888)-873-8049		(406)-751-3375		(888)-873-8049		(406)-751-3375		(888)-873-8049		(406)-751-3375		(888)-290-3658		(406)-751-3365		(888)-290-3658		(406)-751-3365		(888)-290-3658		(406)-751-3365		(888)-290-3658		(406)-751-3365		1	1	1
H2701	807	0	1	04	01	H2701_807_0	3	1		06/03/2011	2012.02	06/03/2011 04:18:22 PM Mountain Daylight Time	06/04/2011 11:09:51 AM Mountain Daylight Time			06/04/2011 12:39:39 PM Mountain Daylight Time	NEW WEST HEALTH SERVICES	New West Health Services	www.newwesthealth.com	New West Medicare Group Plus (PPO)	01	04		1			H2701	807	0	2012	National		1	669	2			2						www.newwesthealth.com	WWW.NEWWESTHEALTH.COM	WWW.EXPRESS-SCRIPTS.COM	(888)-873-8049		(406)-751-3375		(888)-873-8049		(406)-751-3375		(888)-873-8049		(406)-751-3375		(888)-873-8049		(406)-751-3375		(888)-290-3658		(406)-751-3365		(888)-290-3658		(406)-751-3365		(888)-290-3658		(406)-751-3365		(888)-290-3658		(406)-751-3365		1	1	1
H2773	001	0	1	01	01	H2773_001_0	8	1		07/25/2011	2012.01	07/25/2011 04:15:01 PM Eastern Daylight Time	08/09/2011 06:02:40 PM Eastern Daylight Time	08/04/2011 04:57:59 PM Eastern Daylight Time		08/09/2011 06:20:44 PM Eastern Daylight Time	QUALITY HEALTH PLANS OF NEW YORK, INC.	QUALITY HEALTH PLANS	www.qualityhealthplans.com	Advantage Platinum NY (HMO)	01	01		1			H2773	001	0	2012	Nassau, Queens, Staten Island and Suffolk Counties		2	740	2			2						www.qualityhealthplans.com	http://www.qualityhealthplans.com/medicareformulary.html	http://www.qualityhealthplans.com/	(877)-233-7058		(631)-403-4265		(877)-233-7058		(631)-403-4265		(877)-233-7058		(631)-403-4265		(877)-233-7058		(631)-403-4265		(877)-681-4984		(877)-681-4984		(877)-681-4984		(877)-681-4984		(877)-681-4984		(877)-681-4984		(877)-681-4984		(877)-681-4984		2	2	2
H2773	002	0	1	01	01	H2773_002_0	7	1		07/25/2011	2012.01	07/25/2011 04:16:46 PM Eastern Daylight Time	08/09/2011 06:03:03 PM Eastern Daylight Time	08/04/2011 05:09:38 PM Eastern Daylight Time		08/09/2011 06:20:44 PM Eastern Daylight Time	QUALITY HEALTH PLANS OF NEW YORK, INC.	QUALITY HEALTH PLANS	www.qualityhealthplans.com	Advantage Silver NY (HMO)	01	01		1			H2773	002	0	2012	Nassau, Queens, Staten Island and Suffolk Counties		2	710	2			2						www.qualityhealthplans.com	http://www.qualityhealthplans.com/medicareformulary.html	http://www.qualityhealthplans.com/	(877)-233-7058		(631)-403-4265		(877)-233-7058		(631)-403-4265		(877)-233-7058		(631)-403-4265		(877)-233-7058		(631)-403-4265		(877)-681-4984		(877)-681-4984		(877)-681-4984		(877)-681-4984		(877)-681-4984		(877)-681-4984		(877)-681-4984		(877)-681-4984		2	2	2
H2773	003	0	1	01	01	H2773_003_0	7	1		07/25/2011	2012.01	07/25/2011 04:37:07 PM Eastern Daylight Time	08/09/2011 06:03:46 PM Eastern Daylight Time	08/04/2011 05:12:21 PM Eastern Daylight Time		08/09/2011 06:20:44 PM Eastern Daylight Time	QUALITY HEALTH PLANS OF NEW YORK, INC.	QUALITY HEALTH PLANS	www.qualityhealthplans.com	Advantage Health NY - SNP (HMO SNP)	01	01		1			H2773	003	0	2012	Nassau, Queens, Staten Island and Suffolk Counties		2	700	2			1	4		1		00000000000000000010	www.qualityhealthplans.com	http://www.qualityhealthplans.com/medicareformulary.html	http://www.qualityhealthplans.com/	(877)-233-7058		(631)-403-4265		(877)-233-7058		(631)-403-4265		(877)-233-7058		(631)-403-4265		(877)-233-7058		(631)-403-4265		(877)-681-4984		(877)-681-4984		(877)-681-4984		(877)-681-4984		(877)-681-4984		(877)-681-4984		(877)-681-4984		(877)-681-4984		2	2	2
H2773	004	0	1	01	01	H2773_004_0	8	1	2	08/11/2011	2012.01	08/11/2011 01:51:45 PM Eastern Daylight Time	08/11/2011 01:57:36 PM Eastern Daylight Time	08/04/2011 05:53:42 PM Eastern Daylight Time		08/11/2011 02:01:33 PM Eastern Daylight Time	QUALITY HEALTH PLANS OF NEW YORK, INC.	QUALITY HEALTH PLANS	www.qualityhealthplans.com	Advantage Value One NY - Dual (HMO SNP)	01	01		1			H2773	004	0	2012	Nassau, Queens, Staten Island and Suffolk Counties		2	750	2			1	3		1	5		www.qualityhealthplans.com	http://www.qualityhealthplans.com/medicareformulary.html	http://www.qualityhealthplans.com/	(877)-233-7058		(631)-403-4265		(877)-233-7058		(631)-403-4265		(877)-233-7058		(631)-403-4265		(877)-233-7058		(631)-403-4265		(877)-681-4984		(877)-681-4984		(877)-681-4984		(877)-681-4984		(877)-681-4984		(877)-681-4984		(877)-681-4984		(877)-681-4984		2	2	2
H2775	082	0	1	04	01	H2775_082_0	6	1		07/07/2011	2012.02	07/07/2011 04:10:21 PM Central Daylight Time	08/05/2011 03:09:06 PM Central Daylight Time	08/04/2011 10:31:50 AM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.TodaysOptionsPPO.com	Today's Options Advantage Plus 150A (PPO)	01	04		1			H2775	082	0	2012	Select counties in the Northeast		2	3957	2			2						www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		2	2	2
H2775	083	0	1	04	01	H2775_083_0	6	1		07/07/2011	2012.02	07/07/2011 03:32:34 PM Central Daylight Time	08/05/2011 03:14:46 PM Central Daylight Time	08/04/2011 10:30:26 AM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.TodaysOptionsPPO.com	Today's Options Advantage Plus 150A (PPO)	01	04		1			H2775	083	0	2012	Select counties in the Northeast		2	1360	2			2						www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		2	2	2
H2775	084	0	1	04	01	H2775_084_0	9	1		07/07/2011	2012.02	07/07/2011 03:33:00 PM Central Daylight Time	08/05/2011 03:19:29 PM Central Daylight Time	08/04/2011 01:02:58 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.TodaysOptionsPPO.com	Today's Options Advantage Plus 450G (PPO)	01	04		1			H2775	084	0	2012	Select counties in the Northeast		2	735	2			2						www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		2	2	2
H2775	085	0	1	04	01	H2775_085_0	5	1		07/07/2011	2012.02	07/07/2011 03:33:40 PM Central Daylight Time	08/05/2011 03:25:40 PM Central Daylight Time	08/04/2011 10:35:50 AM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.TodaysOptionsPPO.com	Today's Options Advantage Plus 150A (PPO)	01	04		1			H2775	085	0	2012	Select counties in the Northeast		2	245	2			2						www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		2	2	2
H2775	088	0	1	04	01	H2775_088_0	6	1		08/05/2011	2012.02	08/05/2011 11:29:12 AM Central Daylight Time	08/05/2011 03:33:14 PM Central Daylight Time	08/04/2011 12:32:24 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.TodaysOptionsPPO.com	Today's Options Advantage Plus 550B (PPO)	01	04		1			H2775	088	0	2012	Select counties in the Northeast		2	4038	2			2						www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		2	2	2
H2775	089	0	1	04	01	H2775_089_0	7	1		08/05/2011	2012.02	08/05/2011 11:31:55 AM Central Daylight Time	08/05/2011 03:38:04 PM Central Daylight Time	08/04/2011 12:29:42 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.TodaysOptionsPPO.com	Today's Options Advantage Plus 650B (PPO)	01	04		1			H2775	089	0	2012	Select counties in the Northeast		2	3416	2			2						www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		2	2	2
H2775	091	0	1	04	01	H2775_091_0	8	1		07/07/2011	2012.02	07/07/2011 03:34:52 PM Central Daylight Time	08/05/2011 03:44:41 PM Central Daylight Time	08/04/2011 01:10:08 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.TodaysOptionsPPO.com	Today's Options Advantage Plus 450I (PPO)	01	04		1			H2775	091	0	2012	Select counties in the Northeast		2	413	2			2						www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		2	2	2
H2775	094	0	1	04	01	H2775_094_0	2	1		07/07/2011	2012.02	07/07/2011 03:35:20 PM Central Daylight Time	06/05/2011 10:50:27 PM Central Daylight Time			07/08/2011 04:40:04 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.TodaysOptionsPPO.com	Today's Options Advantage 300 (PPO)	01	04		1			H2775	094	0	2012	Select counties in the Northeast		2	372	2			2						www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967										(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089										2	2	2
H2775	095	0	1	04	01	H2775_095_0	3	1		07/07/2011	2012.02	07/07/2011 03:35:41 PM Central Daylight Time	06/05/2011 10:50:45 PM Central Daylight Time			07/08/2011 04:40:04 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.TodaysOptionsPPO.com	Today's Options Advantage 400 (PPO)	01	04		1			H2775	095	0	2012	Select counties in the Northeast		2	1421	2			2						www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967										(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089										2	2	2
H2775	096	0	1	04	01	H2775_096_0	3	1		07/07/2011	2012.02	07/07/2011 03:36:03 PM Central Daylight Time	06/05/2011 10:51:04 PM Central Daylight Time			07/08/2011 04:40:04 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.TodaysOptionsPPO.com	Today's Options Advantage 400 (PPO)	01	04		1			H2775	096	0	2012	Select counties in the Northeast		2	77	2			2						www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967										(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089										2	2	2
H2775	097	0	1	04	01	H2775_097_0	3	1		07/07/2011	2012.02	07/07/2011 03:36:45 PM Central Daylight Time	06/05/2011 10:51:23 PM Central Daylight Time			07/08/2011 04:40:04 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.TodaysOptionsPPO.com	Today's Options Advantage 400 (PPO)	01	04		1			H2775	097	0	2012	Select counties in the Northeast		2	20	2			2						www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967										(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089										2	2	2
H2775	098	0	1	04	01	H2775_098_0	3	1		07/07/2011	2012.02	07/07/2011 03:38:56 PM Central Daylight Time	08/05/2011 10:21:50 AM Central Daylight Time	08/04/2011 10:33:38 AM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.TodaysOptionsPPO.com	Today's Options Advantage Plus 150A (PPO)	01	04		1			H2775	098	0	2012	Select counties in the Northeast		2	284	2			2						www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		2	2	2
H2775	801	0	1	04	01	H2775_801_0	2	1		05/26/2011	2012.02	05/26/2011 07:30:48 PM Central Daylight Time	06/05/2011 11:56:08 PM Central Daylight Time			06/06/2011 12:31:04 AM Central Daylight Time	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.TodaysOptionsPPO.com	Today's Options PPO - MA Group Plan (PPO)	01	04		1			H2775	801	0	2012	National		1	100	2			2						www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967										(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089										1	1	1
H2775	802	0	1	04	01	H2775_802_0	2	1		06/02/2011	2012.02	06/02/2011 10:48:15 AM Central Daylight Time	06/06/2011 12:01:55 AM Central Daylight Time			06/06/2011 12:31:04 AM Central Daylight Time	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.TodaysOptionsPPO.com	Today's Options PPO - MAPD Group Plan (PPO)	01	04		1			H2775	802	0	2012	National		1	100	2			2						www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		1	1	1
H2775	803	0	1	04	01	H2775_803_0	2	1		06/02/2011	2012.02	06/02/2011 10:48:43 AM Central Daylight Time	06/06/2011 12:14:38 AM Central Daylight Time			06/06/2011 12:31:04 AM Central Daylight Time	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.TodaysOptionsPPO.com	Today's Options PPO - MAPD Group Plan - NCY (PPO)	01	04		1			H2775	803	0	2012	National		1	100	2			2						www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	http://www.TodaysOptionsPPO.com	(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		1	1	1
H2802	001	0	1	01	01	H2802_001_0	6	1		08/08/2011	2012.02	08/08/2011 11:16:28 AM Central Daylight Time	08/04/2011 08:18:13 PM Central Daylight Time	08/05/2011 01:27:49 PM Central Daylight Time		08/09/2011 01:25:28 PM Central Daylight Time	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H2802	001	0	2012	Douglas and Pottawattamie Counties		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2803	001	0	1	02	01	H2803_001_0	7	1		08/09/2011	2012.02	08/09/2011 09:31:08 AM Central Daylight Time	08/04/2011 08:21:27 PM Central Daylight Time	08/05/2011 01:28:04 PM Central Daylight Time		08/09/2011 01:25:28 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus Plan 1 (HMO-POS)	01	02		1			H2803	001	0	2012	Douglas and Pottawattamie Counties		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2803	002	0	1	02	01	H2803_002_0	6	1		08/09/2011	2012.02	08/09/2011 09:31:28 AM Central Daylight Time	08/04/2011 08:22:02 PM Central Daylight Time	08/05/2011 01:28:19 PM Central Daylight Time		08/09/2011 01:25:28 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus Plan 1 (HMO-POS)	01	02		1			H2803	002	0	2012	Select rural counties in Nebraska and Iowa		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2803	010	0	1	02	01	H2803_010_0	6	1	2	07/22/2011	2012.02	07/22/2011 11:58:57 AM Central Daylight Time	08/04/2011 08:22:31 PM Central Daylight Time	08/05/2011 01:01:22 PM Central Daylight Time		08/09/2011 12:16:18 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Dual Complete (HMO-POS SNP)	01	02		1			H2803	010	0	2012	Omaha, NE and Council Bluffs, IA area		2		2			1	3		1	2		www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(866)-480-1086		(866)-480-1086		(888)-834-3721		(888)-834-3721		(866)-480-2064		(866)-480-2064		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2803	012	0	1	02	01	H2803_012_0	6	1	2	07/22/2011	2012.02	07/22/2011 12:01:30 PM Central Daylight Time	08/04/2011 08:23:01 PM Central Daylight Time	08/05/2011 01:01:43 PM Central Daylight Time		08/09/2011 12:16:18 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Dual Complete (HMO-POS SNP)	01	02		1			H2803	012	0	2012	Polk, Dallas and Warren Counties		2		2			1	3		1	2		www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(866)-480-1086		(866)-480-1086		(888)-834-3721		(888)-834-3721		(866)-480-1086		(866)-480-1086		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2803	801	0	1	02	01	H2803_801_0	3	1		07/06/2011	2012.02	07/06/2011 04:44:29 PM Central Daylight Time	06/05/2011 10:51:26 AM Central Daylight Time			07/21/2011 08:26:26 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO-POS)	01	02		1			H2803	801	0	2012	Select Counties in Nebraska and Iowa		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2810	001	0	1	04	01	H2810_001_0	10	1		08/09/2011	2012.02	08/09/2011 05:42:29 PM Pacific Daylight Time	07/22/2011 03:24:50 PM Pacific Daylight Time	08/08/2011 07:56:09 PM Pacific Daylight Time		08/09/2011 05:47:40 PM Pacific Daylight Time	GROUP HEALTH OPTIONS	Group Health Options, Inc.	www.ghc.org/medicare	Group Health Options Clear Care Prestige (PPO)	01	04		1			H2810	001	0	2012	All Counties Served by Group Health Options Inc.		2		2			2						http://www.ghc.org/provider/index.jhtml	www.ghc.org/health_plans/index.jhtml?reposid=/common/healthPlans/Medicare/aboutPartDFormulary.html	www.ghc.org	(888)-901-4600		(206)-901-4600		(800)-446-8882		(800)-446-8882		(888)-901-4600		(206)-901-4600		(800)-446-8882		(800)-446-8882		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		2	2	2
H2810	002	0	1	04	01	H2810_002_0	9	1		08/09/2011	2012.02	08/09/2011 05:43:11 PM Pacific Daylight Time	08/08/2011 07:55:59 PM Pacific Daylight Time	08/08/2011 07:55:50 PM Pacific Daylight Time		08/09/2011 05:47:40 PM Pacific Daylight Time	GROUP HEALTH OPTIONS	Group Health Options, Inc.	www.ghc.org/medicare	Group Health Options Clear Care Elite (PPO)	01	04		1			H2810	002	0	2012	All Counties Served by Group Health Options Inc.		2		2			2						http://www.ghc.org/provider/index.jhtml	www.ghc.org/health_plans/index.jhtml?reposid=/common/healthPlans/Medicare/aboutPartDFormulary.html	www.ghc.org	(888)-901-4600		(206)-901-4600		(800)-446-8882		(800)-446-8882		(888)-901-4600		(206)-901-4600		(800)-446-8882		(800)-446-8882		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		2	2	2
H2815	001	0	1	20	08	H2815_001_0	1	1		05/23/2011	2012.01	05/23/2011 11:19:30 AM Mountain Daylight Time		05/22/2011 02:53:00 PM Mountain Daylight Time		05/23/2011 02:02:55 PM Mountain Daylight Time	VOLUNTEERS OF AMERICA NATIONAL SERVICES	Senior CommUnity Care of Colorado	www.seniorcommunitycare.org	Senior CommUnity Care of Colorado (PACE)	08	20		1			H2815	001	0	2012	Senior CommUnity Care of Colorado		2		2			2							www.voa.org	www.voa.org									(888)-476-8120		(970)-252-0522		(888)-476-8120		(970)-252-0522										(970)-835-4072		(970)-252-0522		(970)-835-4072		(970)-252-0522				
H2815	002	0	1	20	08	H2815_002_0	1	1		05/23/2011	2012.01	05/23/2011 11:20:06 AM Mountain Daylight Time		05/22/2011 02:53:01 PM Mountain Daylight Time		05/23/2011 02:02:55 PM Mountain Daylight Time	VOLUNTEERS OF AMERICA NATIONAL SERVICES	Senior CommUnity Care of Colorado	www.seniorcommunitycare.org	Senior CommUnity Care of Colorado (PACE)	08	20		1			H2815	002	0	2012	Senior CommUnity Care of Colorado		2		2			2							www.voa.org	www.voa.org									(888)-476-8120		(970)-252-0522		(888)-476-8120		(970)-252-0522										(970)-835-4072		(970)-252-0522		(970)-835-4072		(970)-252-0522				
H2816	001	0	1	09	04	H2816_001_0	2	1		07/07/2011	2012.02	07/07/2011 10:45:08 AM Central Daylight Time	06/05/2011 10:52:00 PM Central Daylight Time			07/08/2011 04:40:04 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE  HEALTH INSUR CO OF NY	Universal American	www.TodaysOptions.com	Today's Options Premier 100 (PFFS)	04	09	1	1			H2816	001	0	2012	Select counties in the Northeast		2	412	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										2	2	2
H2816	002	0	1	09	04	H2816_002_0	2	1		07/06/2011	2012.02	07/06/2011 05:23:46 PM Central Daylight Time	06/05/2011 10:52:19 PM Central Daylight Time			07/08/2011 04:40:04 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE  HEALTH INSUR CO OF NY	Universal American	www.TodaysOptions.com	Today's Options Premier 100 (PFFS)	04	09	1	1			H2816	002	0	2012	Select counties in the Northeast		2	3461	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										2	2	2
H2816	007	0	1	09	04	H2816_007_0	4	1		07/06/2011	2012.02	07/06/2011 05:23:56 PM Central Daylight Time	07/15/2011 02:39:29 PM Central Daylight Time			07/18/2011 11:20:32 AM Central Daylight Time	AMERICAN PROGRESSIVE LIFE  HEALTH INSUR CO OF NY	Universal American	www.TodaysOptions.com	Today's Options Premier 300 (PFFS)	04	09	1	1			H2816	007	0	2012	Select counties in the Northeast		2	11783	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										2	2	2
H2816	008	0	1	09	04	H2816_008_0	4	1		07/13/2011	2012.02	07/13/2011 01:38:54 PM Central Daylight Time	06/05/2011 10:52:57 PM Central Daylight Time			07/14/2011 05:11:53 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE  HEALTH INSUR CO OF NY	Universal American	www.TodaysOptions.com	Today's Options Premier 400 (PFFS)	04	09	1	1			H2816	008	0	2012	Select counties in the Northeast		2	1334	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										2	2	2
H2816	009	0	1	09	04	H2816_009_0	4	1		07/13/2011	2012.02	07/13/2011 01:39:58 PM Central Daylight Time	06/05/2011 10:53:15 PM Central Daylight Time			07/14/2011 05:11:53 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE  HEALTH INSUR CO OF NY	Universal American	www.TodaysOptions.com	Today's Options Premier 400 (PFFS)	04	09	1	1			H2816	009	0	2012	Select counties in the Northeast		2	1747	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										2	2	2
H2816	010	0	1	09	04	H2816_010_0	5	1		07/13/2011	2012.02	07/13/2011 01:41:23 PM Central Daylight Time	07/15/2011 02:41:19 PM Central Daylight Time			07/18/2011 11:20:32 AM Central Daylight Time	AMERICAN PROGRESSIVE LIFE  HEALTH INSUR CO OF NY	Universal American	www.TodaysOptions.com	Today's Options Premier 400 (PFFS)	04	09	1	1			H2816	010	0	2012	Select counties in the Northeast		2	570	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										2	2	2
H2816	013	0	1	09	04	H2816_013_0	5	1		07/06/2011	2012.02	07/06/2011 05:24:11 PM Central Daylight Time	08/04/2011 05:24:36 PM Central Daylight Time	08/04/2011 11:38:40 AM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE  HEALTH INSUR CO OF NY	Universal American	www.TodaysOptions.com	Today's Options Premier Plus 150A (PFFS)	04	09	1	1			H2816	013	0	2012	Select counties in the Northeast		2	2531	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		2	2	2
H2816	014	0	1	09	04	H2816_014_0	4	1		07/06/2011	2012.02	07/06/2011 05:24:23 PM Central Daylight Time	08/04/2011 05:25:50 PM Central Daylight Time	08/04/2011 10:55:08 AM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE  HEALTH INSUR CO OF NY	Universal American	www.TodaysOptions.com	Today's Options Premier Plus 150A (PFFS)	04	09	1	1			H2816	014	0	2012	Select counties in the Northeast		2	960	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		2	2	2
H2816	019	0	1	09	04	H2816_019_0	6	1		07/06/2011	2012.02	07/06/2011 05:24:36 PM Central Daylight Time	08/04/2011 05:25:18 PM Central Daylight Time	08/04/2011 12:43:54 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE  HEALTH INSUR CO OF NY	Universal American	www.TodaysOptions.com	Today's Options Premier Plus 350B (PFFS)	04	09	1	1			H2816	019	0	2012	Select counties in the Northeast		2	710	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		2	2	2
H2816	020	0	1	09	04	H2816_020_0	6	1		07/13/2011	2012.02	07/13/2011 01:42:13 PM Central Daylight Time	08/04/2011 04:34:58 PM Central Daylight Time	08/04/2011 12:27:02 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE  HEALTH INSUR CO OF NY	Universal American	www.TodaysOptions.com	Today's Options Premier Plus 450B (PFFS)	04	09	1	1			H2816	020	0	2012	Select counties in the Northeast		2	660	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		2	2	2
H2816	021	0	1	09	04	H2816_021_0	8	1		07/13/2011	2012.02	07/13/2011 01:42:43 PM Central Daylight Time	08/04/2011 04:42:59 PM Central Daylight Time	08/04/2011 01:07:22 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE  HEALTH INSUR CO OF NY	Universal American	www.TodaysOptions.com	Today's Options Premier Plus 450H (PFFS)	04	09	1	1			H2816	021	0	2012	Select counties in the Northeast		2	532	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		2	2	2
H2816	022	0	1	09	04	H2816_022_0	9	1		07/13/2011	2012.02	07/13/2011 01:43:34 PM Central Daylight Time	08/04/2011 05:05:01 PM Central Daylight Time	08/04/2011 01:01:34 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE  HEALTH INSUR CO OF NY	Universal American	www.TodaysOptions.com	Today's Options Premier Plus 450G (PFFS)	04	09	1	1			H2816	022	0	2012	Select counties in the Northeast		2	298	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		2	2	2
H2816	025	0	1	09	04	H2816_025_0	2	1		07/06/2011	2012.02	07/06/2011 05:24:53 PM Central Daylight Time	06/05/2011 10:55:43 PM Central Daylight Time			07/08/2011 04:40:04 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE  HEALTH INSUR CO OF NY	Universal American	www.TodaysOptions.com	Today's Options Premier 100 (PFFS)	04	09	1	1			H2816	025	0	2012	Select counties in the Northeast		2	387	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										2	2	2
H2816	026	0	1	09	04	H2816_026_0	2	1		07/06/2011	2012.02	07/06/2011 05:25:05 PM Central Daylight Time	06/05/2011 10:56:03 PM Central Daylight Time			07/08/2011 04:40:04 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE  HEALTH INSUR CO OF NY	Universal American	www.TodaysOptions.com	Today's Options Premier 100 (PFFS)	04	09	1	1			H2816	026	0	2012	Select counties in the Northeast		2	387	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										2	2	2
H2816	027	0	1	09	04	H2816_027_0	3	1		07/06/2011	2012.02	07/06/2011 05:25:12 PM Central Daylight Time	08/04/2011 05:14:18 PM Central Daylight Time	08/04/2011 10:55:58 AM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE  HEALTH INSUR CO OF NY	Universal American	www.TodaysOptions.com	Today's Options Premier Plus 150A (PFFS)	04	09	1	1			H2816	027	0	2012	Select counties in the Northeast		2	114	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		2	2	2
H2816	028	0	1	09	04	H2816_028_0	3	1		07/15/2011	2012.02	07/15/2011 03:52:22 PM Central Daylight Time	08/04/2011 05:23:17 PM Central Daylight Time	08/04/2011 11:00:48 AM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE  HEALTH INSUR CO OF NY	Universal American	www.TodaysOptions.com	Today's Options Premier Plus 150A (PFFS)	04	09	1	1			H2816	028	0	2012	Select counties in the Northeast		2	114	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		2	2	2
H2816	801	0	1	09	04	H2816_801_0	2	1		06/03/2011	2012.02	06/03/2011 03:51:06 PM Central Daylight Time	06/05/2011 11:10:34 PM Central Daylight Time			06/06/2011 12:15:29 AM Central Daylight Time	AMERICAN PROGRESSIVE LIFE  HEALTH INSUR CO OF NY	Universal American	www.TodaysOptions.com	Today's Options PFFS - MA Group Plan (PFFS)	04	09	1	1			H2816	801	0	2012	National		1	100	2			2							www.todaysoptions.com	www.todaysoptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923										(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089										1	1	1
H2816	802	0	1	09	04	H2816_802_0	2	1		06/02/2011	2012.02	06/02/2011 01:37:34 PM Central Daylight Time	06/05/2011 11:06:25 PM Central Daylight Time			06/06/2011 12:15:29 AM Central Daylight Time	AMERICAN PROGRESSIVE LIFE  HEALTH INSUR CO OF NY	Universal American	www.TodaysOptions.com	Today's Options PFFS - MAPD Group Plan (PFFS)	04	09	1	1			H2816	802	0	2012	National		1	100	2			2							www.todaysoptions.com	www.todaysoptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		1	1	1
H2816	803	0	1	09	04	H2816_803_0	2	1		06/02/2011	2012.02	06/02/2011 01:38:04 PM Central Daylight Time	06/05/2011 11:19:53 PM Central Daylight Time			06/06/2011 12:15:29 AM Central Daylight Time	AMERICAN PROGRESSIVE LIFE  HEALTH INSUR CO OF NY	Universal American	www.TodaysOptions.com	Today's Options PFFS - MAPD Group Plan - NCY (PFFS)	04	09	1	1			H2816	803	0	2012	National		1	100	2			2							www.todaysoptions.com	www.todaysoptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		1	1	1
H2836	001	0	1	04	01	H2836_001_0	7	1		08/04/2011	2012.02	08/04/2011 03:59:22 PM Eastern Daylight Time	08/08/2011 06:21:39 PM Eastern Daylight Time	08/08/2011 06:22:19 PM Eastern Daylight Time		08/08/2011 06:27:58 PM Eastern Daylight Time	ANTHEM HEALTH PLANS, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem MediBlue Preferred Standard (PPO)	01	04		1			H2836	001	0	2012	All Counties in CT		2	1280	2			2						www.anthem.com/medicare	www.anthem.com	www.anthem.com	(866)-673-4157		(866)-673-4157		(800)-797-0984		(800)-797-0984		(866)-673-4157		(866)-673-4157		(800)-797-0984		(800)-797-0984		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		2	2	2
H2836	801	0	1	04	01	H2836_801_0	7	1		07/13/2011	2012.02	07/13/2011 01:42:34 PM Eastern Daylight Time	07/22/2011 11:57:46 AM Eastern Daylight Time			07/22/2011 01:57:05 PM Eastern Daylight Time	ANTHEM HEALTH PLANS, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem MediBlue Preferred (PPO)	01	04		1			H2836	801	0	2012	Connecticut		1	3847	2			2						www.anthem.com/medicare	www.anthem.com	www.anthem.com	(866)-220-9827		(866)-220-9827		(800)-409-7056		(800)-409-7056		(866)-220-9827		(866)-220-9827		(800)-409-7056		(800)-409-7056		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		2	2	2
H2836	802	0	1	04	01	H2836_802_0	4	1		06/04/2011	2012.02	06/04/2011 01:59:46 PM Eastern Daylight Time	07/22/2011 11:57:47 AM Eastern Daylight Time			07/22/2011 01:57:05 PM Eastern Daylight Time	ANTHEM HEALTH PLANS, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem MediBlue Preferred (PPO)	01	04		1			H2836	802	0	2012	Connecticut		1	50	2			2						www.anthem.com/medicare	www.anthem.com	www.anthem.com	(866)-220-9827		(866)-220-9827		(800)-409-7056		(800)-409-7056										(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894										2	2	2
H2836	803	0	1	04	01	H2836_803_0	4	1		06/04/2011	2012.02	06/04/2011 02:00:21 PM Eastern Daylight Time	07/22/2011 11:57:48 AM Eastern Daylight Time			07/22/2011 01:57:05 PM Eastern Daylight Time	ANTHEM HEALTH PLANS, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem MediBlue Preferred (PPO)	01	04		1			H2836	803	0	2012	Connecticut		1	50	2			2						www.anthem.com/medicare	www.anthem.com	www.anthem.com	(866)-220-9827		(866)-220-9827		(800)-409-7056		(800)-409-7056		(866)-220-9827		(866)-220-9827		(800)-409-7056		(800)-409-7056		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		2	2	2
H2836	804	0	1	04	01	H2836_804_0	4	1		06/04/2011	2012.02	06/04/2011 02:00:47 PM Eastern Daylight Time	07/22/2011 11:57:49 AM Eastern Daylight Time			07/22/2011 01:57:05 PM Eastern Daylight Time	ANTHEM HEALTH PLANS, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem MediBlue Preferred (PPO)	01	04		1			H2836	804	0	2012	Connecticut		1	50	2			2						www.anthem.com/medicare	www.anthem.com	www.anthem.com	(866)-220-9827		(866)-220-9827		(800)-409-7056		(800)-409-7056										(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894										2	2	2
H2899	001	0	1	01	01	H2899_001_0	8	1		08/08/2011	2012.02	08/08/2011 09:56:05 AM Central Daylight Time	08/07/2011 12:33:52 PM Central Daylight Time	08/04/2011 12:37:00 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARCADIAN HEALTH PLAN OF NORTH CAROLINA, INC.	Southeast Community Care	www.southeastcommunitycare.com	Southeast Community Care - Plus (HMO)	01	01		1			H2899	001	0	2012	Eastern North Carolina		2		2			2							www.southeastcommunitycare.com	www.southeastcommunitycare.com	(800)-573-8597		(800)-573-8597		(877)-268-3866		(919)-781-8000		(800)-573-8597		(800)-573-8597		(877)-268-3866		(919)-781-8000		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H2899	002	0	1	01	01	H2899_002_0	7	1	2	07/07/2011	2012.02	07/07/2011 10:51:05 AM Central Daylight Time	07/17/2011 05:22:01 PM Central Daylight Time	07/19/2011 07:34:57 PM Central Daylight Time		07/20/2011 04:17:07 PM Central Daylight Time	ARCADIAN HEALTH PLAN OF NORTH CAROLINA, INC.	Southeast Community Care	www.southeastcommunitycare.com	Southeast Community Care - Dual Plus (HMO SNP)	01	01		1			H2899	002	0	2012	Eastern North Carolina		2		2			1	3		1	1			www.southeastcommunitycare.com	www.southeastcommunitycare.com	(800)-573-8597		(800)-573-8597		(877)-268-3866		(919)-781-8000		(800)-573-8597		(800)-573-8597		(877)-268-3866		(919)-781-8000		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H2899	003	0	1	01	01	H2899_003_0	8	1		08/08/2011	2012.02	08/08/2011 11:18:56 AM Central Daylight Time	08/07/2011 12:35:21 PM Central Daylight Time	08/04/2011 12:38:52 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARCADIAN HEALTH PLAN OF NORTH CAROLINA, INC.	Southeast Community Care	www.southeastcommunitycare.com	Southeast Community Care - Plus (HMO)	01	01		1			H2899	003	0	2012	Guilford		2		2			2							www.southeastcommunitycare.com	www.southeastcommunitycare.com	(800)-573-8597		(800)-573-8597		(877)-268-3866		(919)-781-8000		(800)-573-8597		(800)-573-8597		(877)-268-3866		(919)-781-8000		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H2899	006	0	1	01	01	H2899_006_0	8	1		08/08/2011	2012.02	08/08/2011 10:00:03 AM Central Daylight Time	08/07/2011 12:36:49 PM Central Daylight Time	08/04/2011 12:39:29 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARCADIAN HEALTH PLAN OF NORTH CAROLINA, INC.	Southeast Community Care	www.southeastcommunitycare.com	Southeast Community Care - Plus (HMO)	01	01		1			H2899	006	0	2012	Carteret		2		2			2							www.southeastcommunitycare.com	www.southeastcommunitycare.com	(800)-573-8597		(800)-573-8597		(877)-268-3866		(919)-781-8000		(800)-573-8597		(800)-573-8597		(877)-268-3866		(919)-781-8000		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H2899	009	0	1	01	01	H2899_009_0	8	1		08/08/2011	2012.02	08/08/2011 10:00:36 AM Central Daylight Time	08/07/2011 12:38:13 PM Central Daylight Time	08/04/2011 12:40:10 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARCADIAN HEALTH PLAN OF NORTH CAROLINA, INC.	Southeast Community Care	www.southeastcommunitycare.com	Southeast Community Care - Plus (HMO)	01	01		1			H2899	009	0	2012	Beaufort		2		2			2							www.southeastcommunitycare.com	www.southeastcommunitycare.com	(800)-573-8597		(800)-573-8597		(877)-268-3866		(919)-781-8000		(800)-573-8597		(800)-573-8597		(877)-268-3866		(919)-781-8000		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H2905	001	0	1	04	01	H2905_001_0	5	1		07/25/2011	2012.02	07/25/2011 08:47:50 AM Central Daylight Time	08/05/2011 03:59:10 PM Central Daylight Time	08/05/2011 01:02:06 PM Central Daylight Time		08/09/2011 01:10:07 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierraspectrumppo.com	Sierra Spectrum (PPO)	01	04		1			H2905	001	0	2012	Washington county		2		2			2						http://www.sierraspectrumppo.com	http://www.sierraspectrumppo.com	http://www.sierraspectrumppo.com	(877)-559-4512		(877)-559-4512		(877)-271-8591		(877)-271-8591		(877)-559-4512		(877)-559-4512		(877)-271-8591		(877)-271-8591		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2906	003	0	1	04	01	H2906_003_0	7	1		08/09/2011	2012.02	08/09/2011 05:55:15 PM Pacific Daylight Time	08/12/2011 09:20:47 AM Pacific Daylight Time	08/09/2011 05:53:32 PM Pacific Daylight Time		08/12/2011 09:22:28 AM Pacific Daylight Time	HOMETOWN HEALTH PLAN	Senior Care Plus	www.SeniorCarePlus.com	Senior Care Plus: Freedom Rx Premier Plan (PPO)	01	04		1			H2906	003	0	2012	Washoe County, NV		2	395	2			2						http://www.SeniorCarePlus.com	http://www.hometownhealth.com/SCPlus/scp_m_prescriptions.asp	http://www.hometownhealth.com/scplus/scp_m_prescriptions.asp	(888)-775-7003		(775)-982-3112		(888)-775-7003		(775)-982-3158		(888)-341-8576		(775)-982-3112		(888)-775-7003		(775)-982-3158		(877)-711-1192		(775)-982-3240		(877)-711-1192		(775)-982-3240		(888)-206-8041		(775)-982-3240		(877)-711-1192		(775)-982-3240		2	2	2
H2906	005	0	1	04	01	H2906_005_0	9	1		07/25/2011	2012.02	07/25/2011 11:46:07 AM Pacific Daylight Time	08/12/2011 09:20:49 AM Pacific Daylight Time	08/09/2011 05:50:51 PM Pacific Daylight Time		08/12/2011 09:22:28 AM Pacific Daylight Time	HOMETOWN HEALTH PLAN	Senior Care Plus	www.SeniorCarePlus.com	Senior Care Plus: Freedom Rx Select Plan (PPO)	01	04		1			H2906	005	0	2012	Carson City, Churchill, Douglas, Lyon, Storey - NV		2	119	2			2						http://www.SeniorCarePlus.com	http://www.hometownhealth.com/SCPlus/scp_m_prescriptions.asp	http://www.hometownhealth.com/scplus/scp_m_prescriptions.asp	(888)-775-7003		(775)-982-3112		(888)-775-7003		(775)-982-3158		(888)-341-8576		(775)-982-3112		(888)-775-7003		(775)-982-3158		(877)-711-1192		(775)-982-3240		(877)-711-1192		(775)-982-3240		(888)-206-8041		(775)-982-3240		(877)-711-1192		(775)-982-3240		2	2	2
H2906	006	0	1	04	01	H2906_006_0	6	1		08/09/2011	2012.02	08/09/2011 05:58:11 PM Pacific Daylight Time	08/09/2011 05:51:27 PM Pacific Daylight Time	08/09/2011 05:51:24 PM Pacific Daylight Time		08/09/2011 06:24:20 PM Pacific Daylight Time	HOMETOWN HEALTH PLAN	Senior Care Plus	www.SeniorCarePlus.com	Senior Care Plus: Freedom Rx Plan (PPO)	01	04		1			H2906	006	0	2012	Carson City, Churchill, Douglas, Lyon, Storey - NV		2	224	2			2						http://www.SeniorCarePlus.com	http://www.hometownhealth.com/SCPlus/scp_m_prescriptions.asp	http://www.hometownhealth.com/scplus/scp_m_prescriptions.asp	(888)-775-7003		(775)-982-3112		(888)-775-7003		(775)-982-3158		(888)-341-8576		(775)-982-3112		(888)-775-7003		(775)-982-3158		(877)-711-1192		(775)-982-3240		(877)-711-1192		(775)-982-3240		(888)-206-8041		(775)-982-3240		(877)-711-1192		(775)-982-3240		2	2	2
H2906	801	0	1	04	01	H2906_801_0	2	1		06/02/2011	2012.02	06/02/2011 02:58:21 PM Pacific Daylight Time	06/06/2011 11:14:22 AM Pacific Daylight Time			06/06/2011 12:20:44 PM Pacific Daylight Time	HOMETOWN HEALTH PLAN	Senior Care Plus	www.SeniorCarePlus.com	Senior Care Plus: Freedom Group (PPO)	01	04		1			H2906	801	0	2012	State of Nevada		1	9	2			2						http://www.SeniorCarePlus.com	http://www.hometownhealth.com/SCPlus/scp_m_prescriptions.asp	http://www.hometownhealth.com/scplus/scp_m_prescriptions.asp	(888)-775-7003		(775)-982-3112		(888)-775-7003		(775)-982-3158		(888)-341-8576		(775)-982-3112		(888)-775-7003		(775)-982-3158		(877)-711-1192		(775)-982-3240		(877)-711-1192		(775)-982-3240		(888)-206-8041		(775)-982-3240		(877)-711-1192		(775)-982-3240		1	1	1
H2926	001	0	1	01	01	H2926_001_0	3	1	2	07/22/2011	2012.02	07/22/2011 11:19:33 AM Central Daylight Time	08/08/2011 05:22:25 PM Central Daylight Time	08/08/2011 05:26:30 PM Central Daylight Time		08/08/2011 07:00:59 PM Central Daylight Time	PRIMEWEST HEALTH SYSTEM	PrimeWest Health	www.primewest.org	Prime Health Complete (HMO SNP)	01	01		1			H2926	001	0	2012	Northern, west central, and southwestern Minnesota		2	241	2			1	3		1	5		www.primewest.org/FindA/Default.aspx	http://www.primewest.org/FindA/Drug.aspx	http://www.primewest.org/FindA/Pharmacy.aspx	(877)-600-4913		(320)-335-5243		(877)-600-4913		(320)-335-5243		(877)-600-4913		(320)-335-5243		(877)-600-4913		(320)-335-5243		(800)-627-3529		(800)-627-3529		(800)-627-3529		(800)-627-3529		(800)-627-3529		(800)-627-3529		(800)-627-3529		(800)-627-3529		2	2	2
H2931	002	0	1	02	01	H2931_002_0	7	1		08/05/2011	2012.02	08/05/2011 01:36:12 PM Central Daylight Time	08/05/2011 02:38:39 PM Central Daylight Time	08/05/2011 01:02:27 PM Central Daylight Time		08/09/2011 01:10:07 PM Central Daylight Time	HEALTH PLAN OF NEVADA, INC.	Health Plan of Nevada, Inc.	www.seniordimensions.com	Senior Dimensions Southern Nevada (HMO-POS)	01	02		1			H2931	002	0	2012	Clark and Nye counties		2		2			2						www.seniordimensions.com	www.seniordimensions.com	www.seniordimensions.com	(800)-650-6232		(800)-650-6232		(877)-271-8591		(877)-271-8591		(800)-650-6232		(800)-650-6232		(877)-271-8591		(877)-271-8591		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2931	004	0	1	01	01	H2931_004_0	6	1		08/05/2011	2012.02	08/05/2011 01:37:08 PM Central Daylight Time	08/05/2011 02:39:12 PM Central Daylight Time	08/05/2011 01:02:50 PM Central Daylight Time		08/09/2011 01:10:07 PM Central Daylight Time	HEALTH PLAN OF NEVADA, INC.	Health Plan of Nevada, Inc.	www.seniordimensions.com	Senior Dimensions Greater Nevada (HMO)	01	01		1			H2931	004	0	2012	Lyon, Mineral, Esmeralda, and portions of Washoe		2		2			2						www.seniordimensions.com	www.seniordimensions.com	www.seniordimensions.com	(800)-650-6232		(800)-650-6232		(877)-271-8591		(877)-271-8591		(800)-650-6232		(800)-650-6232		(877)-271-8591		(877)-271-8591		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2931	801	0	1	01	01	H2931_801_0	2	1		07/06/2011	2012.02	07/06/2011 04:44:37 PM Central Daylight Time	06/03/2011 03:35:13 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	HEALTH PLAN OF NEVADA, INC.	Health Plan of Nevada, Inc.	www.seniordimensions.com	Basic Group (with Drug) Coverage (HMO)	01	01		1			H2931	801	0	2012	Counties: Clk, Esmrld, Ny, Lyn, Mnrl, parts of Wsh		1		2			2						www.seniordimensions.com	www.seniordimensions.com	www.seniordimensions.com	(800)-650-6232		(702)-242-7301		(877)-271-8591		(877)-271-8591		(800)-650-6232		(702)-242-7301		(877)-271-8591		(877)-271-8591		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2931	803	0	1	01	01	H2931_803_0	2	1		07/06/2011	2012.02	07/06/2011 04:44:41 PM Central Daylight Time	06/03/2011 03:35:46 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	HEALTH PLAN OF NEVADA, INC.	Health Plan of Nevada, Inc.	www.seniordimensions.com	Basic Group MA Only Coverage (HMO)	01	01		1			H2931	803	0	2012	Counties: Clk, Esmrld, Ny, Lyn, Mnrl, parts of Wsh		1		2			2						www.seniordimensions.com	www.seniordimensions.com	www.seniordimensions.com	(800)-650-6232		(702)-242-7301		(877)-271-8591		(877)-271-8591										(711)		(711)		(711)		(711)										2	2	2
H2931	804	0	1	01	01	H2931_804_0	2	1		07/06/2011	2012.02	07/06/2011 04:44:44 PM Central Daylight Time	06/03/2011 03:36:19 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	HEALTH PLAN OF NEVADA, INC.	Health Plan of Nevada, Inc.	www.seniordimensions.com	(NCY) Basic Group (With Drug) Coverage (HMO)	01	01		1			H2931	804	0	2012	Counties: Clk, Esmrld, Ny, Lyn, Mnrl, parts of Wsh		1		2			2						www.seniordimensions.com	www.seniordimensions.com	www.seniordimensions.com	(800)-650-6232		(702)-242-7301		(877)-271-8591		(877)-271-8591		(800)-650-6232		(702)-242-7301		(877)-271-8591		(877)-271-8591		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2936	001	0	1	20	08	H2936_001_0	3	1		05/26/2011	2012.02	05/26/2011 02:11:45 PM Eastern Daylight Time		05/24/2011 12:21:13 PM Eastern Daylight Time		05/31/2011 11:36:03 AM Eastern Daylight Time	LIFECIRCLES	LIFECIRCLES	http:www.lifecircles-pace.org	LifeCircles (PACE)	08	20		1			H2936	001	0	2012	Muskegon, Ottawa		2		2			2							www.lifecircles-pace.org	www.lifecircles-pace.org									(888)-204-8626		(231)-733-8686		(888)-204-8626		(231)-733-8686										(888)-204-8626		(231)-733-8686		(888)-204-8626		(231)-733-8686				
H2936	002	0	1	20	08	H2936_002_0	3	1		05/26/2011	2012.02	05/26/2011 02:11:59 PM Eastern Daylight Time		05/24/2011 12:21:13 PM Eastern Daylight Time		05/31/2011 11:36:03 AM Eastern Daylight Time	LIFECIRCLES	LIFECIRCLES	http:www.lifecircles-pace.org	002 - Medicare Only (PACE)	08	20		1			H2936	002	0	2012	002 - Medicare Only		2		2			2							www.lifecircles-pace.org	www.lifecircles-pace.org									(888)-204-8626		(231)-733-8686		(888)-204-8626		(231)-733-8686										(888)-204-8626		(231)-733-8686		(888)-204-8626		(231)-733-8686				
H2941	001	0	1	20	08	H2941_001_0	1	1		05/31/2011	2012.02	05/31/2011 11:27:18 AM Eastern Daylight Time		05/31/2011 10:19:18 AM Eastern Daylight Time		05/31/2011 11:29:51 AM Eastern Daylight Time	SENTARA LIFE CARE CORPORATION, INC	Sentara Senior Community Care	www.sentara.com	Sentara Senior Community Care Dual (PACE)	08	20		1			H2941	001	0	2012	Chesapeake, Norfolk, Portsmouth, Suffolk, VA Beach		2		2			2							www.sentara.com	www.sentara.com									(800)-736-8272		(757)-502-7800		(800)-736-8272		(757)-502-7800										(800)-225-7784		(757)-552-7120		(800)-225-7784		(757)-552-7120				
H2941	002	0	1	20	08	H2941_002_0	1	1		05/31/2011	2012.02	05/31/2011 11:27:47 AM Eastern Daylight Time		05/31/2011 10:19:23 AM Eastern Daylight Time		05/31/2011 11:29:51 AM Eastern Daylight Time	SENTARA LIFE CARE CORPORATION, INC	Sentara Senior Community Care	www.sentara.com	Sentara Senior Community Care Private (PACE)	08	20		1			H2941	002	0	2012	Chesapeake, Norfolk, Portsmouth, Suffolk, VA Beach		2		2			2							www.sentara.com	www.sentara.com									(800)-736-8272		(757)-502-7800		(800)-736-8272		(757)-502-7800										(800)-225-7784		(757)-552-7120		(800)-225-7784		(757)-552-7120				
H2944	004	0	1	09	04	H2944_004_0	7	1		07/07/2011	2012.02	07/07/2011 02:08:44 PM Eastern Daylight Time	08/05/2011 11:35:40 AM Eastern Daylight Time	08/04/2011 12:05:16 PM Eastern Daylight Time		08/09/2011 10:58:20 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H2944-004 (PFFS)	04	09	3	1			H2944	004	0	2012	Select counties in Iowa and Nebraska		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2944	013	0	1	09	04	H2944_013_0	6	1		08/08/2011	2012.02	08/08/2011 11:52:08 AM Eastern Daylight Time	08/05/2011 05:45:29 PM Eastern Daylight Time	08/04/2011 12:05:35 PM Eastern Daylight Time		08/08/2011 04:32:56 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H2944-013 (PFFS)	04	09	3	1			H2944	013	0	2012	Select Counties in AR, CO, KS, MO and OK		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2944	019	0	1	09	04	H2944_019_0	7	1		07/07/2011	2012.02	07/07/2011 02:09:24 PM Eastern Daylight Time	08/05/2011 11:32:13 AM Eastern Daylight Time	08/04/2011 12:06:01 PM Eastern Daylight Time		08/09/2011 10:58:20 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H2944-019 (PFFS)	04	09	3	1			H2944	019	0	2012	Select Counties in North Dakota and South Dakota		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2944	024	0	1	09	04	H2944_024_0	6	1		07/05/2011	2012.02	07/05/2011 01:14:41 PM Eastern Daylight Time	08/07/2011 04:37:52 PM Eastern Daylight Time	08/04/2011 12:06:18 PM Eastern Daylight Time		08/08/2011 03:49:43 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H2944-024 (PFFS)	04	09	3	1			H2944	024	0	2012	Select Counties in Texas		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2944	041	0	1	09	04	H2944_041_0	6	1		07/06/2011	2012.02	07/06/2011 01:23:16 PM Eastern Daylight Time	08/04/2011 02:20:14 PM Eastern Daylight Time	08/04/2011 12:06:37 PM Eastern Daylight Time		08/08/2011 03:04:56 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H2944-041 (PFFS)	04	09	3	1			H2944	041	0	2012	Select Counties in Illinois		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2944	044	0	1	09	04	H2944_044_0	6	1		07/06/2011	2012.02	07/06/2011 09:22:47 AM Eastern Daylight Time	08/04/2011 02:22:56 PM Eastern Daylight Time	08/04/2011 12:06:55 PM Eastern Daylight Time		08/08/2011 03:08:59 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H2944-044 (PFFS)	04	09	3	1			H2944	044	0	2012	Select Counties in Michigan		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2944	052	0	1	09	04	H2944_052_0	8	1		07/20/2011	2012.02	07/20/2011 10:39:43 AM Eastern Daylight Time	08/04/2011 03:31:14 PM Eastern Daylight Time	08/04/2011 12:07:18 PM Eastern Daylight Time		08/08/2011 04:57:01 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H2944-052 (PFFS)	04	09	3	1			H2944	052	0	2012	Select Counties in Montana		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2944	053	0	1	09	04	H2944_053_0	5	1		07/07/2011	2012.02	07/07/2011 01:40:10 PM Eastern Daylight Time	08/08/2011 11:24:30 AM Eastern Daylight Time	08/04/2011 12:07:36 PM Eastern Daylight Time		08/08/2011 04:09:10 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H2944-053 (PFFS)	04	09	3	1			H2944	053	0	2012	Select Counties in Nevada		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2944	065	0	1	09	04	H2944_065_0	7	1		07/06/2011	2012.02	07/06/2011 09:24:21 AM Eastern Daylight Time	08/04/2011 02:24:46 PM Eastern Daylight Time	08/04/2011 12:08:04 PM Eastern Daylight Time		08/08/2011 03:08:59 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H2944-065 (PFFS)	04	09	3	1			H2944	065	0	2012	Select Counties in Wisconsin		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2944	071	0	1	09	04	H2944_071_0	7	1		07/20/2011	2012.02	07/20/2011 10:40:05 AM Eastern Daylight Time	08/04/2011 03:30:17 PM Eastern Daylight Time	08/04/2011 12:08:24 PM Eastern Daylight Time		08/08/2011 05:00:54 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H2944-071 (PFFS)	04	09	3	1			H2944	071	0	2012	Select Counties in Wyoming		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2944	078	0	1	09	04	H2944_078_0	7	1		07/07/2011	2012.02	07/07/2011 12:01:20 PM Eastern Daylight Time	08/05/2011 10:51:18 PM Eastern Daylight Time	08/04/2011 12:08:44 PM Eastern Daylight Time		08/08/2011 07:12:55 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H2944-078 (PFFS)	04	09	3	1			H2944	078	0	2012	Select Counties in Virginia		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2944	085	0	1	09	04	H2944_085_0	9	1		07/06/2011	2012.02	07/06/2011 04:04:33 PM Eastern Daylight Time	08/05/2011 03:56:06 PM Eastern Daylight Time	08/04/2011 12:09:03 PM Eastern Daylight Time		08/08/2011 04:05:26 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H2944-085 (PFFS)	04	09	3	1			H2944	085	0	2012	Select Counties in Mississippi		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2944	106	0	1	09	04	H2944_106_0	6	1		07/07/2011	2012.02	07/07/2011 12:03:34 PM Eastern Daylight Time	08/05/2011 10:48:17 PM Eastern Daylight Time	08/04/2011 12:09:21 PM Eastern Daylight Time		08/08/2011 06:46:35 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H2944-106 (PFFS)	04	09	3	1			H2944	106	0	2012	Select Counties in New Hampshire and Vermont		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2944	114	0	1	09	04	H2944_114_0	8	1		07/06/2011	2012.02	07/06/2011 04:28:42 PM Eastern Daylight Time	08/05/2011 08:56:24 AM Eastern Daylight Time	08/04/2011 12:09:40 PM Eastern Daylight Time		08/08/2011 03:57:47 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H2944-114 (PFFS)	04	09	3	1			H2944	114	0	2012	Select Counties in Georgia		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2944	124	0	1	09	04	H2944_124_0	9	1		07/07/2011	2012.02	07/07/2011 12:42:42 PM Eastern Daylight Time	08/05/2011 10:48:53 PM Eastern Daylight Time	08/04/2011 12:10:08 PM Eastern Daylight Time		08/09/2011 10:57:03 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H2944-124 (PFFS)	04	09	3	1			H2944	124	0	2012	Select Counties in Indiana		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2944	127	0	1	09	04	H2944_127_0	11	1		07/06/2011	2012.02	07/06/2011 11:56:54 AM Eastern Daylight Time	08/05/2011 10:49:20 PM Eastern Daylight Time	08/04/2011 12:10:25 PM Eastern Daylight Time		08/09/2011 10:57:03 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H2944-127 (PFFS)	04	09	3	1			H2944	127	0	2012	Select Counties in Kentucky		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2944	128	0	1	09	04	H2944_128_0	10	1		07/06/2011	2012.02	07/06/2011 12:01:43 PM Eastern Daylight Time	08/05/2011 10:49:31 PM Eastern Daylight Time	08/04/2011 12:10:46 PM Eastern Daylight Time		08/09/2011 10:57:03 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H2944-128 (PFFS)	04	09	3	1			H2944	128	0	2012	Select Counties in Kentucky		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2944	133	0	1	09	04	H2944_133_0	8	1		07/06/2011	2012.02	07/06/2011 04:28:55 PM Eastern Daylight Time	08/05/2011 08:57:38 AM Eastern Daylight Time	08/04/2011 12:11:03 PM Eastern Daylight Time		08/08/2011 03:57:47 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H2944-133 (PFFS)	04	09	3	1			H2944	133	0	2012	Select Counties in North Carolina		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2944	137	0	1	09	04	H2944_137_0	8	1		07/06/2011	2012.02	07/06/2011 04:29:09 PM Eastern Daylight Time	08/05/2011 09:02:41 AM Eastern Daylight Time	08/04/2011 12:11:22 PM Eastern Daylight Time		08/08/2011 03:57:47 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H2944-137 (PFFS)	04	09	3	1			H2944	137	0	2012	Select Counties in North Carolina		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2944	166	0	1	09	04	H2944_166_0	4	1		07/07/2011	2012.02	07/07/2011 02:11:17 PM Eastern Daylight Time	05/27/2011 03:17:41 PM Eastern Daylight Time			07/07/2011 03:43:58 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H2944-166 (PFFS)	04	09	3	1			H2944	166	0	2012	Select Counties in North Dakota and South Dakota		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H2944	178	0	1	09	04	H2944_178_0	3	1		07/07/2011	2012.02	07/07/2011 02:11:59 PM Eastern Daylight Time	05/27/2011 03:32:41 PM Eastern Daylight Time			07/07/2011 03:43:58 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H2944-178 (PFFS)	04	09	3	1			H2944	178	0	2012	Select counties in Iowa and Nebraska		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H2944	185	0	1	09	04	H2944_185_0	3	1		07/20/2011	2012.02	07/20/2011 10:40:34 AM Eastern Daylight Time	06/03/2011 02:54:18 PM Eastern Daylight Time			07/20/2011 11:12:20 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H2944-185 (PFFS)	04	09	3	1			H2944	185	0	2012	Select Counties in Montana and Wyoming		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H2944	193	0	1	09	04	H2944_193_0	4	1		07/06/2011	2012.02	07/06/2011 04:29:21 PM Eastern Daylight Time	05/28/2011 02:00:02 PM Eastern Daylight Time			07/07/2011 09:33:16 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H2944-193 (PFFS)	04	09	3	1			H2944	193	0	2012	Select Counties in Georgia		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H2944	194	0	1	09	04	H2944_194_0	4	1		07/06/2011	2012.02	07/06/2011 03:46:04 PM Eastern Daylight Time	05/28/2011 01:59:20 PM Eastern Daylight Time			07/07/2011 09:33:16 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H2944-194 (PFFS)	04	09	3	1			H2944	194	0	2012	Select Counties in North Carolina		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H2944	197	0	1	09	04	H2944_197_0	7	1		07/20/2011	2012.02	07/20/2011 10:27:39 AM Eastern Daylight Time	06/03/2011 04:17:31 PM Eastern Daylight Time			07/20/2011 10:39:04 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H2944-197 (PFFS)	04	09	3	1			H2944	197	0	2012	Select Counties in AR, CO, KS, MO and OK		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H2944	198	0	1	09	04	H2944_198_0	3	1		07/20/2011	2012.02	07/20/2011 10:42:05 AM Eastern Daylight Time	05/27/2011 04:33:25 PM Eastern Daylight Time			07/20/2011 11:49:06 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H2944-198 (PFFS)	04	09	3	1			H2944	198	0	2012	Select Counties in Illinois Michigan and Wisconsin		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H2944	201	0	1	09	04	H2944_201_0	3	1		07/05/2011	2012.02	07/05/2011 01:17:14 PM Eastern Daylight Time	06/01/2011 01:45:22 PM Eastern Daylight Time			07/07/2011 08:53:25 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H2944-201 (PFFS)	04	09	3	1			H2944	201	0	2012	Select Counties in Texas		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H2944	204	0	1	09	04	H2944_204_0	6	1		08/08/2011	2012.02	08/08/2011 11:52:19 AM Eastern Daylight Time	08/05/2011 05:46:38 PM Eastern Daylight Time	08/04/2011 12:11:41 PM Eastern Daylight Time		08/08/2011 04:32:56 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H2944-204 (PFFS)	04	09	3	1			H2944	204	0	2012	Select Counties in AR, CO, KS, MO and OK		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2949	009	0	1	01	01	H2949_009_0	4	1		07/08/2011	2012.02	07/08/2011 04:09:06 PM Eastern Daylight Time	06/03/2011 02:08:25 PM Eastern Daylight Time			07/11/2011 01:48:58 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H2949-009 (HMO)	01	01		1			H2949	009	0	2012	Clark (Partial)  and Nye (Partial) Counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H2949	012	0	1	01	01	H2949_012_0	6	1		07/08/2011	2012.02	07/08/2011 04:07:27 PM Eastern Daylight Time	08/04/2011 03:33:24 PM Eastern Daylight Time	08/04/2011 12:11:56 PM Eastern Daylight Time		08/08/2011 04:09:10 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H2949-012 (HMO)	01	01		1			H2949	012	0	2012	Clark (Partial) and Nye (Partial) Counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2949	013	0	1	01	01	H2949_013_0	7	1		07/14/2011	2012.02	07/14/2011 08:42:28 AM Eastern Daylight Time	08/04/2011 04:17:35 PM Eastern Daylight Time	08/04/2011 12:12:16 PM Eastern Daylight Time		08/08/2011 04:15:16 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-CVD/CHF/DM H2949-013 (HMO SNP)	01	01		1			H2949	013	0	2012	Clark (Partial) and Nye (Partial) counties		2		2			1	4		1		00000000000000000010	www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2949	014	0	1	01	01	H2949_014_0	5	1		07/11/2011	2012.02	07/11/2011 01:27:30 PM Eastern Daylight Time	08/04/2011 03:22:20 PM Eastern Daylight Time	08/04/2011 12:12:45 PM Eastern Daylight Time		08/08/2011 04:15:16 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-CLD H2949-014 (HMO SNP)	01	01		1			H2949	014	0	2012	Clark (Partial) and Nye (Partial) counties		2		2			1	4		1		00000000000100000000	www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H2949	805	0	1	01	01	H2949_805_0	2	1		07/06/2011	2012.02	07/06/2011 10:55:33 AM Eastern Daylight Time	05/27/2011 03:22:06 PM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H2949	805	0	2012	Select counties in Nevada		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H2949	807	0	1	01	01	H2949_807_0	2	1		07/06/2011	2012.02	07/06/2011 10:55:39 AM Eastern Daylight Time	05/28/2011 07:22:29 AM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H2949	807	0	2012	Select counties in Nevada		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
H2949	808	0	1	01	01	H2949_808_0	2	1		07/06/2011	2012.02	07/06/2011 10:55:43 AM Eastern Daylight Time	05/27/2011 05:20:24 PM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Employer Sponsored Non-CY (HMO)	01	01		1			H2949	808	0	2012	Select counties in Nevada		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H2960	004	0	1	01	01	H2960_004_0	4	1		07/21/2011	2012.02	07/21/2011 05:08:09 PM Pacific Daylight Time	08/09/2011 05:49:54 PM Pacific Daylight Time	08/09/2011 05:49:50 PM Pacific Daylight Time		08/09/2011 06:24:20 PM Pacific Daylight Time	HOMETOWN HEALTH PLAN	Senior Care Plus	www.SeniorCarePlus.com	Senior Care Plus: Value Rx Enhanced Plan (HMO)	01	01		1			H2960	004	0	2012	Washoe County, NV		2	3035	2			2						http://www.SeniorCarePlus.com	http://www.hometownhealth.com/scplus/scp_m_prescriptions.asp	http://www.hometownhealth.com/scplus/scp_m_prescriptions.asp	(888)-775-7003		(775)-982-3112		(888)-775-7003		(775)-982-3158		(888)-341-8576		(775)-982-3112		(888)-775-7003		(775)-982-3158		(877)-711-1192		(775)-982-3240		(877)-711-1192		(775)-982-3240		(888)-206-8041		(775)-982-3240		(877)-711-1192		(775)-982-3240		2	2	2
H2960	009	0	1	01	01	H2960_009_0	4	1		07/21/2011	2012.02	07/21/2011 05:08:25 PM Pacific Daylight Time	07/21/2011 05:12:43 PM Pacific Daylight Time			07/21/2011 05:27:52 PM Pacific Daylight Time	HOMETOWN HEALTH PLAN	Senior Care Plus	www.SeniorCarePlus.com	Senior Care Plus: Value Basic Plan (HMO)	01	01		1			H2960	009	0	2012	Washoe County, NV		2	348	2			2						http://www.SeniorCarePlus.com	http://www.hometownhealth.com/scplus/scp_m_prescriptions.asp	http://www.hometownhealth.com/scplus/scp_m_prescriptions.asp	(888)-775-7003		(775)-982-3112		(888)-775-7003		(775)-982-3158										(877)-711-1192		(775)-982-3240		(877)-711-1192		(775)-982-3240										2	2	2
H2960	010	0	1	01	01	H2960_010_0	5	1		08/09/2011	2012.02	08/09/2011 05:59:07 PM Pacific Daylight Time	08/12/2011 09:20:48 AM Pacific Daylight Time	08/09/2011 05:53:22 PM Pacific Daylight Time		08/12/2011 09:22:28 AM Pacific Daylight Time	HOMETOWN HEALTH PLAN	Senior Care Plus	www.SeniorCarePlus.com	Senior Care Plus: Value Rx Premier Plan (HMO)	01	01		1			H2960	010	0	2012	Washoe County, NV		2	1216	2			2						http://www.SeniorCarePlus.com	http://www.hometownhealth.com/scplus/scp_m_prescriptions.asp	http://www.hometownhealth.com/scplus/scp_m_prescriptions.asp	(888)-775-7003		(775)-982-3112		(888)-775-7003		(775)-982-3158		(888)-341-8576		(775)-982-3112		(888)-775-7003		(775)-982-3158		(877)-711-1192		(775)-982-3240		(877)-711-1192		(775)-982-3240		(888)-206-8041		(775)-982-3240		(877)-711-1192		(775)-982-3240		2	2	2
H2960	012	0	1	01	01	H2960_012_0	5	1		08/09/2011	2012.02	08/09/2011 06:00:51 PM Pacific Daylight Time	08/12/2011 09:20:46 AM Pacific Daylight Time	08/09/2011 05:51:40 PM Pacific Daylight Time		08/12/2011 09:22:28 AM Pacific Daylight Time	HOMETOWN HEALTH PLAN	Senior Care Plus	www.SeniorCarePlus.com	Senior Care Plus: Value Rx Plan (HMO)	01	01		1			H2960	012	0	2012	Washoe County, NV		2	2363	2			2						http://www.SeniorCarePlus.com	http://www.hometownhealth.com/scplus/scp_m_prescriptions.asp	http://www.hometownhealth.com/scplus/scp_m_prescriptions.asp	(888)-775-7003		(775)-982-3112		(888)-775-7003		(775)-982-3158		(888)-341-8576		(775)-982-3112		(888)-775-7003		(775)-982-3158		(877)-711-1192		(775)-982-3240		(877)-711-1192		(775)-982-3240		(888)-206-8041		(775)-982-3240		(877)-711-1192		(775)-982-3240		2	2	2
H2960	018	0	1	01	01	H2960_018_0	4	1		07/21/2011	2012.02	07/21/2011 05:09:12 PM Pacific Daylight Time	08/09/2011 05:51:55 PM Pacific Daylight Time	08/09/2011 05:51:53 PM Pacific Daylight Time		08/09/2011 06:24:20 PM Pacific Daylight Time	HOMETOWN HEALTH PLAN	Senior Care Plus	www.SeniorCarePlus.com	Senior Care Plus: Value Rx Select (HMO)	01	01		1			H2960	018	0	2012	Washoe County, NV		2	1129	2			2						http://www.SeniorCarePlus.com	http://www.hometownhealth.com/scplus/scp_m_prescriptions.asp	http://www.hometownhealth.com/scplus/scp_m_prescriptions.asp	(888)-775-7003		(775)-982-3112		(888)-775-7003		(775)-982-3158		(888)-341-8576		(775)-982-3112		(888)-775-7003		(775)-982-3158		(877)-711-1192		(775)-982-3240		(877)-711-1192		(775)-982-3240		(888)-206-8041		(775)-982-3240		(877)-711-1192		(775)-982-3240		2	2	2
H2960	803	0	1	01	01	H2960_803_0	3	1		06/02/2011	2012.02	06/02/2011 04:33:59 PM Pacific Daylight Time	07/21/2011 05:14:12 PM Pacific Daylight Time			07/21/2011 05:27:52 PM Pacific Daylight Time	HOMETOWN HEALTH PLAN	Senior Care Plus	www.SeniorCarePlus.com	Senior Care Plus: Value Group Plan (HMO)	01	01		1			H2960	803	0	2012	State of Nevada		1	18	2			2						http://www.SeniorCarePlus.com	http://www.hometownhealth.com/scplus/scp_m_prescriptions.asp	http://www.hometownhealth.com/scplus/scp_m_prescriptions.asp	(888)-775-7003		(775)-982-3112		(888)-775-7003		(775)-982-3158		(888)-341-8576		(775)-982-3112		(888)-775-7003		(775)-982-3158		(877)-711-1192		(775)-982-3240		(877)-711-1192		(775)-982-3240		(888)-206-8041		(775)-982-3240		(877)-711-1192		(775)-982-3240		1	1	1
H2992	001	0	1	20	08	H2992_001_0	2	1		05/24/2011	2012.01	05/24/2011 07:01:25 PM Eastern Daylight Time		05/24/2011 06:52:28 PM Eastern Daylight Time		05/24/2011 07:17:07 PM Eastern Daylight Time	SENIORLIFE WASHINGTON, INC.	Senior LIFE Washington / Uniontown / Green	www.seniorlifewashington.com	Senior Life Washington - Dual (PACE)	08	20		1			H2992	001	0	2012	Washington Greene Dual Eligible		2	145	2			2							None	None									(877)-998-5433		(724)-222-5433		(877)-998-5433		(724)-222-5433										(877)-998-5433		(724)-222-5433		(877)-998-5433		(724)-222-5433				
H2992	002	0	1	20	08	H2992_002_0	2	1		05/19/2011	2012.01	05/19/2011 03:28:20 PM Eastern Daylight Time		05/24/2011 06:52:29 PM Eastern Daylight Time		05/24/2011 07:17:07 PM Eastern Daylight Time	SENIORLIFE WASHINGTON, INC.	Senior LIFE Washington / Uniontown / Green	www.seniorlifewashington.com	Senior Life Washington - Medicare Only (PACE)	08	20		1			H2992	002	0	2012	Washington Greene Medicare Only		2	1	2			2							None	None									(877)-998-5433		(724)-222-5433		(877)-998-5433		(724)-222-5433										(877)-998-5433		(724)-222-5433		(877)-998-5433		(724)-222-5433				
H2992	003	0	1	20	08	H2992_003_0	2	1		05/24/2011	2012.01	05/24/2011 07:01:31 PM Eastern Daylight Time		05/24/2011 06:52:29 PM Eastern Daylight Time		05/24/2011 07:17:07 PM Eastern Daylight Time	SENIORLIFE WASHINGTON, INC.	Senior LIFE Washington / Uniontown / Green	www.seniorlifeuniontown.com	Senior LIFE Uniontown - Dual (PACE)	08	20		1			H2992	003	0	2012	Uniontown Greene Dual Eligible		2	145	2			2							None	None									(877)-998-5433		(724)-434-5433		(877)-998-5433		(724)-434-5433										(877)-998-5433		(724)-434-5433		(877)-998-5433		(724)-434-5433				
H2992	004	0	1	20	08	H2992_004_0	2	1		05/19/2011	2012.01	05/19/2011 03:29:08 PM Eastern Daylight Time		05/24/2011 06:52:30 PM Eastern Daylight Time		05/24/2011 07:17:07 PM Eastern Daylight Time	SENIORLIFE WASHINGTON, INC.	Senior LIFE Washington / Uniontown / Green	www.seniorlifeuniontown.com	Senior Life Uniontown - Medicare Only (PACE)	08	20		1			H2992	004	0	2012	Uniontown Greene Medical Only		2	1	2			2							None	None									(877)-998-5433		(724)-434-5433		(877)-998-5433		(724)-434-5433										(877)-998-5433		(724)-434-5433		(877)-998-5433		(724)-434-5433				
H2997	003	0	1	04	01	H2997_003_0	11	1		08/04/2011	2012.02	08/04/2011 08:58:03 AM Pacific Daylight Time	08/08/2011 03:04:45 PM Pacific Daylight Time	08/04/2011 12:42:25 PM Pacific Daylight Time		08/08/2011 11:55:40 PM Pacific Daylight Time	ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred Core (PPO)	01	04		1			H2997	003	0	2012	Clark and Washoe Counties in Nevada		2	5095	2			2						www.anthem.com/medicare	www.anthem.com	www.anthem.com	(866)-754-3077		(866)-754-3077		(800)-797-6403		(800)-797-6403		(866)-754-3077		(866)-754-3077		(800)-797-6403		(800)-797-6403		(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894		(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894		2	2	2
H2997	005	0	1	04	01	H2997_005_0	8	1		08/04/2011	2012.02	08/04/2011 10:11:52 AM Pacific Daylight Time	08/08/2011 03:04:46 PM Pacific Daylight Time	08/04/2011 12:42:26 PM Pacific Daylight Time		08/08/2011 11:55:40 PM Pacific Daylight Time	ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred Core (PPO)	01	04		1			H2997	005	0	2012	Colorado Metro area		2	1137	2			2						www.anthem.com/medicare	www.anthem.com	www.anthem.com	(866)-754-3077		(866)-754-3077		(800)-797-1746		(800)-797-1746		(866)-754-3077		(866)-754-3077		(800)-797-1746		(800)-797-1746		(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894		(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894		2	2	2
H2997	006	0	1	04	01	H2997_006_0	8	1		08/04/2011	2012.02	08/04/2011 10:11:58 AM Pacific Daylight Time	08/08/2011 03:04:46 PM Pacific Daylight Time	08/04/2011 12:42:26 PM Pacific Daylight Time		08/08/2011 11:55:40 PM Pacific Daylight Time	ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred Premier (PPO)	01	04		1			H2997	006	0	2012	Colorado Metro Area		2	201	2			2						www.anthem.com/medicare	www.anthem.com	www.anthem.com	(866)-754-3077		(866)-754-3077		(800)-797-1746		(800)-797-1746		(866)-754-3077		(866)-754-3077		(800)-797-1746		(800)-797-1746		(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894		(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894		2	2	2
H2997	803	0	1	04	01	H2997_803_0	8	1		07/07/2011	2012.02	07/07/2011 12:41:59 PM Eastern Daylight Time	07/22/2011 11:57:50 AM Eastern Daylight Time			07/22/2011 01:36:47 PM Eastern Daylight Time	ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred (PPO)	01	04		1			H2997	803	0	2012	Nevada		1	15595	2			2							www.anthem.com	www.anthem.com	(877)-411-1640		(877)-411-1640		(877)-411-1647		(877)-411-1647		(877)-411-1640		(877)-411-1640		(877)-411-1647		(877)-411-1647		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		2	2	2
H2997	804	0	1	04	01	H2997_804_0	6	1		07/07/2011	2012.02	07/07/2011 12:41:38 PM Eastern Daylight Time	07/22/2011 11:57:50 AM Eastern Daylight Time			07/22/2011 01:36:47 PM Eastern Daylight Time	ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred (PPO)	01	04		1			H2997	804	0	2012	Nevada		1	50	2			2							www.anthem.com	www.anthem.com	(877)-411-1640		(877)-411-1640		(877)-411-1647		(877)-411-1647										(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657										2	2	2
H2997	805	0	1	04	01	H2997_805_0	8	1		07/07/2011	2012.02	07/07/2011 12:42:25 PM Eastern Daylight Time	07/22/2011 11:57:51 AM Eastern Daylight Time			07/22/2011 01:36:47 PM Eastern Daylight Time	ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred (PPO)	01	04		1			H2997	805	0	2012	Nevada		1	50	2			2							www.anthem.com	www.anthem.com	(877)-411-1640		(877)-411-1640		(877)-411-1647		(877)-411-1647		(877)-411-1640		(877)-411-1640		(877)-411-1647		(877)-411-1647		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		2	2	2
H2997	806	0	1	04	01	H2997_806_0	6	1		07/07/2011	2012.02	07/07/2011 12:42:41 PM Eastern Daylight Time	07/22/2011 11:57:52 AM Eastern Daylight Time			07/22/2011 01:36:47 PM Eastern Daylight Time	ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred (PPO)	01	04		1			H2997	806	0	2012	Nevada		1	50	2			2							www.anthem.com	www.anthem.com	(877)-411-1640		(877)-411-1640		(877)-411-1647		(877)-411-1647										(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657										2	2	2
H3028	001	0	1	01	01	H3028_001_0	4	1		07/08/2011	2012.02	07/08/2011 09:57:02 AM Eastern Daylight Time	08/07/2011 04:14:06 PM Eastern Daylight Time	08/04/2011 12:13:04 PM Eastern Daylight Time		08/08/2011 04:57:59 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H3028-001 (HMO)	01	01		1			H3028	001	0	2012	Albuquerque Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3028	801	0	1	01	01	H3028_801_0	2	1		07/06/2011	2012.02	07/06/2011 10:55:47 AM Eastern Daylight Time	05/27/2011 03:32:38 PM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H3028	801	0	2012	Select counties in New Mexico		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H3028	803	0	1	01	01	H3028_803_0	2	1		07/06/2011	2012.02	07/06/2011 10:55:53 AM Eastern Daylight Time	05/27/2011 05:21:19 PM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H3028	803	0	2012	Select counties in New Mexico		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
H3028	804	0	1	01	01	H3028_804_0	2	1		07/06/2011	2012.02	07/06/2011 10:55:57 AM Eastern Daylight Time	05/27/2011 05:22:18 PM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Employer Sponsored Non-CY (HMO)	01	01		1			H3028	804	0	2012	Select counties in New Mexico		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H3044	001	0	1	01	01	H3044_001_0	9	1		07/20/2011	2012.02	07/20/2011 03:01:47 PM Central Daylight Time	08/05/2011 03:26:50 PM Central Daylight Time	08/04/2011 04:58:50 PM Central Daylight Time		08/05/2011 06:09:07 PM Central Daylight Time	NHP OF INDIANA, LLC	Welborn Health Plans	www.welbornhealthplans.com	Silver Rx (HMO)	01	01		1			H3044	001	0	2012	Eight Southwestern Indiana Counties		2	700	2			2						www.welbornhealthplans.com	www.welbornhealthplans.com	www.caremark.com	(800)-521-0265		(812)-426-6600		(800)-521-0265		(812)-426-6600		(888)-816-7981		(888)-816-7981		(800)-521-0265		(812)-426-6600		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(866)-236-1069		(866)-236-1069		(800)-743-3333		(800)-743-3333		2	2	2
H3044	002	0	1	01	01	H3044_002_0	7	1		07/20/2011	2012.02	07/20/2011 03:04:14 PM Central Daylight Time	07/22/2011 01:57:58 PM Central Daylight Time			07/25/2011 12:23:42 PM Central Daylight Time	NHP OF INDIANA, LLC	Welborn Health Plans	www.welbornhealthplans.com	Silver (HMO)	01	01		1			H3044	002	0	2012	Eight Southwestern Indiana Counties		2	350	2			2						www.welbornhealthplans.com	www.welbornhealthplans.com	www.caremark.com	(800)-521-0265		(812)-426-6600		(800)-521-0265		(812)-426-6600										(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333										2	2	2
H3044	003	0	1	01	01	H3044_003_0	8	1		08/05/2011	2012.02	08/05/2011 06:04:01 PM Central Daylight Time	08/05/2011 03:24:52 PM Central Daylight Time	08/04/2011 04:59:34 PM Central Daylight Time		08/05/2011 06:09:07 PM Central Daylight Time	NHP OF INDIANA, LLC	Welborn Health Plans	www.welbornhealthplans.com	Platinum Rx (HMO)	01	01		1			H3044	003	0	2012	Eight Southwestern Indiana Counties		2	1525	2			2						www.welbornhealthplans.com	www.welbornhealthplans.com	www.caremark.com	(800)-521-0265		(812)-426-6600		(800)-521-0265		(812)-426-6600		(888)-816-7981		(888)-816-7981		(800)-521-0265		(812)-426-6600		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(866)-236-1069		(866)-236-1069		(800)-743-3333		(800)-743-3333		2	2	2
H3044	004	0	1	02	01	H3044_004_0	9	1		08/05/2011	2012.02	08/05/2011 06:04:31 PM Central Daylight Time	08/05/2011 03:22:54 PM Central Daylight Time	08/04/2011 05:00:16 PM Central Daylight Time		08/05/2011 06:09:07 PM Central Daylight Time	NHP OF INDIANA, LLC	Welborn Health Plans	www.welbornhealthplans.com	Platinum Select Rx (HMO-POS)	01	02		1			H3044	004	0	2012	Eight Southwestern Indiana Counties		2	650	2			2						www.welbornhealthplans.com	www.welbornhealthplans.com	www.caremark.com	(800)-521-0265		(812)-426-6600		(800)-521-0265		(812)-426-6600		(888)-816-7981		(888)-816-7981		(800)-521-0265		(812)-426-6600		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(866)-236-1069		(866)-236-1069		(800)-743-3333		(800)-743-3333		2	2	2
H3044	005	0	1	01	01	H3044_005_0	8	1		07/20/2011	2012.02	07/20/2011 12:39:49 PM Central Daylight Time	08/05/2011 03:27:46 PM Central Daylight Time	08/04/2011 05:00:46 PM Central Daylight Time		08/05/2011 06:09:07 PM Central Daylight Time	NHP OF INDIANA, LLC	Welborn Health Plans	www.welbornhealthplans.com	Value Rx (HMO)	01	01		1			H3044	005	0	2012	Eight southwestern counties of Indiana		2	300	2			2						www.welbornhealthplans.com	www.welbornhealthplans.com	www.caremark.com	(800)-521-0265		(812)-426-6600		(800)-521-0265		(812)-426-6600		(888)-816-7981		(888)-816-7981		(800)-521-0265		(812)-426-6600		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(866)-236-1069		(866)-236-1069		(800)-743-3333		(800)-743-3333		2	2	2
H3044	801	0	1	02	01	H3044_801_0	2	1		05/31/2011	2012.02	05/31/2011 11:15:04 AM Central Daylight Time	06/05/2011 10:54:52 PM Central Daylight Time			06/06/2011 01:13:06 PM Central Daylight Time	NHP OF INDIANA, LLC	Welborn Health Plans	www.welbornhealthplans.com	Access (HMO-POS)	01	02		1			H3044	801	0	2012	All contiguous United States		1	50	2			2						www.welbornhealthplans.com	www.welbornhealthplans.com	www.caremark.com	(800)-521-0265		(812)-426-6600		(800)-521-0265		(812)-426-6600										(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333										1	1	1
H3044	802	0	1	02	01	H3044_802_0	2	1		05/25/2011	2012.02	05/25/2011 10:42:12 AM Central Daylight Time	06/05/2011 10:56:14 PM Central Daylight Time			06/06/2011 01:13:06 PM Central Daylight Time	NHP OF INDIANA, LLC	Welborn Health Plans	www.welbornhealthplans.com	Access Rx (HMO-POS)	01	02		1			H3044	802	0	2012	All contiguous United States		1	50	2			2						www.welbornhealthplans.com	www.welbornhealthplans.com	www.caremark.com	(800)-521-0265		(812)-426-6600		(800)-521-0265		(812)-426-6600		(888)-816-7981		(888)-816-7981		(800)-521-0265		(812)-426-6600		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(866)-236-1069		(866)-236-1069		(800)-743-3333		(800)-743-3333		1	1	1
H3044	803	0	1	02	01	H3044_803_0	2	1		05/25/2011	2012.02	05/25/2011 10:43:45 AM Central Daylight Time	06/05/2011 10:57:46 PM Central Daylight Time			06/06/2011 01:13:06 PM Central Daylight Time	NHP OF INDIANA, LLC	Welborn Health Plans	www.welbornhealthplans.com	Select (HMO-POS)	01	02		1			H3044	803	0	2012	All contiguous United States		1	50	2			2						www.welbornhealthplans.com	www.welbornhealthplans.com	www.caremark.com	(800)-521-0265		(812)-426-6600		(800)-521-0265		(812)-426-6600										(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333										1	1	1
H3044	804	0	1	02	01	H3044_804_0	4	1		05/25/2011	2012.02	05/25/2011 10:44:19 AM Central Daylight Time	07/22/2011 02:08:26 PM Central Daylight Time			07/25/2011 12:23:42 PM Central Daylight Time	NHP OF INDIANA, LLC	Welborn Health Plans	www.welbornhealthplans.com	Select Rx (HMO-POS)	01	02		1			H3044	804	0	2012	All contiguous United States		1	50	2			2						www.welbornhealthplans.com	www.welbornhealthplans.com	www.caremark.com	(800)-521-0265		(812)-426-6600		(800)-521-0265		(812)-426-6600		(888)-816-7981		(888)-816-7981		(800)-521-0265		(812)-426-6600		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(866)-236-1069		(866)-236-1069		(800)-743-3333		(800)-743-3333		1	1	1
H3107	004	0	1	02	01	H3107_004_0	4	1		08/04/2011	2012.02	08/04/2011 05:10:41 PM Central Daylight Time	08/08/2011 02:23:21 PM Central Daylight Time	08/05/2011 01:03:10 PM Central Daylight Time		08/09/2011 02:16:58 PM Central Daylight Time	OXFORD HEALTH PLANS (NJ), INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H3107	004	0	2012	Northern and Central New Jersey		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-234-1228		(800)-234-1228		(800)-547-5514		(800)-547-5514		(800)-234-1228		(800)-234-1228		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3107	008	0	1	02	01	H3107_008_0	5	1		07/20/2011	2012.02	07/20/2011 11:22:05 AM Central Daylight Time	07/22/2011 02:10:36 PM Central Daylight Time			07/25/2011 01:57:11 PM Central Daylight Time	OXFORD HEALTH PLANS (NJ), INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus Essential (HMO-POS)	01	02		1			H3107	008	0	2012	Northern and Central New Jersey		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-234-1228		(800)-234-1228		(800)-547-5514		(800)-547-5514										(711)		(711)		(711)		(711)										2	2	2
H3107	012	0	1	01	01	H3107_012_0	5	1		08/05/2011	2012.02	08/05/2011 09:46:01 AM Central Daylight Time	08/08/2011 02:24:02 PM Central Daylight Time	08/05/2011 01:28:34 PM Central Daylight Time		08/09/2011 02:16:58 PM Central Daylight Time	OXFORD HEALTH PLANS (NJ), INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H3107	012	0	2012	Essex and Ocean County		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-234-1228		(800)-234-1228		(800)-547-5514		(800)-547-5514		(800)-234-1228		(800)-234-1228		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3107	801	0	1	01	01	H3107_801_0	2	1		07/06/2011	2012.02	07/06/2011 04:44:52 PM Central Daylight Time	06/03/2011 03:05:36 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	OXFORD HEALTH PLANS (NJ), INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H3107	801	0	2012	State of New Jersey Counties		1		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3107	803	0	1	01	01	H3107_803_0	2	1		07/06/2011	2012.02	07/06/2011 04:44:57 PM Central Daylight Time	06/03/2011 03:06:08 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	OXFORD HEALTH PLANS (NJ), INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H3107	803	0	2012	State of New Jersey Counties		1		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548										(711)		(711)		(711)		(711)										2	2	2
H3107	804	0	1	01	01	H3107_804_0	2	1		07/06/2011	2012.02	07/06/2011 04:45:03 PM Central Daylight Time	06/03/2011 03:06:39 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	OXFORD HEALTH PLANS (NJ), INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H3107	804	0	2012	Morris NJ		1		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3107	807	0	1	02	01	H3107_807_0	2	1		07/06/2011	2012.02	07/06/2011 04:45:21 PM Central Daylight Time	06/03/2011 03:07:12 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	OXFORD HEALTH PLANS (NJ), INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO-POS)	01	02		1			H3107	807	0	2012	Select Counties		1		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3113	001	0	1	01	01	H3113_001_0	4	1		07/22/2011	2012.02	07/22/2011 12:33:26 PM Central Daylight Time	08/05/2011 10:51:54 AM Central Daylight Time	08/05/2011 01:03:33 PM Central Daylight Time		08/09/2011 04:38:46 PM Central Daylight Time	OXFORD HEALTH PLANS (NJ), INC.	Evercare by UnitedHealthcare	www.EvercareHealthPlans.com	UnitedHealthcare Nursing Home Plan (HMO SNP)	01	01		1			H3113	001	0	2012	Bergen,Essex,Hudson,Passaic,Union,Morris,Somerset		2		2			1	1	1	1			www.EvercareHealthPlans.com	EvercareHealthPlans.com/prescription_drug_coverage.jsp	www.PrescriptionSolutions.com	(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3132	001	0	1	01	01	H3132_001_0	9	1		08/10/2011	2012.02	08/10/2011 09:49:17 AM Pacific Daylight Time	08/08/2011 02:30:02 PM Pacific Daylight Time	08/08/2011 02:30:03 PM Pacific Daylight Time		08/10/2011 11:21:19 AM Pacific Daylight Time	AHF MCO OF FLORIDA, INC.	POSITIVE HEALTHCARE PARTNERS	www.positivehealthcare.org	POSITIVE HEALTHCARE PARTNERS (HMO SNP)	01	01		1			H3132	001	0	2012	POSITIVE HEALTHCARE PARTNERS BROWARD AND DADE		2	706	2			1	4		1		00000000001000000000	www.positivehealthcare.org	www.positivehealthcare.org	www.positivehealthcare.org	(888)-456-4715		(888)-456-4715		(888)-456-4715		(888)-456-4715		(866)-763-9096		(866)-763-9096		(888)-456-4715		(888)-456-4715		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3144	001	0	1	01	01	H3144_001_0	7	1		08/09/2011	2012.02	08/09/2011 01:22:14 PM Central Daylight Time	08/08/2011 05:07:28 PM Central Daylight Time	08/09/2011 01:09:35 PM Central Daylight Time		08/09/2011 01:36:28 PM Central Daylight Time	PERSONALCARE INSURANCE OF ILLINOIS, INC.	PersonalCare	www.advantraplans.com	Coventry Total Care (HMO)	01	01		1			H3144	001	0	2012	Central and Northern Illinois		2	540	2			2						www.pcadvantra.com	www.pcadvantra.com	www.pcadvantra.com	(866)-784-4916		(866)-784-4916		(877)-983-7775		(877)-983-7775		(866)-784-4916		(866)-784-4916		(877)-983-7775		(877)-983-7775		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3144	801	0	1	01	01	H3144_801_0	2	1		06/01/2011	2012.02	06/01/2011 03:08:13 PM Central Daylight Time	07/27/2011 02:08:21 PM Central Daylight Time			07/28/2011 08:07:02 AM Central Daylight Time	PERSONALCARE INSURANCE OF ILLINOIS, INC.	PersonalCare	www.advantraplans.com	Employer Group Calendar Rx (HMO)	01	01		1			H3144	801	0	2012	Central and Northern Illinois		1	100	2			2						www.pcadvantra.com	www.pcadvantra.com	www.pcadvantra.com	(866)-784-4916		(866)-784-4916		(877)-983-7775		(877)-983-7775		(866)-784-4916		(866)-784-4916		(877)-983-7775		(877)-983-7775		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H3144	802	0	1	01	01	H3144_802_0	2	1		06/01/2011	2012.02	06/01/2011 03:08:27 PM Central Daylight Time	07/27/2011 02:09:16 PM Central Daylight Time			07/28/2011 08:07:02 AM Central Daylight Time	PERSONALCARE INSURANCE OF ILLINOIS, INC.	PersonalCare	www.advantraplans.com	Employer Group Non Calendar Rx (HMO)	01	01		1			H3144	802	0	2012	Central and Northern Illinois		1	100	2			2						www.pcadvantra.com	www.pcadvantra.com	www.pcadvantra.com	(866)-784-4916		(866)-784-4916		(877)-983-7775		(877)-983-7775		(866)-784-4916		(866)-784-4916		(877)-983-7775		(877)-983-7775		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H3144	803	0	1	01	01	H3144_803_0	3	1		06/01/2011	2012.02	06/01/2011 03:08:45 PM Central Daylight Time	07/27/2011 02:15:24 PM Central Daylight Time			07/29/2011 09:31:19 AM Central Daylight Time	PERSONALCARE INSURANCE OF ILLINOIS, INC.	PersonalCare	www.advantraplans.com	Employer Group Calendar No Rx (HMO)	01	01		1			H3144	803	0	2012	Central and Northern Illinois		1	100	2			2						www.pcadvantra.com	www.pcadvantra.com	www.pcadvantra.com	(866)-784-4916		(866)-784-4916		(877)-983-7775		(877)-983-7775										(711)		(711)		(711)		(711)										1	1	1
H3152	022	0	1	01	01	H3152_022_0	3	1		07/08/2011	2012.02	07/08/2011 10:00:51 AM Central Daylight Time	08/04/2011 01:37:46 PM Central Daylight Time	08/04/2011 09:42:54 AM Central Daylight Time		08/08/2011 09:25:05 AM Central Daylight Time	AETNA HEALTH, INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Standard Plan (HMO)	01	01		1			H3152	022	0	2012	Southern New Jersey		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H3152	045	0	1	01	01	H3152_045_0	2	1		07/08/2011	2012.02	07/08/2011 10:01:59 AM Central Daylight Time	07/15/2011 11:32:43 AM Central Daylight Time			07/18/2011 09:27:55 AM Central Daylight Time	AETNA HEALTH, INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Basic Plan (HMO)	01	01		1			H3152	045	0	2012	Northern New Jersey		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748										2	2	2
H3152	046	0	1	01	01	H3152_046_0	3	1		07/08/2011	2012.02	07/08/2011 10:02:20 AM Central Daylight Time	08/04/2011 01:40:37 PM Central Daylight Time	08/04/2011 09:43:18 AM Central Daylight Time		08/08/2011 09:25:05 AM Central Daylight Time	AETNA HEALTH, INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (HMO)	01	01		1			H3152	046	0	2012	Northern New Jersey		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H3152	048	0	1	01	01	H3152_048_0	5	1		07/12/2011	2012.02	07/12/2011 03:39:28 PM Central Daylight Time	08/04/2011 01:41:27 PM Central Daylight Time	08/04/2011 09:43:52 AM Central Daylight Time		08/08/2011 09:25:05 AM Central Daylight Time	AETNA HEALTH, INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (HMO)	01	01		1			H3152	048	0	2012	Northern New Jersey		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H3152	077	0	1	01	01	H3152_077_0	5	1		07/12/2011	2012.02	07/12/2011 02:44:02 PM Central Daylight Time	08/04/2011 01:42:27 PM Central Daylight Time	08/04/2011 09:44:29 AM Central Daylight Time		08/08/2011 09:25:05 AM Central Daylight Time	AETNA HEALTH, INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Standard Plan (HMO)	01	01		1			H3152	077	0	2012	Mercer County		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H3152	801	0	1	01	01	H3152_801_0	2	1		04/22/2011	2012.02	04/22/2011 09:52:18 AM Eastern Daylight Time	06/02/2011 01:28:41 PM Eastern Daylight Time			06/03/2011 06:19:28 PM Eastern Daylight Time	AETNA HEALTH, INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan (HMO)	01	01		1			H3152	801	0	2012	New Jersey		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748										1	1	1
H3152	804	0	1	01	01	H3152_804_0	2	1		04/22/2011	2012.02	04/22/2011 09:52:35 AM Eastern Daylight Time	06/02/2011 01:21:43 PM Eastern Daylight Time			06/03/2011 06:19:28 PM Eastern Daylight Time	AETNA HEALTH, INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan w/Rx CY (HMO)	01	01		1			H3152	804	0	2012	New Jersey		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		1	1	1
H3154	004	0	1	01	01	H3154_004_0	4	1		08/08/2011	2012.02	08/08/2011 11:41:52 AM Eastern Daylight Time	08/09/2011 09:01:53 AM Eastern Daylight Time	08/09/2011 09:01:18 AM Eastern Daylight Time		08/09/2011 09:15:14 AM Eastern Daylight Time	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www.HorizonBlue.com/Medicare	Horizon Medicare Blue Value w/ Rx Std (HMO)	01	01		1			H3154	004	0	2012	New Jersey		2		2			2						www.horizonblue.com	http://www.horizonblue.com/medicare/partd/Pharmacy_Formulary_search.aspx	http://www.horizonblue.com/medicare/partd/	(800)-365-2223		(800)-365-2223		(800)-224-1234		(800)-224-1234		(866)-236-7376		(866)-236-7376		(800)-224-1234		(800)-224-1234		(800)-855-2881		(800)-855-2881		(800)-852-7899		(800)-852-7899		(866)-236-1069		(866)-236-1069		(800)-852-7899		(800)-852-7899		2	2	2
H3154	005	0	1	02	01	H3154_005_0	6	1		07/19/2011	2012.02	07/19/2011 09:54:36 AM Eastern Daylight Time	07/15/2011 08:53:34 AM Eastern Daylight Time			07/19/2011 01:47:28 PM Eastern Daylight Time	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www.HorizonBlue.com/Medicare	Horizon Medicare Blue Access (HMO-POS)	01	02		1			H3154	005	0	2012	New Jersey		2		2			2						www.horizonblue.com	http://www.horizonblue.com/medicare/partd/Pharmacy_Formulary_search.aspx	http://www.horizonblue.com/medicare/partd/	(800)-365-2223		(800)-365-2223		(800)-224-1234		(800)-224-1234										(800)-855-2881		(800)-855-2881		(800)-852-7899		(800)-852-7899										2	2	2
H3154	006	0	1	02	01	H3154_006_0	5	1		07/19/2011	2012.02	07/19/2011 09:55:31 AM Eastern Daylight Time	08/09/2011 09:03:08 AM Eastern Daylight Time	08/09/2011 09:02:36 AM Eastern Daylight Time		08/09/2011 09:15:14 AM Eastern Daylight Time	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www.HorizonBlue.com/Medicare	Horizon Medicare Blue Access w/Rx Enhanced (HMO-POS)	01	02		1			H3154	006	0	2012	New Jersey		2		2			2						www.horizonblue.com	http://www.horizonblue.com/medicare/partd/Pharmacy_Formulary_search.aspx	http://www.horizonblue.com/medicare/partd/	(800)-365-2223		(800)-365-2223		(800)-224-1234		(800)-224-1234		(866)-236-7376		(866)-236-7376		(800)-224-1234		(800)-224-1234		(800)-855-2881		(800)-855-2881		(800)-852-7899		(800)-852-7899		(866)-236-1069		(866)-236-1069		(800)-852-7899		(800)-852-7899		2	2	2
H3154	012	0	1	02	01	H3154_012_0	5	1		07/19/2011	2012.02	07/19/2011 09:56:04 AM Eastern Daylight Time	08/09/2011 09:04:21 AM Eastern Daylight Time	08/09/2011 09:03:47 AM Eastern Daylight Time		08/09/2011 09:15:14 AM Eastern Daylight Time	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www.HorizonBlue.com/Medicare	Horizon Medicare Blue Access w/ Rx Std (HMO-POS)	01	02		1			H3154	012	0	2012	New Jersey		2		2			2						www.horizonblue.com	http://www.horizonblue.com/medicare/partd/Pharmacy_Formulary_search.aspx	http://www.horizonblue.com/medicare/partd/	(800)-365-2223		(800)-365-2223		(800)-224-1234		(800)-224-1234		(866)-236-7376		(866)-236-7376		(800)-224-1234		(800)-224-1234		(800)-855-2881		(800)-855-2881		(800)-852-7899		(800)-852-7899		(866)-236-1069		(866)-236-1069		(800)-852-7899		(800)-852-7899		2	2	2
H3154	013	0	1	01	01	H3154_013_0	5	1		07/13/2011	2012.02	07/13/2011 08:38:03 AM Eastern Daylight Time	07/15/2011 08:56:30 AM Eastern Daylight Time			07/15/2011 09:10:57 AM Eastern Daylight Time	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www.HorizonBlue.com/Medicare	Horizon Medicare Blue Value (HMO)	01	01		1			H3154	013	0	2012	New Jersey		2		2			2						www.horizonblue.com	http://www.horizonblue.com/medicare/partd/Pharmacy_Formulary_search.aspx	http://www.horizonblue.com/medicare/partd/	(800)-365-2223		(800)-365-2223		(800)-224-1234		(800)-224-1234										(800)-855-2881		(800)-855-2881		(800)-852-7899		(800)-852-7899										2	2	2
H3154	016	0	1	01	01	H3154_016_0	4	1		07/13/2011	2012.02	07/13/2011 08:38:58 AM Eastern Daylight Time	08/09/2011 09:05:36 AM Eastern Daylight Time	08/09/2011 09:05:01 AM Eastern Daylight Time		08/09/2011 09:15:14 AM Eastern Daylight Time	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www.HorizonBlue.com/Medicare	Horizon Medicare Blue Value w/ Rx Enhanced (HMO)	01	01		1			H3154	016	0	2012	New Jersey		2		2			2						www.horizonblue.com	http://www.horizonblue.com/medicare/partd/Pharmacy_Formulary_search.aspx	http://www.horizonblue.com/medicare/partd/	(800)-365-2223		(800)-365-2223		(800)-224-1234		(800)-224-1234		(866)-236-7376		(866)-236-7376		(800)-224-1234		(800)-224-1234		(800)-855-2881		(800)-855-2881		(800)-852-7899		(800)-852-7899		(866)-236-1069		(866)-236-1069		(800)-852-7899		(800)-852-7899		2	2	2
H3154	020	0	1	01	01	H3154_020_0	4	1	2	08/08/2011	2012.02	08/08/2011 11:42:25 AM Eastern Daylight Time	08/09/2011 09:06:50 AM Eastern Daylight Time	08/09/2011 09:06:25 AM Eastern Daylight Time		08/09/2011 09:15:14 AM Eastern Daylight Time	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www.HorizonBlue.com/Medicare	Horizon Medicare Blue TotalCare (HMO SNP)	01	01		1			H3154	020	0	2012	NJ		2		2			1	3		1	5		www.horizonblue.com	http://www.horizonblue.com/medicare/partd/Pharmacy_Formulary_search.aspx	http://www.horizonblue.com/medicare/partd/	(800)-365-2223		(800)-365-2223		(800)-224-1234		(800)-224-1234		(866)-236-7376		(866)-236-7376		(800)-224-1234		(800)-224-1234		(800)-855-2881		(800)-855-2881		(800)-852-7899		(800)-852-7899		(866)-236-1069		(866)-236-1069		(800)-852-7899		(800)-852-7899		2	2	2
H3154	801	0	1	02	01	H3154_801_0	5	1		07/20/2011	2012.02	07/20/2011 01:00:21 PM Eastern Daylight Time	07/15/2011 08:59:16 AM Eastern Daylight Time			07/20/2011 01:41:47 PM Eastern Daylight Time	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www.horizonblue.com/Medicare	Horizon Medicare Blue Access Group (HMO-POS)	01	02		1			H3154	801	0	2012	New Jersey		1		2			2						www.horizonblue.com	http://www.horizonblue.com/medicare/partd/Pharmacy_Formulary_search.aspx	http://www.horizonblue.com/medicare/partd/	(800)-365-2223		(800)-365-2223		(800)-224-1234		(800)-224-1234										(800)-855-2881		(800)-855-2881		(800)-852-7899		(800)-852-7899										2	2	2
H3154	802	0	1	02	01	H3154_802_0	5	1		07/20/2011	2012.02	07/20/2011 01:00:34 PM Eastern Daylight Time	07/15/2011 08:59:52 AM Eastern Daylight Time			07/20/2011 01:41:47 PM Eastern Daylight Time	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www.horizonblue.com/Medicare	Horizon Medicare Blue Access Grp w/ Rx (HMO-POS)	01	02		1			H3154	802	0	2012	New Jersey		1		2			2						www.horizonblue.com	http://www.horizonblue.com/medicare/partd/Pharmacy_Formulary_search.aspx	http://www.horizonblue.com/medicare/partd/	(800)-365-2223		(800)-365-2223		(800)-224-1234		(800)-224-1234		(866)-236-7376		(866)-236-7376		(800)-224-1234		(800)-224-1234		(800)-855-2881		(800)-855-2881		(800)-852-7899		(800)-852-7899		(866)-236-1069		(866)-236-1069		(800)-852-7899		(800)-852-7899		2	2	2
H3154	805	0	1	02	01	H3154_805_0	6	1		07/20/2011	2012.02	07/20/2011 01:02:24 PM Eastern Daylight Time	07/15/2011 09:01:31 AM Eastern Daylight Time			07/20/2011 01:41:47 PM Eastern Daylight Time	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www.horizonblue.com/Medicare	Horizon Medicare Blue Access Grp w/ Rx (HMO-POS)	01	02		1			H3154	805	0	2012	New Jersey		1		2			2						www.horizonblue.com	http://www.horizonblue.com/medicare/partd/Pharmacy_Formulary_search.aspx	http://www.horizonblue.com/medicare/partd/	(800)-365-2223		(800)-365-2223		(800)-224-1234		(800)-224-1234		(866)-236-7376		(866)-236-7376		(800)-224-1234		(800)-224-1234		(800)-855-2881		(800)-855-2881		(800)-852-7899		(800)-852-7899		(866)-236-1069		(866)-236-1069		(800)-852-7899		(800)-852-7899		2	2	2
H3156	027	0	1	01	01	H3156_027_0	6	1		07/13/2011	2012.02	07/13/2011 02:29:47 PM Eastern Daylight Time	07/19/2011 10:49:36 AM Eastern Daylight Time			07/19/2011 11:54:14 AM Eastern Daylight Time	AMERIHEALTH HMO_INC	AmeriHealth 65	www.amerihealthmedicare.com	AmeriHealth 65 NJ Medical Only (HMO)	01	01		1			H3156	027	0	2012	Salem, Burlington, Camden, Cumberland, Gloucester		2	36	2			2							http://www.amerihealthmedicare.com/find_a_drug/index.html	http://www.amerihealthmedicare.com/find_a_provider/index.html	(800)-645-3965		(800)-645-3965		(800)-898-3492		(800)-898-3492										(888)-857-4816		(888)-857-4816		(877)-219-5457		(877)-219-5457										2	2	2
H3156	028	0	1	01	01	H3156_028_0	7	1		07/14/2011	2012.02	07/14/2011 09:23:18 AM Eastern Daylight Time	08/04/2011 02:38:01 PM Eastern Daylight Time	08/04/2011 01:46:05 PM Eastern Daylight Time		08/05/2011 05:36:25 PM Eastern Daylight Time	AMERIHEALTH HMO_INC	AmeriHealth 65	www.amerihealthmedicare.com	AmeriHealth 65 NJ Rx (HMO)	01	01		1			H3156	028	0	2012	Salem, Burlington, Camden, Cumberland, Gloucester		2	488	2			2							http://www.amerihealthmedicare.com/find_a_drug/index.html	http://www.amerihealthmedicare.com/find_a_provider/index.html	(800)-645-3965		(800)-645-3965		(800)-898-3492		(800)-898-3492		(800)-645-3965		(800)-645-3965		(800)-898-3492		(800)-898-3492		(888)-857-4816		(888)-857-4816		(877)-219-5457		(877)-219-5457		(888)-857-4816		(888)-857-4816		(877)-219-5457		(877)-219-5457		2	2	2
H3156	801	0	1	01	01	H3156_801_0	5	1		07/18/2011	2012.02	07/18/2011 10:19:32 PM Eastern Daylight Time	08/18/2011 03:10:09 PM Eastern Daylight Time			08/18/2011 04:31:31 PM Eastern Daylight Time	AMERIHEALTH HMO_INC	AmeriHealth 65	www.amerihealthmedicare.com	AmeriHealth 65 NJ Group Medical Only (HMO)	01	01		1			H3156	801	0	2012	State of New Jersey		1		2			2							http://www.amerihealthmedicare.com/find_a_drug/index.html	http://www.amerihealthmedicare.com/find_a_provider/index.html	(800)-645-3965		(800)-645-3965		(800)-898-3492		(800)-898-3492										(888)-857-4816		(888)-857-4816		(877)-219-5457		(877)-219-5457										2	2	2
H3156	803	0	1	01	01	H3156_803_0	5	1		07/18/2011	2012.02	07/18/2011 10:21:00 PM Eastern Daylight Time	08/18/2011 03:13:33 PM Eastern Daylight Time			08/18/2011 04:31:31 PM Eastern Daylight Time	AMERIHEALTH HMO_INC	AmeriHealth 65	www.amerihealthmedicare.com	AmeriHealth 65 NJ Group Rx (HMO)	01	01		1			H3156	803	0	2012	State of New Jersey		1		2			2							http://www.amerihealthmedicare.com/find_a_drug/index.html	http://www.amerihealthmedicare.com/find_a_provider/index.html	(800)-645-3965		(800)-645-3965		(800)-898-3492		(800)-898-3492		(800)-645-3965		(800)-645-3965		(800)-898-3492		(800)-898-3492		(888)-857-4816		(888)-857-4816		(877)-219-5457		(877)-219-5457		(888)-857-4816		(888)-857-4816		(877)-219-5457		(877)-219-5457		2	2	2
H3164	003	0	1	01	01	H3164_003_0	6	1	2	07/22/2011	2012.02	07/22/2011 12:04:11 PM Central Daylight Time	08/05/2011 10:50:42 AM Central Daylight Time	08/05/2011 01:03:54 PM Central Daylight Time		08/09/2011 12:16:18 PM Central Daylight Time	AMERICHOICE OF NEW JERSEY, INC	UnitedHealthcare Community Plan	www.UHCDualComplete.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H3164	003	0	2012	Northern, Central, and Southern New Jersey		2		2			1	3		1	2		www.UHCDualComplete.com	www.americhoice.com	www.prescriptionsolutions.com	(800)-514-4911		(800)-514-4911		(888)-565-8170		(888)-565-8170		(800)-514-4911		(800)-514-4911		(888)-565-8170		(888)-565-8170		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3204	001	0	1	01	01	H3204_001_0	12	1		08/19/2011	2012.02	08/19/2011 10:56:08 AM Mountain Daylight Time	08/08/2011 10:04:06 AM Mountain Daylight Time	08/08/2011 10:04:10 AM Mountain Daylight Time		08/19/2011 11:10:20 AM Mountain Daylight Time	PRESBYTERIAN HEALTH PLAN	Presbyterian Senior Care (HMO)	www.phs.org	Presbyterian Senior Care Plan 2 with Rx (HMO)	01	01		1			H3204	001	0	2012	Greater Albuquerque Area		2	13530	2			2							http://www.phs.org/idc/groups/public/@phs/@marketing/documents/phscontent/pel_00078312.pdf	http://www.phs.org/PHS/programs/pharmacy/Medicare/index.htm	(800)-797-5343		(505)-923-6060		(800)-347-4766		(505)-923-8458		(800)-797-5343		(505)-923-6060		(800)-347-4766		(505)-923-8458		(888)-625-8818		(888)-625-8818		(888)-625-6429		(888)-625-6429		(888)-625-8818		(888)-625-8818		(888)-625-6429		(888)-625-6429		2	2	2
H3204	007	0	1	01	01	H3204_007_0	12	1		08/19/2011	2012.02	08/19/2011 10:59:17 AM Mountain Daylight Time	08/08/2011 10:05:11 AM Mountain Daylight Time	08/08/2011 10:05:15 AM Mountain Daylight Time		08/19/2011 11:10:20 AM Mountain Daylight Time	PRESBYTERIAN HEALTH PLAN	Presbyterian Senior Care (HMO)	www.phs.org	Presbyterian Senior Care Plan 3 with Rx (HMO)	01	01		1			H3204	007	0	2012	Greater Albuquerque Area		2	5438	2			2							http://www.phs.org/idc/groups/public/@phs/@marketing/documents/phscontent/pel_00078312.pdf	http://www.phs.org/PHS/programs/pharmacy/Medicare/index.htm	(800)-797-5343		(505)-923-6060		(800)-347-4766		(505)-923-8458		(800)-797-5343		(505)-923-6060		(800)-347-4766		(505)-923-8458		(888)-625-8818		(888)-625-8818		(888)-625-6429		(888)-625-6429		(888)-625-8818		(888)-625-8818		(888)-625-6429		(888)-625-6429		2	2	2
H3204	008	0	1	01	01	H3204_008_0	8	1		08/19/2011	2012.02	08/19/2011 10:57:06 AM Mountain Daylight Time	06/06/2011 07:21:02 AM Mountain Daylight Time			08/19/2011 11:10:20 AM Mountain Daylight Time	PRESBYTERIAN HEALTH PLAN	Presbyterian Senior Care (HMO)	www.phs.org	Presbyterian Senior Care Plan 1 (HMO)	01	01		1			H3204	008	0	2012	Greater Albuquerque Area		2	1592	2			2							http://www.phs.org/idc/groups/public/@phs/@marketing/documents/phscontent/pel_00078312.pdf	http://www.phs.org/PHS/programs/pharmacy/Medicare/index.htm	(800)-797-5343		(505)-923-6060		(800)-347-4766		(505)-923-8458										(888)-625-8818		(888)-625-8818		(888)-625-6429		(888)-625-6429										2	2	2
H3204	801	0	1	01	01	H3204_801_0	4	1		06/06/2011	2012.02	06/06/2011 10:50:30 AM Mountain Daylight Time	06/06/2011 07:21:36 AM Mountain Daylight Time			06/06/2011 11:42:03 AM Mountain Daylight Time	PRESBYTERIAN HEALTH PLAN	Presbyterian Senior Care (HMO)	www.phs.org	Pres Senior Care Emp Group Plan 2 with Rx (HMO)	01	01		1			H3204	801	0	2012	Greater Albuquerque Area		1	2509	2			2							http://www.phs.org/idc/groups/public/@phs/@marketing/documents/phscontent/pel_00078312.pdf	http://www.phs.org/PHS/programs/pharmacy/Medicare/index.htm	(800)-797-5343		(505)-923-6060		(800)-347-4766		(505)-923-8458		(800)-797-5343		(505)-923-6060		(800)-347-4766		(505)-923-8458		(888)-625-8818		(888)-625-8818		(888)-625-6429		(888)-625-6429		(888)-625-8818		(888)-625-8818		(888)-625-6429		(888)-625-6429		1	1	1
H3204	802	0	1	01	01	H3204_802_0	4	1		06/06/2011	2012.02	06/06/2011 10:50:38 AM Mountain Daylight Time	06/05/2011 08:06:28 AM Mountain Daylight Time			06/06/2011 11:42:03 AM Mountain Daylight Time	PRESBYTERIAN HEALTH PLAN	Presbyterian Senior Care (HMO)	www.phs.org	Pres Senior Care Emp Group Plan 1 (HMO)	01	01		1			H3204	802	0	2012	Greater Albuquerque Area		1		2			2							http://www.phs.org/idc/groups/public/@phs/@marketing/documents/phscontent/pel_00078312.pdf	http://www.phs.org/PHS/programs/pharmacy/Medicare/index.htm	(800)-797-5343		(505)-923-6060		(800)-347-4766		(505)-923-8458										(888)-625-8818		(888)-625-8818		(888)-625-6429		(888)-625-6429										1	1	1
H3204	803	0	1	01	01	H3204_803_0	4	1		06/06/2011	2012.02	06/06/2011 10:50:44 AM Mountain Daylight Time	06/05/2011 08:06:34 AM Mountain Daylight Time			06/06/2011 11:42:03 AM Mountain Daylight Time	PRESBYTERIAN HEALTH PLAN	Presbyterian Senior Care (HMO)	www.phs.org	Pres Senior Care Emp Group Plan 2 w/ Rx NC (HMO)	01	01		1			H3204	803	0	2012	Greater Albuquerque Area		1		2			2							http://www.phs.org/idc/groups/public/@phs/@marketing/documents/phscontent/pel_00078312.pdf	http://www.phs.org/PHS/programs/pharmacy/Medicare/index.htm	(800)-797-5343		(505)-923-6060		(800)-347-4766		(505)-923-8458		(800)-797-5343		(505)-923-6060		(800)-347-4766		(505)-923-8458		(888)-625-8818		(888)-625-8818		(888)-625-6429		(888)-625-6429		(888)-625-8818		(888)-625-8818		(888)-625-6429		(888)-625-6429		1	1	1
H3206	001	0	1	04	01	H3206_001_0	12	1		08/19/2011	2012.02	08/19/2011 10:57:26 AM Mountain Daylight Time	08/08/2011 10:07:25 AM Mountain Daylight Time	08/08/2011 10:07:29 AM Mountain Daylight Time		08/19/2011 11:10:20 AM Mountain Daylight Time	PRESBYTERIAN INSURANCE COMPANY, INC.	Presbyterian MediCare PPO	www.phs.org	Presbyterian MediCare PPO Plan 2 with Rx (PPO)	01	04		1			H3206	001	0	2012	New Mexico		2	3478	2			2							http://www.phs.org/idc/groups/public/@phs/@marketing/documents/phscontent/pel_00078312.pdf	http://www.phs.org/PHS/programs/pharmacy/index.htm	(800)-797-5343		(505)-923-6060		(800)-347-4766		(505)-923-8458		(800)-797-5343		(505)-923-6060		(800)-347-4766		(505)-923-8458		(888)-625-8818		(888)-625-8818		(888)-625-6429		(888)-625-6429		(888)-625-8818		(888)-625-8818		(888)-625-6429		(888)-625-6429		2	2	2
H3206	002	0	1	04	01	H3206_002_0	12	1		08/19/2011	2012.02	08/19/2011 10:57:40 AM Mountain Daylight Time	08/08/2011 10:09:38 AM Mountain Daylight Time	08/08/2011 10:09:49 AM Mountain Daylight Time		08/19/2011 11:10:20 AM Mountain Daylight Time	PRESBYTERIAN INSURANCE COMPANY, INC.	Presbyterian MediCare PPO	www.phs.org	Presbyterian MediCare PPO Plan 3 with Rx (PPO)	01	04		1			H3206	002	0	2012	New Mexico		2	1364	2			2							http://www.phs.org/idc/groups/public/@phs/@marketing/documents/phscontent/pel_00078312.pdf	http://www.phs.org/PHS/programs/pharmacy/index.htm	(800)-797-5343		(505)-923-6060		(800)-347-4766		(505)-923-8458		(800)-797-5343		(505)-923-6060		(800)-347-4766		(505)-923-8458		(888)-625-8818		(888)-625-8818		(888)-625-6429		(888)-625-6429		(888)-625-8818		(888)-625-8818		(888)-625-6429		(888)-625-6429		2	2	2
H3206	003	0	1	04	01	H3206_003_0	9	1		08/19/2011	2012.02	08/19/2011 10:57:53 AM Mountain Daylight Time	06/05/2011 08:07:04 AM Mountain Daylight Time			08/19/2011 11:10:20 AM Mountain Daylight Time	PRESBYTERIAN INSURANCE COMPANY, INC.	Presbyterian MediCare PPO	www.phs.org	Presbyterian MediCare PPO Plan 1 (PPO)	01	04		1			H3206	003	0	2012	New Mexico		2	470	2			2							http://www.phs.org/idc/groups/public/@phs/@marketing/documents/phscontent/pel_00078312.pdf	http://www.phs.org/PHS/programs/pharmacy/index.htm	(800)-797-5343		(505)-923-6060		(800)-347-4766		(505)-923-8458										(888)-625-8818		(888)-625-8818		(888)-625-6429		(888)-625-6429										2	2	2
H3206	801	0	1	04	01	H3206_801_0	4	1		06/06/2011	2012.02	06/06/2011 10:52:10 AM Mountain Daylight Time	06/05/2011 08:07:15 AM Mountain Daylight Time			06/06/2011 11:42:03 AM Mountain Daylight Time	PRESBYTERIAN INSURANCE COMPANY, INC.	Presbyterian MediCare PPO	www.phs.org	Pres MediCare PPO Emp Group Plan 2 with Rx (PPO)	01	04		1			H3206	801	0	2012	New Mexico		1	4432	2			2							http://www.phs.org/idc/groups/public/@phs/@marketing/documents/phscontent/pel_00078312.pdf	http://www.phs.org/PHS/programs/pharmacy/index.htm	(800)-797-5343		(505)-923-6060		(800)-347-4766		(505)-923-8458		(800)-797-5343		(505)-923-6060		(800)-347-4766		(505)-923-8458		(888)-625-8818		(888)-625-8818		(888)-625-6429		(888)-625-6429		(888)-625-8818		(888)-625-8818		(888)-625-6429		(888)-625-6429		1	1	1
H3206	802	0	1	04	01	H3206_802_0	4	1		06/06/2011	2012.02	06/06/2011 10:52:16 AM Mountain Daylight Time	06/05/2011 08:07:29 AM Mountain Daylight Time			06/06/2011 11:42:03 AM Mountain Daylight Time	PRESBYTERIAN INSURANCE COMPANY, INC.	Presbyterian MediCare PPO	www.phs.org	Pres Medicare PPO Employer Group Plan 1 (PPO)	01	04		1			H3206	802	0	2012	New Mexico		1		2			2							http://www.phs.org/idc/groups/public/@phs/@marketing/documents/phscontent/pel_00078312.pdf	http://www.phs.org/PHS/programs/pharmacy/index.htm	(800)-797-5343		(505)-923-6060		(800)-347-4766		(505)-923-8458										(888)-625-8818		(888)-625-8818		(888)-625-6429		(888)-625-6429										1	1	1
H3206	803	0	1	04	01	H3206_803_0	4	1		06/06/2011	2012.02	06/06/2011 10:52:21 AM Mountain Daylight Time	06/05/2011 08:07:34 AM Mountain Daylight Time			06/06/2011 11:42:03 AM Mountain Daylight Time	PRESBYTERIAN INSURANCE COMPANY, INC.	Presbyterian MediCare PPO	www.phs.org	Pres MediCare PPO Empl Group Plan 2 +Rx NC (PPO)	01	04		1			H3206	803	0	2012	New Mexico		1		2			2							http://www.phs.org/idc/groups/public/@phs/@marketing/documents/phscontent/pel_00078312.pdf	http://www.phs.org/PHS/programs/pharmacy/index.htm	(800)-797-5343		(505)-923-6060		(800)-347-4766		(505)-923-8458		(800)-797-5343		(505)-923-6060		(800)-347-4766		(505)-923-8458		(888)-625-8818		(888)-625-8818		(888)-625-6429		(888)-625-6429		(888)-625-8818		(888)-625-8818		(888)-625-6429		(888)-625-6429		1	1	1
H3209	001	0	1	04	01	H3209_001_0	4	1		07/22/2011	2012.02	07/22/2011 12:07:46 PM Central Daylight Time	08/09/2011 05:34:16 PM Central Daylight Time	08/05/2011 01:04:16 PM Central Daylight Time		08/09/2011 06:05:11 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	Evercare by UnitedHealthcare	www.EvercareHealthPlans.com	UnitedHealthcare Nursing Home Plan (PPO SNP)	01	04		1			H3209	001	0	2012	Bernalillo County		2		2			1	1	1	1			www.EvercareHealthPlans.com	EvercareHealthPlans.com/prescription_drug_coverage.jsp	www.PrescriptionSolutions.com	(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3209	002	0	1	04	01	H3209_002_0	6	1	2	07/22/2011	2012.02	07/22/2011 12:05:14 PM Central Daylight Time	08/09/2011 01:50:46 PM Central Daylight Time	08/05/2011 01:04:38 PM Central Daylight Time		08/09/2011 02:22:44 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	Evercare by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Dual Complete (PPO SNP)	01	04		1			H3209	002	0	2012	Bernalillo, Sandoval, Santa Fe, Valencia Counties		2		2			1	3		1	2		www.EvercareHealthPlans.com	EvercareHealthPlans.com/prescription_drug_coverage.jsp	www.PrescriptionSolutions.com	(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3240	010	0	1	01	01	H3240_010_0	7	1		07/19/2011	2012.02	07/19/2011 07:50:12 AM Eastern Daylight Time	08/05/2011 09:55:00 AM Eastern Daylight Time	08/04/2011 05:26:00 PM Eastern Daylight Time		08/09/2011 05:31:53 PM Eastern Daylight Time	AMERIGROUP NEW JERSEY, INC.	Amerigroup Community Care	www.myamerigroup.com/medicare	Amerivantage Balance + Rx (HMO)	01	01		1			H3240	010	0	2012	Eastern / Central New Jersey		2	1674	2			2						www.myamerigroup.com/medicare	http://www.amerigroupcorp.com/Members/amerivantage/_documents	http://www.amerigroupcorp.com/Members/amerivantage	(866)-805-4589		(866)-805-4589		(877)-470-4131		(877)-470-4131		(866)-805-4589		(866)-805-4589		(877)-470-4131		(877)-470-4131		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		2	2	2
H3240	013	0	1	01	01	H3240_013_0	7	1	2	08/05/2011	2012.02	08/05/2011 10:23:45 AM Eastern Daylight Time	08/05/2011 09:55:00 AM Eastern Daylight Time	08/04/2011 05:26:00 PM Eastern Daylight Time		08/09/2011 05:31:53 PM Eastern Daylight Time	AMERIGROUP NEW JERSEY, INC.	Amerigroup Community Care	www.myamerigroup.com/medicare	Amerivantage Specialty + Rx (HMO SNP)	01	01		1			H3240	013	0	2012	Eastern / Central New Jersey		2	838	2			1	3		1	1		www.myamerigroup.com/medicare	http://www.amerigroupcorp.com/Members/amerivantage/_documents	http://www.amerigroupcorp.com/Members/amerivantage	(866)-805-4589		(866)-805-4589		(877)-470-4131		(877)-470-4131		(866)-805-4589		(866)-805-4589		(877)-470-4131		(877)-470-4131		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		2	2	2
H3251	002	0	1	01	01	H3251_002_0	7	1		08/02/2011	2012.02	08/02/2011 12:44:27 PM Mountain Daylight Time	08/04/2011 05:07:36 PM Mountain Daylight Time	08/04/2011 08:43:57 AM Mountain Daylight Time		08/05/2011 03:07:27 PM Mountain Daylight Time	LOVELACE HEALTH SYSTEM, INC.	Lovelace Medicare Plan	www.lovelacemedicareplan.com	Lovelace Medicare Plan -- Standard Plan (HMO)	01	01		1			H3251	002	0	2012	Greater Albuquerque / Santa Fe Area		2	18108	2			2						www.lovelacemedicareplan.com	www.lovelacemedicareplan.com	www.lovelacemedicareplan.com	(855)-730-5683		(855)-730-5683		(800)-262-3757		(800)-262-3757		(855)-730-5683		(855)-730-5683		(800)-262-3757		(800)-262-3757		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3251	021	0	1	02	01	H3251_021_0	7	1		08/02/2011	2012.02	08/02/2011 12:44:37 PM Mountain Daylight Time	08/04/2011 05:09:04 PM Mountain Daylight Time	08/04/2011 09:49:46 AM Mountain Daylight Time		08/05/2011 03:13:16 PM Mountain Daylight Time	LOVELACE HEALTH SYSTEM, INC.	Lovelace Medicare Plan	www.lovelacemedicareplan.com	Lovelace Medicare Plan -- Enhanced Plan (HMO-POS)	01	02		1			H3251	021	0	2012	Greater Albuquerque / Santa Fe Area		2	4549	2			2						www.lovelacemedicareplan.com	www.lovelacemedicareplan.com	www.lovelacemedicareplan.com	(855)-730-5683		(855)-730-5683		(800)-262-3757		(800)-262-3757		(855)-730-5683		(855)-730-5683		(800)-262-3757		(800)-262-3757		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3251	023	0	1	01	01	H3251_023_0	6	1		08/02/2011	2012.02	08/02/2011 12:44:46 PM Mountain Daylight Time	07/27/2011 12:37:19 PM Mountain Daylight Time			08/02/2011 01:01:17 PM Mountain Daylight Time	LOVELACE HEALTH SYSTEM, INC.	Lovelace Medicare Plan	www.lovelaceseniorplan.com	Lovelace Medicare Plan - Medical Only (HMO)	01	01		1			H3251	023	0	2012	Greater Albuquerque / Santa Fe Area		2	119	2			2						www.lovelacemedicareplan.com	www.lovelacemedicareplan.com	www.lovelacemedicareplan.com	(855)-730-5683		(855)-730-5683		(800)-262-3757		(800)-262-3757										(711)		(711)		(711)		(711)										2	2	2
H3251	024	0	1	01	01	H3251_024_0	6	1		08/02/2011	2012.02	08/02/2011 12:45:01 PM Mountain Daylight Time	08/04/2011 05:10:34 PM Mountain Daylight Time	08/04/2011 09:51:19 AM Mountain Daylight Time		08/05/2011 03:33:08 PM Mountain Daylight Time	LOVELACE HEALTH SYSTEM, INC.	Lovelace Medicare Plan	www.lovelacemedicareplan.com	Lovelace Medicare Plan (HMO)	01	01		1			H3251	024	0	2012	San Juan County Area		2	100	2			2						www.lovelacemedicareplan.com	www.lovelacemedicareplan.com	www.lovelacemedicareplan.com	(855)-730-5683		(855)-730-5683		(800)-262-3757		(800)-262-3757		(855)-730-5683		(855)-730-5683		(800)-262-3757		(800)-262-3757		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3251	804	0	1	01	01	H3251_804_0	3	1		06/05/2011	2012.02	06/05/2011 03:01:22 PM Mountain Daylight Time	07/17/2011 10:57:32 PM Mountain Daylight Time			07/19/2011 05:20:52 PM Mountain Daylight Time	LOVELACE HEALTH SYSTEM, INC.	Lovelace Medicare Plan	www.lovelacemedicareplan.com	Lovelace Employer Group Medicare Plan (HMO)	01	01		1			H3251	804	0	2012	New Mexico Statewide		1	7102	2			2						www.lovelacemedicareplan.com	www.lovelacemedicareplan.com	www.lovelacemedicareplan.com	(855)-730-5683		(855)-730-5683		(800)-262-3757		(800)-262-3757		(855)-730-5683		(855)-730-5683		(800)-262-3757		(800)-262-3757		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H3283	001	0	1	04	01	H3283_001_0	7	1		07/11/2011	2012.02	07/11/2011 01:47:24 PM Central Daylight Time	06/02/2011 05:32:48 PM Central Daylight Time	06/02/2011 07:49:19 AM Central Daylight Time		07/11/2011 01:59:46 PM Central Daylight Time	MEDICA HEALTH PLANS	Medica Health Plans	www.medica.com	Medica Clear Solution with Part D Option 1 (PPO)	01	04		1			H3283	001	0	2012	Select Counties in MN, ND and SD		2		2			2						https://www.medica.com	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	(800)-234-8755		(952)-992-2300		(800)-906-5432		(952)-992-2345		(800)-234-8755		(952)-992-2300		(800)-906-5432		(952)-992-2345		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		2	2	2
H3283	002	0	1	04	01	H3283_002_0	8	1		07/22/2011	2012.02	07/22/2011 09:55:39 AM Central Daylight Time	06/02/2011 05:31:59 PM Central Daylight Time	07/22/2011 08:40:28 AM Central Daylight Time		07/22/2011 10:00:41 AM Central Daylight Time	MEDICA HEALTH PLANS	Medica Health Plans	www.medica.com	Medica Clear Solution with Part D Option 3 (PPO)	01	04		1			H3283	002	0	2012	Select Counties in MN, ND and SD		2		2			2						https://www.medica.com	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	(800)-234-8755		(952)-992-2300		(800)-906-5432		(952)-992-2345		(800)-234-8755		(952)-992-2300		(800)-906-5432		(952)-992-2345		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		2	2	2
H3283	801	0	1	04	01	H3283_801_0	5	1		06/16/2011	2012.02	06/16/2011 09:33:43 AM Central Daylight Time	06/15/2011 05:31:27 PM Central Daylight Time			06/16/2011 09:34:54 AM Central Daylight Time	MEDICA HEALTH PLANS	Medica Health Plans	www.medica.com	Medica Group Clear Solution No Part D (PPO)	01	04		1			H3283	801	0	2012	National Group PPO		1		2			2						https://www.medica.com	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	(800)-575-2330		(952)-992-2330		(800)-575-2330		(952)-992-2330										(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880										1	1	1
H3283	802	0	1	04	01	H3283_802_0	5	1		06/16/2011	2012.02	06/16/2011 09:33:54 AM Central Daylight Time	06/15/2011 05:29:59 PM Central Daylight Time			06/16/2011 09:34:54 AM Central Daylight Time	MEDICA HEALTH PLANS	Medica Health Plans	www.medica.com	Medica Grp Clear Solution Calendar w/4-tier Part D (PPO)	01	04		1			H3283	802	0	2012	National Group PPO		1		2			2						https://www.medica.com	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	(800)-575-2330		(952)-992-2330		(800)-575-2330		(952)-992-2330		(800)-575-2330		(952)-992-2330		(800)-575-2330		(952)-992-2330		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		1	1	1
H3305	007	0	1	02	01	H3305_007_0	4	1		07/15/2011	2012.02	07/15/2011 10:51:46 AM Eastern Daylight Time	07/06/2011 10:02:50 AM Eastern Daylight Time			08/10/2011 07:37:14 AM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.joinMVPmedicare.com	Preferred Gold (HMO-POS)	01	02		1			H3305	007	0	2012	Rochester Area		2	1026	2			2						www.mvphealthcare.com	https://www.mvphealthcare.com/medicare/documents/2011_Comprehensive_Formulary_roc.pdf	www.mvphealthcare.com	(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205										(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220										2	2	2
H3305	011	0	1	02	01	H3305_011_0	5	1		07/25/2011	2012.02	07/25/2011 10:49:48 AM Eastern Daylight Time	08/05/2011 05:14:45 PM Eastern Daylight Time	08/05/2011 01:19:53 PM Eastern Daylight Time		08/09/2011 08:19:34 AM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.joinMVPmedicare.com	Preferred Gold Rx (HMO-POS)	01	02		1			H3305	011	0	2012	Rochester Area		2	29115	2			2						www.mvphealthcare.com	https://www.mvphealthcare.com/medicare/documents/2011_Comprehensive_Formulary_roc.pdf	www.mvphealthcare.com	(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205		(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		2	2	2
H3305	015	0	1	02	01	H3305_015_0	5	1		07/15/2011	2012.02	07/15/2011 10:52:12 AM Eastern Daylight Time	08/05/2011 02:47:44 PM Eastern Daylight Time	08/05/2011 01:23:19 PM Eastern Daylight Time		08/09/2011 08:19:34 AM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.joinMVPmedicare.com	GoldValue Rx (HMO-POS)	01	02		1			H3305	015	0	2012	Rochester Area		2	7804	2			2						www.mvphealthcare.com	https://www.mvphealthcare.com/medicare/documents/2011_Comprehensive_Formulary_roc.pdf	www.mvphealthcare.com	(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205		(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		2	2	2
H3305	016	0	1	02	01	H3305_016_0	5	1		07/15/2011	2012.02	07/15/2011 10:52:27 AM Eastern Daylight Time	07/06/2011 10:05:33 AM Eastern Daylight Time			08/10/2011 07:37:14 AM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.joinMVPmedicare.com	Preferred Gold (HMO-POS)	01	02		1			H3305	016	0	2012	Buffalo Area		2	20	2			2						www.mvphealthcare.com	https://www.mvphealthcare.com/medicare/documents/2011_Comprehensive_Formulary_roc.pdf	www.mvphealthcare.com	(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205										(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220										2	2	2
H3305	017	0	1	02	01	H3305_017_0	6	1		07/15/2011	2012.02	07/15/2011 10:52:35 AM Eastern Daylight Time	08/19/2011 07:56:42 AM Eastern Daylight Time	08/05/2011 01:24:48 PM Eastern Daylight Time		08/19/2011 08:32:29 AM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.joinMVPmedicare.com	Preferred Gold Rx (HMO-POS)	01	02		1			H3305	017	0	2012	Buffalo Area		2	80	2			2						www.mvphealthcare.com	https://www.mvphealthcare.com/medicare/documents/2011_Comprehensive_Formulary_roc.pdf	www.mvphealthcare.com	(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205		(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		2	2	2
H3305	018	0	1	02	01	H3305_018_0	5	1		07/15/2011	2012.02	07/15/2011 10:52:48 AM Eastern Daylight Time	08/05/2011 02:49:21 PM Eastern Daylight Time	08/05/2011 01:25:39 PM Eastern Daylight Time		08/09/2011 08:19:34 AM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.joinMVPmedicare.com	GoldValue Rx (HMO-POS)	01	02		1			H3305	018	0	2012	Buffalo Area		2	50	2			2						www.mvphealthcare.com	https://www.mvphealthcare.com/medicare/documents/2011_Comprehensive_Formulary_roc.pdf	www.mvphealthcare.com	(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205		(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		2	2	2
H3305	801	0	1	02	01	H3305_801_0	1	1		05/31/2011	2012.02	05/31/2011 03:56:47 PM Eastern Daylight Time	06/03/2011 07:42:20 PM Eastern Daylight Time			06/04/2011 08:15:31 AM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.mvphealthcare.com	Preferred Gold - Employer Group (HMO-POS)	01	02		1			H3305	801	0	2012	Rochester and Western New York		1	1705	2			2						www.mvphealthcare.com	https://www.mvphealthcare.com/medicare/documents/2011_Comprehensive_Formulary_roc.pdf	www.mvphealthcare.com	(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205										(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220										1	1	1
H3305	803	0	1	02	01	H3305_803_0	1	1		05/11/2011	2012.02	05/11/2011 03:02:44 PM Eastern Daylight Time	06/04/2011 11:13:19 AM Eastern Daylight Time			06/04/2011 11:51:58 AM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.mvphealthcare.com	Preferred Gold Rx - Employer Group (HMO-POS)	01	02		1			H3305	803	0	2012	Rochester and Western New York		1	10760	2			2						www.mvphealthcare.com	https://www.mvphealthcare.com/medicare/documents/2011_Comprehensive_Formulary_roc.pdf	www.mvphealthcare.com	(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205		(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		1	1	1
H3307	002	0	1	01	01	H3307_002_0	5	1		08/05/2011	2012.02	08/05/2011 09:44:19 AM Central Daylight Time	08/08/2011 10:33:56 AM Central Daylight Time	08/05/2011 01:05:00 PM Central Daylight Time		08/09/2011 02:16:58 PM Central Daylight Time	OXFORD HEALTH PLANS (NY), INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H3307	002	0	2012	New York City		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-234-1228		(800)-234-1228		(800)-547-5514		(800)-547-5514		(800)-234-1228		(800)-234-1228		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3307	012	0	1	01	01	H3307_012_0	6	1		08/05/2011	2012.02	08/05/2011 09:43:21 AM Central Daylight Time	08/08/2011 10:34:37 AM Central Daylight Time	08/05/2011 01:05:23 PM Central Daylight Time		08/09/2011 04:28:20 PM Central Daylight Time	OXFORD HEALTH PLANS (NY), INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H3307	012	0	2012	Rockland, Orange and Westchester counties		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-234-1228		(800)-234-1228		(800)-547-5514		(800)-547-5514		(800)-234-1228		(800)-234-1228		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3307	015	0	1	01	01	H3307_015_0	4	1		08/08/2011	2012.02	08/08/2011 09:22:44 AM Central Daylight Time	08/08/2011 10:35:17 AM Central Daylight Time	08/05/2011 01:05:45 PM Central Daylight Time		08/09/2011 04:28:20 PM Central Daylight Time	OXFORD HEALTH PLANS (NY), INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Mosaic (HMO)	01	01		1			H3307	015	0	2012	New York City		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-234-1228		(800)-234-1228		(800)-547-5514		(800)-547-5514		(800)-234-1228		(800)-234-1228		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3307	018	0	1	01	01	H3307_018_0	3	1		07/20/2011	2012.02	07/20/2011 11:34:15 AM Central Daylight Time	07/22/2011 01:28:53 PM Central Daylight Time			07/25/2011 02:15:50 PM Central Daylight Time	OXFORD HEALTH PLANS (NY), INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Essential (HMO)	01	01		1			H3307	018	0	2012	NYC and Rockland, Orange, and Westchester Counties		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-234-1228		(800)-234-1228		(800)-547-5514		(800)-547-5514										(711)		(711)		(711)		(711)										2	2	2
H3307	020	0	1	01	01	H3307_020_0	4	1	2	08/05/2011	2012.02	08/05/2011 04:40:39 PM Central Daylight Time	08/08/2011 10:35:57 AM Central Daylight Time	08/05/2011 01:06:06 PM Central Daylight Time		08/09/2011 12:16:18 PM Central Daylight Time	OXFORD HEALTH PLANS (NY), INC.	SecureHorizons by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Dual Complete LP (HMO SNP)	01	01		1			H3307	020	0	2012	Bronx,Kings,New York,Queens and Richmond Counties		2		2			1	3		1	2		www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-234-1228		(800)-234-1228		(888)-834-3721		(888)-834-3721		(800)-234-1228		(800)-234-1228		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3307	802	0	1	01	01	H3307_802_0	2	1		07/06/2011	2012.02	07/06/2011 04:45:29 PM Central Daylight Time	06/03/2011 03:24:10 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	OXFORD HEALTH PLANS (NY), INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H3307	802	0	2012	New York Metropolitan Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3307	804	0	1	01	01	H3307_804_0	2	1		07/06/2011	2012.02	07/06/2011 04:45:33 PM Central Daylight Time	06/03/2011 03:25:06 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	OXFORD HEALTH PLANS (NY), INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H3307	804	0	2012	New York Metropolitan Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548										(711)		(711)		(711)		(711)										2	2	2
H3307	805	0	1	01	01	H3307_805_0	2	1		07/06/2011	2012.02	07/06/2011 04:45:37 PM Central Daylight Time	06/03/2011 03:25:59 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	OXFORD HEALTH PLANS (NY), INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H3307	805	0	2012	State of New York		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3307	807	0	1	02	01	H3307_807_0	2	1		07/06/2011	2012.02	07/06/2011 04:45:47 PM Central Daylight Time	06/03/2011 03:26:54 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	OXFORD HEALTH PLANS (NY), INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO-POS)	01	02		1			H3307	807	0	2012	Select Counties		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3312	002	0	1	01	01	H3312_002_0	5	1		07/18/2011	2012.02	07/18/2011 10:14:18 AM Central Daylight Time	08/05/2011 09:29:57 AM Central Daylight Time	08/04/2011 09:45:00 AM Central Daylight Time		08/08/2011 09:25:05 AM Central Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (HMO)	01	01		1			H3312	002	0	2012	Bronx and Kings Counties		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H3312	018	0	1	01	01	H3312_018_0	4	1		07/08/2011	2012.02	07/08/2011 11:00:23 AM Central Daylight Time	08/05/2011 09:32:33 AM Central Daylight Time	08/04/2011 09:46:30 AM Central Daylight Time		08/08/2011 09:25:05 AM Central Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (HMO)	01	01		1			H3312	018	0	2012	Rockland and Westchester Counties		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H3312	025	0	1	01	01	H3312_025_0	4	1		07/08/2011	2012.02	07/08/2011 11:00:36 AM Central Daylight Time	08/05/2011 09:35:18 AM Central Daylight Time	08/04/2011 09:47:05 AM Central Daylight Time		08/08/2011 09:25:05 AM Central Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Standard Plan (HMO)	01	01		1			H3312	025	0	2012	New York,  Queens and Richmond Counties		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H3312	040	0	1	01	01	H3312_040_0	2	1		07/08/2011	2012.02	07/08/2011 11:00:50 AM Central Daylight Time	07/15/2011 10:05:13 AM Central Daylight Time			07/18/2011 09:27:55 AM Central Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Basic Plan (HMO)	01	01		1			H3312	040	0	2012	Rockland and Westchester Counties		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748										2	2	2
H3312	043	0	1	01	01	H3312_043_0	5	1		07/12/2011	2012.02	07/12/2011 02:46:37 PM Central Daylight Time	08/05/2011 09:38:28 AM Central Daylight Time	08/04/2011 09:47:29 AM Central Daylight Time		08/08/2011 09:25:05 AM Central Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (HMO)	01	01		1			H3312	043	0	2012	New York, Queens and Richmond Counties		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H3312	048	0	1	01	01	H3312_048_0	5	1		07/12/2011	2012.02	07/12/2011 03:37:47 PM Central Daylight Time	08/05/2011 09:40:31 AM Central Daylight Time	08/04/2011 09:47:57 AM Central Daylight Time		08/08/2011 09:25:05 AM Central Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (HMO)	01	01		1			H3312	048	0	2012	Upstate New York		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H3312	801	0	1	01	01	H3312_801_0	2	1		04/22/2011	2012.02	04/22/2011 09:53:03 AM Eastern Daylight Time	06/02/2011 10:51:23 AM Eastern Daylight Time			06/03/2011 06:19:28 PM Eastern Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan (HMO)	01	01		1			H3312	801	0	2012	New York		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748										1	1	1
H3312	804	0	1	01	01	H3312_804_0	1	1		04/22/2011	2012.02	04/22/2011 09:53:21 AM Eastern Daylight Time	06/02/2011 11:05:19 AM Eastern Daylight Time			06/03/2011 10:12:16 AM Eastern Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan w/Rx CY (HMO)	01	01		1			H3312	804	0	2012	New York		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		1	1	1
H3321	001	0	1	20	08	H3321_001_0	1	1		06/03/2011	2012.01	06/03/2011 11:42:05 AM Eastern Daylight Time		06/01/2011 08:39:01 AM Eastern Daylight Time		06/03/2011 11:43:21 AM Eastern Daylight Time	INDEPENDENT LIVING SRVCS OF CENTRAL NY	Independent Living Srvcs Of Central Ny	www.loretto-cny.org	Loretto Independent Living Services, Inc (PACE)	08	20		1			H3321	001	0	2012	Onondaga County		2		2			2							Independent Living Services of Central New York, Inc	www.loretto-cny.org									(877)-208-5284		(315)-452-5800		(877)-208-5284		(315)-452-5800										(877)-208-5284		(315)-452-5800		(877)-208-5284		(315)-452-5800				
H3321	003	0	1	20	08	H3321_003_0	1	1		06/03/2011	2012.01	06/03/2011 11:42:16 AM Eastern Daylight Time		06/01/2011 08:39:01 AM Eastern Daylight Time		06/03/2011 11:43:21 AM Eastern Daylight Time	INDEPENDENT LIVING SRVCS OF CENTRAL NY	Independent Living Srvcs Of Central Ny	www.loretto-cny.org	Loretto Independent Living Services, Inc (PACE)	08	20		1			H3321	003	0	2012	Onondaga County		2		2			2							Independent Living Services of Central New York, Inc	www.loretto-cny.org									(877)-208-5284		(315)-452-5800		(877)-208-5284		(315)-452-5800										(877)-208-5284		(315)-452-5800		(877)-208-5284		(315)-452-5800				
H3322	001	0	1	20	08	H3322_001_0	1	1		05/24/2011	2012.02	05/24/2011 01:11:41 PM Eastern Daylight Time		05/23/2011 06:20:07 PM Eastern Daylight Time		05/24/2011 01:28:29 PM Eastern Daylight Time	SENIOR CARE CONNECTION, INC.	Eddy SeniorCare	www.nehealth.com	Senior Care Connection dba Eddy SeniorCare (PACE)	08	20		1			H3322	001	0	2012	Schenectady County, Albany County, NY		2		2			2							www.northeasthealth.com	www.northeasthealth.com									(518)-382-3290	6350	(518)-382-3290	6350	(518)-382-3290	6361	(518)-382-3290	6361									(518)-382-3290	6350	(518)-382-3290	6350	(518)-382-3290	6361	(518)-382-3290	6361			
H3322	002	0	1	20	08	H3322_002_0	1	1		05/24/2011	2012.02	05/24/2011 01:13:31 PM Eastern Daylight Time		05/23/2011 06:20:24 PM Eastern Daylight Time		05/24/2011 01:28:29 PM Eastern Daylight Time	SENIOR CARE CONNECTION, INC.	Eddy SeniorCare	www.nehealth.com	Senior Care Connection (PACE)	08	20		1			H3322	002	0	2012	Schenectady County, Albany County		2		2			2							www.northeasthealth.com	www.northeasthealth.com									(518)-382-3290	6350	(518)-382-3290	6350	(518)-382-3290	6361	(518)-382-3290	6361									(518)-382-3290	6350	(518)-382-3290	6350	(518)-382-3290	6361	(518)-382-3290	6361			
H3327	001	0	1	01	01	H3327_001_0	7	1		08/09/2011	2012.02	08/09/2011 11:37:44 AM Eastern Daylight Time	08/08/2011 12:47:56 PM Eastern Daylight Time	08/04/2011 04:30:34 PM Eastern Daylight Time		08/09/2011 12:25:08 PM Eastern Daylight Time	TOUCHSTONE HEALTH HMO, INC.	Touchstone Health	www.touchstoneh.com	Touchstone Health Medicare Power (HMO)	01	01		1			H3327	001	0	2012	New York City and Hudson Counties		2	4900	2			2						http://www.touchstoneh.com	http://www.touchstoneh.com/formulary	http://www.touchstoneh.com/pharmacy	(888)-777-0204		(888)-777-0204		(877)-805-3650		(877)-805-3650		(888)-777-0204		(888)-777-0204		(877)-805-3650		(877)-805-3650		(877)-867-5814		(877)-867-5814		(877)-867-5813		(877)-867-5813		(877)-867-5814		(877)-867-5814		(877)-867-5813		(877)-867-5813		2	2	2
H3327	002	0	1	01	01	H3327_002_0	6	1		06/03/2011	2012.02	06/03/2011 03:32:45 PM Eastern Daylight Time	08/05/2011 02:34:48 PM Eastern Daylight Time	08/04/2011 04:35:20 PM Eastern Daylight Time		08/08/2011 12:46:24 PM Eastern Daylight Time	TOUCHSTONE HEALTH HMO, INC.	Touchstone Health	www.touchstoneh.com	Touchstone Health Medicare Total (HMO)	01	01		1			H3327	002	0	2012	New York City and Hudson Counties		2	6633	2			2						http://www.touchstoneh.com	http://www.touchstoneh.com/formulary	http://www.touchstoneh.com/pharmacy	(888)-777-0204		(888)-777-0204		(877)-805-3650		(877)-805-3650		(888)-777-0204		(888)-777-0204		(877)-805-3650		(877)-805-3650		(877)-867-5814		(877)-867-5814		(877)-867-5813		(877)-867-5813		(877)-867-5814		(877)-867-5814		(877)-867-5813		(877)-867-5813		2	2	2
H3327	026	0	1	01	01	H3327_026_0	7	1	2	07/01/2011	2012.02	07/01/2011 09:50:57 AM Eastern Daylight Time	08/05/2011 02:37:58 PM Eastern Daylight Time	08/04/2011 04:42:38 PM Eastern Daylight Time		08/08/2011 12:46:24 PM Eastern Daylight Time	TOUCHSTONE HEALTH HMO, INC.	Touchstone Health	www.touchstoneh.com	Touchstone Health Medicare Prestige (HMO SNP)	01	01		1			H3327	026	0	2012	Bronx, Queens, Kings, Richmond and Hudson Counties		2	1861	2			1	3		1	5		http://www.touchstoneh.com	http://www.touchstoneh.com/formulary	http://www.touchstoneh.com/pharmacy	(888)-777-0204		(888)-777-0204		(877)-805-3650		(877)-805-3650		(888)-777-0204		(888)-777-0204		(877)-805-3650		(877)-805-3650		(877)-867-5814		(877)-867-5814		(877)-867-5813		(877)-867-5813		(877)-867-5814		(877)-867-5814		(877)-867-5813		(877)-867-5813		2	2	2
H3327	037	0	1	01	01	H3327_037_0	6	1		08/09/2011	2012.02	08/09/2011 11:38:21 AM Eastern Daylight Time	08/08/2011 12:45:26 PM Eastern Daylight Time	08/04/2011 04:51:42 PM Eastern Daylight Time		08/09/2011 12:25:08 PM Eastern Daylight Time	TOUCHSTONE HEALTH HMO, INC.	Touchstone Health	www.touchstoneh.com	Touchstone Health Medicare Core (HMO)	01	01		1			H3327	037	0	2012	New York City and Hudson Counties		2	122	2			2						http://www.touchstoneh.com	http://www.touchstoneh.com/formulary	http://www.touchstoneh.com/pharmacy	(888)-777-0204		(888)-777-0204		(877)-805-3650		(877)-805-3650		(888)-777-0204		(888)-777-0204		(877)-805-3650		(877)-805-3650		(877)-867-5814		(877)-867-5814		(877)-867-5813		(877)-867-5813		(877)-867-5814		(877)-867-5814		(877)-867-5813		(877)-867-5813		2	2	2
H3327	038	0	1	02	01	H3327_038_0	7	1		08/09/2011	2012.02	08/09/2011 11:44:27 AM Eastern Daylight Time	08/09/2011 11:59:26 AM Eastern Daylight Time	08/04/2011 04:54:02 PM Eastern Daylight Time		08/09/2011 12:25:08 PM Eastern Daylight Time	TOUCHSTONE HEALTH HMO, INC.	Touchstone Health	www.touchstoneh.com	Touchstone Health Medicare Freedom (HMO-POS)	01	02		1			H3327	038	0	2012	New York City and Hudson Counties		2	191	2			2						http://www.touchstoneh.com	http://www.touchstoneh.com/formulary	http://www.touchstoneh.com/pharmacy	(888)-777-0204		(888)-777-0204		(877)-805-3650		(877)-805-3650		(888)-777-0204		(888)-777-0204		(877)-805-3650		(877)-805-3650		(877)-867-5814		(877)-867-5814		(877)-867-5813		(877)-867-5813		(877)-867-5814		(877)-867-5814		(877)-867-5813		(877)-867-5813		2	2	2
H3327	801	0	1	01	01	H3327_801_0	3	1		06/04/2011	2012.02	06/04/2011 02:23:43 PM Eastern Daylight Time	08/02/2011 05:39:34 PM Eastern Daylight Time			08/08/2011 01:56:16 PM Eastern Daylight Time	TOUCHSTONE HEALTH HMO, INC.	Touchstone Health	http://www.touchstoneh.com	Touchstone Health Medicare Power (HMO)	01	01		1			H3327	801	0	2012	Employer - New York		1	42	2			2						http://www.touchstoneh.com	http://www.touchstoneh.com/formulary	http://www.touchstoneh.com/pharmacy	(888)-777-0204		(888)-777-0204		(877)-805-3650		(877)-805-3650		(888)-777-0204		(888)-777-0204		(877)-805-3650		(877)-805-3650		(877)-867-5814		(877)-867-5814		(877)-867-5813		(877)-867-5813		(877)-867-5814		(877)-867-5814		(877)-867-5813		(877)-867-5813		2	2	2
H3327	802	0	1	01	01	H3327_802_0	3	1		06/04/2011	2012.02	06/04/2011 02:23:34 PM Eastern Daylight Time	08/02/2011 05:40:54 PM Eastern Daylight Time			08/08/2011 01:56:16 PM Eastern Daylight Time	TOUCHSTONE HEALTH HMO, INC.	Touchstone Health	http://www.touchstoneh.com	Touchstone Health Medicare Clear (HMO)	01	01		1			H3327	802	0	2012	Employer - New York		1	42	2			2						http://www.touchstoneh.com	http://www.touchstoneh.com/formulary	http://www.touchstoneh.com/pharmacy	(888)-777-0204		(888)-777-0204		(877)-805-3650		(877)-805-3650										(877)-867-5814		(877)-867-5814		(877)-867-5813		(877)-867-5813										2	2	2
H3327	803	0	1	01	01	H3327_803_0	3	1		06/04/2011	2012.02	06/04/2011 02:23:24 PM Eastern Daylight Time	08/02/2011 05:44:54 PM Eastern Daylight Time			08/08/2011 01:56:16 PM Eastern Daylight Time	TOUCHSTONE HEALTH HMO, INC.	Touchstone Health	http://www.touchstoneh.com	Touchstone Health Medicare Power (HMO)	01	01		1			H3327	803	0	2012	Employer - New York		1	42	2			2						http://www.touchstoneh.com	http://www.touchstoneh.com/formulary	http://www.touchstoneh.com/pharmacy	(888)-777-0204		(888)-777-0204		(877)-805-3650		(877)-805-3650		(888)-777-0204		(888)-777-0204		(877)-805-3650		(877)-805-3650		(877)-867-5814		(877)-867-5814		(877)-867-5813		(877)-867-5813		(877)-867-5814		(877)-867-5814		(877)-867-5813		(877)-867-5813		2	2	2
H3327	805	0	1	02	01	H3327_805_0	3	1		06/04/2011	2012.02	06/04/2011 03:21:28 PM Eastern Daylight Time	08/02/2011 05:45:30 PM Eastern Daylight Time			08/08/2011 01:56:16 PM Eastern Daylight Time	TOUCHSTONE HEALTH HMO, INC.	Touchstone Health	http://www.touchstoneh.com	Touchstone Health Medicare Freedom (HMO-POS)	01	02		1			H3327	805	0	2012	Employer - New York		1	42	2			2						http://www.touchstoneh.com	http://www.touchstoneh.com/formulary	http://www.touchstoneh.com/pharmacy	(888)-777-0204		(888)-777-0204		(877)-805-3650		(877)-805-3650		(888)-777-0204		(888)-777-0204		(877)-805-3650		(877)-805-3650		(877)-867-5814		(877)-867-5814		(877)-867-5813		(877)-867-5813		(877)-867-5814		(877)-867-5814		(877)-867-5813		(877)-867-5813		2	2	2
H3327	806	0	1	02	01	H3327_806_0	3	1		06/04/2011	2012.02	06/04/2011 05:11:49 PM Eastern Daylight Time	08/02/2011 05:40:50 PM Eastern Daylight Time			08/08/2011 01:56:16 PM Eastern Daylight Time	TOUCHSTONE HEALTH HMO, INC.	Touchstone Health	http://www.touchstoneh.com	Touchstone Health Medicare Clear (HMO-POS)	01	02		1			H3327	806	0	2012	Employer - New York		1	42	2			2						http://www.touchstoneh.com	http://www.touchstoneh.com/formulary	http://www.touchstoneh.com/pharmacy	(888)-777-0204		(888)-777-0204		(877)-805-3650		(877)-805-3650										(877)-867-5814		(877)-867-5814		(877)-867-5813		(877)-867-5813										2	2	2
H3327	807	0	1	02	01	H3327_807_0	3	1		06/04/2011	2012.02	06/04/2011 05:11:28 PM Eastern Daylight Time	08/02/2011 05:38:52 PM Eastern Daylight Time			08/08/2011 01:56:16 PM Eastern Daylight Time	TOUCHSTONE HEALTH HMO, INC.	Touchstone Health	http://www.touchstoneh.com	Touchstone Health Medicare Freedom (HMO-POS)	01	02		1			H3327	807	0	2012	Employer - New York		1	42	2			2						http://www.touchstoneh.com	http://www.touchstoneh.com/formulary	http://www.touchstoneh.com/pharmacy	(888)-777-0204		(888)-777-0204		(877)-805-3650		(877)-805-3650		(888)-777-0204		(888)-777-0204		(877)-805-3650		(877)-805-3650		(877)-867-5814		(877)-867-5814		(877)-867-5813		(877)-867-5813		(877)-867-5814		(877)-867-5814		(877)-867-5813		(877)-867-5813		2	2	2
H3328	001	0	1	02	01	H3328_001_0	3	1		06/04/2011	2012.02	06/04/2011 06:44:10 AM Eastern Daylight Time	06/03/2011 10:34:42 AM Eastern Daylight Time			06/04/2011 06:46:02 AM Eastern Daylight Time	NEW YORK STATE CATHOLIC HLTH PLAN INC	Fidelis Care	www.fideliscare.org	Fidelis Medicare Advantage without Rx (HMO-POS)	01	02		1			H3328	001	0	2012	NY Counties		2	196	2			2						www.fideliscare.org/apps/providersearch	www.fideliscare.org	www.caremark.com	(800)-247-1447		(800)-247-1447		(800)-860-8707		(800)-860-8707										(800)-695-8544		(800)-695-8544		(800)-558-1125		(800)-558-1125										2	2	2
H3328	002	0	1	01	01	H3328_002_0	5	1	2	08/09/2011	2012.02	08/09/2011 08:46:14 AM Eastern Daylight Time	08/05/2011 07:22:46 AM Eastern Daylight Time	08/10/2011 03:19:02 PM Eastern Daylight Time		08/10/2011 03:38:54 PM Eastern Daylight Time	NEW YORK STATE CATHOLIC HLTH PLAN INC	Fidelis Care	www.fideliscare.org	Fidelis Dual Advantage (HMO SNP)	01	01		1			H3328	002	0	2012	NY Counties		2	1234	2			1	3		1	3		www.fideliscare.org/apps/providersearch	www.fideliscare.org	www.caremark.com	(800)-247-1447		(800)-247-1447		(800)-860-8707		(800)-860-8707		(800)-247-1447		(800)-247-1447		(800)-860-8707		(800)-860-8707		(800)-695-8544		(800)-695-8544		(800)-558-1125		(800)-558-1125		(800)-695-8544		(800)-695-8544		(800)-558-1125		(800)-558-1125		2	2	2
H3328	003	0	1	02	01	H3328_003_0	4	1		08/09/2011	2012.02	08/09/2011 10:57:46 AM Eastern Daylight Time	08/05/2011 07:22:44 AM Eastern Daylight Time	08/05/2011 07:22:44 AM Eastern Daylight Time		08/09/2011 10:59:11 AM Eastern Daylight Time	NEW YORK STATE CATHOLIC HLTH PLAN INC	Fidelis Care	www.fideliscare.org	Fidelis Medicare Advantage Flex (HMO-POS)	01	02		1			H3328	003	0	2012	NY Counties		2	7156	2			2						www.fideliscare.org/apps/providersearch	www.fideliscare.org	www.caremark.com	(800)-247-1447		(800)-247-1447		(800)-860-8707		(800)-860-8707		(800)-247-1447		(800)-247-1447		(800)-860-8707		(800)-860-8707		(800)-695-8544		(800)-695-8544		(800)-558-1125		(800)-558-1125		(800)-695-8544		(800)-695-8544		(800)-558-1125		(800)-558-1125		2	2	2
H3328	013	0	1	01	01	H3328_013_0	4	1	2	08/09/2011	2012.02	08/09/2011 08:49:21 AM Eastern Daylight Time	08/05/2011 07:22:44 AM Eastern Daylight Time	08/05/2011 07:22:44 AM Eastern Daylight Time		08/09/2011 10:59:11 AM Eastern Daylight Time	NEW YORK STATE CATHOLIC HLTH PLAN INC	Fidelis Care	www.fideliscare.org	Fidelis Dual Advantage Flex (HMO SNP)	01	01		1			H3328	013	0	2012	NY Counties		2	1795	2			1	3		1	1		www.fideliscare.org/apps/providersearch	www.fideliscare.org	www.caremark.com	(800)-247-1447		(800)-247-1447		(800)-860-8707		(800)-860-8707		(800)-247-1447		(800)-247-1447		(800)-860-8707		(800)-860-8707		(800)-695-8544		(800)-695-8544		(800)-558-1125		(800)-558-1125		(800)-695-8544		(800)-695-8544		(800)-558-1125		(800)-558-1125		2	2	2
H3328	801	0	1	02	01	H3328_801_0	2	1		06/04/2011	2012.02	06/04/2011 06:52:43 AM Eastern Daylight Time	06/03/2011 02:10:54 PM Eastern Daylight Time			06/04/2011 06:52:55 AM Eastern Daylight Time	NEW YORK STATE CATHOLIC HLTH PLAN INC	Fidelis Care	www.fideliscare.org	Fidelis Medicare Advantage Employer without RX (HMO-POS)	01	02		1			H3328	801	0	2012	New York Counties		1	10	2			2						www.fideliscare.org/apps/providersearch	www.fideliscare.org	www.caremark.com	(800)-247-1447		(800)-247-1447		(800)-860-8707		(800)-860-8707										(800)-695-8544		(800)-695-8544		(800)-558-1125		(800)-558-1125										2	2	2
H3328	802	0	1	02	01	H3328_802_0	3	1		06/04/2011	2012.02	06/04/2011 04:59:29 PM Eastern Daylight Time	06/03/2011 02:17:00 PM Eastern Daylight Time			06/04/2011 04:59:43 PM Eastern Daylight Time	NEW YORK STATE CATHOLIC HLTH PLAN INC	Fidelis Care	www.fideliscare.org	Fidelis Medicare Advantage Employer (HMO-POS)	01	02		1			H3328	802	0	2012	New York Counties		1	10	2			2						www.fideliscare.org/apps/providersearch	www.fideliscare.org	www.caremark.com	(800)-247-1447		(800)-247-1447		(800)-860-8707		(800)-860-8707		(800)-247-1447		(800)-247-1447		(800)-860-8707		(800)-860-8707		(800)-695-8544		(800)-695-8544		(800)-558-1125		(800)-558-1125		(800)-695-8544		(800)-695-8544		(800)-558-1125		(800)-558-1125		2	2	2
H3328	803	0	1	02	01	H3328_803_0	1	1		05/31/2011	2012.02	05/31/2011 01:27:38 PM Eastern Daylight Time	06/03/2011 02:20:50 PM Eastern Daylight Time			06/03/2011 02:22:31 PM Eastern Daylight Time	NEW YORK STATE CATHOLIC HLTH PLAN INC	Fidelis Care	www.fideliscare.org	Fidelis Medicare Advantage Employer Non-calendar (HMO-POS)	01	02		1			H3328	803	0	2012	New York Counties		1	10	2			2						www.fideliscare.org/apps/providersearch	www.fideliscare.org	www.caremark.com	(800)-247-1447		(800)-247-1447		(800)-860-8707		(800)-860-8707		(800)-247-1447		(800)-247-1447		(800)-860-8707		(800)-860-8707		(800)-695-8544		(800)-695-8544		(800)-558-1125		(800)-558-1125		(800)-695-8544		(800)-695-8544		(800)-558-1125		(800)-558-1125		2	2	2
H3329	001	0	1	20	08	H3329_001_0	1	1		05/23/2011	2012.02	05/23/2011 01:46:29 PM Eastern Daylight Time		05/20/2011 03:34:00 PM Eastern Daylight Time		05/24/2011 11:51:05 AM Eastern Daylight Time	COMPREHENSIVE CARE MANAGEMENT CORP.	Comprehensive Care Management Corp.	www.ccmny.org	CCMC PACE Dual Eligible (PACE)	08	20		1			H3329	001	0	2012	NYC  and Westchester Counties		2		2			2							N/A	N/A									(877)-226-8500		(718)-515-8600		(877)-226-8500		(718)-515-8600										(800)-650-2774		(800)-650-2774		(800)-650-2774		(800)-650-2774				
H3329	002	0	1	20	08	H3329_002_0	1	1		05/23/2011	2012.02	05/23/2011 01:47:05 PM Eastern Daylight Time		05/20/2011 03:34:00 PM Eastern Daylight Time		05/24/2011 11:51:05 AM Eastern Daylight Time	COMPREHENSIVE CARE MANAGEMENT CORP.	Comprehensive Care Management Corp.	www.ccmny.org	CCMC - PACE - Medicare only (PACE)	08	20		1			H3329	002	0	2012	NYC and Westchester Counties		2		2			2							N/A	N/A									(877)-226-8500		(718)-515-8600		(877)-226-8500		(718)-515-8600										(800)-650-2774		(800)-650-2774		(800)-650-2774		(800)-650-2774				
H3330	021	1	1	01	01	H3330_021_1	8	1		09/20/2011	2012.02	09/20/2011 12:49:55 PM Eastern Daylight Time	08/05/2011 12:29:55 PM Eastern Daylight Time	08/05/2011 12:30:01 PM Eastern Daylight Time		09/20/2011 01:45:25 PM Eastern Daylight Time	HEALTH INSURANCE PLAN OF GREATER NEW YORK	EmblemHealth Medicare HMO	www.emblemhealth.com	VIP (HMO)	01	01		1			H3330	021	1	2012	Counties of NYC, Westchester and Long Island	New York City	2		2			2							emblemhealth.com	emblemhealth.com	(800)-447-8255		(800)-447-8255		(800)-447-9169		(800)-447-9169		(800)-447-8255		(800)-447-8255		(866)-447-6979		(866)-447-6979		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		2	2	2
H3330	021	2	1	01	01	H3330_021_2	8	1		09/20/2011	2012.02	09/20/2011 12:51:10 PM Eastern Daylight Time	08/05/2011 12:30:07 PM Eastern Daylight Time	08/05/2011 12:30:13 PM Eastern Daylight Time		09/20/2011 01:45:25 PM Eastern Daylight Time	HEALTH INSURANCE PLAN OF GREATER NEW YORK	EmblemHealth Medicare HMO	www.emblemhealth.com	VIP (HMO)	01	01		1			H3330	021	2	2012	Counties of NYC, Westchester and Long Island	Nassau County	2		2			2							emblemhealth.com	emblemhealth.com	(800)-447-8255		(800)-447-8255		(800)-447-9169		(800)-447-9169		(800)-447-8255		(800)-447-8255		(866)-447-6979		(866)-447-6979		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		2	2	2
H3330	021	3	1	01	01	H3330_021_3	9	1		09/20/2011	2012.02	09/20/2011 12:52:00 PM Eastern Daylight Time	08/05/2011 12:30:19 PM Eastern Daylight Time	08/05/2011 12:30:24 PM Eastern Daylight Time		09/20/2011 01:45:25 PM Eastern Daylight Time	HEALTH INSURANCE PLAN OF GREATER NEW YORK	EmblemHealth Medicare HMO	www.emblemhealth.com	VIP (HMO)	01	01		1			H3330	021	3	2012	Counties of NYC, Westchester and Long Island	Suffolk and Westchester Counties	2		2			2							emblemhealth.com	emblemhealth.com	(800)-447-8255		(800)-447-8255		(800)-447-9169		(800)-447-9169		(800)-447-8255		(800)-447-8255		(866)-447-6979		(866)-447-6979		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		2	2	2
H3330	029	0	1	01	01	H3330_029_0	10	1	2	09/20/2011	2012.02	09/20/2011 12:52:43 PM Eastern Daylight Time	08/12/2011 12:28:52 PM Eastern Daylight Time	08/12/2011 12:28:59 PM Eastern Daylight Time		09/20/2011 01:45:25 PM Eastern Daylight Time	HEALTH INSURANCE PLAN OF GREATER NEW YORK	EmblemHealth Medicare HMO	www.emblemhealth.com	Dual Eligible (HMO SNP)	01	01		1			H3330	029	0	2012	Counties of NYC, Westchester and Long Island		2		2			1	3		1	2			emblemhealth.com	emblemhealth.com	(800)-447-8255		(800)-447-8255		(800)-447-9169		(800)-447-9169		(800)-447-8255		(800)-447-8255		(866)-447-6979		(866)-447-6979		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		2	2	2
H3330	032	1	1	01	01	H3330_032_1	8	1		09/20/2011	2012.02	09/20/2011 12:53:21 PM Eastern Daylight Time	08/05/2011 12:30:42 PM Eastern Daylight Time	08/05/2011 12:30:47 PM Eastern Daylight Time		09/20/2011 01:45:25 PM Eastern Daylight Time	HEALTH INSURANCE PLAN OF GREATER NEW YORK	EmblemHealth Medicare HMO	www.emblemhealth.com	VIP Essential (HMO)	01	01		1			H3330	032	1	2012	Counties of NYC, Westchester and Long Island	New York City	2		2			2							emblemhealth.com	emblemhealth.com	(800)-447-8255		(800)-447-8255		(800)-447-9169		(800)-447-9169		(800)-447-8255		(800)-447-8255		(866)-447-6979		(866)-447-6979		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		2	2	2
H3330	032	2	1	01	01	H3330_032_2	8	1		09/20/2011	2012.02	09/20/2011 12:53:48 PM Eastern Daylight Time	08/05/2011 12:30:52 PM Eastern Daylight Time	08/05/2011 12:30:57 PM Eastern Daylight Time		09/20/2011 01:45:25 PM Eastern Daylight Time	HEALTH INSURANCE PLAN OF GREATER NEW YORK	EmblemHealth Medicare HMO	www.emblemhealth.com	VIP Essential (HMO)	01	01		1			H3330	032	2	2012	Counties of NYC, Westchester and Long Island	Nassau	2		2			2							emblemhealth.com	emblemhealth.com	(800)-447-8255		(800)-447-8255		(800)-447-9169		(800)-447-9169		(800)-447-8255		(800)-447-8255		(866)-447-6979		(866)-447-6979		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		2	2	2
H3330	032	3	1	01	01	H3330_032_3	9	1		09/20/2011	2012.02	09/20/2011 12:54:18 PM Eastern Daylight Time	08/05/2011 12:31:03 PM Eastern Daylight Time	08/05/2011 12:31:08 PM Eastern Daylight Time		09/20/2011 01:45:25 PM Eastern Daylight Time	HEALTH INSURANCE PLAN OF GREATER NEW YORK	EmblemHealth Medicare HMO	www.emblemhealth.com	VIP Essential (HMO)	01	01		1			H3330	032	3	2012	Counties of NYC, Westchester and Long Island	Suffolk and Westchester	2		2			2							emblemhealth.com	emblemhealth.com	(800)-447-8255		(800)-447-8255		(800)-447-9169		(800)-447-9169		(800)-447-8255		(800)-447-8255		(866)-447-6979		(866)-447-6979		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		2	2	2
H3330	033	1	1	01	01	H3330_033_1	8	1		09/20/2011	2012.02	09/20/2011 12:54:43 PM Eastern Daylight Time	08/05/2011 12:31:14 PM Eastern Daylight Time	08/05/2011 12:31:20 PM Eastern Daylight Time		09/20/2011 01:45:25 PM Eastern Daylight Time	HEALTH INSURANCE PLAN OF GREATER NEW YORK	EmblemHealth Medicare HMO	www.emblemhealth.com	VIP High Option (HMO)	01	01		1			H3330	033	1	2012	Counties of NYC, Westchester and Long Island	New York City	2		2			2							emblemhealth.com	emblemhealth.com	(800)-447-8255		(800)-447-8255		(800)-447-9169		(800)-447-9169		(800)-447-8255		(800)-447-8255		(866)-447-6979		(866)-447-6979		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		2	2	2
H3330	033	2	1	01	01	H3330_033_2	8	1		09/20/2011	2012.02	09/20/2011 12:55:10 PM Eastern Daylight Time	08/05/2011 12:31:27 PM Eastern Daylight Time	08/05/2011 12:31:32 PM Eastern Daylight Time		09/20/2011 01:45:25 PM Eastern Daylight Time	HEALTH INSURANCE PLAN OF GREATER NEW YORK	EmblemHealth Medicare HMO	www.emblemhealth.com	VIP High Option (HMO)	01	01		1			H3330	033	2	2012	Counties of NYC, Westchester and Long Island	Nassau	2		2			2							emblemhealth.com	emblemhealth.com	(800)-447-8255		(800)-447-8255		(800)-447-9169		(800)-447-9169		(800)-447-8255		(800)-447-8255		(866)-447-6979		(866)-447-6979		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		2	2	2
H3330	033	3	1	01	01	H3330_033_3	9	1		09/20/2011	2012.02	09/20/2011 12:55:34 PM Eastern Daylight Time	08/05/2011 12:31:38 PM Eastern Daylight Time	08/05/2011 12:31:44 PM Eastern Daylight Time		09/20/2011 01:45:25 PM Eastern Daylight Time	HEALTH INSURANCE PLAN OF GREATER NEW YORK	EmblemHealth Medicare HMO	www.emblemhealth.com	VIP High Option (HMO)	01	01		1			H3330	033	3	2012	Counties of NYC, Westchester and Long Island	Suffolk and Westchester	2		2			2							emblemhealth.com	emblemhealth.com	(800)-447-8255		(800)-447-8255		(800)-447-9169		(800)-447-9169		(800)-447-8255		(800)-447-8255		(866)-447-6979		(866)-447-6979		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		2	2	2
H3330	808	0	2	01	01	H3330_808_0	5	1		07/01/2011	2012.02	07/01/2011 10:01:48 AM Eastern Daylight Time	07/21/2011 10:21:49 AM Eastern Daylight Time			07/21/2011 10:22:28 AM Eastern Daylight Time	HEALTH INSURANCE PLAN OF GREATER NEW YORK	EmblemHealth Medicare HMO	www.emblemhealth.com	Part A Payers (HMO)	01	01		2	1		H3330	808	0	2012	Counties of NYC:, Westchester and Long Island		1		2			2							emblemhealth.com	emblemhealth.com	(800)-447-8255		(800)-447-8255		(800)-447-9169		(800)-447-9169		(800)-447-8255		(800)-447-8255		(866)-447-6979		(866)-447-6979		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		2	2	2
H3330	810	0	1	01	01	H3330_810_0	5	1	2	07/01/2011	2012.02	07/01/2011 10:01:55 AM Eastern Daylight Time	07/21/2011 09:19:34 AM Eastern Daylight Time			07/21/2011 09:39:10 AM Eastern Daylight Time	HEALTH INSURANCE PLAN OF GREATER NEW YORK	EmblemHealth Medicare HMO	www.emblemhealth.com	Dual Eligible Group (HMO SNP)	01	01		1			H3330	810	0	2012	Counties of NYC, Westchester and Long Island		1		2			1	3		1	2			emblemhealth.com	emblemhealth.com	(800)-447-8255		(800)-447-8255		(800)-447-9169		(800)-447-9169		(800)-447-8255		(800)-447-8255		(866)-447-6979		(866)-447-6979		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		2	2	2
H3330	814	0	1	01	01	H3330_814_0	5	1		07/01/2011	2012.02	07/01/2011 10:02:09 AM Eastern Daylight Time	07/21/2011 09:19:46 AM Eastern Daylight Time			07/21/2011 09:39:10 AM Eastern Daylight Time	HEALTH INSURANCE PLAN OF GREATER NEW YORK	EmblemHealth Medicare HMO	www.emblemhealth.com	VIP Premier (HMO)	01	01		1			H3330	814	0	2012	Counties of NYC, Nassau, Suffolk, Westchester		1		2			2							emblemhealth.com	emblemhealth.com	(800)-447-8255		(800)-447-8255		(800)-447-9169		(800)-447-9169		(800)-447-8255		(800)-447-8255		(866)-447-6979		(866)-447-6979		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		2	2	2
H3330	815	0	1	01	01	H3330_815_0	5	1		07/01/2011	2012.02	07/01/2011 10:02:17 AM Eastern Daylight Time	07/21/2011 09:20:00 AM Eastern Daylight Time			07/21/2011 09:39:10 AM Eastern Daylight Time	HEALTH INSURANCE PLAN OF GREATER NEW YORK	EmblemHealth Medicare HMO	www.emblemhealth.com	VIP Rx Carveout (HMO)	01	01		1			H3330	815	0	2012	Counties of NYC, Nassau, Suffolk, Westchester		1		2			2							emblemhealth.com	emblemhealth.com	(800)-447-8255		(800)-447-8255		(800)-447-9169		(800)-447-9169										(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786										2	2	2
H3331	001	0	1	20	08	H3331_001_0	1	1		05/23/2011	2012.02	05/23/2011 03:21:33 PM Eastern Daylight Time		05/20/2011 04:56:30 PM Eastern Daylight Time		05/23/2011 03:27:28 PM Eastern Daylight Time	INDEPENDENT LIVING FOR SENIORS, INC.	Independent Living For Seniors, Inc.	www.independentlivingforseniors.org	Living for Seniors Dually Eligible (PACE)	08	20		1			H3331	001	0	2012	Monroe County		2		2			2							www.viahealth.org/body_senior.cfm?id=65	www.viahealth.org/hillhaven									(800)-896-0211		(585)-922-2831		(800)-896-0211		(585)-922-2831										(800)-896-0211		(585)-922-2831		(800)-896-0211		(585)-922-2831				
H3331	002	0	1	20	08	H3331_002_0	1	1		05/23/2011	2012.02	05/23/2011 03:22:03 PM Eastern Daylight Time		05/20/2011 04:56:30 PM Eastern Daylight Time		05/23/2011 03:27:28 PM Eastern Daylight Time	INDEPENDENT LIVING FOR SENIORS, INC.	Independent Living For Seniors, Inc.	www.independentlivingforseniors.org	Independent Living for Seniors Care only (PACE)	08	20		1			H3331	002	0	2012	Monroe County		2		2			2							www.viahealth.org/body_senior.cfm?id=65	www.viahealth.org/hillhaven									(800)-896-0211		(585)-922-2831		(800)-896-0211		(585)-922-2831										(800)-896-0211		(585)-922-2831		(800)-896-0211		(585)-922-2831				
H3333	037	0	1	09	04	H3333_037_0	4	1		07/07/2011	2012.02	07/07/2011 04:09:59 PM Central Daylight Time	07/15/2011 02:25:31 PM Central Daylight Time			07/18/2011 11:20:32 AM Central Daylight Time	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.TodaysOptions.com	Today's Options Premier 400 (PFFS)	04	09	2	1			H3333	037	0	2012	Select counties in the Northeast		2	355	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										2		2
H3333	039	0	1	09	04	H3333_039_0	4	1		07/06/2011	2012.02	07/06/2011 05:25:45 PM Central Daylight Time	07/15/2011 02:26:32 PM Central Daylight Time			07/18/2011 11:20:32 AM Central Daylight Time	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.TodaysOptions.com	Today's Options Premier 400 (PFFS)	04	09	2	1			H3333	039	0	2012	Select counties in the Northeast		2	605	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										2		2
H3333	055	0	1	09	04	H3333_055_0	6	1		07/06/2011	2012.02	07/06/2011 05:25:53 PM Central Daylight Time	08/04/2011 05:34:59 PM Central Daylight Time	08/04/2011 12:41:50 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.TodaysOptions.com	Today's Options Premier Plus 450B (PFFS)	04	09	2	1			H3333	055	0	2012	Select counties in the Northeast		2	281	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867		(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		2		2
H3333	057	0	1	09	04	H3333_057_0	6	1		07/06/2011	2012.02	07/06/2011 05:26:04 PM Central Daylight Time	08/04/2011 05:44:06 PM Central Daylight Time	08/04/2011 12:33:44 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.TodaysOptions.com	Today's Options Premier Plus 450B (PFFS)	04	09	2	1			H3333	057	0	2012	Select counties in the Northeast		2	394	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867		(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		2		2
H3333	163	0	1	09	04	H3333_163_0	2	1		07/06/2011	2012.02	07/06/2011 05:26:23 PM Central Daylight Time	06/05/2011 10:58:09 PM Central Daylight Time			07/08/2011 04:40:04 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.TodaysOptions.com	Today's Options Premier 200 (PFFS)	04	09	2	1			H3333	163	0	2012	Select counties in the Northeast		2	20	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										2		2
H3333	164	0	1	09	04	H3333_164_0	2	1		07/06/2011	2012.02	07/06/2011 04:14:45 PM Central Daylight Time	06/05/2011 10:58:27 PM Central Daylight Time			07/08/2011 04:40:04 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.TodaysOptions.com	Today's Options Premier 200 (PFFS)	04	09	2	1			H3333	164	0	2012	Select counties in the Northeast		2	20	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										2		2
H3333	165	0	1	09	04	H3333_165_0	4	1		07/06/2011	2012.02	07/06/2011 04:14:58 PM Central Daylight Time	08/04/2011 05:53:42 PM Central Daylight Time	08/04/2011 11:39:26 AM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.TodaysOptions.com	Today's Options Premier Plus 250A (PFFS)	04	09	2	1			H3333	165	0	2012	Select counties in the Northeast		2	100	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867		(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		2		2
H3333	166	0	1	09	04	H3333_166_0	4	1		07/06/2011	2012.02	07/06/2011 04:15:12 PM Central Daylight Time	08/04/2011 06:04:04 PM Central Daylight Time	08/04/2011 11:03:12 AM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.TodaysOptions.com	Today's Options Premier Plus 250A (PFFS)	04	09	2	1			H3333	166	0	2012	Select counties in the Northeast		2	14	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867		(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		2		2
H3335	002	0	1	04	01	H3335_002_0	9	1		07/12/2011	2012.02	07/12/2011 09:16:11 AM Eastern Daylight Time	08/04/2011 08:51:00 AM Eastern Daylight Time	08/03/2011 06:08:00 PM Eastern Daylight Time		08/08/2011 08:39:32 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.univerahealthcare.com	Univera Medicare PPO Plan 102 (PPO)	01	04		1			H3335	002	0	2012	Western New York		2		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		2	2	2
H3335	005	0	1	04	01	H3335_005_0	7	1		07/12/2011	2012.02	07/12/2011 09:16:29 AM Eastern Daylight Time	08/04/2011 05:27:00 PM Eastern Daylight Time	08/03/2011 06:09:00 PM Eastern Daylight Time		08/08/2011 08:39:32 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellusbcbs.com	Medicare Blue PPO Plan TWO (PPO)	01	04		1			H3335	005	0	2012	Utica-Rome Metro		2		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		2	2	2
H3335	006	0	1	04	01	H3335_006_0	7	1		07/12/2011	2012.02	07/12/2011 09:16:45 AM Eastern Daylight Time	08/04/2011 08:59:00 AM Eastern Daylight Time	08/03/2011 06:09:00 PM Eastern Daylight Time		08/08/2011 08:39:32 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellusbcbs.com	Medicare Blue PPO Plan THREE (PPO)	01	04		1			H3335	006	0	2012	Utica-Rome Metro		2		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		2	2	2
H3335	008	0	1	04	01	H3335_008_0	7	1		07/12/2011	2012.02	07/12/2011 09:16:59 AM Eastern Daylight Time	08/04/2011 09:05:00 AM Eastern Daylight Time	08/03/2011 06:09:00 PM Eastern Daylight Time		08/08/2011 08:39:32 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellusbcbs.com	Medicare Blue PPO Plan TWO (PPO)	01	04		1			H3335	008	0	2012	Southern Tier of NY State		2		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		2	2	2
H3335	009	0	1	04	01	H3335_009_0	7	1		07/12/2011	2012.02	07/12/2011 09:17:13 AM Eastern Daylight Time	08/04/2011 09:06:00 AM Eastern Daylight Time	08/03/2011 06:09:00 PM Eastern Daylight Time		08/08/2011 08:39:32 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellusbcbs.com	Medicare Blue PPO Plan THREE (PPO)	01	04		1			H3335	009	0	2012	Southern Tier of NY State		2		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		2	2	2
H3335	014	0	1	04	01	H3335_014_0	7	1		07/12/2011	2012.02	07/12/2011 09:17:25 AM Eastern Daylight Time	08/04/2011 10:07:00 AM Eastern Daylight Time	08/03/2011 06:10:00 PM Eastern Daylight Time		08/08/2011 08:39:32 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellusbcbs.com	Medicare Blue PPO Plan TWO (PPO)	01	04		1			H3335	014	0	2012	Metro Syracuse		2		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		2	2	2
H3335	015	0	1	04	01	H3335_015_0	7	1		07/12/2011	2012.02	07/12/2011 09:17:38 AM Eastern Daylight Time	08/04/2011 10:08:00 AM Eastern Daylight Time	08/03/2011 06:10:00 PM Eastern Daylight Time		08/08/2011 08:39:32 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellusbcbs.com	Medicare Blue PPO Plan THREE (PPO)	01	04		1			H3335	015	0	2012	Metro Syracuse		2		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		2	2	2
H3335	018	0	1	04	01	H3335_018_0	6	1		07/12/2011	2012.02	07/12/2011 09:17:52 AM Eastern Daylight Time	08/04/2011 08:54:00 AM Eastern Daylight Time	08/03/2011 06:10:00 PM Eastern Daylight Time		08/08/2011 08:39:32 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellusbcbs.com	Medicare Blue PPO Plan SIX (PPO)	01	04		1			H3335	018	0	2012	Central Leatherstocking		2		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		2	2	2
H3335	021	0	1	04	01	H3335_021_0	6	1		07/12/2011	2012.02	07/12/2011 09:18:05 AM Eastern Daylight Time	08/04/2011 09:00:00 AM Eastern Daylight Time	08/03/2011 06:11:00 PM Eastern Daylight Time		08/08/2011 08:39:32 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellusbcbs.com	Medicare Blue PPO Plan SEVEN (PPO)	01	04		1			H3335	021	0	2012	North Country		2		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		2	2	2
H3335	032	0	1	04	01	H3335_032_0	9	1		07/12/2011	2012.02	07/12/2011 09:18:18 AM Eastern Daylight Time	08/04/2011 08:39:00 AM Eastern Daylight Time	08/03/2011 06:11:00 PM Eastern Daylight Time		08/08/2011 08:39:32 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellusbcbs.com	Medicare Blue PPO Plan 201 (PPO)	01	04		1			H3335	032	0	2012	Rochester Metro Area		2		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		2	2	2
H3335	037	0	1	04	01	H3335_037_0	7	1		07/12/2011	2012.02	07/12/2011 09:18:32 AM Eastern Daylight Time	08/04/2011 09:01:00 AM Eastern Daylight Time	08/03/2011 06:11:00 PM Eastern Daylight Time		08/08/2011 08:39:32 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellusbcbs.com	Medicare Blue PPO Plan ONE (PPO)	01	04		1			H3335	037	0	2012	Southern Tier of NY State		2		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		2	2	2
H3335	038	0	1	04	01	H3335_038_0	7	1		07/12/2011	2012.02	07/12/2011 09:18:46 AM Eastern Daylight Time	08/04/2011 09:07:00 AM Eastern Daylight Time	08/03/2011 06:11:00 PM Eastern Daylight Time		08/08/2011 08:39:32 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellusbcbs.com	Medicare Blue PPO Plan ONE (PPO)	01	04		1			H3335	038	0	2012	Metro Syracuse		2		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		2	2	2
H3335	041	0	1	04	01	H3335_041_0	6	1		07/15/2011	2012.02	07/15/2011 08:01:17 AM Eastern Daylight Time	06/06/2011 07:43:42 AM Eastern Daylight Time			07/15/2011 07:54:09 PM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellusbcbs.com	Medicare Blue PPO Plan FOUR (PPO)	01	04		1			H3335	041	0	2012	Utica-Rome Metro		2		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986										(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220										2	2	2
H3335	042	0	1	04	01	H3335_042_0	6	1		07/15/2011	2012.02	07/15/2011 08:04:01 AM Eastern Daylight Time	06/06/2011 07:43:44 AM Eastern Daylight Time			07/15/2011 07:54:09 PM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellusbcbs.com	Medicare Blue PPO Plan FOUR (PPO)	01	04		1			H3335	042	0	2012	Southern Tier of NY State		2		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986										(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220										2	2	2
H3335	043	0	1	04	01	H3335_043_0	6	1		07/15/2011	2012.02	07/15/2011 08:07:49 AM Eastern Daylight Time	06/06/2011 07:43:45 AM Eastern Daylight Time			07/15/2011 07:54:09 PM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellusbcbs.com	Medicare Blue PPO Plan FOUR (PPO)	01	04		1			H3335	043	0	2012	Metro Syracuse		2		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986										(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220										2	2	2
H3335	044	0	1	04	01	H3335_044_0	6	1		07/15/2011	2012.02	07/15/2011 08:11:44 AM Eastern Daylight Time	06/06/2011 07:43:47 AM Eastern Daylight Time			07/15/2011 07:54:09 PM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellusbcbs.com	Medicare Blue PPO Plan FOUR (PPO)	01	04		1			H3335	044	0	2012	Central Leatherstocking		2		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986										(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220										2	2	2
H3335	045	0	1	04	01	H3335_045_0	7	1		07/15/2011	2012.02	07/15/2011 08:14:19 AM Eastern Daylight Time	06/06/2011 07:43:49 AM Eastern Daylight Time			07/15/2011 07:54:09 PM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellusbcbs.com	Medicare Blue PPO Plan FOUR (PPO)	01	04		1			H3335	045	0	2012	North Country		2		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986										(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220										2	2	2
H3335	051	0	1	04	01	H3335_051_0	7	1		07/15/2011	2012.02	07/15/2011 08:27:16 AM Eastern Daylight Time	08/04/2011 08:56:00 AM Eastern Daylight Time	08/03/2011 06:12:00 PM Eastern Daylight Time		08/08/2011 08:39:32 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellusbcbs.com	Medicare Blue PPO Plan ONE (PPO)	01	04		1			H3335	051	0	2012	Utica-Rome Metro		2		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		2	2	2
H3335	801	0	1	04	01	H3335_801_0	6	1		07/11/2011	2012.02	07/11/2011 10:40:19 AM Eastern Daylight Time	06/06/2011 12:59:14 PM Eastern Daylight Time			07/13/2011 02:50:50 PM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.univerahealthcare.com	Univera Medicare PPO Group (PPO)	01	04		1			H3335	801	0	2012	Western New York		1		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		2	2	2
H3335	811	0	1	04	01	H3335_811_0	6	1		07/11/2011	2012.02	07/11/2011 10:41:19 AM Eastern Daylight Time	06/06/2011 12:59:16 PM Eastern Daylight Time			07/13/2011 02:50:50 PM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellusbcbs.com	Medicare Blue PPO Group (PPO)	01	04		1			H3335	811	0	2012	Rochester Metro Area and Eastern New York Area		1		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		2	2	2
H3335	813	0	1	04	01	H3335_813_0	6	1		07/11/2011	2012.02	07/11/2011 10:41:51 AM Eastern Daylight Time	06/06/2011 12:59:18 PM Eastern Daylight Time			07/13/2011 02:50:50 PM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.univerahealthcare.com	Univera Medicare PPO Group (PPO)	01	04		1			H3335	813	0	2012	Western New York		1		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986										(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220										2	2	2
H3335	819	0	1	04	01	H3335_819_0	6	1		07/11/2011	2012.02	07/11/2011 10:42:48 AM Eastern Daylight Time	06/06/2011 12:59:19 PM Eastern Daylight Time			07/13/2011 02:50:50 PM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellusbcbs.com	Medicare Blue PPO Group (PPO)	01	04		1			H3335	819	0	2012	Rochester Metro Area and Eastern New York Area		1		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986										(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220										2	2	2
H3335	820	0	1	04	01	H3335_820_0	6	1		07/11/2011	2012.02	07/11/2011 10:43:44 AM Eastern Daylight Time	06/06/2011 12:59:21 PM Eastern Daylight Time			07/13/2011 02:50:50 PM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellusbcbs.com	Medicare Blue PPO Group Non-Calendar (PPO)	01	04		1			H3335	820	0	2012	Rochester Metro Area and Eastern New York Area		1		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		2	2	2
H3335	822	0	1	04	01	H3335_822_0	6	1		07/11/2011	2012.02	07/11/2011 10:45:01 AM Eastern Daylight Time	06/06/2011 12:59:23 PM Eastern Daylight Time			07/13/2011 02:50:50 PM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.univerahealthcare.com	Univera Medicare PPO Group Non-Calendar (PPO)	01	04		1			H3335	822	0	2012	Western New York		1		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		2	2	2
H3337	001	0	1	01	01	H3337_001_0	9	1		07/18/2011	2012.02	07/18/2011 03:20:22 PM Pacific Daylight Time	08/04/2011 02:42:51 PM Pacific Daylight Time	08/04/2011 12:17:40 PM Pacific Daylight Time		08/05/2011 09:30:51 AM Pacific Daylight Time	LIBERTY HEALTH ADVANTAGE, INC.	Liberty Health Advantage	http://libertyhealthadvantage.com/	Liberty Health Advantage Preferred Choice (HMO)	01	01		1			H3337	001	0	2012	Bronx, Kings, Nassau, New York, Queens, Richmond		2		2			2						www.libertyhealthadvantage.com	http://www.libertyhealthadvantage.com/	http://www.libertyhealthadvantage.com/	(866)-542-4269		(866)-542-4269		(866)-542-4269		(866)-542-4269		(800)-546-5677		(800)-546-5677		(866)-542-4269		(866)-542-4269		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(866)-706-4757		(866)-706-4757		(800)-662-1220		(800)-662-1220		2	2	2
H3337	003	0	1	01	01	H3337_003_0	9	1	2	08/04/2011	2012.02	08/04/2011 02:50:17 PM Pacific Daylight Time	08/04/2011 02:43:29 PM Pacific Daylight Time	08/04/2011 12:21:22 PM Pacific Daylight Time		08/05/2011 09:30:51 AM Pacific Daylight Time	LIBERTY HEALTH ADVANTAGE, INC.	Liberty Health Advantage	http://libertyhealthadvantage.com/	Liberty Health Advantage Dual Power (HMO SNP)	01	01		1			H3337	003	0	2012	Bronx, Kings, Nassau, New York, Queens, Richmond		2		2			1	3		1	3		www.libertyhealthadvantage.com	http://www.libertyhealthadvantage.com/	http://www.libertyhealthadvantage.com/	(866)-542-4269		(866)-542-4269		(866)-542-4269		(866)-542-4269		(800)-546-5677		(800)-546-5677		(866)-542-4269		(866)-542-4269		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(866)-706-4757		(866)-706-4757		(800)-662-1220		(800)-662-1220		2	2	2
H3342	001	0	1	04	01	H3342_001_0	9	1		08/08/2011	2012.02	08/08/2011 09:32:12 AM Eastern Daylight Time	08/09/2011 12:17:31 AM Eastern Daylight Time	08/09/2011 12:17:48 AM Eastern Daylight Time		08/09/2011 12:21:16 AM Eastern Daylight Time	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Empire BlueCross BlueShield	www.empireblue.com/medicare	Empire MediBlue Freedom III (PPO)	01	04		1			H3342	001	0	2012	New York City and Nassau County in New York		2	3586	2			2						www.empireblue.com/medicare	www.empireblue.com	www.empireblue.com	(866)-395-5175		(866)-395-5175		(800)-797-6308		(800)-797-6308		(866)-395-5175		(866)-395-5175		(800)-797-6308		(800)-797-6308		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		2	2	2
H3342	002	0	1	04	01	H3342_002_0	8	1		08/08/2011	2012.02	08/08/2011 08:20:08 PM Eastern Daylight Time	08/08/2011 08:31:55 PM Eastern Daylight Time	08/08/2011 08:27:56 PM Eastern Daylight Time		08/08/2011 08:45:57 PM Eastern Daylight Time	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Empire BlueCross BlueShield	www.empireblue.com/medicare	Empire MediBlue Freedom III (PPO)	01	04		1			H3342	002	0	2012	Select Counties in New York		2	2749	2			2						www.empireblue.com/medicare	www.empireblue.com	www.empireblue.com	(866)-395-5175		(866)-395-5175		(800)-797-6308		(800)-797-6308		(866)-395-5175		(866)-395-5175		(800)-797-6308		(800)-797-6308		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		2	2	2
H3342	012	0	1	04	01	H3342_012_0	8	1		08/08/2011	2012.02	08/08/2011 08:20:13 PM Eastern Daylight Time	08/08/2011 08:32:06 PM Eastern Daylight Time	08/08/2011 08:28:56 PM Eastern Daylight Time		08/08/2011 09:18:19 PM Eastern Daylight Time	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Empire BlueCross BlueShield	www.empireblue.com/medicare	Empire MediBlue Freedom I (PPO)	01	04		1			H3342	012	0	2012	Select Counties in New York		2	44209	2			2						www.empireblue.com/medicare	www.empireblue.com	www.empireblue.com	(866)-395-5175		(866)-395-5175		(800)-797-6308		(800)-797-6308		(866)-395-5175		(866)-395-5175		(800)-797-6308		(800)-797-6308		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		2	2	2
H3342	013	0	1	04	01	H3342_013_0	7	1		08/08/2011	2012.02	08/08/2011 08:20:19 PM Eastern Daylight Time	08/08/2011 08:32:51 PM Eastern Daylight Time	08/08/2011 08:29:03 PM Eastern Daylight Time		08/08/2011 09:22:25 PM Eastern Daylight Time	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Empire BlueCross BlueShield	www.empireblue.com/medicare	Empire MediBlue Freedom II (PPO)	01	04		1			H3342	013	0	2012	New York City and Nassau County in New York		2	3345	2			2						www.empireblue.com/medicare	www.empireblue.com	www.empireblue.com	(866)-395-5175		(866)-395-5175		(800)-797-6308		(800)-797-6308		(866)-395-5175		(866)-395-5175		(800)-797-6308		(800)-797-6308		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		2	2	2
H3342	014	0	1	04	01	H3342_014_0	7	1		08/08/2011	2012.02	08/08/2011 08:20:24 PM Eastern Daylight Time	08/08/2011 08:35:13 PM Eastern Daylight Time	08/08/2011 08:29:11 PM Eastern Daylight Time		08/08/2011 09:24:45 PM Eastern Daylight Time	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Empire BlueCross BlueShield	www.empireblue.com/medicare	Empire MediBlue Freedom II (PPO)	01	04		1			H3342	014	0	2012	Select Counties in New York		2	3945	2			2						www.empireblue.com/medicare	www.empireblue.com	www.empireblue.com	(866)-395-5175		(866)-395-5175		(800)-797-6308		(800)-797-6308		(866)-395-5175		(866)-395-5175		(800)-797-6308		(800)-797-6308		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		2	2	2
H3342	015	0	1	04	01	H3342_015_0	7	1		08/08/2011	2012.02	08/08/2011 08:20:28 PM Eastern Daylight Time	08/08/2011 08:35:24 PM Eastern Daylight Time	08/08/2011 08:29:18 PM Eastern Daylight Time		08/08/2011 09:29:06 PM Eastern Daylight Time	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Empire BlueCross BlueShield	www.empireblue.com/medicare	Empire MediBlue Freedom II (PPO)	01	04		1			H3342	015	0	2012	Suffolk County in New York		2	1789	2			2						www.empireblue.com/medicare	www.empireblue.com	www.empireblue.com	(866)-395-5175		(866)-395-5175		(800)-797-6308		(800)-797-6308		(866)-395-5175		(866)-395-5175		(800)-797-6308		(800)-797-6308		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		2	2	2
H3342	808	0	1	04	01	H3342_808_0	6	1		07/22/2011	2012.02	07/22/2011 10:19:26 AM Eastern Daylight Time	07/26/2011 11:39:00 AM Eastern Daylight Time			07/26/2011 11:49:55 AM Eastern Daylight Time	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Empire BlueCross BlueShield	www.empireblue.com/medicare	Empire MediBlue Freedom (PPO)	01	04		1			H3342	808	0	2012	New York		1	5735	2			2						www.empireblue.com/medicare	www.empireblue.com	www.empireblue.com	(866)-222-0444		(866)-222-0444		(866)-205-6551		(866)-205-6551		(866)-222-0444		(866)-222-0444		(866)-205-6551		(866)-205-6551		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		2	2	2
H3342	809	0	1	04	01	H3342_809_0	4	1		06/04/2011	2012.02	06/04/2011 02:02:16 PM Eastern Daylight Time	07/26/2011 11:39:01 AM Eastern Daylight Time			07/26/2011 11:49:55 AM Eastern Daylight Time	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Empire BlueCross BlueShield	www.empireblue.com/medicare	Empire MediBlue Freedom (PPO)	01	04		1			H3342	809	0	2012	New York		1	50	2			2						www.empireblue.com/medicare	www.empireblue.com	www.empireblue.com	(866)-222-0444		(866)-222-0444		(866)-205-6551		(866)-205-6551										(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894										2	2	2
H3342	810	0	1	04	01	H3342_810_0	4	1		06/04/2011	2012.02	06/04/2011 02:02:39 PM Eastern Daylight Time	07/26/2011 11:39:02 AM Eastern Daylight Time			07/26/2011 11:49:55 AM Eastern Daylight Time	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Empire BlueCross BlueShield	www.empireblue.com/medicare	Empire MediBlue Freedom (PPO)	01	04		1			H3342	810	0	2012	New York		1	50	2			2						www.empireblue.com/medicare	www.empireblue.com	www.empireblue.com	(866)-222-0444		(866)-222-0444		(866)-205-6551		(866)-205-6551		(866)-222-0444		(866)-222-0444		(866)-205-6551		(866)-205-6551		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		2	2	2
H3342	811	0	1	04	01	H3342_811_0	4	1		06/04/2011	2012.02	06/04/2011 02:03:04 PM Eastern Daylight Time	07/26/2011 11:39:03 AM Eastern Daylight Time			07/26/2011 11:49:55 AM Eastern Daylight Time	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Empire BlueCross BlueShield	www.empireblue.com/medicare	Empire MediBlue Freedom (PPO)	01	04		1			H3342	811	0	2012	New York		1	50	2			2						www.empireblue.com/medicare	www.empireblue.com	www.empireblue.com	(866)-222-0444		(866)-222-0444		(866)-205-6551		(866)-205-6551										(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894										2	2	2
H3344	003	0	1	04	01	H3344_003_0	7	1		08/09/2011	2012.02	08/09/2011 01:11:25 PM Eastern Daylight Time	08/09/2011 08:24:36 AM Eastern Daylight Time	08/09/2011 08:23:58 AM Eastern Daylight Time		08/09/2011 02:37:05 PM Eastern Daylight Time	INDEPENDENT HEALTH BENEFITS CORPORATION	Independent Health	www.independenthealth.com	Independent Health Medicare Passport Premier (PPO)	01	04		1			H3344	003	0	2012	Western New York		2	590	2			2						www.independenthealth.com	www.independenthealth.com	www.independentheatlh.com	(800)-665-1502		(716)-250-4401		(800)-958-4405		(716)-635-4900		(800)-665-1502		(716)-250-4401		(800)-958-4405		(716)-635-4900		(800)-432-1110		(716)-631-3108		(888)-357-9167		(716)-635-4840		(800)-432-1110		(716)-631-3108		(888)-357-9167		(716)-635-4840		2	2	2
H3344	005	0	1	04	01	H3344_005_0	10	1		08/09/2011	2012.02	08/09/2011 01:11:42 PM Eastern Daylight Time	08/09/2011 08:23:40 AM Eastern Daylight Time	08/09/2011 08:23:04 AM Eastern Daylight Time		08/09/2011 02:37:05 PM Eastern Daylight Time	INDEPENDENT HEALTH BENEFITS CORPORATION	Independent Health	www.independenthealth.com	Independent Health Medicare Passport Advantage (PPO)	01	04		1			H3344	005	0	2012	Western New York		2	2090	2			2						www.independenthealth.com	www.independenthealth.com	www.independentheatlh.com	(800)-665-1502		(716)-250-4401		(800)-958-4405		(716)-635-4900		(800)-665-1502		(716)-250-4401		(800)-958-4405		(716)-635-4900		(800)-432-1110		(716)-631-3108		(888)-357-9167		(716)-635-4840		(800)-432-1110		(716)-631-3108		(888)-357-9167		(716)-635-4840		2	2	2
H3344	006	0	1	04	01	H3344_006_0	5	1		08/09/2011	2012.02	08/09/2011 01:11:49 PM Eastern Daylight Time	08/09/2011 08:22:46 AM Eastern Daylight Time	08/09/2011 08:21:56 AM Eastern Daylight Time		08/09/2011 02:37:05 PM Eastern Daylight Time	INDEPENDENT HEALTH BENEFITS CORPORATION	Independent Health	www.independenthealth.com	Independent Health Medicare Passport Basic (PPO)	01	04		1			H3344	006	0	2012	Western New York		2	1328	2			2						www.independenthealth.com	www.independenthealth.com	www.independentheatlh.com	(800)-665-1502		(716)-250-4401		(800)-958-4405		(716)-635-4900		(800)-665-1502		(716)-250-4401		(800)-958-4405		(716)-635-4900		(800)-432-1110		(716)-631-3108		(888)-357-9167		(716)-635-4840		(800)-432-1110		(716)-631-3108		(888)-357-9167		(716)-635-4840		2	2	2
H3344	801	0	1	04	01	H3344_801_0	1	1		05/26/2011	2012.02	05/26/2011 04:24:28 PM Eastern Daylight Time	06/03/2011 06:10:42 PM Eastern Daylight Time			06/04/2011 08:46:04 AM Eastern Daylight Time	INDEPENDENT HEALTH BENEFITS CORPORATION	Independent Health	www.independenthealth.com	Independent Health Medicare PPO Base (PPO)	01	04		1			H3344	801	0	2012	IH Network and Medicare Deemed Network		1	1022	2			2						www.independenthealth.com	www.independenthealth.com	www.independentheatlh.com	(800)-665-1502		(716)-250-4401		(800)-958-4405		(716)-635-4900		(800)-665-1502		(716)-250-4401		(800)-958-4405		(716)-635-4900		(800)-432-1110		(716)-631-3108		(888)-357-9167		(716)-635-4840		(800)-432-1110		(716)-631-3108		(888)-357-9167		(716)-635-4840		1	1	1
H3344	803	0	1	04	01	H3344_803_0	1	1		05/26/2011	2012.02	05/26/2011 04:24:35 PM Eastern Daylight Time	06/03/2011 06:11:38 PM Eastern Daylight Time			06/04/2011 08:46:04 AM Eastern Daylight Time	INDEPENDENT HEALTH BENEFITS CORPORATION	Independent Health	www.independenthealth.com	Independent Health Medicare PPO Base (PPO)	01	04		1			H3344	803	0	2012	IH Network and Medicare Deemed Network		1	0	2			2						www.independenthealth.com	www.independenthealth.com	www.independentheatlh.com	(800)-665-1502		(716)-250-4401		(800)-958-4405		(716)-635-4900		(800)-665-1502		(716)-250-4401		(800)-958-4405		(716)-635-4900		(800)-432-1110		(716)-631-3108		(888)-357-9167		(716)-635-4840		(800)-432-1110		(716)-631-3108		(888)-357-9167		(716)-635-4840		1	1	1
H3344	804	0	1	04	01	H3344_804_0	1	1		05/26/2011	2012.02	05/26/2011 04:24:52 PM Eastern Daylight Time	06/03/2011 06:10:00 PM Eastern Daylight Time			06/04/2011 08:46:04 AM Eastern Daylight Time	INDEPENDENT HEALTH BENEFITS CORPORATION	Independent Health	www.independenthealth.com	Independent Health Medicare PPO Base (PPO)	01	04		1			H3344	804	0	2012	IH Network and Medicare Deemed Network		1	0	2			2						www.independenthealth.com	www.independenthealth.com	www.independentheatlh.com	(800)-665-1502		(716)-250-4401		(800)-958-4405		(716)-635-4900										(800)-432-1110		(716)-631-3108		(888)-357-9167		(716)-635-4840										1	1	1
H3346	002	0	1	04	01	H3346_002_0	7	1		07/15/2011	2012.02	07/15/2011 10:58:02 AM Eastern Daylight Time	08/05/2011 02:51:00 PM Eastern Daylight Time	08/05/2011 01:17:58 PM Eastern Daylight Time		08/09/2011 08:24:48 AM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.joinMVPmedicare.com	GoldAnywhere Rx (PPO)	01	04		1			H3346	002	0	2012	Rochester Area		2	822	2			2						www.mvphealthcare.com	https://www.mvphealthcare.com/medicare/documents/2011_Comprehensive_Formulary_roc.pdf	www.mvphealthcare.com	(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205		(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		2	2	2
H3346	007	0	1	04	01	H3346_007_0	7	1		07/15/2011	2012.02	07/15/2011 10:57:22 AM Eastern Daylight Time	08/05/2011 02:52:06 PM Eastern Daylight Time	08/05/2011 01:26:27 PM Eastern Daylight Time		08/09/2011 08:24:48 AM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.joinMVPmedicare.com	GoldAnywhere Rx (PPO)	01	04		1			H3346	007	0	2012	Buffalo Area		2	80	2			2						www.mvphealthcare.com	https://www.mvphealthcare.com/medicare/documents/2011_Comprehensive_Formulary_roc.pdf	www.mvphealthcare.com	(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205		(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		2	2	2
H3346	802	0	1	04	01	H3346_802_0	1	1		05/31/2011	2012.02	05/31/2011 10:38:56 AM Eastern Daylight Time	06/04/2011 11:13:19 AM Eastern Daylight Time			06/04/2011 11:56:06 AM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.mvphealthcare.com	GoldAnywhere Rx - Employer Group (PPO)	01	04		1			H3346	802	0	2012	Rochester and Western New York		1	1700	2			2						www.mvphealthcare.com	https://www.mvphealthcare.com/medicare/documents/2011_Comprehensive_Formulary_roc.pdf	www.mvphealthcare.com	(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205		(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		1	1	1
H3346	803	0	1	04	01	H3346_803_0	2	1		06/05/2011	2012.02	06/05/2011 10:19:58 AM Eastern Daylight Time	06/05/2011 09:59:36 AM Eastern Daylight Time			06/05/2011 10:20:36 AM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.mvphealthcare.com	Kodak GoldAnywhere Rx (PPO)	01	04		1			H3346	803	0	2012	Rochester and Western NY		1	22778	2			2						www.mvphealthcare.com	https://www.mvphealthcare.com/medicare/documents/2011_Comprehensive_Formulary_roc.pdf	www.mvphealthcare.com	(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205		(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		1	1	1
H3346	804	0	1	04	01	H3346_804_0	1	1		05/27/2011	2012.02	05/27/2011 09:22:10 AM Eastern Daylight Time	06/04/2011 11:14:12 AM Eastern Daylight Time			06/04/2011 12:21:22 PM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.mvphealthcare.com	Kodak USA Care Rx (PPO)	01	04		1			H3346	804	0	2012	United States and Puerto Rico		1	15381	2			2						www.mvphealthcare.com	https://www.mvphealthcare.com/medicare/documents/2011_Comprehensive_Formulary_roc.pdf	www.mvphealthcare.com	(888)-597-4419		(888)-597-4419		(888)-280-6205		(888)-280-6205		(888)-597-4419		(888)-597-4419		(888)-280-6205		(888)-280-6205		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		1	1	1
H3346	805	0	1	04	01	H3346_805_0	1	1		05/27/2011	2012.02	05/27/2011 09:26:06 AM Eastern Daylight Time	06/04/2011 11:14:12 AM Eastern Daylight Time			06/04/2011 12:18:54 PM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.mvphealthcare.com	USA Care Rx - Employer Group (PPO)	01	04		1			H3346	805	0	2012	United States and Puerto Rico		1	149	2			2						www.mvphealthcare.com	https://www.mvphealthcare.com/medicare/documents/2011_Comprehensive_Formulary_roc.pdf	www.mvphealthcare.com	(888)-597-4419		(888)-597-4419		(888)-280-6205		(888)-280-6205		(888)-597-4419		(888)-597-4419		(888)-280-6205		(888)-280-6205		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		1	1	1
H3347	002	0	1	01	01	H3347_002_0	5	1	2	06/06/2011	2012.02	06/06/2011 05:32:57 PM Eastern Daylight Time	06/06/2011 04:49:42 PM Eastern Daylight Time	06/04/2011 05:14:12 PM Eastern Daylight Time		06/06/2011 06:39:12 PM Eastern Daylight Time	ELDERPLAN, INC.	Elderplan	www.Elderplan.org	Elderplan For Medicaid Beneficiaries (HMO SNP)	01	01		1			H3347	002	000	2012	New York Metropolitan Area		2		2			1	3		1	2		www.Elderplan.org	www.elderplan.org	http://www.ipsrx.com	(800)-353-3765		(718)-921-7979		(866)-695-8101		(866)-695-8101		(800)-353-3765		(718)-921-7979		(866)-695-8101		(866)-695-8101		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		2	2	2
H3347	003	0	1	01	01	H3347_003_0	5	1		06/06/2011	2012.02	06/06/2011 05:33:51 PM Eastern Daylight Time	06/06/2011 04:51:00 PM Eastern Daylight Time	06/04/2011 12:40:36 PM Eastern Daylight Time		06/06/2011 06:39:12 PM Eastern Daylight Time	ELDERPLAN, INC.	Elderplan	www.Elderplan.org	Elderplan Advantage For Nursing Home Residents (HMO SNP)	01	01		1			H3347	003	000	2012	New York Metropolitan Area		2		2			1	1	1	1			www.Elderplan.org	www.elderplan.org	http://www.ipsrx.com	(800)-353-3765		(718)-921-7979		(866)-695-8101		(866)-695-8101		(800)-353-3765		(718)-921-7979		(866)-695-8101		(866)-695-8101		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		2	2	2
H3347	005	0	1	01	01	H3347_005_0	8	1		08/08/2011	2012.02	08/08/2011 11:18:48 AM Eastern Daylight Time	08/05/2011 12:14:54 PM Eastern Daylight Time	08/04/2011 05:00:26 PM Eastern Daylight Time		08/08/2011 11:24:08 AM Eastern Daylight Time	ELDERPLAN, INC.	Elderplan	www.Elderplan.org	Elderplan Classic: Zero Premium (HMO)	01	01		1			H3347	005	000	2012	New York Metropolitan Area		2		2			2						www.Elderplan.org	www.elderplan.org	http://www.ipsrx.com	(800)-353-3765		(718)-921-7979		(866)-695-8101		(866)-695-8101		(800)-353-3765		(718)-921-7979		(866)-695-8101		(866)-695-8101		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		2	2	2
H3347	007	0	1	01	01	H3347_007_0	6	1	2	06/06/2011	2012.02	06/06/2011 07:00:46 PM Eastern Daylight Time	06/15/2011 02:07:16 PM Eastern Daylight Time	06/04/2011 05:19:28 PM Eastern Daylight Time		06/17/2011 09:43:24 AM Eastern Daylight Time	ELDERPLAN, INC.	Elderplan	www.Elderplan.org	Elderplan Plus Long Term Care (HMO SNP)	01	01		1			H3347	007	000	2012	New York Metropolitan Area		2		2			1	3		1	3		www.Elderplan.org	www.elderplan.org	http://www.ipsrx.com	(877)-891-6447		(718)-921-7979		(866)-695-8101		(866)-695-8101		(877)-891-6447		(718)-921-7979		(866)-695-8101		(866)-695-8101		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		2	2	2
H3347	008	0	1	01	01	H3347_008_0	5	1	2	06/06/2011	2012.02	06/06/2011 05:35:47 PM Eastern Daylight Time	06/06/2011 04:54:28 PM Eastern Daylight Time	06/04/2011 05:23:42 PM Eastern Daylight Time		06/06/2011 06:39:12 PM Eastern Daylight Time	ELDERPLAN, INC.	Elderplan	www.Elderplan.org	Elderplan Medicaid Advantage (HMO SNP)	01	01		1			H3347	008	000	2012	New York Metropolitan Area		2		2			1	3		1	3		www.Elderplan.org	www.elderplan.org	http://www.ipsrx.com	(800)-353-3765		(718)-921-7979		(866)-695-8101		(866)-695-8101		(800)-353-3765		(718)-921-7979		(866)-695-8101		(866)-695-8101		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		2	2	2
H3347	009	0	1	01	01	H3347_009_0	8	1		08/08/2011	2012.02	08/08/2011 11:17:35 AM Eastern Daylight Time	08/05/2011 12:23:30 PM Eastern Daylight Time	08/04/2011 05:02:04 PM Eastern Daylight Time		08/08/2011 11:24:08 AM Eastern Daylight Time	ELDERPLAN, INC.	Elderplan	www.Elderplan.org	Elderplan Extra Help (HMO)	01	01		1			H3347	009	000	2012	New York Metropolitan Area		2		2			2						www.Elderplan.org	www.elderplan.org	http://www.ipsrx.com	(800)-353-3765		(718)-921-7979		(866)-695-8101		(866)-695-8101		(800)-353-3765		(718)-921-7979		(866)-695-8101		(866)-695-8101		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		2	2	2
H3347	010	0	1	02	01	H3347_010_0	8	1		08/08/2011	2012.02	08/08/2011 11:17:58 AM Eastern Daylight Time	08/05/2011 12:18:02 PM Eastern Daylight Time	08/04/2011 05:02:36 PM Eastern Daylight Time		08/08/2011 11:24:08 AM Eastern Daylight Time	ELDERPLAN, INC.	Elderplan	www.Elderplan.org	Elderplan Independence Choice (HMO-POS)	01	02		1			H3347	010	000	2012	New York Metropolitan Area		2		2			2						www.Elderplan.org	www.elderplan.org	http://www.ipsrx.com	(800)-353-3765		(718)-921-7979		(866)-695-8101		(866)-695-8101		(800)-353-3765		(718)-921-7979		(866)-695-8101		(866)-695-8101		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		2	2	2
H3351	001	0	1	02	01	H3351_001_0	6	1		07/27/2011	2012.02	07/27/2011 09:17:19 AM Eastern Daylight Time	06/06/2011 07:44:03 AM Eastern Daylight Time			07/27/2011 10:32:56 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.univerahealthcare.com	SeniorChoice Select (HMO-POS)	01	02		1			H3351	001	0	2012	Western New York		2		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986										(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220										2	2	2
H3351	002	0	1	02	01	H3351_002_0	8	1		07/27/2011	2012.02	07/27/2011 09:17:41 AM Eastern Daylight Time	08/04/2011 08:41:00 AM Eastern Daylight Time	08/03/2011 06:12:00 PM Eastern Daylight Time		08/08/2011 08:39:32 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.univerahealthcare.com	SeniorChoice Secure (HMO-POS)	01	02		1			H3351	002	0	2012	Western New York		2		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		2	2	2
H3351	006	0	1	02	01	H3351_006_0	9	1		07/27/2011	2012.02	07/27/2011 09:17:59 AM Eastern Daylight Time	08/04/2011 08:35:00 AM Eastern Daylight Time	08/03/2011 06:12:00 PM Eastern Daylight Time		08/08/2011 08:39:32 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellusbcbs.com	Medicare Blue Choice Optimum (HMO-POS)	01	02		1			H3351	006	0	2012	Metro Rochester		2		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		2	2	2
H3351	007	0	1	02	01	H3351_007_0	7	1		07/27/2011	2012.02	07/27/2011 09:18:17 AM Eastern Daylight Time	06/06/2011 07:44:09 AM Eastern Daylight Time			07/27/2011 10:32:56 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellusbcbs.com	Medicare Blue Choice Platinum (HMO-POS)	01	02		1			H3351	007	0	2012	Metro Rochester		2		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986										(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220										2	2	2
H3351	010	0	1	01	01	H3351_010_0	9	1		07/27/2011	2012.02	07/27/2011 09:18:35 AM Eastern Daylight Time	08/04/2011 08:42:00 AM Eastern Daylight Time	08/03/2011 06:13:00 PM Eastern Daylight Time		08/08/2011 08:39:32 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.univerahealthcare.com	SeniorChoice Value (HMO)	01	01		1			H3351	010	0	2012	Western New York		2		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		2	2	2
H3351	011	0	1	01	01	H3351_011_0	9	1		07/27/2011	2012.02	07/27/2011 09:19:03 AM Eastern Daylight Time	08/04/2011 08:37:00 AM Eastern Daylight Time	08/03/2011 06:13:00 PM Eastern Daylight Time		08/08/2011 08:39:32 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellusbcbs.com	Medicare Blue Choice Value (HMO)	01	01		1			H3351	011	0	2012	Metro Rochester		2		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		2	2	2
H3351	012	0	1	01	01	H3351_012_0	9	1		07/27/2011	2012.02	07/27/2011 09:19:13 AM Eastern Daylight Time	08/04/2011 08:49:00 AM Eastern Daylight Time	08/03/2011 06:13:00 PM Eastern Daylight Time		08/08/2011 08:39:32 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.univerahealthcare.com	SeniorChoice Value Plus (HMO)	01	01		1			H3351	012	0	2012	Western New York		2		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		2	2	2
H3351	013	0	1	01	01	H3351_013_0	9	1		07/27/2011	2012.02	07/27/2011 09:19:34 AM Eastern Daylight Time	08/04/2011 08:38:00 AM Eastern Daylight Time	08/03/2011 06:13:00 PM Eastern Daylight Time		08/08/2011 08:39:32 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellusbcbs.com	Medicare Blue Choice Value Plus (HMO)	01	01		1			H3351	013	0	2012	Metro Rochester		2		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		2	2	2
H3351	801	0	1	02	01	H3351_801_0	5	1		07/27/2011	2012.02	07/27/2011 09:22:00 AM Eastern Daylight Time	06/06/2011 12:59:24 PM Eastern Daylight Time			07/27/2011 10:32:56 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.univerahealthcare.com	SeniorChoice - Group (HMO-POS)	01	02		1			H3351	801	0	2012	Western New York		1		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		2	2	2
H3351	802	0	1	02	01	H3351_802_0	5	1		07/27/2011	2012.02	07/27/2011 09:23:08 AM Eastern Daylight Time	06/06/2011 12:59:26 PM Eastern Daylight Time			07/27/2011 10:32:56 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellusbcbs.com	Medicare Blue Choice - Group (HMO-POS)	01	02		1			H3351	802	0	2012	Metro Rochester		1		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		2	2	2
H3351	803	0	1	02	01	H3351_803_0	5	1		07/27/2011	2012.02	07/27/2011 09:23:21 AM Eastern Daylight Time	06/06/2011 12:59:28 PM Eastern Daylight Time			07/27/2011 10:32:56 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.univerahealthcare.com	SeniorChoice - Group (HMO-POS)	01	02		1			H3351	803	0	2012	Western New York		1		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986										(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220										2	2	2
H3351	804	0	1	02	01	H3351_804_0	5	1		07/27/2011	2012.02	07/27/2011 09:23:45 AM Eastern Daylight Time	06/06/2011 12:59:29 PM Eastern Daylight Time			07/27/2011 10:32:56 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellusbcbs.com	Medicare Blue Choice - Group (HMO-POS)	01	02		1			H3351	804	0	2012	Metro Rochester		1		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986										(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220										2	2	2
H3351	805	0	1	02	01	H3351_805_0	5	1		07/27/2011	2012.02	07/27/2011 09:24:06 AM Eastern Daylight Time	06/06/2011 12:59:31 PM Eastern Daylight Time			07/27/2011 10:32:56 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.univerahealthcare.com	SeniorChoice Group Non-Calendar (HMO-POS)	01	02		1			H3351	805	0	2012	Western New York		1		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		2	2	2
H3351	806	0	1	02	01	H3351_806_0	5	1		07/27/2011	2012.02	07/27/2011 09:24:24 AM Eastern Daylight Time	06/06/2011 12:59:13 PM Eastern Daylight Time			07/27/2011 10:32:56 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellusbcbs.com	Medicare Blue Choice Group Non-Calendar (HMO-POS)	01	02		1			H3351	806	0	2012	Metro Rochester		1		2			2						www.excellusbcbs.com or www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	www.excellusbcbs.com and www.univerahealthcare.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		2	2	2
H3356	001	0	1	18	06	H3356_001_0	5	1		07/18/2011	2012.02	07/18/2011 03:16:33 PM Eastern Daylight Time		08/03/2011 06:14:00 PM Eastern Daylight Time		08/08/2011 08:39:32 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC.	Excellus BlueCross BlueShield	www.excellusbcbs.com	Blue Choice Senior (Cost)	06	18		1			H3356	001	0	2012	Metro Rochester and Finger Lakes area		2		2			2							www.excellusbcbs.com	www.excellusbcbs.com	(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		2	2	2
H3356	801	0		18	06	H3356_801_0	1	1		05/02/2011	2012.02						EXCELLUS HEALTH PLAN, INC.	Excellus BlueCross BlueShield	www.excellusbcbs.com	Blue Choice Senior - Group (Cost)	06	18					H3356	801	0	2012	Metro Rochester		1					2							www.excellusbcbs.com	www.excellusbcbs.com	(877)-883-9577		(877)-883-9577		(800)-659-1986				(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220				
H3359	001	0	1	01	01	H3359_001_0	5	1		08/09/2011	2012.02	08/09/2011 11:26:51 AM Eastern Daylight Time	08/09/2011 04:11:54 PM Eastern Daylight Time	08/09/2011 04:12:29 PM Eastern Daylight Time		08/09/2011 05:30:27 PM Eastern Daylight Time	MANAGED HEALTH, INC.	Healthfirst Medicare Plan	www.healthfirstny.org	Healthfirst 65 Plus Plan (HMO)	01	01		1			H3359	001	0	2012	New York City and Nassau County		2	25902	2			2						www.healthfirstny.org	www.healthfirstny.org	www.healthfirstny.org	(888)-260-1010		(888)-260-1010		(877)-237-1303		(877)-237-1303		(888)-260-1010		(888)-260-1010		(877)-237-1303		(877)-237-1303		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		2	2	2
H3359	019	0	1	01	01	H3359_019_0	5	1		08/09/2011	2012.02	08/09/2011 11:25:39 AM Eastern Daylight Time	08/09/2011 04:13:16 PM Eastern Daylight Time	08/09/2011 04:13:50 PM Eastern Daylight Time		08/09/2011 05:30:27 PM Eastern Daylight Time	MANAGED HEALTH, INC.	Healthfirst Medicare Plan	www.healthfirstny.org	Healthfirst Increased Benefits Plan (HMO)	01	01		1			H3359	019	0	2012	New York City and Nassau County		2	17911	2			2						www.healthfirstny.org	www.healthfirstny.org	www.healthfirstny.org	(888)-260-1010		(888)-260-1010		(877)-237-1303		(877)-237-1303		(888)-260-1010		(888)-260-1010		(877)-237-1303		(877)-237-1303		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		2	2	2
H3359	021	0	1	01	01	H3359_021_0	5	1	2	08/09/2011	2012.02	08/09/2011 09:07:33 AM Eastern Daylight Time	08/09/2011 04:14:37 PM Eastern Daylight Time	08/09/2011 04:15:09 PM Eastern Daylight Time		08/09/2011 05:30:27 PM Eastern Daylight Time	MANAGED HEALTH, INC.	Healthfirst Medicare Plan	www.healthfirstny.org	Healthfirst Life Improvement Plan (HMO SNP)	01	01		1			H3359	021	0	2012	New York City, Nassau and Westchester Counties		2	51229	2			1	3		1	2		www.healthfirstny.org	www.healthfirstny.org	www.healthfirstny.org	(888)-260-1010		(888)-260-1010		(877)-237-1303		(877)-237-1303		(888)-260-1010		(888)-260-1010		(877)-237-1303		(877)-237-1303		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		2	2	2
H3359	027	0	1	01	01	H3359_027_0	4	1		07/08/2011	2012.02	07/08/2011 11:20:13 AM Eastern Daylight Time	07/19/2011 12:10:32 PM Eastern Daylight Time			07/19/2011 01:45:00 PM Eastern Daylight Time	MANAGED HEALTH, INC.	Healthfirst Medicare Plan	www.healthfirstny.org	Healthfirst Coordinated Benefits Plan (HMO)	01	01		1			H3359	027	0	2012	New York City and Nassau County		2	1132	2			2						www.healthfirstny.org	www.healthfirstny.org	www.healthfirstny.org	(888)-260-1010		(888)-260-1010		(877)-237-1303		(877)-237-1303										(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220										2	2	2
H3359	032	0	1	01	01	H3359_032_0	5	1		08/09/2011	2012.02	08/09/2011 11:28:06 AM Eastern Daylight Time	08/09/2011 04:15:59 PM Eastern Daylight Time	08/09/2011 04:16:28 PM Eastern Daylight Time		08/09/2011 05:30:27 PM Eastern Daylight Time	MANAGED HEALTH, INC.	Healthfirst Medicare Plan	www.healthfirstny.org	Healthfirst Jade Benefits Plan (HMO)	01	01		1			H3359	032	0	2012	New York, Kings, and Queens Counties		2	1359	2			2						www.healthfirstny.org	www.healthfirstny.org	www.healthfirstny.org	(888)-260-1010		(888)-260-1010		(877)-237-1303		(877)-237-1303		(888)-260-1010		(888)-260-1010		(877)-237-1303		(877)-237-1303		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		2	2	2
H3359	033	0	1	01	01	H3359_033_0	5	1	2	08/09/2011	2012.02	08/09/2011 09:06:21 AM Eastern Daylight Time	08/09/2011 04:17:15 PM Eastern Daylight Time	08/09/2011 04:17:49 PM Eastern Daylight Time		08/09/2011 05:30:27 PM Eastern Daylight Time	MANAGED HEALTH, INC.	Healthfirst Medicare Plan	www.healthfirstny.org	Healthfirst Maximum Plan (HMO SNP)	01	01		1			H3359	033	0	2012	New York City, Nassau and Westchester Counties		2	259	2			1	3		1	5		www.healthfirstny.org	www.healthfirstny.org	www.healthfirstny.org	(888)-260-1010		(888)-260-1010		(877)-237-1303		(877)-237-1303		(888)-260-1010		(888)-260-1010		(877)-237-1303		(877)-237-1303		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		2	2	2
H3359	034	0	1	01	01	H3359_034_0	5	1	2	08/09/2011	2012.02	08/09/2011 09:08:53 AM Eastern Daylight Time	08/09/2011 04:18:30 PM Eastern Daylight Time	08/09/2011 04:19:03 PM Eastern Daylight Time		08/09/2011 05:30:27 PM Eastern Daylight Time	MANAGED HEALTH, INC.	Healthfirst Medicare Plan	www.healthfirstny.org	Healthfirst CompleteCare (HMO SNP)	01	01		1			H3359	034	0	2012	New York City		2	113	2			1	3		1	5		www.healthfirstny.org	www.healthfirstny.org	www.healthfirstny.org	(888)-260-1010		(888)-260-1010		(877)-237-1303		(877)-237-1303		(888)-260-1010		(888)-260-1010		(877)-237-1303		(877)-237-1303		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		2	2	2
H3359	804	0	1	01	01	H3359_804_0	4	1		06/01/2011	2012.02	06/01/2011 01:04:16 PM Eastern Daylight Time	07/19/2011 12:15:14 PM Eastern Daylight Time			07/19/2011 01:45:00 PM Eastern Daylight Time	MANAGED HEALTH, INC.	Healthfirst Medicare Plan	www.healthfirstny.org	Employer Group 1 (HMO)	01	01		1			H3359	804	0	2012	National		1	2	2			2						www.healthfirstny.org	www.healthfirstny.org	www.healthfirstny.org	(888)-260-1010		(888)-260-1010		(877)-237-1303		(877)-237-1303		(888)-260-1010		(888)-260-1010		(877)-237-1303		(877)-237-1303		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		2	2	2
H3359	805	0	1	01	01	H3359_805_0	3	1		05/12/2011	2012.02	05/12/2011 12:03:03 PM Eastern Daylight Time	07/19/2011 12:16:20 PM Eastern Daylight Time			07/19/2011 01:45:00 PM Eastern Daylight Time	MANAGED HEALTH, INC.	Healthfirst Medicare Plan	www.healthfirstny.org	Employer Group 2 (HMO)	01	01		1			H3359	805	0	2012	National		1	2	2			2						www.healthfirstny.org	www.healthfirstny.org	www.healthfirstny.org	(888)-260-1010		(888)-260-1010		(877)-237-1303		(877)-237-1303										(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220										2	2	2
H3361	043	0	1	01	01	H3361_043_0	8	1	2	07/21/2011	2012.02	07/21/2011 01:48:10 PM Eastern Daylight Time	08/05/2011 02:16:35 PM Eastern Daylight Time	08/11/2011 01:20:03 PM Eastern Daylight Time		08/11/2011 02:04:00 PM Eastern Daylight Time	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	WellCare Liberty (HMO SNP)	01	01		1			H3361	043	0	2012	Downstate NY and Erie, Onondaga Counties		2		2			1	3		1	5			www.wellcare.com	www.wellcare.com	(866)-491-5746		(866)-491-5746		(877)-232-7119		(877)-232-7119		(866)-491-5746		(866)-491-5746		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H3361	059	0	1	01	01	H3361_059_0	6	1		07/21/2011	2012.02	07/21/2011 01:48:20 PM Eastern Daylight Time	07/21/2011 03:33:25 PM Eastern Daylight Time			07/21/2011 03:41:34 PM Eastern Daylight Time	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	WellCare Advance (HMO)	01	01		1			H3361	059	0	2012	Upstate New York		2		2			2							www.wellcare.com	www.wellcare.com	(800)-278-5155		(800)-278-5155		(877)-232-7119		(877)-232-7119										(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272										2	2	2
H3361	065	0	1	01	01	H3361_065_0	7	1	2	07/21/2011	2012.02	07/21/2011 01:48:31 PM Eastern Daylight Time	08/05/2011 02:17:08 PM Eastern Daylight Time	08/04/2011 08:03:30 PM Eastern Daylight Time		08/08/2011 03:21:23 PM Eastern Daylight Time	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	WellCare Access (HMO SNP)	01	01		1			H3361	065	0	2012	Upstate New York		2		2			1	3		1	1			www.wellcare.com	www.wellcare.com	(866)-482-3363		(866)-482-3363		(877)-232-7119		(877)-232-7119		(866)-482-3363		(866)-482-3363		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H3361	098	0	1	01	01	H3361_098_0	8	1	2	07/21/2011	2012.02	07/21/2011 01:48:41 PM Eastern Daylight Time	08/05/2011 02:17:24 PM Eastern Daylight Time	08/11/2011 01:17:17 PM Eastern Daylight Time		08/11/2011 02:04:00 PM Eastern Daylight Time	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	WellCare Liberty (HMO SNP)	01	01		1			H3361	098	0	2012	Upstate New York		2		2			1	3		1	5			www.wellcare.com	www.wellcare.com	(866)-491-5746		(866)-491-5746		(877)-232-7119		(877)-232-7119		(866)-491-5746		(866)-491-5746		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H3361	099	0	1	02	01	H3361_099_0	7	1		07/21/2011	2012.02	07/21/2011 01:48:50 PM Eastern Daylight Time	08/05/2011 02:17:41 PM Eastern Daylight Time	08/04/2011 08:10:40 PM Eastern Daylight Time		08/08/2011 03:21:23 PM Eastern Daylight Time	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	WellCare Value (HMO-POS)	01	02		1			H3361	099	0	2012	Upstate New York		2		2			2							www.wellcare.com	www.wellcare.com	(800)-278-5155		(800)-278-5155		(877)-232-7119		(877)-232-7119		(800)-278-5155		(800)-278-5155		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H3361	105	0	1	01	01	H3361_105_0	7	1	2	07/21/2011	2012.02	07/21/2011 01:49:00 PM Eastern Daylight Time	08/05/2011 02:17:58 PM Eastern Daylight Time	08/04/2011 08:12:19 PM Eastern Daylight Time		08/08/2011 03:21:23 PM Eastern Daylight Time	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	WellCare Advocate Complete (HMO SNP)	01	01		1			H3361	105	0	2012	Bronx, Kings, Queens, New York Counties		2		2			1	3		1	4			www.wellcare.com	www.wellcare.com	(866)-661-1232		(866)-661-1232		(877)-232-7119		(877)-232-7119		(866)-661-1232		(866)-661-1232		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H3361	106	0	1	02	01	H3361_106_0	7	1		07/21/2011	2012.02	07/21/2011 01:49:10 PM Eastern Daylight Time	08/05/2011 02:18:16 PM Eastern Daylight Time	08/04/2011 08:14:31 PM Eastern Daylight Time		08/08/2011 03:21:23 PM Eastern Daylight Time	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	WellCare Choice (HMO-POS)	01	02		1			H3361	106	0	2012	Downstate New York		2		2			2							www.wellcare.com	www.wellcare.com	(800)-278-5155		(800)-278-5155		(877)-232-7119		(877)-232-7119		(800)-278-5155		(800)-278-5155		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H3361	109	0	1	01	01	H3361_109_0	7	1	2	07/21/2011	2012.02	07/21/2011 01:49:23 PM Eastern Daylight Time	08/05/2011 02:18:34 PM Eastern Daylight Time	08/04/2011 08:16:54 PM Eastern Daylight Time		08/08/2011 03:21:23 PM Eastern Daylight Time	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	WellCare Access (HMO SNP)	01	01		1			H3361	109	0	2012	Downstate New York		2		2			1	3		1	1			www.wellcare.com	www.wellcare.com	(866)-482-3363		(866)-482-3363		(877)-232-7119		(877)-232-7119		(866)-482-3363		(866)-482-3363		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H3361	129	0	1	02	01	H3361_129_0	8	1		07/21/2011	2012.02	07/21/2011 01:49:33 PM Eastern Daylight Time	08/05/2011 02:18:50 PM Eastern Daylight Time	08/11/2011 11:17:01 AM Eastern Daylight Time		08/11/2011 02:04:00 PM Eastern Daylight Time	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	WellCare Choice (HMO-POS)	01	02		1			H3361	129	0	2012	Upstate New York		2		2			2							www.wellcare.com	www.wellcare.com	(800)-278-5155		(800)-278-5155		(877)-232-7119		(877)-232-7119		(800)-278-5155		(800)-278-5155		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H3361	130	0	1	01	01	H3361_130_0	8	1		07/21/2011	2012.02	07/21/2011 01:49:42 PM Eastern Daylight Time	08/05/2011 02:19:06 PM Eastern Daylight Time	08/11/2011 11:18:01 AM Eastern Daylight Time		08/11/2011 02:04:00 PM Eastern Daylight Time	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	WellCare Rx (HMO)	01	01		1			H3361	130	0	2012	Downstate New York		2		2			2							www.wellcare.com	www.wellcare.com	(800)-278-5155		(800)-278-5155		(877)-232-7119		(877)-232-7119		(800)-278-5155		(800)-278-5155		(877)-232-7119		(877)-232-7119		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		(877)-247-6272		2	2	2
H3362	003	0	1	01	01	H3362_003_0	7	1		08/09/2011	2012.02	08/09/2011 01:12:06 PM Eastern Daylight Time	08/09/2011 08:21:20 AM Eastern Daylight Time	08/09/2011 08:20:30 AM Eastern Daylight Time		08/09/2011 02:37:05 PM Eastern Daylight Time	INDEPENDENT HEALTH ASSOCIATION, INC.	Independent Health	www.independenthealth.com	Independent Health Encompass 65 (HMO)	01	01		1			H3362	003	0	2012	Western New York		2	36597	2			2						www.independenthealth.com	www.independenthealth.com	www.independenthealth.com	(800)-665-1502		(716)-250-4401		(800)-958-4405		(716)-635-4900		(800)-665-1502		(716)-250-4401		(800)-958-4405		(716)-635-4900		(800)-432-1110		(716)-631-3108		(888)-357-9167		(716)-635-4840		(800)-432-1110		(716)-631-3108		(888)-357-9167		(716)-635-4840		2	2	2
H3362	016	0	1	01	01	H3362_016_0	2	1		07/20/2011	2012.02	07/20/2011 02:05:53 PM Eastern Daylight Time	06/03/2011 05:22:56 PM Eastern Daylight Time			07/21/2011 10:46:17 AM Eastern Daylight Time	INDEPENDENT HEALTH ASSOCIATION, INC.	Independent Health	www.independenthealth.com	Independent Health Encompass 65 (HMO)	01	01		1			H3362	016	0	2012	Western New York		2	3040	2			2						www.independenthealth.com	www.independenthealth.com	www.independenthealth.com	(800)-665-1502		(716)-250-4401		(800)-958-4405		(716)-635-4900										(800)-432-1110		(716)-631-3108		(888)-357-9167		(716)-635-4840										2	2	2
H3362	017	0	1	01	01	H3362_017_0	6	1		08/09/2011	2012.02	08/09/2011 01:12:22 PM Eastern Daylight Time	08/09/2011 08:20:10 AM Eastern Daylight Time	08/09/2011 08:19:26 AM Eastern Daylight Time		08/09/2011 02:37:05 PM Eastern Daylight Time	INDEPENDENT HEALTH ASSOCIATION, INC.	Independent Health	www.independenthealth.com	Independent Health Encompass 65 Basic (HMO)	01	01		1			H3362	017	0	2012	Western New York		2	13101	2			2						www.independenthealth.com	www.independenthealth.com	www.independenthealth.com	(800)-665-1502		(716)-250-4401		(800)-958-4405		(716)-635-4900		(800)-665-1502		(716)-250-4401		(800)-958-4405		(716)-635-4900		(800)-432-1110		(716)-631-3108		(888)-357-9167		(716)-635-4840		(800)-432-1110		(716)-631-3108		(888)-357-9167		(716)-635-4840		2	2	2
H3362	020	0	1	01	01	H3362_020_0	5	1		08/09/2011	2012.02	08/09/2011 01:12:33 PM Eastern Daylight Time	08/09/2011 08:25:38 AM Eastern Daylight Time	08/09/2011 08:25:00 AM Eastern Daylight Time		08/09/2011 02:37:05 PM Eastern Daylight Time	INDEPENDENT HEALTH ASSOCIATION, INC.	Independent Health	www.independenthealth.com	Independent Health Medicare Family Choice (HMO SNP)	01	01		1			H3362	020	0	2012	Erie and Niagara Counties		2	1330	2			1	1	3	1			www.independenthealth.com	www.independenthealth.com	www.independenthealth.com	(800)-665-1502		(716)-250-4401		(800)-958-4405		(716)-635-4900		(800)-665-1502		(716)-250-4401		(800)-958-4405		(716)-635-4900		(800)-432-1110		(716)-631-3108		(888)-357-9167		(716)-635-4840		(800)-432-1110		(716)-631-3108		(888)-357-9167		(716)-635-4840		2	2	2
H3362	801	0	1	02	01	H3362_801_0	1	1		05/26/2011	2012.02	05/26/2011 04:23:12 PM Eastern Daylight Time	06/04/2011 10:00:12 AM Eastern Daylight Time			06/04/2011 10:12:26 AM Eastern Daylight Time	INDEPENDENT HEALTH ASSOCIATION, INC.	Independent Health	www.independenthealth.com	Independent Health Medicare Encompass (HMO-POS)	01	02		1			H3362	801	0	2012	New York State		1	2774	2			2						www.independenthealth.com	www.independenthealth.com	www.independenthealth.com	(800)-665-1502		(716)-250-4401		(800)-958-4405		(716)-635-4900		(800)-665-1502		(716)-250-4401		(800)-958-4405		(716)-635-4900		(800)-432-1110		(716)-631-3108		(888)-357-9167		(716)-635-4840		(800)-432-1110		(716)-631-3108		(888)-357-9167		(716)-635-4840		1	1	1
H3362	807	0	1	02	01	H3362_807_0	1	1		05/26/2011	2012.02	05/26/2011 04:23:20 PM Eastern Daylight Time	06/03/2011 06:15:12 PM Eastern Daylight Time			06/04/2011 08:46:04 AM Eastern Daylight Time	INDEPENDENT HEALTH ASSOCIATION, INC.	Independent Health	www.independenthealth.com	Independent Health Medicare Encompass POS (HMO-POS)	01	02		1			H3362	807	0	2012	IH Network and Medicare Deemed Network		1	6759	2			2						www.independenthealth.com	www.independenthealth.com	www.independenthealth.com	(800)-665-1502		(716)-250-4401		(800)-958-4405		(716)-635-4900		(800)-665-1502		(716)-250-4401		(800)-958-4405		(716)-635-4900		(800)-432-1110		(716)-631-3108		(888)-357-9167		(716)-635-4840		(800)-432-1110		(716)-631-3108		(888)-357-9167		(716)-635-4840		1	1	1
H3362	817	0	1	02	01	H3362_817_0	1	1		05/26/2011	2012.02	05/26/2011 04:23:28 PM Eastern Daylight Time	06/03/2011 06:15:52 PM Eastern Daylight Time			06/04/2011 08:46:04 AM Eastern Daylight Time	INDEPENDENT HEALTH ASSOCIATION, INC.	Independent Health	www.independenthealth.com	Independent Health Medicare Encompass POS (HMO-POS)	01	02		1			H3362	817	0	2012	IH Network and Medicare Deemed Network		1	0	2			2						www.independenthealth.com	www.independenthealth.com	www.independenthealth.com	(800)-665-1502		(716)-250-4401		(800)-958-4405		(716)-635-4900		(800)-665-1502		(716)-250-4401		(800)-958-4405		(716)-635-4900		(800)-432-1110		(716)-631-3108		(888)-357-9167		(716)-635-4840		(800)-432-1110		(716)-631-3108		(888)-357-9167		(716)-635-4840		1	1	1
H3362	819	0	1	02	01	H3362_819_0	1	1		05/26/2011	2012.02	05/26/2011 04:23:36 PM Eastern Daylight Time	06/03/2011 06:16:42 PM Eastern Daylight Time			06/04/2011 08:46:04 AM Eastern Daylight Time	INDEPENDENT HEALTH ASSOCIATION, INC.	Independent Health	www.independenthealth.com	Independent Health Medicare Encompass POS (HMO-POS)	01	02		1			H3362	819	0	2012	IH Network and Medicare Deemed Network		1	140	2			2						www.independenthealth.com	www.independenthealth.com	www.independenthealth.com	(800)-665-1502		(716)-250-4401		(800)-958-4405		(716)-635-4900										(800)-432-1110		(716)-631-3108		(888)-357-9167		(716)-635-4840										1	1	1
H3362	820	0	1	02	01	H3362_820_0	1	1		05/26/2011	2012.02	05/26/2011 04:23:48 PM Eastern Daylight Time	06/04/2011 10:00:13 AM Eastern Daylight Time			06/04/2011 10:12:26 AM Eastern Daylight Time	INDEPENDENT HEALTH ASSOCIATION, INC.	Independent Health	www.independenthealth.com	Independent Health Medicare Encompass (HMO-POS)	01	02		1			H3362	820	0	2012	New York State		1	0	2			2						www.independenthealth.com	www.independenthealth.com	www.independenthealth.com	(800)-665-1502		(716)-250-4401		(800)-958-4405		(716)-635-4900										(800)-432-1110		(716)-631-3108		(888)-357-9167		(716)-635-4840										1	1	1
H3370	001	0	1	01	01	H3370_001_0	9	1		08/05/2011	2012.02	08/05/2011 05:23:59 PM Eastern Daylight Time	08/08/2011 08:36:19 PM Eastern Daylight Time	08/08/2011 08:39:32 PM Eastern Daylight Time		08/08/2011 09:32:06 PM Eastern Daylight Time	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield	www.empireblue.com/medicare	Empire MediBlue Plus (HMO)	01	01		1			H3370	001	0	2012	New York City Region in New York		2	31162	2			2						www.empireblue.com/Medicare	www.empireblue.com	www.empireblue.com	(800)-499-9554		(800)-499-9554		(800)-797-6159		(800)-797-6159		(800)-499-9554		(800)-499-9554		(800)-797-6159		(800)-797-6159		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		2	2	2
H3370	002	0	1	01	01	H3370_002_0	8	1		08/08/2011	2012.02	08/08/2011 08:20:37 PM Eastern Daylight Time	08/08/2011 08:36:45 PM Eastern Daylight Time	08/08/2011 08:39:42 PM Eastern Daylight Time		08/08/2011 09:34:39 PM Eastern Daylight Time	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield	www.empireblue.com/medicare	Empire MediBlue Select (HMO)	01	01		1			H3370	002	0	2012	Metro-North and Mid-Hudson Regions in New York		2	9829	2			2						www.empireblue.com/Medicare	www.empireblue.com	www.empireblue.com	(800)-499-9554		(800)-499-9554		(800)-797-6159		(800)-797-6159		(800)-499-9554		(800)-499-9554		(800)-797-6159		(800)-797-6159		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		2	2	2
H3370	003	0	1	01	01	H3370_003_0	8	1		08/08/2011	2012.02	08/08/2011 08:20:43 PM Eastern Daylight Time	08/08/2011 08:36:59 PM Eastern Daylight Time	08/08/2011 08:39:49 PM Eastern Daylight Time		08/08/2011 09:37:04 PM Eastern Daylight Time	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield	www.empireblue.com/medicare	Empire MediBlue Plus (HMO)	01	01		1			H3370	003	0	2012	Nassau County in New York		2	6382	2			2						www.empireblue.com/Medicare	www.empireblue.com	www.empireblue.com	(800)-499-9554		(800)-499-9554		(800)-797-6159		(800)-797-6159		(800)-499-9554		(800)-499-9554		(800)-797-6159		(800)-797-6159		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		2	2	2
H3370	004	0	1	01	01	H3370_004_0	8	1		08/08/2011	2012.02	08/08/2011 08:20:47 PM Eastern Daylight Time	08/08/2011 08:37:15 PM Eastern Daylight Time	08/08/2011 08:40:02 PM Eastern Daylight Time		08/08/2011 09:39:28 PM Eastern Daylight Time	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield	www.empireblue.com/medicare	Empire MediBlue Plus (HMO)	01	01		1			H3370	004	0	2012	Suffolk County in New York		2	10581	2			2						www.empireblue.com/Medicare	www.empireblue.com	www.empireblue.com	(800)-499-9554		(800)-499-9554		(800)-797-6159		(800)-797-6159		(800)-499-9554		(800)-499-9554		(800)-797-6159		(800)-797-6159		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		2	2	2
H3370	014	0	1	01	01	H3370_014_0	8	1		08/08/2011	2012.02	08/08/2011 08:20:53 PM Eastern Daylight Time	08/08/2011 08:37:28 PM Eastern Daylight Time	08/08/2011 08:40:15 PM Eastern Daylight Time		08/08/2011 09:41:52 PM Eastern Daylight Time	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield	www.empireblue.com/medicare	Empire MediBlue Plus (HMO)	01	01		1			H3370	014	0	2012	Capital Region in New York		2	669	2			2						www.empireblue.com/Medicare	www.empireblue.com	www.empireblue.com	(800)-499-9554		(800)-499-9554		(800)-797-6159		(800)-797-6159		(800)-499-9554		(800)-499-9554		(800)-797-6159		(800)-797-6159		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		2	2	2
H3370	019	0	1	01	01	H3370_019_0	6	1		08/10/2011	2012.02	08/10/2011 01:54:46 PM Eastern Daylight Time	08/12/2011 11:49:01 AM Eastern Daylight Time			08/12/2011 01:07:47 PM Eastern Daylight Time	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield	www.empireblue.com/medicare	Empire MediBlue Essential (HMO)	01	01		1			H3370	019	0	2012	Select Counties in New York		2	1226	2			2						www.empireblue.com/Medicare	www.empireblue.com	www.empireblue.com	(800)-499-9554		(800)-499-9554		(800)-797-6159		(800)-797-6159										(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894										2	2	2
H3370	022	0	1	01	01	H3370_022_0	8	1		08/08/2011	2012.02	08/08/2011 08:21:05 PM Eastern Daylight Time	08/08/2011 08:37:53 PM Eastern Daylight Time	08/08/2011 08:40:26 PM Eastern Daylight Time		08/08/2011 09:44:32 PM Eastern Daylight Time	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield	www.empireblue.com/medicare	Empire MediBlue Select (HMO)	01	01		1			H3370	022	0	2012	Nassau County in New York		2	470	2			2						www.empireblue.com/Medicare	www.empireblue.com	www.empireblue.com	(800)-499-9554		(800)-499-9554		(800)-797-6159		(800)-797-6159		(800)-499-9554		(800)-499-9554		(800)-797-6159		(800)-797-6159		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		2	2	2
H3370	801	0	1	01	01	H3370_801_0	6	1		06/05/2011	2012.02	06/05/2011 12:49:43 PM Pacific Daylight Time	07/25/2011 12:58:20 PM Pacific Daylight Time			07/26/2011 09:03:11 AM Pacific Daylight Time	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield	www.empireblue.com/medicare	Empire MediBlue (HMO)	01	01		1			H3370	801	0	2012	New York State		1	1332	2			2						www.empireblue.com/Medicare	www.empireblue.com	www.empireblue.com	(800)-564-9053		(800)-564-9053		(800)-564-9053		(800)-564-9053		(800)-564-9053		(800)-564-9053		(800)-564-9053		(800)-564-9053		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		2	2	2
H3370	803	0	1	01	01	H3370_803_0	6	1		06/05/2011	2012.02	06/05/2011 12:49:56 PM Pacific Daylight Time	07/25/2011 12:58:22 PM Pacific Daylight Time			07/26/2011 09:03:11 AM Pacific Daylight Time	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield	www.empireblue.com/medicare	Empire MediBlue (HMO)	01	01		1			H3370	803	0	2012	New York State		1	974	2			2						www.empireblue.com/Medicare	www.empireblue.com	www.empireblue.com	(800)-564-9053		(800)-564-9053		(800)-564-9053		(800)-564-9053										(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894										2	2	2
H3370	805	0	1	01	01	H3370_805_0	5	1		06/05/2011	2012.02	06/05/2011 12:50:07 PM Pacific Daylight Time	07/25/2011 12:58:22 PM Pacific Daylight Time			07/26/2011 09:03:11 AM Pacific Daylight Time	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield	www.empireblue.com/medicare	Empire MediBlue (HMO)	01	01		1			H3370	805	0	2012	New York State		1	50	2			2						www.empireblue.com/Medicare	www.empireblue.com	www.empireblue.com	(800)-564-9053		(800)-564-9053		(800)-564-9053		(800)-564-9053		(800)-564-9053		(800)-564-9053		(800)-564-9053		(800)-564-9053		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		2	2	2
H3379	001	0	1	01	01	H3379_001_0	4	1		08/08/2011	2012.02	08/08/2011 09:24:20 AM Central Daylight Time	08/05/2011 03:08:18 PM Central Daylight Time	08/05/2011 01:28:50 PM Central Daylight Time		08/09/2011 04:28:20 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW YORK, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H3379	001	0	2012	New York City		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3379	002	0	1	01	01	H3379_002_0	3	1		07/22/2011	2012.02	07/22/2011 12:34:03 PM Central Daylight Time	08/05/2011 03:08:57 PM Central Daylight Time	08/05/2011 01:06:29 PM Central Daylight Time		08/09/2011 04:38:46 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW YORK, INC.	SecureHorizons by UnitedHealthcare	www.EvercareHealthPlans.com	UnitedHealthcare Nursing Home Plan (HMO SNP)	01	01		1			H3379	002	0	2012	New York Metropolitan Area		2		2			1	1	1	1			www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com	www.PrescriptionSolutions.com	(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3379	022	0	1	01	01	H3379_022_0	3	1		08/09/2011	2012.02	08/09/2011 12:06:06 PM Central Daylight Time	08/09/2011 10:45:15 AM Central Daylight Time	08/05/2011 01:06:51 PM Central Daylight Time		08/09/2011 04:38:46 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW YORK, INC.	SecureHorizons by UnitedHealthcare	www.EvercareHealthPlans.com	UnitedHealthcare Nursing Home Plan (HMO SNP)	01	01		1			H3379	022	0	2012	Upstate New York		2		2			1	1	1	1			www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com	www.PrescriptionSolutions.com	(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3384	013	0	1	01	01	H3384_013_0	10	1		07/22/2011	2012.02	07/22/2011 02:29:05 PM Eastern Daylight Time	08/09/2011 02:28:18 PM Eastern Daylight Time	08/09/2011 02:28:26 PM Eastern Daylight Time		08/09/2011 02:40:07 PM Eastern Daylight Time	HEALTHNOW NEW YORK INC	BlueCross BlueShield of WNY and BlueShield of NENY	www.bsneny.com	BlueShield Senior Blue HMO 652 PartD (HMO)	01	01		1			H3384	013	0	2012	Northeastern New York		2	4656	2			2						http://www.bcbswny.com (for Western NY members) and http://www.bsneny.com (for Northeast NY member)	http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	www.bcbswny.com   www.bsneny.com	(800)-329-2792		(800)-329-2792		(877)-258-7453		(877)-258-7453		(800)-329-2792		(800)-329-2792		(877)-258-7453		(877)-258-7453		(877)-834-6918		(877)-834-6918		(877)-513-1470		(877)-513-1470		(877)-834-6918		(877)-834-6918		(877)-513-1470		(877)-513-1470		2	2	2
H3384	015	0	1	01	01	H3384_015_0	6	1		07/20/2011	2012.02	07/20/2011 03:55:09 PM Eastern Daylight Time	07/22/2011 02:26:56 PM Eastern Daylight Time			07/22/2011 02:45:28 PM Eastern Daylight Time	HEALTHNOW NEW YORK INC	BlueCross BlueShield of WNY and BlueShield of NENY	www.bsneny.com	BlueShield Senior Blue HMO 601 (HMO)	01	01		1			H3384	015	0	2012	Northeastern New York		2	1125	2			2						http://www.bcbswny.com (for Western NY members) and http://www.bsneny.com (for Northeast NY member)	http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	www.bcbswny.com   www.bsneny.com	(800)-329-2792		(800)-329-2792		(877)-258-7453		(877)-258-7453										(877)-834-6918		(877)-834-6918		(877)-513-1470		(877)-513-1470										2	2	2
H3384	019	0	1	01	01	H3384_019_0	9	1		07/20/2011	2012.02	07/20/2011 03:55:23 PM Eastern Daylight Time	08/09/2011 02:28:33 PM Eastern Daylight Time	08/09/2011 02:28:48 PM Eastern Daylight Time		08/09/2011 02:40:07 PM Eastern Daylight Time	HEALTHNOW NEW YORK INC	BlueCross BlueShield of WNY and BlueShield of NENY	www.bcbswny.com	BlueCross BlueShield Senior Blue HMO 651 PartD (HMO)	01	01		1			H3384	019	0	2012	Western New York		2	11396	2			2						http://www.bcbswny.com (for Western NY members) and http://www.bsneny.com (for Northeast NY member)	http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	www.bcbswny.com   www.bsneny.com	(800)-329-2792		(800)-329-2792		(888)-587-2583		(888)-587-2583		(800)-329-2792		(800)-329-2792		(888)-587-2583		(888)-587-2583		(877)-834-6918		(877)-834-6918		(877)-286-5710		(877)-286-5710		(877)-834-6918		(877)-834-6918		(877)-286-5710		(877)-286-5710		2	2	2
H3384	022	0	1	01	01	H3384_022_0	6	1		07/20/2011	2012.02	07/20/2011 03:55:39 PM Eastern Daylight Time	07/22/2011 02:27:20 PM Eastern Daylight Time			07/22/2011 02:45:28 PM Eastern Daylight Time	HEALTHNOW NEW YORK INC	BlueCross BlueShield of WNY and BlueShield of NENY	www.bcbswny.com	BlueCross BlueShield Senior Blue HMO 601 (HMO)	01	01		1			H3384	022	0	2012	Western New York		2	2909	2			2						http://www.bcbswny.com (for Western NY members) and http://www.bsneny.com (for Northeast NY member)	http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	www.bcbswny.com   www.bsneny.com	(800)-329-2792		(800)-329-2792		(888)-587-2583		(888)-587-2583										(877)-834-6918		(877)-834-6918		(877)-286-5710		(877)-286-5710										2	2	2
H3384	041	0	1	01	01	H3384_041_0	9	1		07/20/2011	2012.02	07/20/2011 03:55:51 PM Eastern Daylight Time	08/09/2011 02:29:01 PM Eastern Daylight Time	08/09/2011 02:29:07 PM Eastern Daylight Time		08/09/2011 02:40:07 PM Eastern Daylight Time	HEALTHNOW NEW YORK INC	BlueCross BlueShield of WNY and BlueShield of NENY	www.bcbswny.com	BlueCross BlueShield Senior Blue HMO 653 PartD (HMO)	01	01		1			H3384	041	0	2012	Western New York		2	9697	2			2						http://www.bcbswny.com (for Western NY members) and http://www.bsneny.com (for Northeast NY member)	http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	www.bcbswny.com   www.bsneny.com	(800)-329-2792		(800)-329-2792		(888)-587-2583		(888)-587-2583		(800)-329-2792		(800)-329-2792		(888)-587-2583		(888)-587-2583		(877)-834-6918		(877)-834-6918		(877)-286-5710		(877)-286-5710		(877)-834-6918		(877)-834-6918		(877)-286-5710		(877)-286-5710		2	2	2
H3384	053	0	1	01	01	H3384_053_0	18	1		08/10/2011	2012.02	08/10/2011 09:19:34 AM Eastern Daylight Time	08/09/2011 02:29:15 PM Eastern Daylight Time	08/09/2011 02:29:21 PM Eastern Daylight Time		08/10/2011 09:21:15 AM Eastern Daylight Time	HEALTHNOW NEW YORK INC	BlueCross BlueShield of WNY and BlueShield of NENY	www.bsneny.com	BlueShield Senior Blue HMO 651 PartD (HMO)	01	01		1			H3384	053	0	2012	Northeastern New York		2	3502	2			2						http://www.bcbswny.com (for Western NY members) and http://www.bsneny.com (for Northeast NY member)	http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	www.bcbswny.com   www.bsneny.com	(800)-329-2792		(800)-329-2792		(877)-258-7453		(877)-258-7453		(800)-329-2792		(800)-329-2792		(877)-258-7453		(877)-258-7453		(877)-834-6918		(877)-834-6918		(877)-513-1470		(877)-513-1470		(877)-834-6918		(877)-834-6918		(877)-513-1470		(877)-513-1470		2	2	2
H3384	805	0	1	01	01	H3384_805_0	2	1		05/16/2011	2012.02	05/16/2011 01:47:10 PM Eastern Daylight Time	06/05/2011 09:21:10 PM Eastern Daylight Time			06/05/2011 09:48:13 PM Eastern Daylight Time	HEALTHNOW NEW YORK INC	BlueCross BlueShield of WNY and BlueShield of NENY	www.bcbswny.com (WNY) or www.bsneny.com (NENY)	Senior Blue HMO MA Only Plan (HMO)	01	01		1			H3384	805	0	2012	Western and Northeastern New York		1	1000	2			2						http://www.bcbswny.com (for Western NY members) and http://www.bsneny.com (for Northeast NY member)	http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	www.bcbswny.com   www.bsneny.com	(800)-329-2792		(800)-329-2792		(888)-587-2583		(888)-587-2583										(877)-834-6918		(877)-834-6918		(877)-286-5710		(877)-286-5710										1	1	1
H3384	806	0	1	01	01	H3384_806_0	2	1		05/16/2011	2012.02	05/16/2011 10:38:20 AM Eastern Daylight Time	06/05/2011 09:21:20 PM Eastern Daylight Time			06/05/2011 09:48:13 PM Eastern Daylight Time	HEALTHNOW NEW YORK INC	BlueCross BlueShield of WNY and BlueShield of NENY	www.bcbswny.com (WNY) or www.bsneny.com (NENY)	Senior Blue HMO (MA-PD) Calendar Year (HMO)	01	01		1			H3384	806	0	2012	Western and Northeastern New York		1	1000	2			2						http://www.bcbswny.com (for Western NY members) and http://www.bsneny.com (for Northeast NY member)	http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	www.bcbswny.com   www.bsneny.com	(800)-329-2792		(800)-329-2792		(888)-587-2583		(888)-587-2583		(800)-329-2792		(800)-329-2792		(888)-587-2583		(888)-587-2583		(877)-834-6918		(877)-834-6918		(877)-286-5710		(877)-286-5710		(877)-834-6918		(877)-834-6918		(877)-286-5710		(877)-286-5710		1	1	1
H3384	807	0	1	01	01	H3384_807_0	2	1		05/16/2011	2012.02	05/16/2011 01:47:51 PM Eastern Daylight Time	06/05/2011 09:21:29 PM Eastern Daylight Time			06/05/2011 09:48:13 PM Eastern Daylight Time	HEALTHNOW NEW YORK INC	BlueCross BlueShield of WNY and BlueShield of NENY	www.bcbswny.com (WNY) or www.bsneny.com (NENY)	Senior Blue HMO Group (MA-PD) Non-Cal Year (HMO)	01	01		1			H3384	807	0	2012	Western and Northeastern New York		1	1700	2			2						http://www.bcbswny.com (for Western NY members) and http://www.bsneny.com (for Northeast NY member)	http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	www.bcbswny.com   www.bsneny.com	(800)-329-2792		(800)-329-2792		(888)-587-2583		(888)-587-2583		(800)-329-2792		(800)-329-2792		(888)-587-2583		(888)-587-2583		(877)-834-6918		(877)-834-6918		(877)-286-5710		(877)-286-5710		(877)-834-6918		(877)-834-6918		(877)-286-5710		(877)-286-5710		1	1	1
H3387	010	0	1	01	01	H3387_010_0	6	1	2	08/05/2011	2012.02	08/05/2011 04:41:30 PM Central Daylight Time	08/05/2011 01:07:04 PM Central Daylight Time	08/05/2011 01:07:13 PM Central Daylight Time		08/09/2011 12:16:18 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW YORK, INC.	UnitedHealthcare Community Plan	www.UHCDualComplete.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H3387	010	0	2012	New York Counties		2		2			1	3		1	5		www.UHCDualComplete.com	http://www.americhoice.com	www.prescriptionsolutions.com	(800)-514-4912		(800)-514-4912		(888)-565-8170		(888)-565-8170		(800)-514-4912		(800)-514-4912		(888)-565-8170		(888)-565-8170		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3388	001	0	1	01	01	H3388_001_0	6	1		07/12/2011	2012.02	07/12/2011 03:21:06 PM Eastern Daylight Time	07/21/2011 04:34:23 PM Eastern Daylight Time			07/21/2011 05:10:44 PM Eastern Daylight Time	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	CDPHP Medicare Choices	www.cdphp.com	CDPHP Choice (HMO)	01	01		1			H3388	001	0	2012	Capital Region of New York State		2	612	2			2						www.cdphp.com	http://www.cdphp.com/medicare	http://www.cdphp.com/medicare	(888)-248-6522		(518)-641-3950		(888)-519-4455		(518)-641-3400										(877)-261-1164		(518)-641-4000		(877)-261-1164		(518)-641-4000										2	2	2
H3388	002	0	1	01	01	H3388_002_0	9	1		07/07/2011	2012.02	07/07/2011 11:08:41 AM Eastern Daylight Time	08/08/2011 11:42:30 AM Eastern Daylight Time	08/04/2011 05:21:22 PM Eastern Daylight Time		08/08/2011 01:17:20 PM Eastern Daylight Time	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	CDPHP Medicare Choices	www.cdphp.com	CDPHP Choice Rx (HMO)	01	01		1			H3388	002	0	2012	Capital Region of New York State		2	13709	2			2						www.cdphp.com	http://www.cdphp.com/medicare	http://www.cdphp.com/medicare	(888)-248-6522		(518)-641-3950		(888)-519-4455		(518)-641-3400		(866)-289-2319		(518)-641-3950		(888)-519-4455		(518)-641-3400		(877)-261-1164		(518)-641-4000		(877)-261-1164		(518)-641-4000		(866)-236-1069		(518)-641-4000		(877)-261-1164		(518)-641-4000		2	2	2
H3388	004	0	1	01	01	H3388_004_0	11	1		07/07/2011	2012.02	07/07/2011 11:12:54 AM Eastern Daylight Time	08/08/2011 11:43:34 AM Eastern Daylight Time	08/04/2011 05:25:56 PM Eastern Daylight Time		08/08/2011 01:17:20 PM Eastern Daylight Time	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	CDPHP Medicare Choices	www.cdphp.com	CDPHP Value Rx (HMO)	01	01		1			H3388	004	0	2012	Capital Region of New York State		2	3526	2			2						www.cdphp.com	http://www.cdphp.com/medicare	http://www.cdphp.com/medicare	(888)-248-6522		(518)-641-3950		(888)-519-4455		(518)-641-3400		(866)-289-2319		(518)-641-3950		(888)-519-4455		(518)-641-3400		(877)-261-1164		(518)-641-4000		(877)-261-1164		(518)-641-4000		(866)-236-1069		(518)-641-4000		(877)-261-1164		(518)-641-4000		2	2	2
H3388	801	0	1	01	01	H3388_801_0	1	1		05/27/2011	2012.02	05/27/2011 01:59:18 PM Eastern Daylight Time	06/04/2011 09:25:22 PM Eastern Daylight Time			06/05/2011 07:34:08 AM Eastern Daylight Time	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	CDPHP Medicare Choices	www.cdphp.com	CDPHP Group Medicare Rx (HMO)	01	01		1			H3388	801	0	2012	Upstate New York Region		1	2005	2			2						www.cdphp.com	http://www.cdphp.com/medicare	http://www.cdphp.com/medicare	(888)-248-6522		(518)-641-3950		(888)-519-4455		(518)-641-3400		(866)-289-2319		(518)-641-3950		(888)-519-4455		(518)-641-3400		(877)-261-1164		(518)-641-4000		(877)-261-1164		(518)-641-4000		(866)-236-1069		(518)-641-4000		(877)-261-1164		(518)-641-4000		1	1	1
H3388	803	0	1	01	01	H3388_803_0	3	1		05/27/2011	2012.02	05/27/2011 01:59:32 PM Eastern Daylight Time	07/20/2011 01:15:28 PM Eastern Daylight Time			07/22/2011 11:00:41 AM Eastern Daylight Time	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	CDPHP Medicare Choices	www.cdphp.com	CDPHP Group Medicare Rx (HMO)	01	01		1			H3388	803	0	2012	Upstate New York Region		1	79946	2			2						www.cdphp.com	http://www.cdphp.com/medicare	http://www.cdphp.com/medicare	(888)-248-6522		(518)-641-3950		(888)-519-4455		(518)-641-3400		(866)-289-2319		(518)-641-3950		(888)-519-4455		(518)-641-3400		(877)-261-1164		(518)-641-4000		(877)-261-1164		(518)-641-4000		(866)-236-1069		(518)-641-4000		(877)-261-1164		(518)-641-4000		1	1	1
H3388	804	0	1	01	01	H3388_804_0	3	1		05/27/2011	2012.02	05/27/2011 01:59:41 PM Eastern Daylight Time	07/21/2011 04:35:44 PM Eastern Daylight Time			07/22/2011 11:00:41 AM Eastern Daylight Time	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	CDPHP Medicare Choices	www.cdphp.com	CDPHP Group Medicare (HMO)	01	01		1			H3388	804	0	2012	Upstate New York Region		1	87057	2			2						www.cdphp.com	http://www.cdphp.com/medicare	http://www.cdphp.com/medicare	(888)-248-6522		(518)-641-3950		(888)-519-4455		(518)-641-3400										(877)-261-1164		(518)-641-4000		(877)-261-1164		(518)-641-4000										1	1	1
H3404	001	0	1	04	01	H3404_001_0	6	1		07/08/2011	2012.02	07/08/2011 10:38:53 AM Eastern Daylight Time	08/09/2011 07:56:36 AM Eastern Daylight Time	08/08/2011 09:13:51 AM Eastern Daylight Time		08/09/2011 04:44:14 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Blue Cross and Blue Shield of North Carolina	www.bcbsnc.com/medicare	Blue Medicare PPO Enhanced (PPO)	01	04		1			H3404	001	0	2012	Select North Carolina Counties		2	95935	2			2						www.bcbsnc.com/medicare	http://www.bcbsnc.com/medicare/drug-search.cfm	http://www.bcbsnc.com/medicare/pharmacy-search.cfm	(877)-494-7647		(877)-494-7647		(800)-665-8037		(800)-665-8037		(877)-494-7647		(877)-494-7647		(800)-665-8037		(800)-665-8037		(888)-451-9957		(888)-451-9957		(800)-922-3140		(800)-922-3140		(888)-451-9957		(888)-451-9957		(800)-922-3140		(800)-922-3140		2	2	2
H3404	002	0	1	04	01	H3404_002_0	10	1		07/25/2011	2012.02	07/25/2011 09:16:42 AM Eastern Daylight Time	08/12/2011 01:30:03 PM Eastern Daylight Time	08/08/2011 09:18:08 AM Eastern Daylight Time		08/12/2011 02:34:55 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Blue Cross and Blue Shield of North Carolina	www.bcbsnc.com/medicare	Blue Medicare PPO Enhanced Freedom (PPO)	01	04		1			H3404	002	0	2012	Select North Carolina Counties		2	37451	2			2						www.bcbsnc.com/medicare	http://www.bcbsnc.com/medicare/drug-search.cfm	http://www.bcbsnc.com/medicare/pharmacy-search.cfm	(877)-494-7647		(877)-494-7647		(800)-665-8037		(800)-665-8037		(877)-494-7647		(877)-494-7647		(800)-665-8037		(800)-665-8037		(888)-451-9957		(888)-451-9957		(800)-922-3140		(800)-922-3140		(888)-451-9957		(888)-451-9957		(800)-922-3140		(800)-922-3140		2	2	2
H3404	801	0	1	04	01	H3404_801_0	2	1		06/05/2011	2012.02	06/05/2011 01:52:44 PM Eastern Daylight Time	06/06/2011 08:13:12 PM Eastern Daylight Time			06/06/2011 08:23:08 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Blue Cross and Blue Shield of North Carolina	www.bcbsnc.com/medicare	Blue Medicare PPO EGWP Medical Only (PPO)	01	04		1			H3404	801	0	2012	North Carolina Employer Groups		1	8	2			2						www.bcbsnc.com/medicare	http://www.bcbsnc.com/medicare/drug-search.cfm	http://www.bcbsnc.com/medicare/pharmacy-search.cfm	(877)-494-7647		(877)-494-7647		(800)-665-8037		(800)-665-8037										(888)-451-9957		(888)-451-9957		(800)-922-3140		(800)-922-3140										1	1	1
H3404	803	0	1	04	01	H3404_803_0	2	1		06/05/2011	2012.02	06/05/2011 01:48:41 PM Eastern Daylight Time	06/06/2011 08:09:35 PM Eastern Daylight Time			06/06/2011 08:23:08 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Blue Cross and Blue Shield of North Carolina	www.bcbsnc.com/medicare	Blue Medicare PPO EGWP (PPO)	01	04		1			H3404	803	0	2012	North Carolina Employer Groups		1	1473	2			2						www.bcbsnc.com/medicare	http://www.bcbsnc.com/medicare/drug-search.cfm	http://www.bcbsnc.com/medicare/pharmacy-search.cfm	(877)-494-7647		(877)-494-7647		(800)-665-8037		(800)-665-8037		(877)-494-7647		(877)-494-7647		(800)-665-8037		(800)-665-8037		(888)-451-9957		(888)-451-9957		(800)-922-3140		(800)-922-3140		(888)-451-9957		(888)-451-9957		(800)-922-3140		(800)-922-3140		1	1	1
H3404	807	0	1	04	01	H3404_807_0	1	1		06/05/2011	2012.02	06/05/2011 01:53:02 PM Eastern Daylight Time	06/06/2011 06:03:08 PM Eastern Daylight Time			06/06/2011 07:34:42 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Blue Cross and Blue Shield of North Carolina	www.bcbsnc.com/medicare	Blue Medicare PPO NC+ EGWP (PPO)	01	04		1			H3404	807	0	2012	South Atlantic		1	8	2			2						www.bcbsnc.com/medicare	http://www.bcbsnc.com/medicare/drug-search.cfm	http://www.bcbsnc.com/medicare/pharmacy-search.cfm	(877)-494-7647		(877)-494-7647		(800)-665-8037		(800)-665-8037		(877)-494-7647		(877)-494-7647		(800)-665-8037		(800)-665-8037		(888)-451-9957		(888)-451-9957		(800)-922-3140		(800)-922-3140		(888)-451-9957		(888)-451-9957		(800)-922-3140		(800)-922-3140		1	1	1
H3404	808	0	1	04	01	H3404_808_0	1	1		06/05/2011	2012.02	06/05/2011 01:53:14 PM Eastern Daylight Time	06/06/2011 06:05:19 PM Eastern Daylight Time			06/06/2011 07:34:42 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Blue Cross and Blue Shield of North Carolina	www.bcbsnc.com/medicare	Blue Medicare PPO NC+ EGWP Med Only (PPO)	01	04		1			H3404	808	0	2012	South Atlantic		1	8	2			2						www.bcbsnc.com/medicare	http://www.bcbsnc.com/medicare/drug-search.cfm	http://www.bcbsnc.com/medicare/pharmacy-search.cfm	(877)-494-7647		(877)-494-7647		(800)-665-8037		(800)-665-8037										(888)-451-9957		(888)-451-9957		(800)-922-3140		(800)-922-3140										1	1	1
H3405	001	0	1	04	01	H3405_001_0	5	1		07/12/2011	2012.02	07/12/2011 10:22:50 AM Eastern Daylight Time	05/27/2011 03:39:08 PM Eastern Daylight Time	08/04/2011 12:13:22 PM Eastern Daylight Time		08/08/2011 03:57:47 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H3405-001 (PPO)	01	04		1			H3405	001	0	2012	Raleigh Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3405	002	0	1	04	01	H3405_002_0	6	1		07/07/2011	2012.02	07/07/2011 03:17:47 PM Eastern Daylight Time	08/05/2011 08:45:03 AM Eastern Daylight Time	08/04/2011 12:13:42 PM Eastern Daylight Time		08/08/2011 03:57:47 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H3405-002 (PPO)	01	04		1			H3405	002	0	2012	Greensboro / Winston-Salem Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3405	005	0	1	04	01	H3405_005_0	7	1		07/12/2011	2012.02	07/12/2011 10:11:18 AM Eastern Daylight Time	08/05/2011 08:52:42 AM Eastern Daylight Time	08/04/2011 12:14:01 PM Eastern Daylight Time		08/08/2011 03:57:47 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H3405-005 (PPO)	01	04		1			H3405	005	0	2012	Statesville Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3405	007	0	1	04	01	H3405_007_0	6	1		07/07/2011	2012.02	07/07/2011 03:18:57 PM Eastern Daylight Time	08/05/2011 09:04:44 AM Eastern Daylight Time	08/04/2011 12:14:20 PM Eastern Daylight Time		08/08/2011 03:57:47 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H3405-007 (PPO)	01	04		1			H3405	007	0	2012	Select Western North Carolina Counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3410	002	7	1	09	04	H3410_002_7	4	1		07/21/2011	2012.02	07/21/2011 03:09:07 PM Central Daylight Time	07/21/2011 09:01:14 AM Central Daylight Time			07/21/2011 05:18:57 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Silver Connect Plan (PFFS)	04	09	1	1			H3410	002	7	2012	Nationwide	Colorado	2	73	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572										(711)		(711)		(711)		(711)										2	2	2
H3410	002	8	1	09	04	H3410_002_8	4	1		07/21/2011	2012.02	07/21/2011 03:11:53 PM Central Daylight Time	07/21/2011 03:50:08 PM Central Daylight Time			07/21/2011 05:18:57 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Silver Connect Plan (PFFS)	04	09	1	1			H3410	002	8	2012	Nationwide	Idaho	2	2795	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572										(711)		(711)		(711)		(711)										2	2	2
H3410	002	9	1	09	04	H3410_002_9	4	1		07/21/2011	2012.02	07/21/2011 03:11:57 PM Central Daylight Time	07/21/2011 03:42:57 PM Central Daylight Time			07/21/2011 05:18:57 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Silver Connect Plan (PFFS)	04	09	1	1			H3410	002	9	2012	Nationwide	Illinois	2	29	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572										(711)		(711)		(711)		(711)										2	2	2
H3410	002	10	1	09	04	H3410_002_10	4	1		07/21/2011	2012.02	07/21/2011 03:12:01 PM Central Daylight Time	07/21/2011 03:42:12 PM Central Daylight Time			07/21/2011 05:18:57 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Silver Connect Plan (PFFS)	04	09	1	1			H3410	002	10	2012	Nationwide	Kansas	2	34	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572										(711)		(711)		(711)		(711)										2	2	2
H3410	002	11	1	09	04	H3410_002_11	4	1		07/21/2011	2012.02	07/21/2011 03:12:06 PM Central Daylight Time	07/21/2011 03:41:22 PM Central Daylight Time			07/21/2011 05:18:57 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Silver Connect Plan (PFFS)	04	09	1	1			H3410	002	11	2012	Nationwide	Louisiana	2	892	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572										(711)		(711)		(711)		(711)										2	2	2
H3410	002	12	1	09	04	H3410_002_12	4	1		07/21/2011	2012.02	07/21/2011 03:12:11 PM Central Daylight Time	07/21/2011 03:39:47 PM Central Daylight Time			07/21/2011 05:18:57 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Silver Connect Plan (PFFS)	04	09	1	1			H3410	002	12	2012	Nationwide	Missouri	2	171	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572										(711)		(711)		(711)		(711)										2	2	2
H3410	002	13	1	09	04	H3410_002_13	4	1		07/21/2011	2012.02	07/21/2011 03:12:15 PM Central Daylight Time	07/21/2011 03:53:19 PM Central Daylight Time			07/21/2011 05:18:57 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Silver Connect Plan (PFFS)	04	09	1	1			H3410	002	13	2012	Nationwide	Montana	2	3065	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572										(711)		(711)		(711)		(711)										2	2	2
H3410	002	14	1	09	04	H3410_002_14	4	1		07/21/2011	2012.02	07/21/2011 03:12:19 PM Central Daylight Time	07/21/2011 03:55:36 PM Central Daylight Time			07/21/2011 05:18:57 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Silver Connect Plan (PFFS)	04	09	1	1			H3410	002	14	2012	Nationwide	North Carolina	2	52	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572										(711)		(711)		(711)		(711)										2	2	2
H3410	002	15	1	09	04	H3410_002_15	4	1		07/21/2011	2012.02	07/21/2011 03:12:23 PM Central Daylight Time	07/21/2011 03:38:42 PM Central Daylight Time			07/21/2011 05:18:57 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Silver Connect Plan (PFFS)	04	09	1	1			H3410	002	15	2012	Nationwide	Oklahoma	2	1717	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572										(711)		(711)		(711)		(711)										2	2	2
H3410	002	16	1	09	04	H3410_002_16	4	1		07/21/2011	2012.02	07/21/2011 03:12:27 PM Central Daylight Time	07/21/2011 03:56:24 PM Central Daylight Time			07/21/2011 05:18:57 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Silver Connect Plan (PFFS)	04	09	1	1			H3410	002	16	2012	Nationwide	South Carolina	2	1534	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572										(711)		(711)		(711)		(711)										2	2	2
H3410	002	17	1	09	04	H3410_002_17	5	1		07/21/2011	2012.02	07/21/2011 03:12:33 PM Central Daylight Time	07/28/2011 08:57:42 AM Central Daylight Time			07/28/2011 11:23:15 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Silver Connect Plan (PFFS)	04	09	1	1			H3410	002	17	2012	Nationwide	Texas	2	548	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572										(711)		(711)		(711)		(711)										2	2	2
H3410	002	18	1	09	04	H3410_002_18	4	1		07/21/2011	2012.02	07/21/2011 03:12:37 PM Central Daylight Time	07/21/2011 03:54:02 PM Central Daylight Time			07/21/2011 05:18:57 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Silver Connect Plan (PFFS)	04	09	1	1			H3410	002	18	2012	Nationwide	Utah	2	437	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572										(711)		(711)		(711)		(711)										2	2	2
H3410	002	19	1	09	04	H3410_002_19	4	1		07/21/2011	2012.02	07/21/2011 03:12:42 PM Central Daylight Time	07/21/2011 03:51:50 PM Central Daylight Time			07/21/2011 05:18:57 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Silver Connect Plan (PFFS)	04	09	1	1			H3410	002	19	2012	Nationwide	Washington	2	9438	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572										(711)		(711)		(711)		(711)										2	2	2
H3410	003	7	1	09	04	H3410_003_7	6	1		07/21/2011	2012.02	07/21/2011 03:12:46 PM Central Daylight Time	08/04/2011 10:53:54 AM Central Daylight Time	08/04/2011 12:41:09 PM Central Daylight Time		08/05/2011 10:55:22 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Connect Plan (PFFS)	04	09	1	1			H3410	003	7	2012	Nationwide	Colorado	2	14	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H3410	003	8	1	09	04	H3410_003_8	6	1		07/21/2011	2012.02	07/21/2011 03:12:50 PM Central Daylight Time	08/04/2011 10:57:15 AM Central Daylight Time	08/04/2011 12:41:45 PM Central Daylight Time		08/05/2011 10:55:22 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Connect Plan (PFFS)	04	09	1	1			H3410	003	8	2012	Nationwide	Idaho	2	610	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H3410	003	9	1	09	04	H3410_003_9	7	1		07/22/2011	2012.02	07/22/2011 08:41:21 AM Central Daylight Time	08/04/2011 10:58:41 AM Central Daylight Time	08/04/2011 12:42:08 PM Central Daylight Time		08/05/2011 10:55:22 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Connect Plan (PFFS)	04	09	1	1			H3410	003	9	2012	Nationwide	Illinois	2	27	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H3410	003	10	1	09	04	H3410_003_10	6	1		07/21/2011	2012.02	07/21/2011 03:12:59 PM Central Daylight Time	08/04/2011 10:59:44 AM Central Daylight Time	08/04/2011 12:42:36 PM Central Daylight Time		08/05/2011 10:55:22 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Connect Plan (PFFS)	04	09	1	1			H3410	003	10	2012	Nationwide	Kansas	2	47	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H3410	003	11	1	09	04	H3410_003_11	6	1		07/21/2011	2012.02	07/21/2011 03:13:04 PM Central Daylight Time	08/04/2011 11:00:28 AM Central Daylight Time	08/04/2011 12:43:09 PM Central Daylight Time		08/05/2011 10:55:22 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Connect Plan (PFFS)	04	09	1	1			H3410	003	11	2012	Nationwide	Louisiana	2	174	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H3410	003	12	1	09	04	H3410_003_12	6	1		07/21/2011	2012.02	07/21/2011 03:13:07 PM Central Daylight Time	08/04/2011 11:01:21 AM Central Daylight Time	08/04/2011 12:43:32 PM Central Daylight Time		08/05/2011 10:55:22 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Connect Plan (PFFS)	04	09	1	1			H3410	003	12	2012	Nationwide	Missouri	2	55	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H3410	003	13	1	09	04	H3410_003_13	8	1		07/21/2011	2012.02	07/21/2011 03:13:30 PM Central Daylight Time	08/04/2011 10:55:36 AM Central Daylight Time	08/04/2011 12:43:59 PM Central Daylight Time		08/05/2011 10:55:22 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Connect Plan (PFFS)	04	09	1	1			H3410	003	13	2012	Nationwide	Montana	2	416	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H3410	003	14	1	09	04	H3410_003_14	6	1		07/21/2011	2012.02	07/21/2011 03:13:34 PM Central Daylight Time	08/04/2011 10:52:45 AM Central Daylight Time	08/04/2011 12:44:22 PM Central Daylight Time		08/05/2011 10:55:22 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Connect Plan (PFFS)	04	09	1	1			H3410	003	14	2012	Nationwide	North Carolina	2	44	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H3410	003	15	1	09	04	H3410_003_15	6	1		07/21/2011	2012.02	07/21/2011 03:13:38 PM Central Daylight Time	08/04/2011 11:02:10 AM Central Daylight Time	08/04/2011 12:44:47 PM Central Daylight Time		08/05/2011 10:55:22 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Connect Plan (PFFS)	04	09	1	1			H3410	003	15	2012	Nationwide	Oklahoma	2	880	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H3410	003	16	1	09	04	H3410_003_16	6	1		07/21/2011	2012.02	07/21/2011 03:13:41 PM Central Daylight Time	08/04/2011 11:03:32 AM Central Daylight Time	08/04/2011 12:45:12 PM Central Daylight Time		08/05/2011 10:55:22 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Connect Plan (PFFS)	04	09	1	1			H3410	003	16	2012	Nationwide	South Carolina	2	1158	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H3410	003	17	1	09	04	H3410_003_17	6	1		07/21/2011	2012.02	07/21/2011 03:13:45 PM Central Daylight Time	08/04/2011 11:02:53 AM Central Daylight Time	08/04/2011 12:45:34 PM Central Daylight Time		08/05/2011 10:55:22 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Connect Plan (PFFS)	04	09	1	1			H3410	003	17	2012	Nationwide	Texas	2	185	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H3410	003	18	1	09	04	H3410_003_18	6	1		07/21/2011	2012.02	07/21/2011 03:13:49 PM Central Daylight Time	08/04/2011 10:54:48 AM Central Daylight Time	08/04/2011 12:46:01 PM Central Daylight Time		08/05/2011 10:55:22 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Connect Plan (PFFS)	04	09	1	1			H3410	003	18	2012	Nationwide	Utah	2	135	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H3410	003	19	1	09	04	H3410_003_19	6	1		07/21/2011	2012.02	07/21/2011 03:13:52 PM Central Daylight Time	08/04/2011 10:56:24 AM Central Daylight Time	08/04/2011 12:46:24 PM Central Daylight Time		08/05/2011 10:55:22 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Connect Plan (PFFS)	04	09	1	1			H3410	003	19	2012	Nationwide	Washington	2	2010	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H3410	004	7	1	09	04	H3410_004_7	7	1		07/21/2011	2012.02	07/21/2011 03:11:33 PM Central Daylight Time	08/04/2011 11:51:38 AM Central Daylight Time	08/04/2011 12:47:15 PM Central Daylight Time		08/05/2011 11:01:55 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	http://www.sterlinghealth.com	WindsorSterling Emerald Connect Plan (PFFS)	04	09	1	1			H3410	004	7	2012	Nationwide	Colorado	2	1	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H3410	004	8	1	09	04	H3410_004_8	7	1		07/19/2011	2012.02	07/20/2011 11:31:43 AM Central Daylight Time	08/04/2011 11:50:52 AM Central Daylight Time	08/04/2011 12:47:37 PM Central Daylight Time		08/05/2011 11:01:55 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	http://www.sterlinghealth.com	WindsorSterling Emerald Connect Plan (PFFS)	04	09	1	1			H3410	004	8	2012	Nationwide	Idaho	2	42	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H3410	004	9	1	09	04	H3410_004_9	7	1		07/19/2011	2012.02	07/20/2011 11:31:43 AM Central Daylight Time	08/04/2011 11:50:13 AM Central Daylight Time	08/04/2011 12:47:58 PM Central Daylight Time		08/05/2011 11:01:55 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	http://www.sterlinghealth.com	WindsorSterling Emerald Connect Plan (PFFS)	04	09	1	1			H3410	004	9	2012	Nationwide	Illinois	2	2	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H3410	004	10	1	09	04	H3410_004_10	7	1		07/19/2011	2012.02	07/20/2011 11:31:44 AM Central Daylight Time	08/04/2011 11:49:31 AM Central Daylight Time	08/04/2011 12:48:15 PM Central Daylight Time		08/05/2011 11:01:55 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	http://www.sterlinghealth.com	WindsorSterling Emerald Connect Plan (PFFS)	04	09	1	1			H3410	004	10	2012	Nationwide	Kansas	2	3	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H3410	004	11	1	09	04	H3410_004_11	7	1		07/19/2011	2012.02	07/20/2011 11:31:44 AM Central Daylight Time	08/04/2011 11:48:49 AM Central Daylight Time	08/04/2011 12:48:35 PM Central Daylight Time		08/05/2011 11:01:55 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	http://www.sterlinghealth.com	WindsorSterling Emerald Connect Plan (PFFS)	04	09	1	1			H3410	004	11	2012	Nationwide	Louisiana	2	43	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H3410	004	12	1	09	04	H3410_004_12	7	1		07/21/2011	2012.02	07/21/2011 03:14:14 PM Central Daylight Time	08/04/2011 11:48:08 AM Central Daylight Time	08/04/2011 12:48:54 PM Central Daylight Time		08/05/2011 11:01:55 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	http://www.sterlinghealth.com	WindsorSterling Emerald Connect Plan (PFFS)	04	09	1	1			H3410	004	12	2012	Nationwide	Missouri	2	17	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H3410	004	13	1	09	04	H3410_004_13	7	1		07/19/2011	2012.02	07/20/2011 11:31:45 AM Central Daylight Time	08/04/2011 11:47:22 AM Central Daylight Time	08/04/2011 12:49:15 PM Central Daylight Time		08/05/2011 11:01:55 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	http://www.sterlinghealth.com	WindsorSterling Emerald Connect Plan (PFFS)	04	09	1	1			H3410	004	13	2012	Nationwide	Montana	2	29	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H3410	004	14	1	09	04	H3410_004_14	7	1		07/19/2011	2012.02	07/20/2011 11:31:45 AM Central Daylight Time	08/04/2011 11:45:17 AM Central Daylight Time	08/04/2011 12:49:34 PM Central Daylight Time		08/05/2011 11:01:55 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	http://www.sterlinghealth.com	WindsorSterling Emerald Connect Plan (PFFS)	04	09	1	1			H3410	004	14	2012	Nationwide	North Carolina	2	3	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H3410	004	15	1	09	04	H3410_004_15	7	1		07/19/2011	2012.02	07/20/2011 11:31:46 AM Central Daylight Time	08/04/2011 01:07:47 PM Central Daylight Time	08/04/2011 12:49:55 PM Central Daylight Time		08/05/2011 11:01:55 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	http://www.sterlinghealth.com	WindsorSterling Emerald Connect Plan (PFFS)	04	09	1	1			H3410	004	15	2012	Nationwide	Oklahoma	2	61	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H3410	004	17	1	09	04	H3410_004_17	7	1		07/19/2011	2012.02	07/20/2011 11:31:46 AM Central Daylight Time	08/04/2011 11:43:55 AM Central Daylight Time	08/04/2011 12:50:17 PM Central Daylight Time		08/05/2011 11:01:55 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	http://www.sterlinghealth.com	WindsorSterling Emerald Connect Plan (PFFS)	04	09	1	1			H3410	004	17	2012	Nationwide	Texas	2	13	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H3410	004	18	1	09	04	H3410_004_18	7	1		07/19/2011	2012.02	07/20/2011 11:31:47 AM Central Daylight Time	08/04/2011 11:43:17 AM Central Daylight Time	08/04/2011 12:50:52 PM Central Daylight Time		08/05/2011 11:01:55 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	http://www.sterlinghealth.com	WindsorSterling Emerald Connect Plan (PFFS)	04	09	1	1			H3410	004	18	2012	Nationwide	Utah	2	17	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H3410	004	19	1	09	04	H3410_004_19	7	1		07/19/2011	2012.02	07/20/2011 11:31:47 AM Central Daylight Time	08/04/2011 01:19:11 PM Central Daylight Time	08/04/2011 12:51:28 PM Central Daylight Time		08/05/2011 11:01:55 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	http://www.sterlinghealth.com	WindsorSterling Emerald Connect Plan (PFFS)	04	09	1	1			H3410	004	19	2012	Nationwide	Washington	2	155	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-9379		(888)-303-9397		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H3421	001	0	1	09	04	H3421_001_0	5	1		07/01/2011	2012.02	07/01/2011 01:51:28 PM Eastern Daylight Time	06/06/2011 08:03:03 PM Eastern Daylight Time			07/11/2011 09:20:20 AM Eastern Daylight Time	AMERICA'S 1ST CHOICE HEALTH PLANS, INC.	America's 1st Choice Health Plans	www.Americas1stChoice.com	Patriot (PFFS)	04	09	1	1			H3421	001	0	2012	Select Counties in SC		2	1	2			2							www.americas1stchoice.com	www.americas1stchoice.com	(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947										(800)-735-8583		(800)-735-8583		(800)-735-8583		(800)-735-8583										2	2	2
H3421	002	0	1	09	04	H3421_002_0	7	1		07/01/2011	2012.02	07/01/2011 01:51:42 PM Eastern Daylight Time	08/05/2011 03:01:25 PM Eastern Daylight Time	08/05/2011 03:01:25 PM Eastern Daylight Time		08/05/2011 04:51:31 PM Eastern Daylight Time	AMERICA'S 1ST CHOICE HEALTH PLANS, INC.	America's 1st Choice Health Plans	www.Americas1stChoice.com	Patriot Plus (PFFS)	04	09	1	1			H3421	002	0	2012	Select Counties in SC		2	1	2			2							www.americas1stchoice.com	www.americas1stchoice.com	(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947		(800)-735-8583		(800)-735-8583		(800)-735-8583		(800)-735-8583		(800)-735-8583		(800)-735-8583		(800)-735-8583		(800)-735-8583		2	2	2
H3430	001	0	1	20	08	H3430_001_0	1	1		05/25/2011	2012.02	05/25/2011 09:37:41 AM Eastern Daylight Time		05/25/2011 09:42:54 AM Eastern Daylight Time		05/25/2011 09:47:47 AM Eastern Daylight Time	NEIGHBORLY CARE NETWORK, INC.	Neighborly Care PACE Center	www.neighborly.org	Neighborly Care PACE Center (PACE)	08	20		1			H3430	001	0	2012	Neighborly Care PACE Center		2		2			2							http://www.neighborly.org/	http://www.neighborly.org/									(266)-458-2933		(727)-289-0062		(866)-458-2933		(727)-289-0062										(866)-458-2933		(727)-289-0062		(866)-458-2933		(727)-289-0062				
H3430	002	0	1	20	08	H3430_002_0	1	1		05/25/2011	2012.02	05/25/2011 09:38:18 AM Eastern Daylight Time		05/25/2011 09:42:54 AM Eastern Daylight Time		05/25/2011 09:47:47 AM Eastern Daylight Time	NEIGHBORLY CARE NETWORK, INC.	Neighborly Care PACE Center	www.neighborly.org	Neighborly Care PACE Center (PACE)	08	20		1			H3430	002	0	2012	Neighborly Plan PACE Center		2		2			2							http://www.neighborly.org/	http://www.neighborly.org/									(866)-458-2933		(727)-289-0062		(866)-458-2933		(727)-289-0062										(866)-458-2933		(727)-289-0062		(866)-458-2933		(727)-289-0062				
H3449	005	0	1	01	01	H3449_005_0	7	1		11/14/2011	2012.02	11/14/2011 05:04:45 PM Eastern Standard Time	08/09/2011 08:08:40 AM Eastern Standard Time	08/08/2011 09:22:34 AM Eastern Standard Time		11/15/2011 12:26:03 PM Eastern Standard Time	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Blue Cross and Blue Shield of North Carolina	www.bcbsnc.com/medicare	Blue Medicare HMO Enhanced (HMO)	01	01		1			H3449	005	0	2012	Select North Carolina Counties		2	229890	2			2						www.bcbsnc.com/medicare	http://www.bcbsnc.com/medicare/drug-search.cfm	http://www.bcbsnc.com/medicare/pharmacy-search.cfm	(888)-310-4110		(888)-310-4110		(800)-665-8037		(800)-665-8037		(888)-310-4110		(888)-310-4110		(800)-665-8037		(800)-665-8037		(888)-451-9957		(888)-451-9957		(800)-922-3140		(800)-922-3140		(888)-451-9957		(888)-451-9957		(800)-922-3140		(800)-922-3140		2	2	2
H3449	012	0	1	01	01	H3449_012_0	4	1		07/08/2011	2012.02	07/08/2011 10:46:15 AM Eastern Daylight Time	06/16/2011 11:46:42 AM Eastern Daylight Time			07/08/2011 01:08:11 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Blue Cross and Blue Shield of North Carolina	www.bcbsnc.com/medicare	Blue Medicare HMO Medical Only (HMO)	01	01		1			H3449	012	0	2012	Select North Carolina Counties		2	50008	2			2						www.bcbsnc.com/medicare	http://www.bcbsnc.com/medicare/drug-search.cfm	http://www.bcbsnc.com/medicare/pharmacy-search.cfm	(888)-310-4110		(888)-310-4110		(800)-665-8037		(800)-665-8037										(888)-451-9957		(888)-451-9957		(800)-922-3140		(800)-922-3140										2	2	2
H3449	013	0	1	01	01	H3449_013_0	5	1		07/01/2011	2012.02	07/01/2011 12:51:56 PM Eastern Daylight Time	08/09/2011 08:15:12 AM Eastern Daylight Time	08/08/2011 09:29:30 AM Eastern Daylight Time		08/09/2011 04:44:14 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Blue Cross and Blue Shield of North Carolina	www.bcbsnc.com/medicare	Blue Medicare HMO Standard (HMO)	01	01		1			H3449	013	0	2012	Select North Carolina Counties		2	261202	2			2						www.bcbsnc.com/medicare	http://www.bcbsnc.com/medicare/drug-search.cfm	http://www.bcbsnc.com/medicare/pharmacy-search.cfm	(888)-310-4110		(888)-310-4110		(800)-665-8037		(800)-665-8037		(888)-310-4110		(888)-310-4110		(800)-665-8037		(800)-665-8037		(888)-451-9957		(888)-451-9957		(800)-922-3140		(800)-922-3140		(888)-451-9957		(888)-451-9957		(800)-922-3140		(800)-922-3140		2	2	2
H3449	801	0	1	01	01	H3449_801_0	1	1		06/05/2011	2012.02	06/05/2011 11:02:21 AM Eastern Daylight Time	06/06/2011 06:14:56 PM Eastern Daylight Time			06/06/2011 07:34:42 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Blue Cross and Blue Shield of North Carolina	www.bcbsnc.com/medicare	Blue Medicare HMO EGWP (HMO)	01	01		1			H3449	801	0	2012	North Carolina Employer Groups		1		2			2						www.bcbsnc.com/medicare	http://www.bcbsnc.com/medicare/drug-search.cfm	http://www.bcbsnc.com/medicare/pharmacy-search.cfm	(888)-310-4110		(888)-310-4110		(800)-665-8037		(800)-665-8037		(888)-310-4110		(888)-310-4110		(800)-665-8037		(800)-665-8037		(888)-451-9957		(888)-451-9957		(800)-922-3140		(800)-922-3140		(888)-451-9957		(888)-451-9957		(800)-922-3140		(800)-922-3140		1	1	1
H3449	805	0	1	01	01	H3449_805_0	2	1		06/05/2011	2012.02	06/05/2011 01:52:15 PM Eastern Daylight Time	06/06/2011 08:37:56 PM Eastern Daylight Time			06/06/2011 08:50:03 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Blue Cross and Blue Shield of North Carolina	www.bcbsnc.com/medicare	Blue Medicare HMO EGWP Medical Only (HMO)	01	01		1			H3449	805	0	2012	North Carolina Employer Groups		1	8	2			2						www.bcbsnc.com/medicare	http://www.bcbsnc.com/medicare/drug-search.cfm	http://www.bcbsnc.com/medicare/pharmacy-search.cfm	(888)-310-4110		(888)-310-4110		(800)-665-8037		(800)-665-8037										(888)-451-9957		(888)-451-9957		(800)-922-3140		(800)-922-3140										1	1	1
H3449	810	0	1	01	01	H3449_810_0	1	1		06/05/2011	2012.02	06/05/2011 01:50:47 PM Eastern Daylight Time	06/06/2011 06:18:16 PM Eastern Daylight Time			06/06/2011 07:34:42 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Blue Cross and Blue Shield of North Carolina	www.bcbsnc.com/medicare	Blue Medicare HMO (RAI) (HMO)	01	01		1			H3449	810	0	2012	North Carolina Empolyer Groups		1	41170	2			2						www.bcbsnc.com/medicare	http://www.bcbsnc.com/medicare/drug-search.cfm	http://www.bcbsnc.com/medicare/pharmacy-search.cfm	(888)-310-4110		(888)-310-4110		(800)-665-8037		(800)-665-8037		(888)-310-4110		(888)-310-4110		(800)-665-8037		(800)-665-8037		(888)-451-9957		(888)-451-9957		(800)-922-3140		(800)-922-3140		(888)-451-9957		(888)-451-9957		(800)-922-3140		(800)-922-3140		1	1	1
H3456	001	0	1	02	01	H3456_001_0	6	1		08/08/2011	2012.02	08/08/2011 09:34:00 AM Central Daylight Time	08/04/2011 10:11:46 PM Central Daylight Time	08/05/2011 01:29:04 PM Central Daylight Time		08/09/2011 04:28:20 PM Central Daylight Time	UNITEDHEALTHCARE OF NORTH CAROLINA, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H3456	001	0	2012	Select Counties in North Carolina		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3456	010	0	1	01	01	H3456_010_0	3	1		08/09/2011	2012.02	08/09/2011 12:07:54 PM Central Daylight Time	08/08/2011 04:15:47 PM Central Daylight Time	08/05/2011 01:29:20 PM Central Daylight Time		08/09/2011 04:38:46 PM Central Daylight Time	UNITEDHEALTHCARE OF NORTH CAROLINA, INC.	SecureHorizons by UnitedHealthcare	www.EvercareHealthPlans.com	UnitedHealthcare Nursing Home Plan (HMO SNP)	01	01		1			H3456	010	0	2012	Select Counties in North Carolina		2		2			1	1	1	1			www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3456	016	0	1	01	01	H3456_016_0	5	1	2	07/22/2011	2012.02	07/22/2011 12:07:49 PM Central Daylight Time	08/04/2011 10:12:42 PM Central Daylight Time	08/05/2011 01:07:37 PM Central Daylight Time		08/09/2011 12:16:18 PM Central Daylight Time	UNITEDHEALTHCARE OF NORTH CAROLINA, INC.	SecureHorizons by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H3456	016	0	2012	Select Counties in North Carolina		2		2			1	3		1	2		www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3456	020	0	1	02	01	H3456_020_0	6	1		07/20/2011	2012.02	07/20/2011 11:54:26 AM Central Daylight Time	07/22/2011 12:22:42 PM Central Daylight Time			07/25/2011 02:15:50 PM Central Daylight Time	UNITEDHEALTHCARE OF NORTH CAROLINA, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus Essential (HMO-POS)	01	02		1			H3456	020	0	2012	Select Counties in North Carolina		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514										(711)		(711)		(711)		(711)										2	2	2
H3456	023	0	1	02	01	H3456_023_0	6	1		08/08/2011	2012.02	08/08/2011 09:35:56 AM Central Daylight Time	08/04/2011 10:13:21 PM Central Daylight Time	08/05/2011 01:29:36 PM Central Daylight Time		08/09/2011 04:28:20 PM Central Daylight Time	UNITEDHEALTHCARE OF NORTH CAROLINA, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H3456	023	0	2012	Wake and Durham Counties		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3456	025	0	1	02	01	H3456_025_0	6	1		08/05/2011	2012.02	08/05/2011 09:35:00 AM Central Daylight Time	08/04/2011 10:13:56 PM Central Daylight Time	08/05/2011 01:29:51 PM Central Daylight Time		08/09/2011 04:28:20 PM Central Daylight Time	UNITEDHEALTHCARE OF NORTH CAROLINA, INC.	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H3456	025	0	2012	Asheville Area		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3456	801	0	1	01	01	H3456_801_0	2	1		07/06/2011	2012.02	07/06/2011 04:45:53 PM Central Daylight Time	06/03/2011 03:00:50 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF NORTH CAROLINA, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H3456	801	0	2012	Select Counties in North Carolina		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3456	803	0	1	01	01	H3456_803_0	2	1		07/06/2011	2012.02	07/06/2011 04:45:57 PM Central Daylight Time	06/03/2011 03:01:37 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF NORTH CAROLINA, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H3456	803	0	2012	Select Counties in NC		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3456	804	0	1	01	01	H3456_804_0	2	1		07/06/2011	2012.02	07/06/2011 04:46:04 PM Central Daylight Time	06/03/2011 03:02:45 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF NORTH CAROLINA, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H3456	804	0	2012	Select counties in NC		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548										(711)		(711)		(711)		(711)										2	2	2
H3456	805	0	2	01	01	H3456_805_0	2	1		07/06/2011	2012.02	07/06/2011 04:46:13 PM Central Daylight Time	06/03/2011 03:03:58 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF NORTH CAROLINA, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		2	2		H3456	805	0	2012	Select counties in NC		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3456	806	0	2	01	01	H3456_806_0	2	1		07/06/2011	2012.02	07/06/2011 04:46:19 PM Central Daylight Time	06/03/2011 03:05:07 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF NORTH CAROLINA, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		2	2		H3456	806	0	2012	Select counties in NC		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3456	808	0	1	02	01	H3456_808_0	2	1		07/06/2011	2012.02	07/06/2011 04:46:30 PM Central Daylight Time	06/03/2011 03:06:18 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF NORTH CAROLINA, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO-POS)	01	02		1			H3456	808	0	2012	Select counties in NC		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3493	001	0	1	20	08	H3493_001_0	1	1		05/23/2011	2012.02	05/23/2011 12:00:25 PM Central Daylight Time		05/20/2011 10:52:19 AM Central Daylight Time		05/23/2011 12:19:30 PM Central Daylight Time	LIFE AT LOURDES, INC.	LIFE at Lourdes	www.lourdesmed.org	LIFE at Lourdes, Inc (PACE)	08	20		1			H3493	001	0	2012	LIFE at Lourdes		2		2			2							www.lourdesmed.org	www.lourdesmed.org									(856)-675-3355		(856)-675-3355		(856)-675-3355		(856)-675-3355										(856)-675-3355		(856)-675-3355		(856)-675-3355		(856)-675-3355				
H3493	002	0	1	20	08	H3493_002_0	1	1		05/23/2011	2012.02	05/23/2011 12:00:38 PM Central Daylight Time		05/20/2011 10:52:19 AM Central Daylight Time		05/23/2011 12:19:30 PM Central Daylight Time	LIFE AT LOURDES, INC.	LIFE at Lourdes	www.lourdesmed.org	LIFE at Lourdes, Inc (PACE)	08	20		1			H3493	002	0	2012	LIFE at Lourdes		2		2			2							www.lourdesmed.org	www.lourdesmed.org									(856)-675-3355		(856)-675-3355		(856)-675-3355		(856)-675-3355										(856)-675-3355		(856)-675-3355		(856)-675-3355		(856)-675-3355				
H3528	001	0	1	01	01	H3528_001_0	6	1		08/10/2011	2012.02	08/10/2011 04:36:32 PM Eastern Daylight Time	08/09/2011 05:46:38 PM Eastern Daylight Time	08/09/2011 08:38:40 PM Eastern Daylight Time		08/10/2011 04:38:14 PM Eastern Daylight Time	CONNECTICARE, INC.	ConnectiCare, Inc.	www.connecticare.com	ConnectiCare VIP Prime 1 (HMO)	01	01		1			H3528	001	0	2012	State of Connecticut		2	23159	2			2						www.connecticare.com	www.connecticare.com	www.connecticare.com	(800)-224-2273		(800)-224-2273		(877)-224-8220		(877)-224-8220		(800)-224-2273		(800)-224-2273		(877)-224-8220		(877)-224-8220		(800)-842-9710		(800)-842-9710		(800)-842-9710		(800)-842-9710		(800)-842-9710		(800)-842-9710		(800)-842-9710		(800)-842-9710		2	2	2
H3528	002	0	1	01	01	H3528_002_0	4	1		08/09/2011	2012.02	08/09/2011 05:37:04 PM Eastern Daylight Time	08/09/2011 05:46:40 PM Eastern Daylight Time	08/09/2011 08:38:41 PM Eastern Daylight Time		08/09/2011 08:39:43 PM Eastern Daylight Time	CONNECTICARE, INC.	ConnectiCare, Inc.	www.connecticare.com	ConnectiCare VIP Prime 3 (HMO)	01	01		1			H3528	002	0	2012	State of Connecticut		2	8672	2			2						www.connecticare.com	www.connecticare.com	www.connecticare.com	(800)-224-2273		(800)-224-2273		(877)-224-8220		(877)-224-8220		(800)-224-2273		(800)-224-2273		(877)-224-8220		(877)-224-8220		(800)-842-9710		(800)-842-9710		(800)-842-9710		(800)-842-9710		(800)-842-9710		(800)-842-9710		(800)-842-9710		(800)-842-9710		2	2	2
H3528	003	0	1	01	01	H3528_003_0	3	1		07/20/2011	2012.02	07/20/2011 10:24:02 AM Eastern Daylight Time	07/20/2011 10:26:03 AM Eastern Daylight Time			07/20/2011 10:29:04 AM Eastern Daylight Time	CONNECTICARE, INC.	ConnectiCare, Inc.	www.connecticare.com	ConnectiCare VIP Prime 4 (HMO)	01	01		1			H3528	003	0	2012	State of Connecticut		2	999	2			2						www.connecticare.com	www.connecticare.com	www.connecticare.com	(800)-224-2273		(800)-224-2273		(877)-224-8220		(877)-224-8220										(800)-842-9710		(800)-842-9710		(800)-842-9710		(800)-842-9710										2	2	2
H3528	006	0	1	02	01	H3528_006_0	4	1		08/09/2011	2012.02	08/09/2011 05:36:45 PM Eastern Daylight Time	08/09/2011 05:46:14 PM Eastern Daylight Time	08/09/2011 08:38:42 PM Eastern Daylight Time		08/09/2011 08:39:43 PM Eastern Daylight Time	CONNECTICARE, INC.	ConnectiCare, Inc.	www.connecticare.com	ConnectiCare VIP Option 1 (HMO-POS)	01	02		1			H3528	006	0	2012	State of Connecticut		2	1126	2			2						www.connecticare.com	www.connecticare.com	www.connecticare.com	(800)-224-2273		(800)-224-2273		(877)-224-8220		(877)-224-8220		(800)-224-2273		(800)-224-2273		(877)-224-8220		(877)-224-8220		(800)-842-9710		(800)-842-9710		(800)-842-9710		(800)-842-9710		(800)-842-9710		(800)-842-9710		(800)-842-9710		(800)-842-9710		2	2	2
H3528	008	0	1	02	01	H3528_008_0	5	1		08/12/2011	2012.02	08/12/2011 02:04:12 PM Eastern Daylight Time	08/09/2011 05:46:18 PM Eastern Daylight Time	08/09/2011 08:38:39 PM Eastern Daylight Time		08/12/2011 02:16:53 PM Eastern Daylight Time	CONNECTICARE, INC.	ConnectiCare, Inc.	www.connecticare.com	ConnectiCare VIP Option 3 (HMO-POS)	01	02		1			H3528	008	0	2012	State of Connecticut		2	956	2			2						www.connecticare.com	www.connecticare.com	www.connecticare.com	(800)-224-2273		(800)-224-2273		(877)-224-8220		(877)-224-8220		(800)-224-2273		(800)-224-2273		(877)-224-8220		(877)-224-8220		(800)-842-9710		(800)-842-9710		(800)-842-9710		(800)-842-9710		(800)-842-9710		(800)-842-9710		(800)-842-9710		(800)-842-9710		2	2	2
H3528	801	0	1	01	01	H3528_801_0	5	1		06/01/2011	2012.02	06/01/2011 03:45:21 PM Eastern Daylight Time	06/16/2011 05:14:37 PM Eastern Daylight Time			06/16/2011 05:15:15 PM Eastern Daylight Time	CONNECTICARE, INC.	ConnectiCare, Inc.	www.connecticare.com	ConnectiCare VIP (HMO)	01	01		1			H3528	801	0	2012	State of Connecticut		1	1465	2			2						www.connecticare.com	www.connecticare.com	www.connecticare.com	(800)-224-2273		(800)-224-2273		(877)-224-8220		(877)-224-8220		(800)-224-2273		(800)-224-2273		(877)-224-8220		(877)-224-8220		(800)-842-9710		(800)-842-9710		(800)-842-9710		(800)-842-9710		(800)-842-9710		(800)-842-9710		(800)-842-9710		(800)-842-9710		1	1	1
H3528	805	0	1	01	01	H3528_805_0	3	1		06/01/2011	2012.02	06/01/2011 03:45:58 PM Eastern Daylight Time	06/05/2011 05:32:58 PM Eastern Daylight Time			06/05/2011 05:36:00 PM Eastern Daylight Time	CONNECTICARE, INC.	ConnectiCare, Inc.	www.connecticare.com	ConnectiCare VIP (HMO)	01	01		1			H3528	805	0	2012	State of Connecticut		1	185	2			2						www.connecticare.com	www.connecticare.com	www.connecticare.com	(800)-224-2273		(800)-224-2273		(877)-224-8220		(877)-224-8220										(800)-842-9710		(800)-842-9710		(800)-842-9710		(800)-842-9710										1	1	1
H3528	806	0	1	02	01	H3528_806_0	3	1		06/01/2011	2012.02	06/01/2011 03:46:26 PM Eastern Daylight Time	06/05/2011 05:33:57 PM Eastern Daylight Time			06/05/2011 05:36:00 PM Eastern Daylight Time	CONNECTICARE, INC.	ConnectiCare, Inc.	www.connecticare.com	ConnectiCare VIP (HMO-POS)	01	02		1			H3528	806	0	2012	State of Connecticut		1	90	2			2						www.connecticare.com	www.connecticare.com	www.connecticare.com	(800)-224-2273		(800)-224-2273		(877)-224-8220		(877)-224-8220		(800)-224-2273		(800)-224-2273		(877)-224-8220		(877)-224-8220		(800)-842-9710		(800)-842-9710		(800)-842-9710		(800)-842-9710		(800)-842-9710		(800)-842-9710		(800)-842-9710		(800)-842-9710		1	1	1
H3528	807	0	1	02	01	H3528_807_0	3	1		06/01/2011	2012.02	06/01/2011 03:47:09 PM Eastern Daylight Time	06/05/2011 05:34:50 PM Eastern Daylight Time			06/05/2011 05:36:00 PM Eastern Daylight Time	CONNECTICARE, INC.	ConnectiCare, Inc.	www.connecticare.com	ConnectiCare VIP (HMO-POS)	01	02		1			H3528	807	0	2012	State of Connecticut		1	90	2			2						www.connecticare.com	www.connecticare.com	www.connecticare.com	(800)-224-2273		(800)-224-2273		(877)-224-8220		(877)-224-8220										(800)-842-9710		(800)-842-9710		(800)-842-9710		(800)-842-9710										1	1	1
H3533	001	0	1	01	01	H3533_001_0	9	1		08/08/2011	2012.02	08/08/2011 10:01:45 AM Central Daylight Time	08/07/2011 12:39:40 PM Central Daylight Time	08/04/2011 12:40:49 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARCADIAN HEALTH PLAN OF NEW YORK, INC.	Northeast Community Care	www.NortheastCommunityCare.com	Northeast Community Care - Plus (HMO)	01	01		1			H3533	001	0	2012	Syracuse		2		2			2							www.northeastcommunitycare.com	www.northeastcommunitycare.com	(800)-573-8597		(800)-573-8597		(866)-395-4754		(315)-461-4790		(800)-573-8597		(800)-573-8597		(866)-395-4754		(315)-461-4790		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H3533	002	0	1	01	01	H3533_002_0	8	1	2	07/07/2011	2012.02	07/07/2011 10:58:09 AM Central Daylight Time	07/17/2011 05:30:43 PM Central Daylight Time	07/19/2011 07:37:54 PM Central Daylight Time		07/20/2011 04:17:07 PM Central Daylight Time	ARCADIAN HEALTH PLAN OF NEW YORK, INC.	Northeast Community Care	www.NortheastCommunityCare.com	Northeast Community Care - Dual Plus (HMO SNP)	01	01		1			H3533	002	0	2012	Madison, Oneida, Onondaga		2		2			1	3		1	5			www.northeastcommunitycare.com	www.northeastcommunitycare.com	(800)-573-8597		(800)-573-8597		(866)-395-4754		(315)-461-4790		(800)-573-8597		(800)-573-8597		(866)-395-4754		(315)-461-4790		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H3597	001	0	1	01	01	H3597_001_0	5	1		07/12/2011	2012.02	07/12/2011 02:52:58 PM Central Daylight Time	08/05/2011 09:52:00 AM Central Daylight Time	08/04/2011 09:48:28 AM Central Daylight Time		08/08/2011 09:25:05 AM Central Daylight Time	AETNA HEALTH	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (HMO)	01	01		1			H3597	001	0	2012	Cumberland, Penobscot and York Counties		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H3597	002	0	1	01	01	H3597_002_0	5	1		07/12/2011	2012.02	07/12/2011 02:57:15 PM Central Daylight Time	08/05/2011 09:54:57 AM Central Daylight Time	08/04/2011 09:49:04 AM Central Daylight Time		08/08/2011 09:25:05 AM Central Daylight Time	AETNA HEALTH	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Standard Plan (HMO)	01	01		1			H3597	002	0	2012	Cumberland, Penobscot and York Counties		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H3597	801	0	1	01	01	H3597_801_0	1	1		04/22/2011	2012.02	04/22/2011 09:54:08 AM Eastern Daylight Time	06/02/2011 10:08:06 AM Eastern Daylight Time			06/03/2011 10:12:16 AM Eastern Daylight Time	AETNA HEALTH	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan (HMO)	01	01		1			H3597	801	0	2012	Maine		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748										1	1	1
H3597	802	0	1	01	01	H3597_802_0	1	1		04/22/2011	2012.02	04/22/2011 09:54:26 AM Eastern Daylight Time	06/02/2011 10:26:22 AM Eastern Daylight Time			06/03/2011 10:12:16 AM Eastern Daylight Time	AETNA HEALTH	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan w/Rx CY (HMO)	01	01		1			H3597	802	0	2012	Maine		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		1	1	1
H3613	001	0	1	20	08	H3613_001_0	1	1		05/24/2011	2012.02	05/24/2011 01:19:05 PM Eastern Daylight Time		05/24/2011 12:16:44 PM Eastern Daylight Time		05/24/2011 01:20:39 PM Eastern Daylight Time	MCGREGOR PACE	McGregor PACE	McGregorpace.org	McGregor PACE Duel Eligibles (PACE)	08	20		1			H3613	001	0	2012	McGregor PACE  Cuyahoga County		2		2			2							mcgregorpace.org	mcgregorpace.org									(216)-791-3580		(216)-791-3580		(216)-791-3580		(216)-791-3580										(800)-325-2223		(800)-325-2223		(800)-325-2223		(800)-325-2223				
H3613	002	0	1	20	08	H3613_002_0	1	1		05/24/2011	2012.02	05/24/2011 12:58:33 PM Eastern Daylight Time		05/24/2011 12:16:44 PM Eastern Daylight Time		05/24/2011 01:20:39 PM Eastern Daylight Time	MCGREGOR PACE	McGregor PACE	McGregorpace.org	McGregor PACE  Medicare Only Eligibles (PACE)	08	20		1			H3613	002	0	2012	McGregor PACE Cuyahoga County		2		2			2							mcgregorpace.org	mcgregorpace.org									(216)-791-3580		(216)-791-3580		(216)-791-3580		(216)-791-3580										(800)-325-2223		(800)-325-2223		(800)-325-2223		(800)-325-2223				
H3614	001	0	1	20	08	H3614_001_0	1	1		05/20/2011	2012.02	05/20/2011 03:54:29 PM Eastern Daylight Time		05/20/2011 03:26:41 PM Eastern Daylight Time		05/20/2011 03:57:51 PM Eastern Daylight Time	TRIHEALTH SENIORLINK	TriHealth SeniorLink	www.trihealthseniorshealth.com/seniorlink/	TriHealth SeniorLink (PACE)	08	20		1			H3614	001	0	2012	Cincinnati Metropolitan Area		2		2			2							www.trihealthseniorshealth.com	www.trihealthseniorshealth.com									(000)-000-0000		(513)-531-5110		(000)-000-0000		(513)-531-5110										(000)-000-0000		(513)-862-1902		(000)-000-0000		(513)-862-1902				
H3614	002	0	1	20	08	H3614_002_0	1	1		05/20/2011	2012.02	05/20/2011 03:54:54 PM Eastern Daylight Time		05/20/2011 03:26:41 PM Eastern Daylight Time		05/20/2011 03:57:51 PM Eastern Daylight Time	TRIHEALTH SENIORLINK	TriHealth SeniorLink	www.trihealthseniorshealth.com/seniorlink/	TriHealth SeniorLink (PACE)	08	20		1			H3614	002	0	2012	Cincinnati Metropolitan Area		2		2			2							www.trihealthseniorshealth.com	www.trihealthseniorshealth.com									(000)-000-0000		(513)-531-5110		(000)-000-0000		(513)-531-5110										(000)-000-0000		(513)-862-1902		(000)-000-0000		(513)-862-1902				
H3619	001	0	1	04	01	H3619_001_0	7	1		07/11/2011	2012.02	07/11/2011 02:57:41 PM Eastern Daylight Time	08/05/2011 10:38:57 PM Eastern Daylight Time	08/04/2011 12:14:40 PM Eastern Daylight Time		08/08/2011 03:50:34 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H3619-001 (PPO)	01	04		1			H3619	001	0	2012	Cincinnati and Dayton Areas		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3619	004	0	1	04	01	H3619_004_0	6	1		07/11/2011	2012.02	07/11/2011 02:58:34 PM Eastern Daylight Time	05/27/2011 02:20:27 PM Eastern Daylight Time	08/04/2011 12:15:00 PM Eastern Daylight Time		08/08/2011 03:50:34 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H3619-004 (PPO)	01	04		1			H3619	004	0	2012	Cleveland Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3619	012	0	1	04	01	H3619_012_0	8	1		07/11/2011	2012.02	07/11/2011 02:58:53 PM Eastern Daylight Time	08/05/2011 10:41:19 PM Eastern Daylight Time	08/04/2011 12:15:18 PM Eastern Daylight Time		08/08/2011 03:50:34 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H3619-012 (PPO)	01	04		1			H3619	012	0	2012	Columbus Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3619	013	0	1	04	01	H3619_013_0	5	1		07/11/2011	2012.02	07/11/2011 02:59:09 PM Eastern Daylight Time	08/05/2011 10:45:20 PM Eastern Daylight Time	08/04/2011 12:15:37 PM Eastern Daylight Time		08/08/2011 03:50:34 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H3619-013 (PPO)	01	04		1			H3619	013	0	2012	Northwest Ohio Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3619	014	0	1	04	01	H3619_014_0	6	1		07/11/2011	2012.02	07/11/2011 02:59:25 PM Eastern Daylight Time	08/05/2011 10:43:52 PM Eastern Daylight Time	08/04/2011 12:15:55 PM Eastern Daylight Time		08/08/2011 03:50:34 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H3619-014 (PPO)	01	04		1			H3619	014	0	2012	Canton Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3619	015	0	1	04	01	H3619_015_0	5	1		07/11/2011	2012.02	07/11/2011 03:49:37 PM Eastern Daylight Time	08/05/2011 10:44:09 PM Eastern Daylight Time	08/04/2011 12:16:15 PM Eastern Daylight Time		08/08/2011 04:00:01 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H3619-015 (PPO)	01	04		1			H3619	015	0	2012	Hancock and Seneca Counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3619	016	0	1	04	01	H3619_016_0	5	1		07/18/2011	2012.02	07/18/2011 09:20:14 AM Eastern Daylight Time	08/05/2011 10:44:29 PM Eastern Daylight Time	08/04/2011 12:16:45 PM Eastern Daylight Time		08/08/2011 04:00:01 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H3619-016 (PPO)	01	04		1			H3619	016	0	2012	Marion County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3619	017	0	1	04	01	H3619_017_0	4	1		07/11/2011	2012.02	07/11/2011 03:49:59 PM Eastern Daylight Time	05/27/2011 02:09:01 PM Eastern Daylight Time	08/04/2011 12:17:05 PM Eastern Daylight Time		08/08/2011 04:00:01 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H3619-017 (PPO)	01	04		1			H3619	017	0	2012	Upper Ohio Valley Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3620	001	0	1	04	01	H3620_001_0	9	1		08/09/2011	2012.02	08/09/2011 09:20:04 AM Eastern Daylight Time	08/09/2011 09:29:05 AM Eastern Daylight Time	08/05/2011 06:32:32 PM Eastern Daylight Time		08/09/2011 09:36:51 AM Eastern Daylight Time	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	www.primetimehealthplan.com	PrimeTime Health Plan Prime PPO (PPO)	01	04		1			H3620	001	0	2012	Operating in 10 counties in Northeastern Ohio		2		2			2						www.primetimehealthplan.com	www.primetimehealthplan.com	www.primetimehealthplan.com	(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407		(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460		2	2	2
H3620	801	0	1	04	01	H3620_801_0	6	1		06/13/2011	2012.02	06/13/2011 03:30:44 PM Eastern Daylight Time	08/19/2011 11:25:45 AM Eastern Daylight Time			08/19/2011 11:28:52 AM Eastern Daylight Time	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	www.primetimehealthplan.com	Employer Group PPO / CY (PPO)	01	04		1			H3620	801	0	2012	All Counties (Cont. US)		1		2			2						www.primetimehealthplan.com	www.primetimehealthplan.com	www.primetimehealthplan.com	(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407		(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460		1	1	1
H3620	802	0	1	04	01	H3620_802_0	7	1		06/13/2011	2012.02	06/13/2011 03:35:07 PM Eastern Daylight Time	08/19/2011 11:25:42 AM Eastern Daylight Time			08/19/2011 11:28:52 AM Eastern Daylight Time	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	www.primetimehealthplan.com	Employer Group PPO / MA Only CY (PPO)	01	04		1			H3620	802	0	2012	All Ohio Counties		1		2			2						www.primetimehealthplan.com	www.primetimehealthplan.com	www.primetimehealthplan.com	(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407										(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460										1	1	1
H3620	803	0	1	04	01	H3620_803_0	6	1		06/13/2011	2012.02	06/13/2011 03:35:35 PM Eastern Daylight Time	08/19/2011 11:25:36 AM Eastern Daylight Time			08/19/2011 11:28:52 AM Eastern Daylight Time	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	www.primetimehealthplan.com	Employer Group PPO / Non CY (PPO)	01	04		1			H3620	803	0	2012	All Ohio Counties		1		2			2						www.primetimehealthplan.com	www.primetimehealthplan.com	www.primetimehealthplan.com	(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407		(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460		1	1	1
H3620	805	0	2	04	01	H3620_805_0	6	1		06/13/2011	2012.02	06/13/2011 03:48:35 PM Eastern Daylight Time	08/19/2011 11:25:25 AM Eastern Daylight Time			08/19/2011 11:28:52 AM Eastern Daylight Time	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	primetimehealthplan.com	Part B Only MA-PD (PPO)	01	04		2	2		H3620	805	0	2012	EGHP Part B Only MA-PD Ohio		1		2			2						www.primetimehealthplan.com	www.primetimehealthplan.com	www.primetimehealthplan.com	(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407		(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460		1	1	1
H3620	806	0	2	04	01	H3620_806_0	6	1		06/13/2011	2012.02	06/13/2011 03:49:08 PM Eastern Daylight Time	08/19/2011 11:25:37 AM Eastern Daylight Time			08/19/2011 11:28:52 AM Eastern Daylight Time	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	primetimehealthplan.com	Part B Only MA (PPO)	01	04		2	2		H3620	806	0	2012	Part B Only MA Ohio		1		2			2						www.primetimehealthplan.com	www.primetimehealthplan.com	www.primetimehealthplan.com	(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407										(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460										1	1	1
H3623	001	0	1	01	01	H3623_001_0	5	1		07/12/2011	2012.02	07/12/2011 02:58:10 PM Central Daylight Time	08/04/2011 12:35:30 PM Central Daylight Time	08/04/2011 09:49:34 AM Central Daylight Time		08/08/2011 08:23:16 AM Central Daylight Time	AETNA HEALTH,  INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (HMO)	01	01		1			H3623	001	0	2012	Delaware, Franklin, Hamilton and Lucas Counties		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H3623	003	0	1	01	01	H3623_003_0	4	1		07/08/2011	2012.02	07/08/2011 11:22:27 AM Central Daylight Time	08/04/2011 12:43:07 PM Central Daylight Time	08/04/2011 09:50:09 AM Central Daylight Time		08/08/2011 08:23:16 AM Central Daylight Time	AETNA HEALTH,  INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (HMO)	01	01		1			H3623	003	0	2012	Delaware, Franklin, Hamilton and Lucas Counties		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H3623	004	0	1	01	01	H3623_004_0	5	1		07/12/2011	2012.02	07/12/2011 02:59:24 PM Central Daylight Time	08/04/2011 12:59:11 PM Central Daylight Time	08/04/2011 09:50:35 AM Central Daylight Time		08/08/2011 08:23:16 AM Central Daylight Time	AETNA HEALTH,  INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (HMO)	01	01		1			H3623	004	0	2012	Cuyahoga and Summit Counties		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H3623	801	0	1	01	01	H3623_801_0	2	1		04/22/2011	2012.02	04/22/2011 09:54:57 AM Eastern Daylight Time	07/19/2011 10:35:58 AM Central Daylight Time			07/19/2011 04:49:36 PM Central Daylight Time	AETNA HEALTH,  INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan (HMO)	01	01		1			H3623	801	0	2012	Ohio		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748										1	1	1
H3623	802	0	1	01	01	H3623_802_0	2	1		04/22/2011	2012.02	04/22/2011 09:55:13 AM Eastern Daylight Time	07/19/2011 10:35:58 AM Central Daylight Time			07/19/2011 04:49:36 PM Central Daylight Time	AETNA HEALTH,  INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan w/Rx CY (HMO)	01	01		1			H3623	802	0	2012	Ohio		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		1	1	1
H3653	004	0	1	01	01	H3653_004_0	6	1		07/20/2011	2012.02	07/20/2011 07:12:15 AM Eastern Daylight Time	08/04/2011 11:58:25 AM Eastern Daylight Time	08/09/2011 09:07:35 AM Eastern Daylight Time		08/09/2011 09:20:32 AM Eastern Daylight Time	PARAMOUNT CARE, INC	Paramount Elite	www.paramounthealthcare.com/medicareplans	Paramount Elite - Enhanced Medical and Drug (HMO)	01	01		1			H3653	004	0	2012	Paramount Elite - Enhanced (NW Ohio / SE Mich)		2	11971	2			2						http://www.paramounthealthcare.com/medicareplans	http://www.paramounthealthcare.com/medicareplans	http://www.paramounthealthcare.com/medicareplans	(800)-462-3589		(419)-887-2525		(800)-462-3589		(419)-887-2525		(800)-462-3589		(800)-462-3589		(800)-462-3589		(419)-887-2525		(888)-740-5670		(888)-740-5670		(888)-740-5670		(888)-740-5670		(888)-740-5670		(888)-740-5670		(888)-740-5670		(888)-740-5670		2	2	2
H3653	015	0	1	01	01	H3653_015_0	7	1		07/08/2011	2012.02	07/08/2011 08:51:00 AM Eastern Daylight Time	08/04/2011 12:06:35 PM Eastern Daylight Time	08/09/2011 09:07:34 AM Eastern Daylight Time		08/09/2011 09:20:32 AM Eastern Daylight Time	PARAMOUNT CARE, INC	Paramount Elite	www.paramounthealthcare.com/medicareplans	Paramount Elite - Standard Medical and Drug (HMO)	01	01		1			H3653	015	0	2012	Paramount Elite - Standard (NW Ohio / SE Mich)		2	629	2			2						http://www.paramounthealthcare.com/medicareplans	http://www.paramounthealthcare.com/medicareplans	http://www.paramounthealthcare.com/medicareplans	(800)-462-3589		(419)-887-2525		(800)-462-3589		(419)-887-2525		(800)-462-3589		(800)-462-3589		(800)-462-3589		(419)-887-2525		(888)-740-5670		(888)-740-5670		(888)-740-5670		(888)-740-5670		(888)-740-5670		(888)-740-5670		(888)-740-5670		(888)-740-5670		2	2	2
H3653	018	0	1	01	01	H3653_018_0	4	1		07/08/2011	2012.02	07/08/2011 08:51:54 AM Eastern Daylight Time	07/21/2011 06:19:53 PM Eastern Daylight Time			07/25/2011 09:06:08 AM Eastern Daylight Time	PARAMOUNT CARE, INC	Paramount Elite	www.paramounthealthcare.com/medicareplans	Paramount Elite - Enhanced Medical Only (HMO)	01	01		1			H3653	018	0	2012	Paramount Elite - Medical Only (NW Ohio / SE Mich)		2	146	2			2						http://www.paramounthealthcare.com/medicareplans	http://www.paramounthealthcare.com/medicareplans	http://www.paramounthealthcare.com/medicareplans	(800)-462-3589		(419)-887-2525		(800)-462-3589		(419)-887-2525										(888)-740-5670		(888)-740-5670		(888)-740-5670		(888)-740-5670										2	2	2
H3653	803	0	1	01	01	H3653_803_0	1	1		05/31/2011	2012.02	05/31/2011 08:18:27 AM Eastern Daylight Time	06/02/2011 11:45:45 AM Eastern Daylight Time			06/03/2011 02:06:04 PM Eastern Daylight Time	PARAMOUNT CARE, INC	Paramount Elite	www.paramounthealthcare.com/medicareplans	Paramount Elite - Emp Group A/B No Rx (HMO)	01	01		1			H3653	803	0	2012	Paramount Elite - Emp Group A/B No Rx		1	1368	2			2						http://www.paramounthealthcare.com/medicareplans	http://www.paramounthealthcare.com/medicareplans	http://www.paramounthealthcare.com/medicareplans	(800)-462-3589		(419)-887-2525		(800)-462-3589		(419)-887-2525										(888)-740-5670		(888)-740-5670		(888)-740-5670		(888)-740-5670										1	1	1
H3653	806	0	2	01	01	H3653_806_0	1	1		06/03/2011	2012.02	06/03/2011 01:43:44 PM Eastern Daylight Time	06/02/2011 05:10:44 PM Eastern Daylight Time			06/03/2011 02:06:04 PM Eastern Daylight Time	PARAMOUNT CARE, INC	Paramount Elite	www.paramounthealthcare.com/medicareplans	Paramount Elite - Emp Group B only No Rx (HMO)	01	01		2	2		H3653	806	0	2012	Paramount Elite - Emp Group B only No Rx		1	59	2			2						http://www.paramounthealthcare.com/medicareplans	http://www.paramounthealthcare.com/medicareplans	http://www.paramounthealthcare.com/medicareplans	(800)-462-3589		(419)-887-2525		(800)-462-3589		(419)-887-2525										(888)-740-5670		(888)-740-5670		(888)-740-5670		(888)-740-5670										2	1	1
H3653	809	0	1	01	01	H3653_809_0	1	1		05/31/2011	2012.02	05/31/2011 08:22:22 AM Eastern Daylight Time	06/02/2011 11:44:22 AM Eastern Daylight Time			06/03/2011 02:06:04 PM Eastern Daylight Time	PARAMOUNT CARE, INC	Paramount Elite	www.paramounthealthcare.com/medicareplans	Paramount Elite-Emp Group A/B Rx (HMO)	01	01		1			H3653	809	0	2012	Paramount Elite-Emp Group A/B Rx		1	95	2			2						http://www.paramounthealthcare.com/medicareplans	http://www.paramounthealthcare.com/medicareplans	http://www.paramounthealthcare.com/medicareplans	(800)-462-3589		(419)-887-2525		(800)-462-3589		(419)-887-2525		(800)-462-3589		(800)-462-3589		(800)-462-3589		(419)-887-2525		(888)-740-5670		(888)-740-5670		(888)-740-5670		(888)-740-5670		(888)-740-5670		(888)-740-5670		(888)-740-5670		(888)-740-5670		1	1	1
H3655	013	0	1	01	01	H3655_013_0	9	1		08/04/2011	2012.02	08/04/2011 01:52:55 PM Eastern Daylight Time	08/08/2011 07:07:55 PM Eastern Daylight Time	08/08/2011 07:10:11 PM Eastern Daylight Time		08/08/2011 07:18:07 PM Eastern Daylight Time	COMMUNITY INSURANCE COMPANY	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Senior Advantage Basic (HMO)	01	01		1			H3655	013	0	2012	Select Counties in Ohio		2	64963	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(800)-467-1199		(800)-467-1199		(800)-797-5957		(800)-797-5957		(800)-467-1199		(800)-467-1199		(800)-797-5957		(800)-797-5957		(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894		(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894		2	2	2
H3655	030	0	1	01	01	H3655_030_0	9	1		08/04/2011	2012.02	08/04/2011 01:53:49 PM Eastern Daylight Time	08/08/2011 07:08:02 PM Eastern Daylight Time	08/08/2011 07:10:29 PM Eastern Daylight Time		08/08/2011 07:18:07 PM Eastern Daylight Time	COMMUNITY INSURANCE COMPANY	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Senior Advantage Plus (HMO)	01	01		1			H3655	030	0	2012	Select Counties in Ohio		2	13585	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(800)-467-1199		(800)-467-1199		(800)-797-5957		(800)-797-5957		(800)-467-1199		(800)-467-1199		(800)-797-5957		(800)-797-5957		(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894		(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894		2	2	2
H3655	031	0	1	01	01	H3655_031_0	9	1		08/04/2011	2012.02	08/04/2011 01:54:23 PM Eastern Daylight Time	08/08/2011 07:08:12 PM Eastern Daylight Time	08/08/2011 07:10:22 PM Eastern Daylight Time		08/08/2011 07:18:07 PM Eastern Daylight Time	COMMUNITY INSURANCE COMPANY	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Senior Advantage Value (HMO)	01	01		1			H3655	031	0	2012	Select Counties in Ohio		2	6447	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(800)-467-1199		(800)-467-1199		(800)-797-5957		(800)-797-5957		(800)-467-1199		(800)-467-1199		(800)-797-5957		(800)-797-5957		(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894		(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894		2	2	2
H3655	801	0	1	01	01	H3655_801_0	9	1		07/01/2011	2012.02	07/01/2011 10:31:10 AM Pacific Daylight Time	07/22/2011 08:38:57 AM Pacific Daylight Time			07/22/2011 01:55:09 PM Pacific Daylight Time	COMMUNITY INSURANCE COMPANY	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Senior Advantage (HMO)	01	01		1			H3655	801	0	2012	Ohio		1	3862	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-845-8609		(866)-845-8609		(866)-845-8609		(866)-845-8609		(866)-845-8609		(866)-845-8609		(866)-845-8609		(866)-845-8609		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		2	2	2
H3655	803	0	1	01	01	H3655_803_0	6	1		07/01/2011	2012.02	07/01/2011 10:31:34 AM Pacific Daylight Time	07/22/2011 08:38:58 AM Pacific Daylight Time			07/22/2011 01:55:09 PM Pacific Daylight Time	COMMUNITY INSURANCE COMPANY	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Senior Advantage (HMO)	01	01		1			H3655	803	0	2012	Ohio		1	27	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-845-8609		(866)-845-8609		(866)-845-8609		(866)-845-8609										(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754										2	2	2
H3655	804	0	1	01	01	H3655_804_0	5	1		07/01/2011	2012.02	07/01/2011 10:31:59 AM Pacific Daylight Time	07/22/2011 08:38:59 AM Pacific Daylight Time			07/22/2011 01:55:09 PM Pacific Daylight Time	COMMUNITY INSURANCE COMPANY	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Senior Advantage (HMO)	01	01		1			H3655	804	0	2012	Ohio		1	50	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-845-8609		(866)-845-8609		(866)-845-8609		(866)-845-8609		(866)-845-8609		(866)-845-8609		(866)-845-8609		(866)-845-8609		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		2	2	2
H3659	001	0	1	02	01	H3659_001_0	5	1		08/04/2011	2012.02	08/04/2011 03:39:33 PM Central Daylight Time	08/05/2011 09:08:10 AM Central Daylight Time	08/05/2011 01:30:06 PM Central Daylight Time		08/09/2011 12:16:18 PM Central Daylight Time	UNITEDHEALTHCARE OF OHIO, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H3659	001	0	2012	Cincinnati, Columbus and Dayton area Counties		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3659	003	0	1	01	01	H3659_003_0	4	1		08/04/2011	2012.02	08/04/2011 03:43:20 PM Central Daylight Time	08/08/2011 01:15:04 PM Central Daylight Time	08/05/2011 01:30:22 PM Central Daylight Time		08/09/2011 12:16:18 PM Central Daylight Time	UNITEDHEALTHCARE OF OHIO, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H3659	003	0	2012	Cuyahoga, Mahoning, Stark, Summit and Trumbull		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3659	031	0	1	01	01	H3659_031_0	4	1		08/04/2011	2012.02	08/04/2011 04:07:01 PM Central Daylight Time	08/05/2011 09:09:22 AM Central Daylight Time	08/05/2011 01:30:38 PM Central Daylight Time		08/09/2011 12:16:18 PM Central Daylight Time	UNITEDHEALTHCARE OF OHIO, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H3659	031	0	2012	Select Counties in Ohio and Kentucky		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3659	054	0	1	01	01	H3659_054_0	3	1		07/20/2011	2012.02	07/20/2011 12:22:26 PM Central Daylight Time	07/22/2011 01:45:28 PM Central Daylight Time			07/25/2011 01:37:25 PM Central Daylight Time	UNITEDHEALTHCARE OF OHIO, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Essential (HMO)	01	01		1			H3659	054	0	2012	Select Ohio Counties		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514										(711)		(711)		(711)		(711)										2	2	2
H3659	056	0	1	01	01	H3659_056_0	5	1	2	07/22/2011	2012.02	07/22/2011 12:08:33 PM Central Daylight Time	08/05/2011 09:09:58 AM Central Daylight Time	08/05/2011 01:07:59 PM Central Daylight Time		08/09/2011 12:48:01 PM Central Daylight Time	UNITEDHEALTHCARE OF OHIO, INC.	SecureHorizons by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H3659	056	0	2012	Select Counties in Ohio		2		2			1	3		1	2		www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3659	058	0	1	02	01	H3659_058_0	3	1		07/22/2011	2012.02	07/22/2011 12:20:01 PM Central Daylight Time	08/05/2011 09:10:36 AM Central Daylight Time	08/05/2011 01:30:55 PM Central Daylight Time		08/09/2011 04:38:46 PM Central Daylight Time	UNITEDHEALTHCARE OF OHIO, INC.	SecureHorizons by UnitedHealthcare	www.EvercareHealthPlans.com	UnitedHealthcare Nursing Home Plan (HMO-POS SNP)	01	02		1			H3659	058	0	2012	Clark, Warren, Greene Counties		2		2			1	1	1	1			www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3659	801	0	1	01	01	H3659_801_0	2	1		07/06/2011	2012.02	07/06/2011 04:46:36 PM Central Daylight Time	06/03/2011 02:38:54 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF OHIO, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H3659	801	0	2012	OH Employer Sponsored Plan Service Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3659	802	0	1	01	01	H3659_802_0	2	1		07/06/2011	2012.02	07/06/2011 04:46:41 PM Central Daylight Time	06/03/2011 02:40:02 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF OHIO, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H3659	802	0	2012	OH Employer Sponsored Plan Service Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548										(711)		(711)		(711)		(711)										2	2	2
H3659	803	0	1	01	01	H3659_803_0	2	1		07/06/2011	2012.02	07/06/2011 04:46:45 PM Central Daylight Time	06/03/2011 02:41:11 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF OHIO, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H3659	803	0	2012	OH Employer Sponsored Plan Service Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3659	807	0	1	02	01	H3659_807_0	2	1		07/06/2011	2012.02	07/06/2011 04:46:55 PM Central Daylight Time	06/03/2011 02:42:33 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF OHIO, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO-POS)	01	02		1			H3659	807	0	2012	Select counties in KY/OH		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3660	028	0	1	02	01	H3660_028_0	5	1		05/25/2011	2012.02	05/25/2011 01:46:41 PM Eastern Daylight Time	08/08/2011 02:35:32 PM Eastern Daylight Time	08/08/2011 02:35:26 PM Eastern Daylight Time		08/08/2011 02:57:35 PM Eastern Daylight Time	SUMMACARE INC.	SummaCare Secure	www.medicare.summacare.com	SummaCare Secure Gold (HMO-POS)	01	02		1			H3660	028	0	2012	Northeastern Ohio		2		2			2						www.medicare.summacare.com	www.medicare.summacare.com	www.medicare.summacare.com	(800)-996-6250		(330)-996-8885		(888)-464-8440		(330)-996-8440		(800)-996-6250		(330)-996-8885		(888)-464-8440		(330)-996-8440		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		2	2	2
H3660	029	0	1	02	01	H3660_029_0	5	1		05/26/2011	2012.02	05/26/2011 01:05:55 PM Eastern Daylight Time	08/08/2011 02:35:30 PM Eastern Daylight Time	08/08/2011 02:35:26 PM Eastern Daylight Time		08/08/2011 02:57:35 PM Eastern Daylight Time	SUMMACARE INC.	SummaCare Secure	www.medicare.summacare.com	SummaCare Secure Silver (HMO-POS)	01	02		1			H3660	029	0	2012	Northeastern Ohio Area		2		2			2						www.medicare.summacare.com	www.medicare.summacare.com	www.medicare.summacare.com	(800)-996-6250		(330)-996-8885		(888)-464-8440		(330)-996-8440		(800)-996-6250		(330)-996-8885		(888)-464-8440		(330)-996-8440		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		2	2	2
H3660	032	0	1	02	01	H3660_032_0	5	1		05/31/2011	2012.02	05/31/2011 08:18:43 AM Eastern Daylight Time	08/08/2011 02:35:32 PM Eastern Daylight Time	08/08/2011 02:35:30 PM Eastern Daylight Time		08/08/2011 02:57:35 PM Eastern Daylight Time	SUMMACARE INC.	SummaCare Secure	www.medicare.summacare.com	SummaCare Secure Platinum (HMO-POS)	01	02		1			H3660	032	0	2012	Northeastern Ohio Area		2	379	2			2						www.medicare.summacare.com	www.medicare.summacare.com	www.medicare.summacare.com	(800)-996-6250		(330)-996-8885		(888)-464-8440		(330)-996-8440		(800)-996-6250		(330)-996-8885		(888)-464-8440		(330)-996-8440		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		2	2	2
H3660	043	0	1	02	01	H3660_043_0	2	1		05/26/2011	2012.02	05/26/2011 11:29:27 AM Eastern Daylight Time	06/05/2011 01:02:24 PM Eastern Daylight Time			06/05/2011 01:36:34 PM Eastern Daylight Time	SUMMACARE INC.	SummaCare Secure	www.medicare.summacare.com	SummaCare Secure Classic (HMO-POS)	01	02		1			H3660	043	0	2012	Northeastern Ohio		2		2			2						www.medicare.summacare.com	www.medicare.summacare.com	www.medicare.summacare.com	(800)-996-6250		(330)-996-8885		(888)-464-8440		(330)-996-8440										(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750										2	2	2
H3660	044	0	1	01	01	H3660_044_0	4	1		05/25/2011	2012.02	05/25/2011 02:08:09 PM Eastern Daylight Time	08/08/2011 02:35:34 PM Eastern Daylight Time	08/08/2011 02:35:32 PM Eastern Daylight Time		08/08/2011 02:57:35 PM Eastern Daylight Time	SUMMACARE INC.	SummaCare Secure	www.medicare.summacare.com	SummaCare Secure Core (HMO)	01	01		1			H3660	044	0	2012	Northeastern Ohio Area		2		2			2						www.medicare.summacare.com	www.medicare.summacare.com	www.medicare.summacare.com	(800)-996-6250		(330)-996-8885		(888)-464-8440		(330)-996-8440		(800)-996-6250		(330)-996-8885		(888)-464-8440		(330)-996-8440		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		2	2	2
H3660	801	0	1	01	01	H3660_801_0	1	1		05/10/2011	2012.02	05/10/2011 11:22:16 AM Eastern Daylight Time	06/05/2011 01:02:34 PM Eastern Daylight Time			06/05/2011 01:42:39 PM Eastern Daylight Time	SUMMACARE INC.	SummaCare Secure	www.medicare.summacare.com	SummaCare Secure Employer Plan HMO- PD (HMO)	01	01		1			H3660	801	0	2012	Northeastern Ohio Area		1		2			2						www.medicare.summacare.com	www.medicare.summacare.com	www.medicare.summacare.com	(800)-996-6250		(330)-996-8885		(888)-464-8440		(330)-996-8440		(800)-996-6250		(330)-996-8885		(888)-464-8440		(330)-996-8440		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		1	2	2
H3660	802	0	1	01	01	H3660_802_0	1	1		05/10/2011	2012.02	05/10/2011 11:23:40 AM Eastern Daylight Time	06/05/2011 01:02:36 PM Eastern Daylight Time			06/05/2011 01:42:39 PM Eastern Daylight Time	SUMMACARE INC.	SummaCare Secure	www.medicare.summacare.com	SummaCare Secure Employer Plan -HMO- No D (HMO)	01	01		1			H3660	802	0	2012	Northeastern Ohio Area		1		2			2						www.medicare.summacare.com	www.medicare.summacare.com	www.medicare.summacare.com	(800)-996-6250		(330)-996-8885		(888)-464-8440		(330)-996-8440										(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750										1	2	2
H3660	805	0	1	02	01	H3660_805_0	1	1		05/10/2011	2012.02	05/10/2011 11:23:25 AM Eastern Daylight Time	06/05/2011 01:02:38 PM Eastern Daylight Time			06/05/2011 01:42:39 PM Eastern Daylight Time	SUMMACARE INC.	SummaCare Secure	www.medicare.summacare.com	SummaCare Secure POS Employer Plan with D (HMO-POS)	01	02		1			H3660	805	0	2012	Northeastern Ohio Area		1		2			2						www.medicare.summacare.com	www.medicare.summacare.com	www.medicare.summacare.com	(800)-996-6250		(330)-996-8885		(888)-464-8440		(330)-996-8440		(800)-996-6250		(330)-996-8885		(888)-464-8440		(330)-996-8440		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		1	1	2
H3660	806	0	1	02	01	H3660_806_0	1	1		05/10/2011	2012.02	05/10/2011 11:24:25 AM Eastern Daylight Time	06/05/2011 01:02:38 PM Eastern Daylight Time			06/05/2011 01:42:39 PM Eastern Daylight Time	SUMMACARE INC.	SummaCare Secure	www.medicare.summacare.com	SummaCare Secure POS Employer Plan - No D (HMO-POS)	01	02		1			H3660	806	0	2012	Northeastern Ohio Area		1		2			2						www.medicare.summacare.com	www.medicare.summacare.com	www.medicare.summacare.com	(800)-996-6250		(330)-996-8885		(888)-464-8440		(330)-996-8440										(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750										1	1	2
H3664	012	0	1	02	01	H3664_012_0	10	1		08/05/2011	2012.02	08/05/2011 11:52:24 AM Eastern Daylight Time	08/05/2011 06:32:41 PM Eastern Daylight Time	08/05/2011 06:32:32 PM Eastern Daylight Time		08/05/2011 06:43:02 PM Eastern Daylight Time	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	www.primetimehealthplan.com	PrimeTime Health Plan Premier (HMO-POS)	01	02		1			H3664	012	0	2012	Operating in 10 counties in Northeastern Ohio		2		2			2						www.primetimehealthplan.com	www.primetimehealthplan.com	www.primetimehealthplan.com	(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407		(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460		2	2	2
H3664	014	0	1	02	01	H3664_014_0	8	1		07/19/2011	2012.02	07/19/2011 11:04:15 AM Eastern Daylight Time	07/15/2011 02:23:00 PM Eastern Daylight Time			07/19/2011 11:10:22 AM Eastern Daylight Time	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	www.primetimehealthplan.com	PrimeTime Health Plan Basic - MA Only (HMO-POS)	01	02		1			H3664	014	0	2012	Operating in 10 counties in Northeastern Ohio		2		2			2						www.primetimehealthplan.com	www.primetimehealthplan.com	www.primetimehealthplan.com	(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407										(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460										2	2	2
H3664	017	0	1	02	01	H3664_017_0	10	1		08/05/2011	2012.02	08/05/2011 11:50:24 AM Eastern Daylight Time	08/05/2011 06:32:40 PM Eastern Daylight Time	08/05/2011 06:32:43 PM Eastern Daylight Time		08/05/2011 06:43:02 PM Eastern Daylight Time	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	www.primetimehealthplan.com	PrimeTime Health Plan Plus (HMO-POS)	01	02		1			H3664	017	0	2012	Operating in 10 counties in Northeastern Ohio		2		2			2						www.primetimehealthplan.com	www.primetimehealthplan.com	www.primetimehealthplan.com	(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407		(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460		2	2	2
H3664	018	0	1	02	01	H3664_018_0	10	1		08/05/2011	2012.02	08/05/2011 11:51:30 AM Eastern Daylight Time	08/05/2011 06:32:50 PM Eastern Daylight Time	08/05/2011 06:32:52 PM Eastern Daylight Time		08/05/2011 06:43:02 PM Eastern Daylight Time	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	www.primetimehealthplan.com	PrimeTime Health Plan Basic-Select (HMO-POS)	01	02		1			H3664	018	0	2012	Operating in 10 Counties in Northeastern Ohio		2		2			2						www.primetimehealthplan.com	www.primetimehealthplan.com	www.primetimehealthplan.com	(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407		(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460		2	2	2
H3664	801	0	1	02	01	H3664_801_0	4	1		05/06/2011	2012.02	05/06/2011 04:42:26 PM Eastern Daylight Time	07/15/2011 02:23:10 PM Eastern Daylight Time			07/15/2011 04:33:19 PM Eastern Daylight Time	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	www.primetimehealthplan.com	PrimeTime Health Plan Employer Group HMO  - CY (HMO-POS)	01	02		1			H3664	801	0	2012	All Ohio Counties		1		2			2						www.primetimehealthplan.com	www.primetimehealthplan.com	www.primetimehealthplan.com	(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407		(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460		1	1	1
H3664	802	0	1	02	01	H3664_802_0	4	1		05/06/2011	2012.02	05/06/2011 04:42:40 PM Eastern Daylight Time	07/15/2011 02:23:12 PM Eastern Daylight Time			07/15/2011 04:33:19 PM Eastern Daylight Time	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	www.primetimehealthplan.com	PrimeTime Health Plan Employer Group HMO MA-Only (HMO-POS)	01	02		1			H3664	802	0	2012	All Ohio Counties		1		2			2						www.primetimehealthplan.com	www.primetimehealthplan.com	www.primetimehealthplan.com	(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407										(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460										1	1	1
H3664	803	0	1	02	01	H3664_803_0	4	1		05/06/2011	2012.02	05/06/2011 04:42:54 PM Eastern Daylight Time	07/15/2011 02:23:12 PM Eastern Daylight Time			07/15/2011 04:33:19 PM Eastern Daylight Time	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	www.primetimehealthplan.com	PrimeTime Health Plan Employer Group - Non CY (HMO-POS)	01	02		1			H3664	803	0	2012	All Ohio Counties		1		2			2						www.primetimehealthplan.com	www.primetimehealthplan.com	www.primetimehealthplan.com	(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407		(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460		1	1	1
H3664	805	0	2	02	01	H3664_805_0	4	1		05/06/2011	2012.02	05/06/2011 04:43:07 PM Eastern Daylight Time	07/27/2011 08:20:09 AM Eastern Daylight Time			07/27/2011 10:02:29 AM Eastern Daylight Time	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	primetimehealthplan.com	Part B Only MA-PD (HMO-POS)	01	02		2	2		H3664	805	0	2012	Part B Only MA Ohio		1		2			2						www.primetimehealthplan.com	www.primetimehealthplan.com	www.primetimehealthplan.com	(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407		(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460		1	1	1
H3664	806	0	2	02	01	H3664_806_0	4	1		05/06/2011	2012.02	05/06/2011 04:43:25 PM Eastern Daylight Time	07/27/2011 08:20:09 AM Eastern Daylight Time			07/27/2011 10:02:29 AM Eastern Daylight Time	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	primetimehealthplan.com	Part B Only MA (HMO-POS)	01	02		2	2		H3664	806	0	2012	Part B Only MA Ohio		1		2			2						www.primetimehealthplan.com	www.primetimehealthplan.com	www.primetimehealthplan.com	(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407										(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460										1	1	1
H3668	005	0	1	01	01	H3668_005_0	5	1		07/26/2011	2012.02	07/26/2011 04:55:21 PM Eastern Daylight Time	08/08/2011 02:23:06 PM Eastern Daylight Time	08/08/2011 02:28:04 PM Eastern Daylight Time		08/09/2011 08:51:18 AM Eastern Daylight Time	MT. CARMEL HEALTH PLAN, INC.	MediGold	medigold.com	MediGold Classic Preferred (HMO)	01	01		1			H3668	005	0	2012	Greater Central Ohio and Dayton Area		2	26136	2			2						www.medigold.com	www.medigold.com	www.caremark.com	(800)-240-3851		(614)-546-3110		(800)-964-4525		(800)-964-4525		(800)-240-3851		(614)-546-3110		(800)-964-4525		(800)-964-4525		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	2
H3668	011	0	1	01	01	H3668_011_0	5	1		06/06/2011	2012.02	06/06/2011 11:54:12 AM Eastern Daylight Time	08/08/2011 02:24:32 PM Eastern Daylight Time	08/08/2011 02:28:48 PM Eastern Daylight Time		08/09/2011 08:51:18 AM Eastern Daylight Time	MT. CARMEL HEALTH PLAN, INC.	MediGold	medigold.com	MediGold Essential Care (HMO)	01	01		1			H3668	011	0	2012	Greater Central Ohio and Dayton Area		2	1597	2			2						www.medigold.com	www.medigold.com	www.caremark.com	(800)-240-3851		(614)-546-3110		(800)-964-4525		(800)-964-4525		(800)-240-3851		(614)-546-3110		(800)-964-4525		(800)-964-4525		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	2
H3668	013	0	1	01	01	H3668_013_0	2	1		05/25/2011	2012.02	05/25/2011 12:15:44 PM Eastern Daylight Time	05/26/2011 04:24:42 PM Eastern Daylight Time			07/25/2011 01:09:47 PM Eastern Daylight Time	MT. CARMEL HEALTH PLAN, INC.	MediGold	medigold.com	MediGold Medical Only (HMO)	01	01		1			H3668	013	0	2012	Greater Central Ohio and Dayton Area		2	579	1	1		2						www.medigold.com	www.medigold.com	www.caremark.com	(800)-240-3851		(614)-546-3110		(800)-964-4525		(800)-964-4525										(711)		(711)		(711)		(711)										2	1	2
H3668	801	0	1	01	01	H3668_801_0	1	1		05/25/2011	2012.02	05/25/2011 12:15:50 PM Eastern Daylight Time	05/26/2011 06:01:24 PM Eastern Daylight Time			05/27/2011 02:22:52 PM Eastern Daylight Time	MT. CARMEL HEALTH PLAN, INC.	MediGold	medigold.com	EGWP MediGold Medical Only (HMO)	01	01		1			H3668	801	0	2012	Greater Central Ohio and Dayton Area		1	2	2			2						www.medigold.com	www.medigold.com	www.caremark.com	(800)-240-3851		(614)-546-3110		(800)-964-4525		(800)-964-4525										(711)		(711)		(711)		(711)										1	1	1
H3668	802	0	1	01	01	H3668_802_0	1	1		05/25/2011	2012.02	05/25/2011 12:16:01 PM Eastern Daylight Time	05/27/2011 11:36:20 AM Eastern Daylight Time			05/27/2011 02:22:52 PM Eastern Daylight Time	MT. CARMEL HEALTH PLAN, INC.	MediGold	medigold.com	EGWP MediGold Classic (HMO)	01	01		1			H3668	802	0	2012	Greater Central Ohio and Dayton Area		1	425	2			2						www.medigold.com	www.medigold.com	www.caremark.com	(800)-240-3851		(614)-546-3110		(800)-964-4525		(800)-964-4525		(800)-240-3851		(614)-546-3110		(800)-964-4525		(800)-964-4525		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H3668	803	0	1	01	01	H3668_803_0	1	1		05/25/2011	2012.02	05/25/2011 12:16:13 PM Eastern Daylight Time	05/26/2011 07:36:48 PM Eastern Daylight Time			05/27/2011 02:22:52 PM Eastern Daylight Time	MT. CARMEL HEALTH PLAN, INC.	MediGold	medigold.com	EGWP MediGold Custom (HMO)	01	01		1			H3668	803	0	2012	Greater Central Ohio and Dayton		1	180	2			2						www.medigold.com	www.medigold.com	www.caremark.com	(800)-240-3851		(614)-546-3110		(800)-964-4525		(800)-964-4525		(800)-240-3851		(614)-546-3110		(800)-964-4525		(800)-964-4525		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H3668	804	0	1	01	01	H3668_804_0	1	1		05/25/2011	2012.02	05/25/2011 12:16:21 PM Eastern Daylight Time	05/26/2011 07:37:34 PM Eastern Daylight Time			05/27/2011 02:22:52 PM Eastern Daylight Time	MT. CARMEL HEALTH PLAN, INC.	MediGold	medigold.com	EGWP MediGold Classic (HMO)	01	01		1			H3668	804	0	2012	Greater Central Ohio and Dayton		1	20	2			2						www.medigold.com	www.medigold.com	www.caremark.com	(800)-240-3851		(614)-546-3110		(800)-964-4525		(800)-964-4525		(800)-240-3851		(614)-546-3110		(800)-964-4525		(800)-964-4525		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H3672	013	0	1	01	01	H3672_013_0	7	1		07/22/2011	2012.02	07/22/2011 05:01:52 PM Eastern Daylight Time	08/04/2011 03:12:38 PM Eastern Daylight Time	08/04/2011 03:00:58 PM Eastern Daylight Time		08/05/2011 10:26:34 AM Eastern Daylight Time	HOMETOWN HEALTH PLAN	The Health Plan	www.healthplan.org	SecureCare - Option II (HMO)	01	01		1			H3672	013	0	2012	East Central Ohio		2	2360	2			2						www.healthplan.org	www.healthplan.org	www.healthplan.org	(877)-236-2296		(330)-837-6880		(877)-236-2290		(877)-236-2290		(877)-236-2296		(330)-837-6880		(877)-236-2290		(877)-236-2290		(877)-236-2291		(877)-236-2291		(877)-236-2291		(877)-236-2291		(877)-236-2291		(877)-236-2291		(877)-236-2291		(877)-236-2291		2	2	2
H3672	014	0	1	01	01	H3672_014_0	4	1		07/13/2011	2012.02	07/13/2011 04:19:29 PM Eastern Daylight Time	07/14/2011 02:28:21 PM Eastern Daylight Time			07/18/2011 02:11:30 PM Eastern Daylight Time	HOMETOWN HEALTH PLAN	The Health Plan	www.healthplan.org	SecureCare - Option I (HMO)	01	01		1			H3672	014	0	2012	East Central Ohio		2	260	2			2						www.healthplan.org	www.healthplan.org	www.healthplan.org	(877)-236-2296		(330)-837-6880		(877)-236-2290		(877)-236-2290										(877)-236-2291		(877)-236-2291		(877)-236-2291		(877)-236-2291										2	2	2
H3672	016	0	1	01	01	H3672_016_0	7	1		07/22/2011	2012.02	07/22/2011 05:02:05 PM Eastern Daylight Time	08/04/2011 03:15:22 PM Eastern Daylight Time	08/04/2011 03:03:26 PM Eastern Daylight Time		08/05/2011 10:26:34 AM Eastern Daylight Time	HOMETOWN HEALTH PLAN	The Health Plan	www.healthplan.org	SecureCare - Option III (HMO)	01	01		1			H3672	016	0	2012	East Central Ohio		2	2620	2			2						www.healthplan.org	www.healthplan.org	www.healthplan.org	(877)-236-2296		(330)-837-6880		(877)-236-2290		(877)-236-2290		(877)-236-2296		(330)-837-6880		(877)-236-2290		(877)-236-2290		(877)-236-2291		(877)-236-2291		(877)-236-2291		(877)-236-2291		(877)-236-2291		(877)-236-2291		(877)-236-2291		(877)-236-2291		2	2	2
H3672	804	0	1	01	01	H3672_804_0	5	1		07/13/2011	2012.02	07/13/2011 04:19:39 PM Eastern Daylight Time	08/18/2011 09:00:31 AM Eastern Daylight Time			08/18/2011 11:45:16 AM Eastern Daylight Time	HOMETOWN HEALTH PLAN	The Health Plan	www.healthplan.org	SecureCare - Employer (HMO)	01	01		1			H3672	804	0	2012	East Central Ohio		1	10	2			2						www.healthplan.org	www.healthplan.org	www.healthplan.org	(877)-236-2296		(330)-837-6880		(877)-236-2290		(877)-236-2290										(877)-236-2291		(877)-236-2291		(877)-236-2291		(877)-236-2291										2	2	2
H3672	805	0	1	01	01	H3672_805_0	5	1		07/13/2011	2012.02	07/13/2011 04:19:44 PM Eastern Daylight Time	08/18/2011 09:02:49 AM Eastern Daylight Time			08/18/2011 11:45:16 AM Eastern Daylight Time	HOMETOWN HEALTH PLAN	The Health Plan	www.healthplan.org	SecureCare - Employer (HMO)	01	01		1			H3672	805	0	2012	East Central Ohio		1	410	2			2						www.healthplan.org	www.healthplan.org	www.healthplan.org	(877)-236-2296		(330)-837-6880		(877)-236-2290		(877)-236-2290		(877)-236-2296		(330)-837-6880		(877)-236-2290		(877)-236-2290		(877)-236-2291		(877)-236-2291		(877)-236-2291		(877)-236-2291		(877)-236-2291		(877)-236-2291		(877)-236-2291		(877)-236-2291		2	2	2
H3706	001	0	1	01	01	H3706_001_0	3	1		08/05/2011	2012.02	08/05/2011 11:24:53 AM Central Daylight Time	08/08/2011 11:19:12 AM Central Daylight Time	08/04/2011 08:57:54 AM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	TODAYS OPTIONS OF OKLAHOMA, INC.	Universal American	www.GenerationsHealthcare.cc	Generations Healthcare Classic (HMO)	01	01		1			H3706	001	0	2012	Central Oklahoma		2	100	2			2						www.GenerationsHealthcare.cc	www.GenerationsHealthcare.cc	www.GenerationsHealthcare.cc	(866)-547-3060		(866)-547-3060		(866)-618-4074		(866)-618-4074		(866)-547-3060		(866)-547-3060		(866)-618-4074		(866)-618-4074		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		2	2	2
H3706	009	0	1	01	01	H3706_009_0	4	1		10/24/2011	2012.02	10/24/2011 03:36:30 PM Central Daylight Time	07/06/2011 12:40:28 PM Central Daylight Time			10/25/2011 03:47:01 PM Central Daylight Time	TODAYS OPTIONS OF OKLAHOMA, INC.	Universal American	www.GenerationsHealthcare.cc	Generations Healthcare Value (HMO)	01	01		1			H3706	009	0	2012	Central Oklahoma		2	100	2			2						www.GenerationsHealthcare.cc	www.GenerationsHealthcare.cc	www.GenerationsHealthcare.cc	(866)-547-3060		(866)-547-3060		(866)-618-4074		(866)-618-4074										(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089										2	2	2
H3706	017	0	1	01	01	H3706_017_0	3	1		07/08/2011	2012.02	07/08/2011 10:24:35 AM Central Daylight Time	08/08/2011 11:44:21 AM Central Daylight Time	08/04/2011 08:49:32 AM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	TODAYS OPTIONS OF OKLAHOMA, INC.	Universal American	www.GenerationsHealthcare.cc	Generations Healthcare Premier (HMO)	01	01		1			H3706	017	0	2012	Central Oklahoma		2	100	2			2						www.GenerationsHealthcare.cc	www.GenerationsHealthcare.cc	www.GenerationsHealthcare.cc	(866)-547-3060		(866)-547-3060		(866)-618-4074		(866)-618-4074		(866)-547-3060		(866)-547-3060		(866)-618-4074		(866)-618-4074		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		2	2	2
H3706	803	0	1	01	01	H3706_803_0	1	1		06/02/2011	2012.02	06/02/2011 03:42:48 PM Central Daylight Time	06/05/2011 08:44:52 PM Central Daylight Time			06/05/2011 08:52:55 PM Central Daylight Time	TODAYS OPTIONS OF OKLAHOMA, INC.	Universal American	www.GenerationsHealthcare.cc	Generations Healthcare EGHP CY (HMO)	01	01		1			H3706	803	0	2012	Central Oklahoma and Tulsa Metro Areas		1	100	2			2						www.GenerationsHealthcare.cc	www.GenerationsHealthcare.cc	www.GenerationsHealthcare.cc	(866)-547-3060		(866)-547-3060		(866)-618-4074		(866)-618-4074		(866)-547-3060		(866)-547-3060		(866)-618-4074		(866)-618-4074		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		1	1	1
H3706	804	0	1	01	01	H3706_804_0	1	1		06/02/2011	2012.02	06/02/2011 03:41:38 PM Central Daylight Time	06/05/2011 08:46:02 PM Central Daylight Time			06/05/2011 08:52:55 PM Central Daylight Time	TODAYS OPTIONS OF OKLAHOMA, INC.	Universal American	www.GenerationsHealthcare.cc	Generations Healthcare EGHP Non CY (HMO)	01	01		1			H3706	804	0	2012	Central Oklahoma and Tulsa Metro Areas		1	100	2			2						www.GenerationsHealthcare.cc	www.GenerationsHealthcare.cc	www.GenerationsHealthcare.cc	(866)-547-3060		(866)-547-3060		(866)-618-4074		(866)-618-4074		(866)-547-3060		(866)-547-3060		(866)-618-4074		(866)-618-4074		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		1	1	1
H3706	807	0	1	01	01	H3706_807_0	1	1		06/02/2011	2012.02	06/02/2011 03:42:04 PM Central Daylight Time	06/05/2011 08:19:07 PM Central Daylight Time			06/05/2011 08:52:55 PM Central Daylight Time	TODAYS OPTIONS OF OKLAHOMA, INC.	Universal American	www.GenerationsHealthcare.cc	Generations Healthcare EGHP MA only (HMO)	01	01		1			H3706	807	0	2012	Central Oklahoma and Tulsa Metro Areas		1	100	2			2						www.GenerationsHealthcare.cc	www.GenerationsHealthcare.cc	www.GenerationsHealthcare.cc	(866)-547-3060		(866)-547-3060		(866)-618-4074		(866)-618-4074										(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089										1	1	1
H3708	001	0	1	01	01	H3708_001_0	4	1		07/19/2011	2012.02	07/19/2011 04:31:43 PM Central Daylight Time	08/04/2011 04:54:00 PM Central Daylight Time	08/04/2011 08:51:42 AM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	SELECTCARE OF OKLAHOMA, INC.	Universal American	www.SCOklahoma.com	Tribute (HMO SNP)	01	01		1			H3708	001	0	2012	Greater Ardmore and Surrounding Area		2	100	2			1	1	2	1			www.SCOklahoma.com	www.SCOklahoma.com	www.SCOklahoma.com	(800)-817-3515		(800)-817-3515		(800)-817-3515		(800)-817-3515		(800)-817-3515		(800)-817-3515		(800)-817-3515		(800)-817-3515		(800)-958-2692		(800)-958-2692		(800)-958-2692		(800)-958-2692		(800)-958-2692		(800)-958-2692		(800)-958-2692		(800)-958-2692		2	1	1
H3749	001	0	1	01	01	H3749_001_0	7	1		08/08/2011	2012.02	08/08/2011 11:17:48 AM Central Daylight Time	08/05/2011 04:49:09 PM Central Daylight Time	08/05/2011 01:31:10 PM Central Daylight Time		08/09/2011 03:57:48 PM Central Daylight Time	UNITEDHEALTHCARE OF OKLAHOMA, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons (HMO)	01	01		1			H3749	001	0	2012	Oklahoma City area		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3749	004	0	1	01	01	H3749_004_0	7	1		08/09/2011	2012.02	08/09/2011 09:15:12 AM Central Daylight Time	08/05/2011 04:49:35 PM Central Daylight Time	08/05/2011 01:31:29 PM Central Daylight Time		08/09/2011 03:57:48 PM Central Daylight Time	UNITEDHEALTHCARE OF OKLAHOMA, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 1 (HMO)	01	01		1			H3749	004	0	2012	Tulsa area		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3749	017	0	1	01	01	H3749_017_0	7	1		08/05/2011	2012.02	08/05/2011 03:30:58 PM Central Daylight Time	08/05/2011 04:50:03 PM Central Daylight Time	08/05/2011 01:31:47 PM Central Daylight Time		08/09/2011 03:57:48 PM Central Daylight Time	UNITEDHEALTHCARE OF OKLAHOMA, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Plan 2 (HMO)	01	01		1			H3749	017	0	2012	Tulsa area		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3749	801	0	1	01	01	H3749_801_0	2	1		07/06/2011	2012.02	07/06/2011 04:47:05 PM Central Daylight Time	06/03/2011 02:02:21 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF OKLAHOMA, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H3749	801	0	2012	OK Employer Sponsored Plan Service Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548										(711)		(711)		(711)		(711)										2	2	2
H3749	803	0	1	01	01	H3749_803_0	2	1		07/06/2011	2012.02	07/06/2011 04:47:08 PM Central Daylight Time	06/03/2011 02:02:56 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF OKLAHOMA, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H3749	803	0	2012	OK Employer Sponsored Plan Service Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3749	804	0	1	01	01	H3749_804_0	2	1		07/06/2011	2012.02	07/06/2011 04:47:12 PM Central Daylight Time	06/03/2011 02:03:30 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF OKLAHOMA, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H3749	804	0	2012	OK Employer Sponsored Plan Service Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3755	001	0	1	01	01	H3755_001_0	9	1		08/10/2011	2012.02	08/10/2011 09:40:34 AM Central Daylight Time	08/08/2011 12:29:03 PM Central Daylight Time	08/08/2011 12:29:04 PM Central Daylight Time		08/10/2011 09:47:21 AM Central Daylight Time	COMMUNITY CARE HMO, INC	CommunityCare Senior Health Plan	www.ccok.com	Senior Health Plan Platinum (HMO)	01	01		1			H3755	001	0	2012	Tulsa Metro Area		2	15342	2			2						www.ccok.com	http://www.ccok.com/rxformulary?Switch=2	http://www.ccok.com/CommunityCare Medicare/Senior Health Plan.asp	(800)-642-8065		(800)-642-8065		(800)-642-8065		(800)-642-8065		(800)-642-8065		(800)-642-8065		(800)-642-8065		(800)-642-8065		(800)-722-0353		(800)-722-0353		(800)-722-0353		(800)-722-0353		(800)-722-0353		(800)-722-0353		(800)-722-0353		(800)-722-0353		2	2	2
H3755	002	0	1	01	01	H3755_002_0	6	1		07/11/2011	2012.02	07/11/2011 10:26:14 AM Central Daylight Time	06/30/2011 05:55:19 PM Central Daylight Time			07/11/2011 10:46:54 AM Central Daylight Time	COMMUNITY CARE HMO, INC	CommunityCare Senior Health Plan	www.ccok.com	Senior Health Plan Silver (HMO)	01	01		1			H3755	002	0	2012	Tulsa Metro Area		2	2935	2			2						www.ccok.com	http://www.ccok.com/rxformulary?Switch=2	http://www.ccok.com/CommunityCare Medicare/Senior Health Plan.asp	(800)-642-8065		(800)-642-8065		(800)-642-8065		(800)-642-8065										(800)-722-0353		(800)-722-0353		(800)-722-0353		(800)-722-0353										2	2	2
H3755	004	0	1	01	01	H3755_004_0	9	1		08/10/2011	2012.02	08/10/2011 09:39:53 AM Central Daylight Time	08/08/2011 12:29:03 PM Central Daylight Time	08/08/2011 12:29:04 PM Central Daylight Time		08/10/2011 09:47:21 AM Central Daylight Time	COMMUNITY CARE HMO, INC	CommunityCare Senior Health Plan	www.ccok.com	Senior Health Plan Platinum Plus (HMO)	01	01		1			H3755	004	0	2012	Tulsa Metro Area		2	7644	2			2						www.ccok.com	http://www.ccok.com/rxformulary?Switch=2	http://www.ccok.com/CommunityCare Medicare/Senior Health Plan.asp	(800)-642-8065		(800)-642-8065		(800)-642-8065		(800)-642-8065		(800)-642-8065		(800)-642-8065		(800)-642-8065		(800)-642-8065		(800)-722-0353		(800)-722-0353		(800)-722-0353		(800)-722-0353		(800)-722-0353		(800)-722-0353		(800)-722-0353		(800)-722-0353		2	2	2
H3755	801	0	1	01	01	H3755_801_0	4	1		07/11/2011	2012.02	07/11/2011 10:29:46 AM Central Daylight Time	06/05/2011 04:38:56 PM Central Daylight Time			07/11/2011 10:46:54 AM Central Daylight Time	COMMUNITY CARE HMO, INC	CommunityCare Senior Health Plan	www.ccok.com	Senior Health EGHP+D (HMO)	01	01		1			H3755	801	0	2012	Tulsa Metro Area		1	2380	2			2						www.ccok.com	http://www.ccok.com/rxformulary?Switch=2	http://www.ccok.com/CommunityCare Medicare/Senior Health Plan.asp	(800)-642-8065		(800)-642-8065		(800)-642-8065		(800)-642-8065		(800)-642-8065		(800)-642-8065		(800)-642-8065		(800)-642-8065		(800)-722-0353		(800)-722-0353		(800)-722-0353		(800)-722-0353		(800)-722-0353		(800)-722-0353		(800)-722-0353		(800)-722-0353		2	2	2
H3805	001	0	1	01	01	H3805_001_0	5	1		08/05/2011	2012.02	08/05/2011 08:12:36 AM Central Daylight Time	08/04/2011 07:36:14 PM Central Daylight Time	08/05/2011 01:32:03 PM Central Daylight Time		08/09/2011 01:10:07 PM Central Daylight Time	UNITEDHEALTHCARE OF OREGON, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H3805	001	0	2012	Clackamas, Marion, Multnomah, Polk, Washington		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3805	007	0	1	01	01	H3805_007_0	5	1		08/05/2011	2012.02	08/05/2011 08:13:17 AM Central Daylight Time	08/04/2011 07:37:05 PM Central Daylight Time	08/05/2011 01:32:17 PM Central Daylight Time		08/09/2011 01:10:07 PM Central Daylight Time	UNITEDHEALTHCARE OF OREGON, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete (HMO)	01	01		1			H3805	007	0	2012	Benton, Lane, and Linn counties		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3805	801	0	1	01	01	H3805_801_0	2	1		07/06/2011	2012.02	07/06/2011 04:47:20 PM Central Daylight Time	06/03/2011 02:20:24 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF OREGON, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H3805	801	0	2012	OR Employer Sponsored Plan Service Area		1		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548										(711)		(711)		(711)		(711)										2	2	2
H3805	803	0	1	01	01	H3805_803_0	2	1		07/06/2011	2012.02	07/06/2011 04:47:24 PM Central Daylight Time	06/03/2011 02:20:58 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF OREGON, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H3805	803	0	2012	OR Employer Sponsored Plan Service Area		1		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3805	804	0	1	01	01	H3805_804_0	2	1		07/06/2011	2012.02	07/06/2011 04:47:28 PM Central Daylight Time	06/03/2011 02:21:35 PM Central Daylight Time			07/21/2011 08:26:26 AM Central Daylight Time	UNITEDHEALTHCARE OF OREGON, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H3805	804	0	2012	OR Employer Sponsored Plan Service Area		1		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3809	001	0	1	20	08	H3809_001_0	1	1		06/02/2011	2012.02	06/02/2011 09:53:05 PM Pacific Daylight Time		06/02/2011 09:22:27 PM Pacific Daylight Time		06/02/2011 10:50:56 PM Pacific Daylight Time	PROVIDENCE HEALTH  SERVICES - OREGON	Providence ElderPlace Portland	www.providence.org/elderplace	Providence ElderPlace Portland (dual) (PACE)	08	20		1			H3809	001	0	2012	Multnomah County		2		2			2							http://oregon.providence.org/patients/programs/providence-elderplace/Pages/default.aspx	http://oregon.providence.org/patients/programs/providence-elderplace/Pages/default.aspx									(503)-215-6556		(503)-215-6556		(503)-215-6556		(503)-215-6556										(503)-215-6556		(503)-215-6556		(503)-215-6556		(503)-215-6556				
H3809	002	0	1	20	08	H3809_002_0	1	1		06/02/2011	2012.02	06/02/2011 09:53:34 PM Pacific Daylight Time		06/02/2011 09:22:54 PM Pacific Daylight Time		06/02/2011 10:50:56 PM Pacific Daylight Time	PROVIDENCE HEALTH  SERVICES - OREGON	Providence ElderPlace Portland	www.providence.org/elderplace	Providence ElderPlace Portland (pvt pay) (PACE)	08	20		1			H3809	002	0	2012	Multnomah County		2		2			2							http://oregon.providence.org/patients/programs/providence-elderplace/Pages/default.aspx	http://oregon.providence.org/patients/programs/providence-elderplace/Pages/default.aspx									(503)-215-6556		(503)-215-6556		(503)-215-6556		(503)-215-6556										(503)-215-6556		(503)-215-6556		(503)-215-6556		(503)-215-6556				
H3810	001	0	1	01	01	H3810_001_0	7	1		07/19/2011	2012.02	07/19/2011 10:19:30 AM Pacific Daylight Time	07/19/2011 02:28:00 PM Pacific Daylight Time			07/19/2011 04:03:16 PM Pacific Daylight Time	MID ROGUE INDEPENDENT PHYSICIAN ASSOCIATION	CareSource	www.caresourcehealthplans.com	CareSource Gold (HMO)	01	01		1			H3810	001	0	2012	Counties:  JO, JA, DO*,		2	502	2			2						http://www.caresourcehealthplans.com/provider-directory.php	http://www.caresourcehealthplans.com/formularies.php	http://www.caresourcehealthplans.com/provider-directory.php	(888)-460-0185		(541)-471-4106		(888)-460-0185		(541)-471-4106										(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900										2	2	2
H3810	002	0	1	01	01	H3810_002_0	10	1	2	08/04/2011	2012.02	08/04/2011 04:59:23 PM Pacific Standard Time	08/05/2011 12:47:46 PM Pacific Standard Time	08/05/2011 12:47:46 PM Pacific Standard Time		08/05/2011 04:11:06 PM Pacific Standard Time	MID ROGUE INDEPENDENT PHYSICIAN ASSOCIATION	CareSource	www.caresourcehealthplans.com	CareSource - SNP (HMO SNP)	01	01		1			H3810	002	0	2012	Counties: JO, DO*.		2	720	2			1	3		1	2		http://www.caresourcehealthplans.com/provider-directory.php	http://www.caresourcehealthplans.com/formularies.php	http://www.caresourcehealthplans.com/provider-directory.php	(888)-460-0185		(541)-471-4106		(888)-460-0185		(541)-471-4106		(888)-460-0185		(541)-471-4106		(888)-460-0185		(541)-471-4106		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		2	2	2
H3810	003	0	1	01	01	H3810_003_0	11	1		08/02/2011	2012.02	08/02/2011 09:29:56 AM Pacific Standard Time	08/05/2011 12:47:46 PM Pacific Standard Time	08/05/2011 12:47:46 PM Pacific Standard Time		08/05/2011 04:11:06 PM Pacific Standard Time	MID ROGUE INDEPENDENT PHYSICIAN ASSOCIATION	CareSource	www.caresourcehealthplans.com	CareSource Gold Plus Rx (HMO)	01	01		1			H3810	003	0	2012	Counties: JO, JA, DO*		2	1484	2			2						http://www.caresourcehealthplans.com/provider-directory.php	http://www.caresourcehealthplans.com/formularies.php	http://www.caresourcehealthplans.com/provider-directory.php	(888)-460-0185		(541)-471-4106		(888)-460-0185		(541)-471-4106		(888)-460-0185		(541)-471-4106		(888)-460-0185		(541)-471-4106		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		2	2	2
H3810	004	0	1	02	01	H3810_004_0	7	1		07/19/2011	2012.02	07/19/2011 10:15:29 AM Pacific Daylight Time	06/06/2011 02:58:24 PM Pacific Daylight Time			07/19/2011 04:03:16 PM Pacific Daylight Time	MID ROGUE INDEPENDENT PHYSICIAN ASSOCIATION	CareSource	www.caresourcehealthplans.com	CareSource Platinum (HMO-POS)	01	02		1			H3810	004	0	2012	Counties: JO, JA, DO*		2	65	2			2						http://www.caresourcehealthplans.com/provider-directory.php	http://www.caresourcehealthplans.com/formularies.php	http://www.caresourcehealthplans.com/provider-directory.php	(888)-460-0185		(541)-471-4106		(888)-460-0185		(541)-471-4106										(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900										2	2	2
H3810	005	0	1	02	01	H3810_005_0	11	1		07/19/2011	2012.02	07/19/2011 10:15:57 AM Pacific Daylight Time	08/05/2011 12:47:46 PM Pacific Standard Time	08/05/2011 12:47:46 PM Pacific Standard Time		08/05/2011 04:11:06 PM Pacific Standard Time	MID ROGUE INDEPENDENT PHYSICIAN ASSOCIATION	CareSource	www.caresourcehealthplans.com	CareSource Platinum Plus Rx (HMO-POS)	01	02		1			H3810	005	0	2012	Counties: JO, JA, DO*		2	316	2			2						http://www.caresourcehealthplans.com/provider-directory.php	http://www.caresourcehealthplans.com/formularies.php	http://www.caresourcehealthplans.com/provider-directory.php	(888)-460-0185		(541)-471-4106		(888)-460-0185		(541)-471-4106		(888)-460-0185		(541)-471-4106		(888)-460-0185		(541)-471-4106		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		2	2	2
H3810	006	0	1	01	01	H3810_006_0	7	1		07/19/2011	2012.02	07/19/2011 10:16:20 AM Pacific Daylight Time	06/06/2011 02:58:43 PM Pacific Daylight Time			07/19/2011 04:03:16 PM Pacific Daylight Time	MID ROGUE INDEPENDENT PHYSICIAN ASSOCIATION	CareSource	www.caresourcehealthplans.com	CareSource Silver (HMO)	01	01		1			H3810	006	0	2012	Counties: JO, JA, DO*		2	124	2			2						http://www.caresourcehealthplans.com/provider-directory.php	http://www.caresourcehealthplans.com/formularies.php	http://www.caresourcehealthplans.com/provider-directory.php	(888)-460-0185		(541)-471-4106		(888)-460-0185		(541)-471-4106										(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900										2	2	2
H3810	007	0	1	01	01	H3810_007_0	12	1		07/19/2011	2012.02	07/19/2011 10:16:48 AM Pacific Daylight Time	08/05/2011 12:47:46 PM Pacific Standard Time	08/05/2011 12:47:46 PM Pacific Standard Time		08/05/2011 04:11:06 PM Pacific Standard Time	MID ROGUE INDEPENDENT PHYSICIAN ASSOCIATION	CareSource	www.caresourcehealthplans.com	CareSource Silver Plus Rx (HMO)	01	01		1			H3810	007	0	2012	Counties: JO, JA, DO*		2	3506	2			2						http://www.caresourcehealthplans.com/provider-directory.php	http://www.caresourcehealthplans.com/formularies.php	http://www.caresourcehealthplans.com/provider-directory.php	(888)-460-0185		(541)-471-4106		(888)-460-0185		(541)-471-4106		(888)-460-0185		(541)-471-4106		(888)-460-0185		(541)-471-4106		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		2	2	2
H3810	019	0	1	01	01	H3810_019_0	13	1		07/29/2011	2012.02	07/29/2011 08:44:18 AM Pacific Standard Time	08/05/2011 12:47:46 PM Pacific Standard Time	08/05/2011 12:47:46 PM Pacific Standard Time		08/05/2011 04:11:06 PM Pacific Standard Time	MID ROGUE INDEPENDENT PHYSICIAN ASSOCIATION	CareSource	www.caresourcehealthplans.com	CareSource Bronze Rx (HMO)	01	01		1			H3810	019	0	2012	Counties: JO, JA, DO*,		2	200	2			2						http://www.caresourcehealthplans.com/provider-directory.php	http://www.caresourcehealthplans.com/formularies.php	http://www.caresourcehealthplans.com/provider-directory.php	(888)-460-0185		(541)-471-4106		(888)-460-0185		(541)-471-4106		(888)-460-0185		(541)-471-4106		(888)-460-0185		(541)-471-4106		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		2	2	2
H3811	001	0	1	01	01	H3811_001_0	4	1		07/14/2011	2012.02	07/14/2011 08:18:15 AM Pacific Daylight Time	07/19/2011 12:32:18 PM Pacific Daylight Time			07/19/2011 01:04:26 PM Pacific Daylight Time	SAMARITAN HEALTH PLANS, INC.	Samaritan Advantage Health Plan	www.samhealth.org/SHPlans	Samaritan Advantage Conventional Plan (HMO)	01	01		1			H3811	001	0	2012	Benton, Lincoln and Linn county		2	485	2			2						www.samhealth.org/SHPlans	www.samhealth.org/SHPlans	www.samhealth.org/SHPlans	(800)-832-4580		(541)-768-4550		(800)-832-4580		(541)-768-4550										(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900										2	2	2
H3811	002	0	1	01	01	H3811_002_0	6	1		08/09/2011	2012.02	08/09/2011 08:17:48 AM Pacific Daylight Time	08/09/2011 03:33:59 AM Pacific Daylight Time	08/04/2011 10:12:41 AM Pacific Daylight Time		08/09/2011 08:21:13 AM Pacific Daylight Time	SAMARITAN HEALTH PLANS, INC.	Samaritan Advantage Health Plan	www.samhealth.org/SHPlans	Samaritan Advantage Premier Plan (HMO)	01	01		1			H3811	002	0	2012	Benton, Lincoln and Linn county		2	1972	2			2						www.samhealth.org/SHPlans	www.samhealth.org/SHPlans	www.samhealth.org/SHPlans	(800)-832-4580		(541)-768-4550		(800)-832-4580		(541)-768-4550		(800)-832-4580		(541)-768-4550		(800)-832-4580		(541)-768-4550		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		2	2	2
H3811	003	0	1	01	01	H3811_003_0	5	1	2	07/08/2011	2012.02	07/08/2011 02:33:57 PM Pacific Daylight Time	08/09/2011 03:27:13 AM Pacific Daylight Time	08/04/2011 10:16:25 AM Pacific Daylight Time		08/09/2011 08:23:43 AM Pacific Daylight Time	SAMARITAN HEALTH PLANS, INC.	Samaritan Advantage Health Plan	www.samhealth.org/SHPlans	Samaritan Advantage Special Needs Plan (HMO SNP)	01	01		1			H3811	003	0	2012	Benton and Linn counties		2	2025	2			1	3		1	3		www.samhealth.org/SHPlans	www.samhealth.org/SHPlans	www.samhealth.org/SHPlans	(800)-832-4580		(541)-768-4550		(800)-832-4580		(541)-768-4550		(800)-832-4580		(541)-768-4550		(800)-832-4580		(541)-768-4550		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		2	2	2
H3811	009	0	1	01	01	H3811_009_0	6	1		08/02/2011	2012.02	08/02/2011 04:17:56 PM Pacific Daylight Time	08/08/2011 06:16:31 AM Pacific Daylight Time	08/04/2011 10:21:43 AM Pacific Daylight Time		08/09/2011 08:27:55 AM Pacific Daylight Time	SAMARITAN HEALTH PLANS, INC.	Samaritan Advantage Health Plan	www.samhealth.org/SHPlans	Samaritan Advantage Premier Plan Plus (HMO)	01	01		1			H3811	009	0	2012	Benton, Lincoln, and Linn Counties		2	1800	1	1		2						www.samhealth.org/SHPlans	www.samhealth.org/SHPlans	www.samhealth.org/SHPlans	(800)-832-4580		(541)-768-4550		(800)-832-4580		(541)-768-4550		(800)-832-4580		(541)-768-4550		(800)-832-4580		(541)-768-4550		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		2	2	2
H3812	001	0	1	04	01	H3812_001_0	5	1		09/13/2011	2012.02	09/13/2011 01:28:31 PM Central Daylight Time	08/04/2011 06:52:23 PM Central Daylight Time	08/05/2011 01:32:32 PM Central Daylight Time		09/13/2011 01:35:49 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice (PPO)	01	04		1			H3812	001	0	2012	Clackamas,Lane,Multnomah,Marion,Washington,Yamhill		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3812	005	0	1	04	01	H3812_005_0	3	1		07/22/2011	2012.02	07/22/2011 12:08:51 PM Central Daylight Time	08/05/2011 10:53:13 AM Central Daylight Time	08/05/2011 01:32:48 PM Central Daylight Time		08/09/2011 04:41:55 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.EvercareHealthPlans.com	UnitedHealthcare Nursing Home Plan (PPO SNP)	01	04		1			H3812	005	0	2012	Clackamas, Lane, Multnomah and Washington Counties		2		2			1	1	1	1			www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3813	001	0	1	04	01	H3813_001_0	9	1		07/08/2011	2012.02	07/08/2011 01:08:26 PM Pacific Daylight Time	07/14/2011 03:15:57 PM Pacific Daylight Time			07/19/2011 04:32:01 PM Pacific Daylight Time	ODS HEALTH PLAN, INC.	ODS Health Plan, Inc.	www.odscompanies.com/odsadvantage	ODS Advantage PPO (PPO)	01	04		1			H3813	001	0	2012	State of Oregon		2	1000	2			2						www.odscompanies.com/odsadvantage	www.odscompanies.com/odsadvantage	www.odscompanies.com/odsadvantage	(877)-299-9062		(503)-265-4762		(888)-217-2375		(503)-265-2975										(711)		(711)		(711)		(711)										2	2	2
H3813	003	0	1	04	01	H3813_003_0	10	1		08/03/2011	2012.02	08/03/2011 01:29:49 PM Pacific Daylight Time	08/03/2011 02:28:37 PM Pacific Daylight Time	08/03/2011 02:26:38 PM Pacific Daylight Time		08/03/2011 02:33:37 PM Pacific Daylight Time	ODS HEALTH PLAN, INC.	ODS Health Plan, Inc.	www.odscompanies.com/odsadvantage	ODS Advantage PPORX Select (PPO)	01	04		1			H3813	003	0	2012	State of Oregon		2	1000	2			2						www.odscompanies.com/odsadvantage	www.odscompanies.com/odsadvantage	www.odscompanies.com/odsadvantage	(877)-299-9062		(503)-265-4762		(888)-217-2375		(503)-265-2975		(888)-786-7509		(503)-265-4709		(888)-217-2375		(503)-265-2975		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3813	802	0	1	04	01	H3813_802_0	8	1		07/08/2011	2012.02	07/08/2011 01:08:08 PM Pacific Daylight Time	07/13/2011 04:06:34 PM Pacific Daylight Time			07/27/2011 09:48:12 AM Pacific Daylight Time	ODS HEALTH PLAN, INC.	ODS Health Plan, Inc.	www.odscompanies.com/odsadvantage	ODS Advantage PPORX Employer Option (PPO)	01	04		1			H3813	802	0	2012	State of Oregon		1	7000	2			2						www.odscompanies.com/odsadvantage	www.odscompanies.com/odsadvantage	www.odscompanies.com/odsadvantage	(877)-299-9062		(503)-265-4762		(888)-217-2375		(503)-265-2975		(888)-786-7509		(503)-265-4709		(888)-217-2375		(503)-265-2975		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3814	007	0	1	01	01	H3814_007_0	9	1	2	08/11/2011	2012.02	08/11/2011 04:37:32 PM Pacific Daylight Time	08/11/2011 04:21:24 PM Pacific Daylight Time	08/08/2011 11:23:12 AM Pacific Daylight Time		08/11/2011 05:02:31 PM Pacific Daylight Time	ATRIO HEALTH PLANS	ATRIO Health Plans	www.atriohp.com	ATRIO Special Needs Plan (HMO SNP)	01	01		1			H3814	007	0	2012	Douglas and Klamath Counties		2	1972	2			1	3		1	3		www.atriohp.com	http://www.atriohp.com/index.cfm?nav=Current%20Memberslev1=Formulary%20Information	http://www.atriohp.com/index.cfm?nav=Current%20Memberslev1=Pharmacy%20Directory	(877)-672-8620		(541)-672-8620		(877)-672-8620		(541)-672-8620		(877)-672-8620		(541)-672-8620		(877)-672-8620		(541)-672-8620		(800)-735-2900		(541)-735-2900		(800)-735-2900		(541)-735-2900		(800)-735-2900		(541)-735-2900		(800)-735-2900		(541)-735-2900		2	2	1
H3815	001	0	1	01	01	H3815_001_0	10	1		07/28/2011	2012.02	07/28/2011 11:30:57 AM Pacific Daylight Time	08/05/2011 09:33:15 AM Pacific Daylight Time	08/05/2011 09:33:15 AM Pacific Daylight Time		08/05/2011 03:41:53 PM Pacific Daylight Time	CITIZENS CHOICE HEALTHPLAN	Citizens Choice Healthplan	www.citizenschoicehealth.com	Citizens Choice Healthplan (HMO)	01	01		1			H3815	001	0	2012	LA, North OC, SB, RIV		2	15986	2			2						www.citizenschoicehealth.com	www.citizenschoicehealth.com	www.citizenschoicehealth.com	(866)-634-2247		(323)-728-7232	5550	(866)-646-2247		(323)-728-7232	5551	(866)-634-2247		(323)-728-7232	5550	(866)-646-2247		(323)-728-7232	5551	(866)-516-9366		(866)-516-9366		(866)-516-9366		(866)-516-9366		(866)-516-9366		(866)-516-9366		(866)-516-9366		(866)-516-9366		2	2	2
H3817	001	0	1	04	01	H3817_001_0	5	1		07/20/2011	2012.02	07/20/2011 09:56:46 AM Mountain Daylight Time	08/09/2011 03:15:02 PM Pacific Daylight Time			08/09/2011 04:18:49 PM Pacific Daylight Time	REGENCE BLUECROSS BLUESHIELD OF OR	Regence BlueCross BlueShield of Oregon	www.regence.com/medicare	Regence MedAdvantage Basic (PPO)	01	04		1			H3817	001	0	2012	Select Counties in Oregon/Clark Co, WA		2		2			2						www.regence.com/medicare	www.regence.com/OR/products/medicare	www.regence.com/OR/products/medicare	(800)-541-8981		(800)-541-8981		(800)-505-6765		(800)-505-6765										(711)		(711)		(711)		(711)										2	2	2
H3817	002	0	1	04	01	H3817_002_0	7	1		07/20/2011	2012.02	07/20/2011 09:57:20 AM Mountain Daylight Time	08/09/2011 11:35:03 AM Pacific Daylight Time	08/09/2011 08:04:25 AM Pacific Daylight Time		08/09/2011 04:05:20 PM Pacific Daylight Time	REGENCE BLUECROSS BLUESHIELD OF OR	Regence BlueCross BlueShield of Oregon	www.regence.com/medicare	Regence MedAdvantage + Rx Classic (PPO)	01	04		1			H3817	002	0	2012	Select Counties in Oregon/Clark Co, WA		2		2			2						www.regence.com/medicare	www.regence.com/OR/products/medicare	www.regence.com/OR/products/medicare	(800)-541-8981		(800)-541-8981		(800)-505-6765		(800)-505-6765		(800)-541-8981		(800)-541-8981		(800)-505-6765		(800)-505-6765		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3817	003	0	1	04	01	H3817_003_0	6	1		07/20/2011	2012.02	07/20/2011 09:57:58 AM Mountain Daylight Time	08/09/2011 11:32:35 AM Pacific Daylight Time	08/09/2011 08:05:44 AM Pacific Daylight Time		08/09/2011 04:07:50 PM Pacific Daylight Time	REGENCE BLUECROSS BLUESHIELD OF OR	Regence BlueCross BlueShield of Oregon	www.regence.com/medicare	Regence MedAdvantage + Rx Enhanced (PPO)	01	04		1			H3817	003	0	2012	Select Counties in Oregon/Clark Co,Wa		2		2			2						www.regence.com/medicare	www.regence.com/OR/products/medicare	www.regence.com/OR/products/medicare	(800)-541-8981		(800)-541-8981		(800)-505-6765		(800)-505-6765		(800)-541-8981		(800)-541-8981		(800)-505-6765		(800)-505-6765		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3817	801	0	1	04	01	H3817_801_0	4	1		06/03/2011	2012.02	06/03/2011 10:47:02 AM Mountain Daylight Time	08/09/2011 06:12:20 PM Pacific Daylight Time			08/09/2011 06:27:38 PM Pacific Daylight Time	REGENCE BLUECROSS BLUESHIELD OF OR	Regence BlueCross BlueShield of Oregon	www.regence.com/medicare	Regence MedAdvantage (PPO)	01	04		1			H3817	801	0	2012	Nationwide except territories		1		2			2						www.regence.com/medicare	www.regence.com/OR/products/medicare	www.regence.com/OR/products/medicare	(888)-319-8904		(888)-319-8904		(800)-505-6765		(800)-505-6765										(711)		(711)		(711)		(711)										2	2	2
H3817	802	0	1	04	01	H3817_802_0	4	1		06/03/2011	2012.02	06/03/2011 10:44:11 AM Mountain Daylight Time	08/09/2011 06:15:14 PM Pacific Daylight Time			08/09/2011 06:29:34 PM Pacific Daylight Time	REGENCE BLUECROSS BLUESHIELD OF OR	Regence BlueCross BlueShield of Oregon	www.regence.com/medicare	Regence MedAdvantage + Rx (PPO)	01	04		1			H3817	802	0	2012	Nationwide except territories		1		2			2						www.regence.com/medicare	www.regence.com/OR/products/medicare	www.regence.com/OR/products/medicare	(888)-319-8904		(888)-319-8904		(800)-505-6765		(800)-505-6765		(888)-319-8904		(888)-319-8904		(800)-505-6765		(800)-505-6765		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3818	002	0	1	01	01	H3818_002_0	7	1	2	08/08/2011	2012.02	08/08/2011 11:19:54 AM Pacific Daylight Time	08/08/2011 04:10:22 PM Pacific Daylight Time	08/08/2011 04:13:44 PM Pacific Daylight Time		08/09/2011 07:07:54 AM Pacific Daylight Time	FAMILYCARE HEALTH PLANS, INC.	FamilyCare Health Plans, Inc.	familycarehealthplans.org	PremierCare Plus (HMO SNP)	01	01		1			H3818	002	0	2012	Portland Metro Clatsop Morrow Umatilla Counties		2	1800	2			1	3		1	3		www.familycarehealthplans.org	http://www.familycarehealthplans.org	http://www.familycarehealthplans.org	(866)-798-2273		(503)-345-5702		(866)-225-2273		(503)-345-5701		(866)-798-2273		(503)-345-5702		(866)-225-2273		(503)-345-5701		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		2	2	2
H3818	003	0	1	01	01	H3818_003_0	7	1		07/28/2011	2012.02	07/28/2011 01:48:23 PM Pacific Daylight Time	08/08/2011 04:11:16 PM Pacific Daylight Time	08/08/2011 04:14:14 PM Pacific Daylight Time		08/09/2011 07:07:54 AM Pacific Daylight Time	FAMILYCARE HEALTH PLANS, INC.	FamilyCare Health Plans, Inc.	familycarehealthplans.org	PremierCare Choice Rx (HMO)	01	01		1			H3818	003	0	2012	Portland Metro Clatsop Morrow Umatilla Counties		2	750	2			2						www.familycarehealthplans.org	http://www.familycarehealthplans.org	http://www.familycarehealthplans.org	(866)-798-2273		(503)-345-5702		(866)-225-2273		(503)-345-5701		(866)-798-2273		(503)-345-5702		(866)-225-2273		(503)-345-5701		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		2	2	2
H3818	004	0	1	01	01	H3818_004_0	7	1		07/01/2011	2012.02	07/01/2011 08:49:05 AM Pacific Daylight Time	06/06/2011 10:53:01 AM Pacific Daylight Time			07/01/2011 01:58:40 PM Pacific Daylight Time	FAMILYCARE HEALTH PLANS, INC.	FamilyCare Health Plans, Inc.	familycarehealthplans.org	PremierCare Choice (HMO)	01	01		1			H3818	004	0	2012	Portland Metro Clatsop Morrow Umatilla Counties		2	750	2			2						www.familycarehealthplans.org	http://www.familycarehealthplans.org	http://www.familycarehealthplans.org	(866)-798-2273		(503)-345-5702		(866)-225-2273		(503)-345-5701										(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900										2	2	2
H3818	014	0	1	01	01	H3818_014_0	7	1		07/14/2011	2012.02	07/14/2011 04:18:46 PM Pacific Daylight Time	08/08/2011 04:12:32 PM Pacific Daylight Time	08/08/2011 04:14:48 PM Pacific Daylight Time		08/09/2011 07:07:54 AM Pacific Daylight Time	FAMILYCARE HEALTH PLANS, INC.	FamilyCare Health Plans, Inc.	familycarehealthplans.org	PremierCare Value Rx (HMO)	01	01		1			H3818	014	0	2012	Portland Metro Clatsop Morrow Umatilla Counties		2		2			2						www.familycarehealthplans.org	http://www.familycarehealthplans.org	http://www.familycarehealthplans.org	(866)-798-2273		(503)-345-5702		(866)-225-2273		(503)-345-5701		(866)-798-2273		(503)-345-5702		(866)-225-2273		(503)-345-5701		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		2	2	2
H3832	001	0	1	04	01	H3832_001_0	5	1		06/30/2011	2012.02	06/30/2011 11:24:57 AM Hawaiian Standard Time	08/09/2011 01:38:21 PM Hawaiian Standard Time	08/09/2011 01:38:26 PM Hawaiian Standard Time		08/09/2011 01:44:03 PM Hawaiian Standard Time	HAWAII MEDICAL SERVICE ASSOCIATION	Akamai Advantage by HMSA	www.hmsa.com/advantage	Akamai Advantage Select (PPO)	01	04		1			H3832	001	0	2012	Honolulu County		2	5000	2			2						www.hmsa.com/advantage	www.hmsa.com	www.hmsa.com	(800)-776-4672		(808)-948-6000		(800)-620-4672		(808)-948-5555		(800)-776-4672		(808)-948-6000		(800)-620-4672		(808)-948-5555		(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222		2	2	2
H3832	006	0	1	04	01	H3832_006_0	9	1		07/06/2011	2012.02	07/06/2011 09:48:01 AM Hawaiian Standard Time	08/09/2011 01:38:18 PM Hawaiian Standard Time	08/09/2011 01:38:23 PM Hawaiian Standard Time		08/09/2011 01:46:27 PM Hawaiian Standard Time	HAWAII MEDICAL SERVICE ASSOCIATION	Akamai Advantage by HMSA	http://hmsa.com/advantage	Akamai Advantage Select Plus (PPO)	01	04		1			H3832	006	0	2012	State of Hawaii		2	5000	2			2						www.hmsa.com/advantage	www.hmsa.com	www.hmsa.com	(800)-776-4672		(808)-948-6000		(800)-620-4672		(808)-948-5555		(800)-776-4672		(808)-948-6000		(800)-620-4672		(808)-948-5555		(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222		2	2	2
H3832	801	0	1	04	01	H3832_801_0	4	1		05/30/2011	2012.02	05/30/2011 06:45:05 PM Hawaiian Standard Time	06/08/2011 05:37:33 PM Hawaiian Standard Time			06/08/2011 05:38:27 PM Hawaiian Standard Time	HAWAII MEDICAL SERVICE ASSOCIATION	Akamai Advantage by HMSA	www.hmsa.com/advantage	Akamai Advantage EGWP with Drug CY (PPO)	01	04		1			H3832	801	0	2012	State of Hawaii		1	1000	2			2						www.hmsa.com/advantage	www.hmsa.com	www.hmsa.com	(800)-776-4672		(808)-948-6000		(800)-620-4672		(808)-948-5555		(800)-776-4672		(808)-948-6000		(800)-620-4672		(808)-948-5555		(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222		1	1	1
H3832	802	0	1	04	01	H3832_802_0	4	1		05/30/2011	2012.02	05/30/2011 06:45:58 PM Hawaiian Standard Time	06/08/2011 05:37:39 PM Hawaiian Standard Time			06/08/2011 05:41:56 PM Hawaiian Standard Time	HAWAII MEDICAL SERVICE ASSOCIATION	Akamai Advantage by HMSA	www.hmsa.com/advantage	Akamai Advantage EGWP with Drug NCY (PPO)	01	04		1			H3832	802	0	2012	State of Hawaii		1	1000	2			2						www.hmsa.com/advantage	www.hmsa.com	www.hmsa.com	(800)-776-4672		(808)-948-6000		(800)-620-4672		(808)-948-5555		(800)-776-4672		(808)-948-6000		(800)-620-4672		(808)-948-5555		(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222		1	1	1
H3832	805	0	1	04	01	H3832_805_0	4	1		05/30/2011	2012.02	05/30/2011 06:54:26 PM Hawaiian Standard Time	06/08/2011 05:36:51 PM Hawaiian Standard Time			06/08/2011 05:48:54 PM Hawaiian Standard Time	HAWAII MEDICAL SERVICE ASSOCIATION	Akamai Advantage by HMSA	www.hmsa.com/advantage	Akamai Advantage EGWP CY (PPO)	01	04		1			H3832	805	0	2012	State of Hawaii		1	1000	2			2						www.hmsa.com/advantage	www.hmsa.com	www.hmsa.com	(800)-776-4672		(808)-948-6000		(800)-620-4672		(808)-948-5555										(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222										1	1	1
H3832	806	0	1	04	01	H3832_806_0	3	1		05/30/2011	2012.02	05/30/2011 07:03:48 PM Hawaiian Standard Time	06/08/2011 05:36:57 PM Hawaiian Standard Time			06/08/2011 05:46:06 PM Hawaiian Standard Time	HAWAII MEDICAL SERVICE ASSOCIATION	Akamai Advantage by HMSA	www.hmsa.com/advantage	Akamai Advantage EGWP NCY (PPO)	01	04		1			H3832	806	0	2012	State of Hawaii		1	1000	2			2						www.hmsa.com/advantage	www.hmsa.com	www.hmsa.com	(800)-776-4672		(808)-948-6000		(800)-620-4672		(808)-948-5555										(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222										1	1	1
H3864	001	0	1	02	01	H3864_001_0	8	1		07/26/2011	2012.02	07/26/2011 02:53:04 PM Pacific Daylight Time	07/22/2011 08:05:07 AM Pacific Daylight Time			07/26/2011 03:34:42 PM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS, INC.	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare Premier 1 (HMO-POS)	01	02		1			H3864	001	0	2012	Central, Eastern Oregon and Mid-Columbia Gorge		2	900	2			2						http://medicare.pacificsource.com/Tools/ProviderDirectory.aspx	http://medicare.pacificsource.com/Tools/DrugSearch.aspx	https://medicare.pacificsource.com/Tools/PharmacySearch.aspx	(888)-863-3637		(541)-385-5315		(888)-863-3637		(541)-385-5315										(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900										2	2	2
H3864	002	0	1	01	01	H3864_002_0	7	1		07/20/2011	2012.02	07/20/2011 02:17:04 PM Pacific Daylight Time	07/22/2011 08:05:06 AM Pacific Daylight Time			07/22/2011 08:31:26 AM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS, INC.	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare Essentials 2 (HMO)	01	01		1			H3864	002	0	2012	Central, Eastern Oregon and Mid-Columbia Gorge		2	600	2			2						http://medicare.pacificsource.com/Tools/ProviderDirectory.aspx	http://medicare.pacificsource.com/Tools/DrugSearch.aspx	https://medicare.pacificsource.com/Tools/PharmacySearch.aspx	(888)-863-3637		(541)-385-5315		(888)-863-3637		(541)-385-5315										(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900										2	2	2
H3864	006	0	1	01	01	H3864_006_0	8	1		07/20/2011	2012.02	07/20/2011 02:02:17 PM Pacific Daylight Time	08/09/2011 02:21:56 PM Pacific Daylight Time	08/09/2011 02:19:37 PM Pacific Daylight Time		08/09/2011 02:31:09 PM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS, INC.	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare Essentials Rx 6 (HMO)	01	01		1			H3864	006	0	2012	Central, Eastern Oregon and Mid-Columbia Gorge		2	1300	2			2						http://medicare.pacificsource.com/Tools/ProviderDirectory.aspx	http://medicare.pacificsource.com/Tools/DrugSearch.aspx	https://medicare.pacificsource.com/Tools/PharmacySearch.aspx	(888)-863-3637		(541)-385-5315		(888)-863-3637		(541)-385-5315		(888)-863-3637		(541)-385-5315		(888)-863-3637		(541)-385-5315		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		2	2	2
H3864	007	0	1	02	01	H3864_007_0	9	1		07/26/2011	2012.02	07/26/2011 02:55:26 PM Pacific Daylight Time	08/09/2011 02:21:55 PM Pacific Daylight Time	08/09/2011 02:19:37 PM Pacific Daylight Time		08/09/2011 02:31:09 PM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS, INC.	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare Premier Rx 7 (HMO-POS)	01	02		1			H3864	007	0	2012	Central, Eastern Oregon and Mid-Columbia Gorge		2	3000	2			2						http://medicare.pacificsource.com/Tools/ProviderDirectory.aspx	http://medicare.pacificsource.com/Tools/DrugSearch.aspx	https://medicare.pacificsource.com/Tools/PharmacySearch.aspx	(888)-863-3637		(541)-385-5315		(888)-863-3637		(541)-385-5315		(888)-863-3637		(541)-385-5315		(888)-863-3637		(541)-385-5315		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		2	2	2
H3864	014	0	1	01	01	H3864_014_0	8	1		07/20/2011	2012.02	07/20/2011 02:05:21 PM Pacific Daylight Time	08/09/2011 02:21:56 PM Pacific Daylight Time	08/09/2011 02:19:37 PM Pacific Daylight Time		08/09/2011 02:31:09 PM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS, INC.	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare Essentials Rx 14 (HMO)	01	01		1			H3864	014	0	2012	Central, Eastern Oregon and Mid-Columbia Gorge		2	4000	2			2						http://medicare.pacificsource.com/Tools/ProviderDirectory.aspx	http://medicare.pacificsource.com/Tools/DrugSearch.aspx	https://medicare.pacificsource.com/Tools/PharmacySearch.aspx	(888)-863-3637		(541)-385-5315		(888)-863-3637		(541)-385-5315		(888)-863-3637		(541)-385-5315		(888)-863-3637		(541)-385-5315		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		2	2	2
H3864	015	0	1	01	01	H3864_015_0	6	1		07/20/2011	2012.02	07/20/2011 02:06:52 PM Pacific Daylight Time	08/09/2011 02:21:56 PM Pacific Daylight Time	08/09/2011 02:19:36 PM Pacific Daylight Time		08/09/2011 02:31:09 PM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS, INC.	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare Essentials Rx 15 (HMO)	01	01		1			H3864	015	0	2012	Lane County		2	400	2			2						http://medicare.pacificsource.com/Tools/ProviderDirectory.aspx	http://medicare.pacificsource.com/Tools/DrugSearch.aspx	https://medicare.pacificsource.com/Tools/PharmacySearch.aspx	(888)-863-3637		(541)-385-5315		(888)-863-3637		(541)-385-5315		(888)-863-3637		(541)-385-5315		(888)-863-3637		(541)-385-5315		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		2	2	2
H3864	016	0	1	01	01	H3864_016_0	8	1		09/13/2011	2012.02	09/13/2011 10:21:48 AM Pacific Daylight Time	08/09/2011 02:23:48 PM Pacific Daylight Time	08/09/2011 02:19:36 PM Pacific Daylight Time		09/13/2011 10:23:27 AM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS, INC.	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare Essentials Rx 16 (HMO)	01	01		1			H3864	016	0	2012	Southwest Idaho		2	400	2			2						http://medicare.pacificsource.com/Tools/ProviderDirectory.aspx	http://medicare.pacificsource.com/Tools/DrugSearch.aspx	https://medicare.pacificsource.com/Tools/PharmacySearch.aspx	(888)-863-3637		(541)-385-5315		(888)-863-3637		(541)-385-5315		(888)-863-3637		(541)-385-5315		(888)-863-3637		(541)-385-5315		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		2	2	2
H3864	801	0	1	01	01	H3864_801_0	5	1		07/20/2011	2012.02	07/20/2011 02:09:50 PM Pacific Daylight Time	07/22/2011 08:06:21 AM Pacific Daylight Time			07/22/2011 08:31:26 AM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS, INC.	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare Essentials 801 (HMO)	01	01		1			H3864	801	0	2012	Central, Eastern Oregon and Mid-Columbia Gorge		1	1400	2			2						http://medicare.pacificsource.com/Tools/ProviderDirectory.aspx	http://medicare.pacificsource.com/Tools/DrugSearch.aspx	https://medicare.pacificsource.com/Tools/PharmacySearch.aspx	(888)-863-3637		(541)-385-5315		(888)-863-3637		(541)-385-5315										(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900										2	2	2
H3887	001	0	1	02	01	H3887_001_0	3	1		07/22/2011	2012.02	07/22/2011 12:21:32 PM Central Daylight Time	08/05/2011 09:24:19 AM Central Daylight Time	08/05/2011 01:33:22 PM Central Daylight Time		08/09/2011 04:41:55 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.EvercareHealthPlans.com	UnitedHealthcare Nursing Home Plan (HMO-POS SNP)	01	02		1			H3887	001	0	2012	Cook, Du Page, Kane and Lake Counties		2		2			1	1	1	1			www.SecureHorizons.com/ourplans/findaphysician.html	www.securehorizons.com/ourplans/searchformulary.html	www.prescriptionsolutions.com	(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3887	003	0	1	02	01	H3887_003_0	4	1		08/04/2011	2012.02	08/04/2011 04:24:21 PM Central Daylight Time	08/05/2011 09:24:56 AM Central Daylight Time	08/05/2011 01:33:38 PM Central Daylight Time		08/09/2011 12:48:01 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H3887	003	0	2012	Cook, Kane and Will Counties		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.securehorizons.com/ourplans/searchformulary.html	www.prescriptionsolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3907	002	0	1	01	01	H3907_002_0	2	1		06/01/2011	2012.02	06/01/2011 10:18:44 AM Eastern Daylight Time	06/01/2011 12:21:07 PM Eastern Daylight Time			06/01/2011 01:08:25 PM Eastern Daylight Time	UNIVERSITY OF PITTSBURGH MEDICAL CENTER	UPMC Health Plan	http://www.upmchealthplan.com/medicare/	UPMC for Life (HMO)	01	01		1			H3907	002	0	2012	Western Pennsylvania		2	20000	2			2						http://www.upmchealthplan.com/medicare/	http://www.upmchealthplan.com/medicare/partd.html	http://www.upmchealthplan.com/medicare/partd.html	(877)-539-3080		(877)-539-3080		(877)-381-3765		(877)-381-3765										(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629										2	2	2
H3907	006	0	1	01	01	H3907_006_0	6	1		08/08/2011	2012.02	08/08/2011 07:34:26 AM Eastern Daylight Time	08/09/2011 07:06:58 AM Eastern Daylight Time	08/09/2011 07:07:39 AM Eastern Daylight Time		08/09/2011 11:07:02 AM Eastern Daylight Time	UNIVERSITY OF PITTSBURGH MEDICAL CENTER	UPMC Health Plan	http://www.upmchealthplan.com/medicare/	UPMC for Life HMO Rx Enhanced (HMO)	01	01		1			H3907	006	0	2012	Western Pennsylvania		2	12000	2			2						http://www.upmchealthplan.com/medicare/	http://www.upmchealthplan.com/medicare/partd.html	http://www.upmchealthplan.com/medicare/partd.html	(877)-539-3080		(877)-539-3080		(877)-381-3765		(877)-381-3765		(877)-539-3080		(877)-539-3080		(877)-381-3765		(877)-381-3765		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		2	2	2
H3907	029	0	1	01	01	H3907_029_0	6	1		06/07/2011	2012.02	06/07/2011 06:54:07 AM Eastern Daylight Time	08/09/2011 07:03:40 AM Eastern Daylight Time	08/09/2011 07:01:23 AM Eastern Daylight Time		08/09/2011 11:07:02 AM Eastern Daylight Time	UNIVERSITY OF PITTSBURGH MEDICAL CENTER	UPMC Health Plan	http://www.upmchealthplan.com/medicare/	UPMC for Life HMO Rx (HMO)	01	01		1			H3907	029	0	2012	Western Pennsylvania		2	30000	2			2						http://www.upmchealthplan.com/medicare/	http://www.upmchealthplan.com/medicare/partd.html	http://www.upmchealthplan.com/medicare/partd.html	(877)-539-3080		(877)-539-3080		(877)-381-3765		(877)-381-3765		(877)-539-3080		(877)-539-3080		(877)-381-3765		(877)-381-3765		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		2	2	2
H3907	032	0	1	01	01	H3907_032_0	4	1		06/07/2011	2012.02	06/07/2011 06:54:35 AM Eastern Daylight Time	06/29/2011 11:07:20 AM Eastern Daylight Time	06/06/2011 08:21:06 AM Eastern Daylight Time		06/29/2011 01:32:04 PM Eastern Daylight Time	UNIVERSITY OF PITTSBURGH MEDICAL CENTER	UPMC Health Plan	http://www.upmchealthplan.com/medicare/	UPMC for Life Options (HMO SNP)	01	01		1			H3907	032	0	2012	Allegheny County		2	200	2			1	1	3	1			http://www.upmchealthplan.com/medicare/	http://www.upmchealthplan.com/medicare/partd.html	http://www.upmchealthplan.com/medicare/partd.html	(800)-606-8648		(800)-606-8648		(866)-405-8762		(866)-405-8762		(800)-606-8648		(800)-606-8648		(866)-405-8762		(866)-405-8762		(866)-407-8762		(866)-407-8762		(866)-407-8762		(866)-407-8762		(866)-407-8762		(866)-407-8762		(866)-407-8762		(866)-407-8762		2	2	2
H3907	034	0	1	01	01	H3907_034_0	4	1	2	08/09/2011	2012.02	08/09/2011 09:10:48 AM Eastern Daylight Time	08/09/2011 07:08:28 AM Eastern Daylight Time	08/09/2011 07:02:46 AM Eastern Daylight Time		08/09/2011 11:07:02 AM Eastern Daylight Time	UNIVERSITY OF PITTSBURGH MEDICAL CENTER	UPMC Health Plan	http://www.upmchealthplan.com/medicare/	UPMC for Life Specialty Plan (HMO SNP)	01	01		1			H3907	034	0	2012	Western Pennsylvania		2	4800	2			1	3		1	5		http://www.upmchealthplan.com/medicare/	http://www.upmchealthplan.com/medicare/partd.html	http://www.upmchealthplan.com/medicare/partd.html	(800)-606-8648		(800)-606-8648		(866)-405-8762		(866)-405-8762		(800)-606-8648		(800)-606-8648		(866)-405-8762		(866)-405-8762		(866)-407-8762		(866)-407-8762		(866)-407-8762		(866)-407-8762		(866)-407-8762		(866)-407-8762		(866)-407-8762		(866)-407-8762		2	2	2
H3907	801	0	1	01	01	H3907_801_0	2	1		05/25/2011	2012.02	05/25/2011 10:35:08 AM Eastern Daylight Time	06/01/2011 12:58:10 PM Eastern Daylight Time			06/01/2011 01:08:25 PM Eastern Daylight Time	UNIVERSITY OF PITTSBURGH MEDICAL CENTER	UPMC Health Plan	http://www.upmchealthplan.com/medicare/	UPMC Employer Group (HMO)	01	01		1			H3907	801	0	2012	Western Pennsylvania		1	7000	2			2						http://www.upmchealthplan.com/medicare/	http://www.upmchealthplan.com/medicare/partd.html	http://www.upmchealthplan.com/medicare/partd.html	(877)-539-3080		(877)-539-3080		(877)-381-3765		(877)-381-3765										(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629										2	2	2
H3907	802	0	1	01	01	H3907_802_0	4	1		05/25/2011	2012.02	05/25/2011 10:35:21 AM Eastern Daylight Time	06/01/2011 12:28:02 PM Eastern Daylight Time			06/01/2011 01:08:25 PM Eastern Daylight Time	UNIVERSITY OF PITTSBURGH MEDICAL CENTER	UPMC Health Plan	http://www.upmchealthplan.com/medicare/	UPMC Employer Group Rx (HMO)	01	01		1			H3907	802	0	2012	Western Pennsylvania		1	10000	2			2						http://www.upmchealthplan.com/medicare/	http://www.upmchealthplan.com/medicare/partd.html	http://www.upmchealthplan.com/medicare/partd.html	(877)-539-3080		(877)-539-3080		(877)-381-3765		(877)-381-3765		(877)-539-3080		(877)-539-3080		(877)-381-3765		(877)-381-3765		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		2	2	2
H3907	803	0	1	01	01	H3907_803_0	2	1		05/25/2011	2012.02	05/25/2011 10:35:32 AM Eastern Daylight Time	06/01/2011 12:29:23 PM Eastern Daylight Time			06/01/2011 01:08:25 PM Eastern Daylight Time	UNIVERSITY OF PITTSBURGH MEDICAL CENTER	UPMC Health Plan	http://www.upmchealthplan.com/medicare/	UPMC Employer Group Rx (HMO)	01	01		1			H3907	803	0	2012	Western Pennsylvania		1	100	2			2						http://www.upmchealthplan.com/medicare/	http://www.upmchealthplan.com/medicare/partd.html	http://www.upmchealthplan.com/medicare/partd.html	(877)-539-3080		(877)-539-3080		(877)-381-3765		(877)-381-3765		(877)-539-3080		(877)-539-3080		(877)-381-3765		(877)-381-3765		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		2	2	2
H3908	001	0	1	20	08	H3908_001_0	1	1		05/23/2011	2012.02	05/23/2011 01:41:31 PM Eastern Daylight Time		05/20/2011 04:57:25 PM Eastern Daylight Time		05/23/2011 01:45:00 PM Eastern Daylight Time	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA	Trustees Of The University Of Pennsylvania	http://www.lifeupenn.org/	Trustees of the University of Pennsylvania (PACE)	08	20		1			H3908	001	0	2012	Philadelphia, PA		2		2			2							www.LIFEUPENN.org	www.omnicare.com									(215)-573-7200		(215)-573-7200		(215)-573-7200		(215)-573-7200										(215)-573-7200		(215)-573-7200		(215)-573-7200		(215)-573-7200				
H3908	002	0	1	20	08	H3908_002_0	1	1		05/23/2011	2012.02	05/23/2011 01:41:55 PM Eastern Daylight Time		05/20/2011 04:57:25 PM Eastern Daylight Time		05/23/2011 01:45:00 PM Eastern Daylight Time	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA	Trustees Of The University Of Pennsylvania	http://www.lifeupenn.org/	Trustees of the University of Pennsylvania (PACE)	08	20		1			H3908	002	0	2012	Philadelphia, PA		2		2			2							www.LIFEUPENN.org	www.omnicare.com									(215)-573-7200		(215)-573-7200		(215)-573-7200		(215)-573-7200										(215)-573-7200		(215)-573-7200		(215)-573-7200		(215)-573-7200				
H3909	001	0	1	04	01	H3909_001_0	7	1		07/14/2011	2012.02	07/14/2011 10:22:53 AM Eastern Daylight Time	08/04/2011 02:35:59 PM Eastern Daylight Time	08/04/2011 01:51:36 PM Eastern Daylight Time		08/05/2011 05:36:25 PM Eastern Daylight Time	QCC INSURANCE COMPANY	Personal Choice 65	www.ibxmedicare.com	Personal Choice 65 Rx (PPO)	01	04		1			H3909	001	0	2012	Bucks, Philadelphia Counties		2	4075	2			2						www.ibxmedicare.com	http://www.ibxmedicare.com/prescription_drugs/formulary.html	http://www.ibxmedicare.com/prescription_drugs/rx_network.html	(888)-718-3333		(888)-718-3333		(877)-393-6733		(877)-393-6733		(888)-718-3333		(888)-718-3333		(877)-393-6733		(877)-393-6733		(888)-857-4816		(888)-857-4816		(877)-219-5457		(877)-219-5457		(888)-857-4816		(888)-857-4816		(877)-219-5457		(877)-219-5457		2	2	2
H3909	007	0	1	04	01	H3909_007_0	5	1		07/14/2011	2012.02	07/14/2011 10:21:51 AM Eastern Daylight Time	06/15/2011 10:00:04 AM Eastern Daylight Time			07/14/2011 02:37:41 PM Eastern Daylight Time	QCC INSURANCE COMPANY	Personal Choice 65	www.ibxmedicare.com	Personal Choice 65 Medical Only (PPO)	01	04		1			H3909	007	0	2012	Bucks, Philadelphia Counties		2	411	2			2						www.ibxmedicare.com	http://www.ibxmedicare.com/prescription_drugs/formulary.html	http://www.ibxmedicare.com/prescription_drugs/rx_network.html	(888)-718-3333		(888)-718-3333		(877)-393-6733		(877)-393-6733										(888)-857-4816		(888)-857-4816		(877)-219-5457		(877)-219-5457										2	2	2
H3909	801	0	1	04	01	H3909_801_0	4	1		07/14/2011	2012.02	07/14/2011 10:53:56 AM Eastern Daylight Time	06/15/2011 09:52:13 AM Eastern Daylight Time			07/14/2011 02:37:41 PM Eastern Daylight Time	QCC INSURANCE COMPANY	Personal Choice 65	www.ibxmedicare.com	Personal Choice 65 Group Medical Only (PPO)	01	04		1			H3909	801	0	2012	County: Bucks, Chester, Delaware, Montgomery,Phila		1		2			2						www.ibxmedicare.com	http://www.ibxmedicare.com/prescription_drugs/formulary.html	http://www.ibxmedicare.com/prescription_drugs/rx_network.html	(888)-718-3333		(888)-718-3333		(877)-393-6733		(877)-393-6733										(888)-857-4816		(888)-857-4816		(877)-219-5457		(877)-219-5457										2	2	2
H3909	802	0	1	04	01	H3909_802_0	4	1		07/14/2011	2012.02	07/14/2011 10:53:10 AM Eastern Daylight Time	06/15/2011 09:55:07 AM Eastern Daylight Time			07/14/2011 02:37:41 PM Eastern Daylight Time	QCC INSURANCE COMPANY	Personal Choice 65	www.ibxmedicare.com	Personal Choice 65 Group Rx (PPO)	01	04		1			H3909	802	0	2012	County: Bucks, Chester, Delaware, Montgomery,Phila		1		2			2						www.ibxmedicare.com	http://www.ibxmedicare.com/prescription_drugs/formulary.html	http://www.ibxmedicare.com/prescription_drugs/rx_network.html	(888)-718-3333		(888)-718-3333		(877)-393-6733		(877)-393-6733		(888)-718-3333		(888)-718-3333		(877)-393-6733		(877)-393-6733		(888)-857-4816		(888)-857-4816		(877)-219-5457		(877)-219-5457		(888)-857-4816		(888)-857-4816		(877)-219-5457		(877)-219-5457		2	2	2
H3912	001	0	1	04	01	H3912_001_0	3	1		07/22/2011	2012.02	07/22/2011 12:11:19 PM Central Daylight Time	08/08/2011 04:40:11 PM Central Daylight Time	08/05/2011 01:33:55 PM Central Daylight Time		08/09/2011 04:41:55 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	Evercare by UnitedHealthcare	www.EvercareHealthPlans.com	UnitedHealthcare Nursing Home Plan (PPO SNP)	01	04		1			H3912	001	0	2012	Philadelphia,Harrisburg,York and Surrounding Areas		2		2			1	1	1	1			www.EvercareHealthPlans.com	evercarehealthplans.com/prescription_drug_coverage.jsp	www.prescriptionsolutions.com	(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3916	001	0	1	04	01	H3916_001_0	7	1		07/21/2011	2012.02	07/21/2011 12:32:41 PM Eastern Daylight Time	08/04/2011 02:18:27 PM Eastern Daylight Time	08/04/2011 01:01:19 PM Eastern Daylight Time		08/08/2011 11:39:21 AM Eastern Daylight Time	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	FreedomBlue PPO Classic (PPO)	01	04		1			H3916	001	0	2012	Southwestern PA		2		2			2						www.highmark.com	http://highmark.medicare-approvedformularies.com/	www.highmark.com	(800)-550-8722		(800)-550-8722		(866)-682-7969		(866)-682-7969		(800)-550-8722		(800)-550-8722		(866)-682-7969		(866)-682-7969		(888)-422-1226		(888)-422-1226		(711)		(711)		(888)-422-1226		(888)-422-1226		(711)		(711)		2	2	2
H3916	002	0	1	04	01	H3916_002_0	7	1		07/21/2011	2012.02	07/21/2011 12:33:14 PM Eastern Daylight Time	08/04/2011 02:19:03 PM Eastern Daylight Time	08/04/2011 01:02:18 PM Eastern Daylight Time		08/08/2011 11:39:21 AM Eastern Daylight Time	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	FreedomBlue PPO Classic (PPO)	01	04		1			H3916	002	0	2012	West Central PA		2		2			2						www.highmark.com	http://highmark.medicare-approvedformularies.com/	www.highmark.com	(800)-550-8722		(800)-550-8722		(866)-682-7969		(866)-682-7969		(800)-550-8722		(800)-550-8722		(866)-682-7969		(866)-682-7969		(888)-422-1226		(888)-422-1226		(711)		(711)		(888)-422-1226		(888)-422-1226		(711)		(711)		2	2	2
H3916	005	0	1	04	01	H3916_005_0	7	1		07/21/2011	2012.02	07/21/2011 12:36:16 PM Eastern Daylight Time	08/04/2011 02:19:26 PM Eastern Daylight Time	08/04/2011 01:03:11 PM Eastern Daylight Time		08/08/2011 11:39:21 AM Eastern Daylight Time	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	FreedomBlue PPO Deluxe (PPO)	01	04		1			H3916	005	0	2012	Central and Northeastern PA		2		2			2						www.highmark.com	http://highmark.medicare-approvedformularies.com/	www.highmark.com	(800)-550-8722		(800)-550-8722		(866)-682-7971		(866)-682-7971		(800)-550-8722		(800)-550-8722		(866)-682-7971		(866)-682-7971		(888)-422-1226		(888)-422-1226		(711)		(711)		(888)-422-1226		(888)-422-1226		(711)		(711)		2	2	2
H3916	012	0	1	04	01	H3916_012_0	6	1		07/21/2011	2012.02	07/21/2011 12:37:50 PM Eastern Daylight Time	06/04/2011 12:15:56 PM Eastern Daylight Time			07/21/2011 04:24:19 PM Eastern Daylight Time	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	FreedomBlue PPO Value (PPO)	01	04		1			H3916	012	0	2012	Central and Northeastern PA		2		2			2						www.highmark.com	http://highmark.medicare-approvedformularies.com/	www.highmark.com	(800)-550-8722		(800)-550-8722		(866)-682-7971		(866)-682-7971										(888)-422-1226		(888)-422-1226		(711)		(711)										2	2	2
H3916	015	0	1	04	01	H3916_015_0	7	1		07/21/2011	2012.02	07/21/2011 12:36:46 PM Eastern Daylight Time	08/04/2011 02:19:53 PM Eastern Daylight Time	08/04/2011 01:04:01 PM Eastern Daylight Time		08/08/2011 11:39:21 AM Eastern Daylight Time	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	FreedomBlue PPO Standard (PPO)	01	04		1			H3916	015	0	2012	Central and Northeastern PA		2		2			2						www.highmark.com	http://highmark.medicare-approvedformularies.com/	www.highmark.com	(800)-550-8722		(800)-550-8722		(866)-682-7971		(866)-682-7971		(800)-550-8722		(800)-550-8722		(866)-682-7971		(866)-682-7971		(888)-422-1226		(888)-422-1226		(711)		(711)		(888)-422-1226		(888)-422-1226		(711)		(711)		2	2	2
H3916	018	0	1	04	01	H3916_018_0	7	1		07/21/2011	2012.02	07/21/2011 12:37:20 PM Eastern Daylight Time	08/04/2011 02:20:12 PM Eastern Daylight Time	08/04/2011 01:04:52 PM Eastern Daylight Time		08/08/2011 11:39:21 AM Eastern Daylight Time	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	FreedomBlue PPO Basic Rx (PPO)	01	04		1			H3916	018	0	2012	Central and Northeastern PA		2		2			2						www.highmark.com	http://highmark.medicare-approvedformularies.com/	www.highmark.com	(800)-550-8722		(800)-550-8722		(866)-682-7971		(866)-682-7971		(800)-550-8722		(800)-550-8722		(866)-682-7971		(866)-682-7971		(888)-422-1226		(888)-422-1226		(711)		(711)		(888)-422-1226		(888)-422-1226		(711)		(711)		2	2	2
H3916	019	0	1	04	01	H3916_019_0	8	1		07/21/2011	2012.02	07/21/2011 12:34:46 PM Eastern Daylight Time	08/04/2011 02:20:58 PM Eastern Daylight Time	08/04/2011 01:05:43 PM Eastern Daylight Time		08/08/2011 11:39:21 AM Eastern Daylight Time	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	FreedomBlue PPO HD Rx (PPO)	01	04		1			H3916	019	0	2012	Southwestern PA		2		2			2						www.highmark.com	http://highmark.medicare-approvedformularies.com/	www.highmark.com	(800)-550-8722		(800)-550-8722		(866)-682-7969		(866)-682-7969		(800)-550-8722		(800)-550-8722		(866)-682-7969		(866)-682-7969		(888)-422-1226		(888)-422-1226		(711)		(711)		(888)-422-1226		(888)-422-1226		(711)		(711)		2	2	2
H3916	020	0	1	04	01	H3916_020_0	8	1		07/21/2011	2012.02	07/21/2011 12:35:11 PM Eastern Daylight Time	08/04/2011 02:21:27 PM Eastern Daylight Time	08/04/2011 01:06:37 PM Eastern Daylight Time		08/08/2011 11:39:21 AM Eastern Daylight Time	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	FreedomBlue PPO HD Rx (PPO)	01	04		1			H3916	020	0	2012	West Central PA		2		2			2						www.highmark.com	http://highmark.medicare-approvedformularies.com/	www.highmark.com	(800)-550-8722		(800)-550-8722		(866)-682-7969		(866)-682-7969		(800)-550-8722		(800)-550-8722		(866)-682-7969		(866)-682-7969		(888)-422-1226		(888)-422-1226		(711)		(711)		(888)-422-1226		(888)-422-1226		(711)		(711)		2	2	2
H3916	022	0	1	04	01	H3916_022_0	7	1		07/21/2011	2012.02	07/21/2011 12:33:48 PM Eastern Daylight Time	08/04/2011 02:21:45 PM Eastern Daylight Time	08/04/2011 01:07:30 PM Eastern Daylight Time		08/08/2011 11:39:21 AM Eastern Daylight Time	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	FreedomBlue PPO Select (PPO)	01	04		1			H3916	022	0	2012	Southwestern PA		2		2			2						www.highmark.com	http://highmark.medicare-approvedformularies.com/	www.highmark.com	(800)-550-8722		(800)-550-8722		(866)-682-7969		(866)-682-7969		(800)-550-8722		(800)-550-8722		(866)-682-7969		(866)-682-7969		(888)-422-1226		(888)-422-1226		(711)		(711)		(888)-422-1226		(888)-422-1226		(711)		(711)		2	2	2
H3916	024	0	1	04	01	H3916_024_0	7	1		07/21/2011	2012.02	07/21/2011 12:34:20 PM Eastern Daylight Time	08/04/2011 02:22:04 PM Eastern Daylight Time	08/04/2011 01:08:26 PM Eastern Daylight Time		08/08/2011 11:39:21 AM Eastern Daylight Time	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	FreedomBlue PPO Select (PPO)	01	04		1			H3916	024	0	2012	West Central PA		2		2			2						www.highmark.com	http://highmark.medicare-approvedformularies.com/	www.highmark.com	(800)-550-8722		(800)-550-8722		(866)-682-7969		(866)-682-7969		(800)-550-8722		(800)-550-8722		(866)-682-7969		(866)-682-7969		(888)-422-1226		(888)-422-1226		(711)		(711)		(888)-422-1226		(888)-422-1226		(711)		(711)		2	2	2
H3916	025	0	1	04	01	H3916_025_0	8	1		07/21/2011	2012.02	07/21/2011 12:35:49 PM Eastern Daylight Time	08/04/2011 02:22:30 PM Eastern Daylight Time	08/04/2011 01:09:17 PM Eastern Daylight Time		08/08/2011 11:39:21 AM Eastern Daylight Time	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	FreedomBlue PPO HD Rx (PPO)	01	04		1			H3916	025	0	2012	Central and Northeastern PA		2		2			2						www.highmark.com	http://highmark.medicare-approvedformularies.com/	www.highmark.com	(800)-550-8722		(800)-550-8722		(866)-682-7971		(866)-682-7971		(800)-550-8722		(800)-550-8722		(866)-682-7971		(866)-682-7971		(888)-422-1226		(888)-422-1226		(711)		(711)		(888)-422-1226		(888)-422-1226		(711)		(711)		2	2	2
H3916	801	0	1	04	01	H3916_801_0	4	1		06/01/2011	2012.02	06/01/2011 01:00:43 PM Eastern Daylight Time	06/04/2011 12:18:58 PM Eastern Daylight Time			06/04/2011 01:46:43 PM Eastern Daylight Time	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	FreedomBlue PPO MA Pennsylvania (PPO)	01	04		1			H3916	801	0	2012	Pennsylvania		1		2			2						www.highmark.com	http://highmark.medicare-approvedformularies.com/	www.highmark.com	(800)-550-8722		(800)-550-8722		(866)-682-7969		(866)-682-7969										(888)-422-1226		(888)-422-1226		(711)		(711)										1	1	1
H3916	802	0	1	04	01	H3916_802_0	4	1		06/01/2011	2012.02	06/01/2011 01:00:49 PM Eastern Daylight Time	06/04/2011 12:19:29 PM Eastern Daylight Time			06/04/2011 01:46:43 PM Eastern Daylight Time	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	FreedomBlue PPO MA-PD Pennsylvania (PPO)	01	04		1			H3916	802	0	2012	Pennsylvania		1		2			2						www.highmark.com	http://highmark.medicare-approvedformularies.com/	www.highmark.com	(800)-550-8722		(800)-550-8722		(866)-682-7969		(866)-682-7969		(800)-550-8722		(800)-550-8722		(866)-682-7969		(866)-682-7969		(888)-422-1226		(888)-422-1226		(711)		(711)		(888)-422-1226		(888)-422-1226		(711)		(711)		1	1	1
H3916	804	0	1	04	01	H3916_804_0	4	1		06/01/2011	2012.02	06/01/2011 01:00:55 PM Eastern Daylight Time	06/04/2011 12:19:59 PM Eastern Daylight Time			06/04/2011 01:46:43 PM Eastern Daylight Time	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	FreedomBlue PPO MA-PD PA Non-Calendar (PPO)	01	04		1			H3916	804	0	2012	Pennsylvania		1		2			2						www.highmark.com	http://highmark.medicare-approvedformularies.com/	www.highmark.com	(800)-550-8722		(800)-550-8722		(866)-682-7969		(866)-682-7969		(800)-550-8722		(800)-550-8722		(866)-682-7969		(866)-682-7969		(888)-422-1226		(888)-422-1226		(711)		(711)		(888)-422-1226		(888)-422-1226		(711)		(711)		1	1	1
H3917	001	0	1	20	08	H3917_001_0	1	1		05/23/2011	2012.02	05/23/2011 01:29:46 PM Eastern Daylight Time		05/20/2011 04:53:11 PM Eastern Daylight Time		05/23/2011 01:30:39 PM Eastern Daylight Time	PITTSBURGH CARE PARTNERSHIP, INC.	Community LIFE	http://www.commlife.org/	Pittsburgh Care Partnership, Inc. (PACE)	08	20		1			H3917	001	0	2012	Allegheny, Westmoreland Counties (Partial of each)		2		2			2							www.commlife.org	www.commlife.org									(866)-419-1693		(412)-464-2101		(866)-419-1693		(412)-464-2101										(866)-419-1693		(412)-464-2101		(866)-419-1693		(412)-464-2101				
H3917	002	0	1	20	08	H3917_002_0	1	1		05/23/2011	2012.02	05/23/2011 01:30:00 PM Eastern Daylight Time		05/20/2011 04:53:11 PM Eastern Daylight Time		05/23/2011 01:30:39 PM Eastern Daylight Time	PITTSBURGH CARE PARTNERSHIP, INC.	Community LIFE	http://www.commlife.org/	Pittsburgh Care Partnership, Inc. (PACE)	08	20		1			H3917	002	0	2012	Allegheny, Westmoreland Counties (Partial of each)		2		2			2							www.commlife.org	www.commlife.org									(866)-419-1693		(412)-464-2101		(866)-419-1693		(412)-464-2101										(866)-419-1693		(412)-464-2101		(866)-419-1693		(412)-464-2101				
H3918	001	0	1	20	08	H3918_001_0	1	1		05/23/2011	2012.01	05/23/2011 01:39:11 PM Eastern Daylight Time		05/23/2011 01:35:50 PM Eastern Daylight Time		05/23/2011 02:36:20 PM Eastern Daylight Time	LIVING INDEPENDENCE FOR THE ELDERLY	LIFE Pittsburgh	LIFEPittsburgh.org	LIFE Pittsburgh Dual Eligibles Pharmacy (PACE)	08	20		1			H3918	001	0	2012	Partial Allegheny*		2	400	2			2							not applicable -- no formulary	none									(412)-388-8042	4228	(412)-388-8042	4228	(412)-388-8042	4228	(412)-388-8042	4228									(412)-388-8042	4228	(412)-388-8042	4228	(412)-388-8042	4228	(412)-388-8042	4228			
H3918	002	0	1	20	08	H3918_002_0	1	1		05/04/2011	2012.01	05/04/2011 01:56:12 PM Eastern Daylight Time		05/23/2011 01:36:26 PM Eastern Daylight Time		05/23/2011 02:36:20 PM Eastern Daylight Time	LIVING INDEPENDENCE FOR THE ELDERLY	LIFE Pittsburgh	LIFEPittsburgh.org	LIFE Pittsburgh Medicare Only Pharmacy (PACE)	08	20		1			H3918	002	0	2012	Allegheny *		2	400	2			2							not applicable -- no formulary	none									(412)-388-8042	4228	(412)-388-8042	4228	(412)-388-8042	4228	(412)-388-8042	4228									(412)-388-8042	4228	(412)-388-8042	4228	(412)-388-8042	4228	(412)-388-8042	4228			
H3919	001	0	1	20	08	H3919_001_0	1	1		05/23/2011	2012.02	05/23/2011 01:14:31 PM Eastern Daylight Time		05/20/2011 03:29:05 PM Eastern Daylight Time		05/23/2011 01:19:29 PM Eastern Daylight Time	ST. AGNES CONTINUING CARE CENTER	Mercy LIFE	www.mercyhealth.org/life	Mercy LIFE (PACE)	08	20		1			H3919	001	0	2012	Philadelphia		2		2			2							www.mercylife.org	www.mercylife.org									(800)-820-4512	4747	(215)-339-4747		(800)-820-4512	4747	(215)-339-4747										(800)-820-4512	4747	(215)-339-4747		(800)-820-4512	4747	(215)-339-4747				
H3919	002	0	1	20	08	H3919_002_0	1	1		05/23/2011	2012.02	05/23/2011 01:15:06 PM Eastern Daylight Time		05/20/2011 03:29:06 PM Eastern Daylight Time		05/23/2011 01:19:29 PM Eastern Daylight Time	ST. AGNES CONTINUING CARE CENTER	Mercy LIFE	www.mercyhealth.org/life	Mercy LIFE (PACE)	08	20		1			H3919	002	0	2012	Philadelphia		2		2			2							www.mercylife.org	www.mercylife.org									(800)-820-4512	4747	(215)-339-4747		(800)-820-4512	4747	(215)-339-4747										(800)-820-4512		(215)-339-4747		(800)-820-4512	4747	(215)-339-4747				
H3920	001	0	1	01	01	H3920_001_0	8	1		08/18/2011	2012.02	08/18/2011 02:25:23 PM Central Daylight Time	08/17/2011 04:18:34 PM Central Daylight Time	08/05/2011 01:08:19 PM Central Daylight Time		08/18/2011 04:35:53 PM Central Daylight Time	UNITEDHEALTHCARE OF PENNSYLVANIA, INC.	UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare MedicareComplete (HMO)	01	01		1			H3920	001	0	2012	Select counties in Pennsylvania		2		2			2						www.UHCDualComplete.com	http://www.unisonhealthplan.com	www.prescriptionsolutions.com	(800)-290-4009		(800)-290-4009		(888)-565-8202		(888)-565-8202		(800)-290-4009		(800)-290-4009		(888)-565-8202		(888)-565-8202		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3920	009	0	1	01	01	H3920_009_0	6	1	2	07/22/2011	2012.02	07/22/2011 12:09:26 PM Central Daylight Time	08/05/2011 11:53:05 AM Central Daylight Time	08/05/2011 01:08:42 PM Central Daylight Time		08/09/2011 12:48:01 PM Central Daylight Time	UNITEDHEALTHCARE OF PENNSYLVANIA, INC.	UnitedHealthcare Community Plan	www.UHCDualComplete.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H3920	009	0	2012	Pennsylvania Counties		2		2			1	3		1	5		www.UHCDualComplete.com	http://www.unisonhealthplan.com	www.prescriptionsolutions.com	(800)-290-4009		(800)-290-4009		(888)-565-8170		(888)-565-8170		(800)-290-4009		(800)-290-4009		(888)-565-8170		(888)-565-8170		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3921	001	0	1	04	01	H3921_001_0	5	1		08/09/2011	2012.02	08/09/2011 10:55:43 AM Central Daylight Time	08/05/2011 10:48:24 AM Central Daylight Time	08/05/2011 01:34:26 PM Central Daylight Time		08/09/2011 04:28:20 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	UnitedHealthcare MedicareComplete Choice (PPO)	01	04		1			H3921	001	0	2012	Lancaster and York Counties		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-711-6088		(800)-711-6088		(800)-555-5757		(800)-555-5757		(800)-711-6088		(800)-711-6088		(800)-555-5757		(800)-555-5757		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3921	008	0	1	04	01	H3921_008_0	5	1		08/09/2011	2012.02	08/09/2011 10:57:11 AM Central Daylight Time	08/05/2011 10:49:08 AM Central Daylight Time	08/05/2011 01:34:42 PM Central Daylight Time		08/09/2011 04:28:20 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice (PPO)	01	04		1			H3921	008	0	2012	Erie, Lehigh and Northampton counties		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3923	013	0	1	04	01	H3923_013_0	10	1		07/21/2011	2012.02	07/21/2011 11:19:29 AM Eastern Daylight Time	08/08/2011 03:09:10 PM Eastern Daylight Time	08/08/2011 11:49:04 AM Eastern Daylight Time		08/09/2011 11:50:30 AM Eastern Daylight Time	CAPITAL ADVANTAGE INSURANCE COMPANY	Capital Advantage Insurance Company	seniorblueppo.capbluecross.com	SeniorBlue - Option 2 (PPO)	01	04		1			H3923	013	0	2012	21 Counties in Central PA		2	1470	2			2						seniorblueppo.capbluecross.com	https://seniorblueppo.capbluecross.com/PharmacyInformation/	https://seniorblueppo.capbluecross.com/PharmacyInformation/	(866)-987-4213		(866)-987-4213		(800)-990-4201		(800)-990-4201		(866)-987-4213		(866)-987-4213		(800)-990-4201		(800)-990-4201		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		2	2	2
H3923	017	0	1	04	01	H3923_017_0	7	1		07/21/2011	2012.02	07/21/2011 11:12:01 AM Eastern Daylight Time	07/08/2011 06:05:51 PM Eastern Daylight Time	07/20/2011 04:32:50 PM Eastern Daylight Time		07/21/2011 06:27:40 PM Eastern Daylight Time	CAPITAL ADVANTAGE INSURANCE COMPANY	Capital Advantage Insurance Company	seniorblueppo.capbluecross.com	SeniorBlue - Option 1 (PPO)	01	04		1			H3923	017	0	2012	21 Counties in Central PA		2	6975	2			2						seniorblueppo.capbluecross.com	https://seniorblueppo.capbluecross.com/PharmacyInformation/	https://seniorblueppo.capbluecross.com/PharmacyInformation/	(866)-987-4213		(866)-987-4213		(800)-990-4201		(800)-990-4201		(866)-987-4213		(866)-987-4213		(800)-990-4201		(800)-990-4201		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		2	2	2
H3923	801	0	1	04	01	H3923_801_0	6	1		07/07/2011	2012.02	07/07/2011 10:03:54 AM Eastern Daylight Time	06/07/2011 02:22:57 AM Eastern Daylight Time			07/07/2011 10:12:18 AM Eastern Daylight Time	CAPITAL ADVANTAGE INSURANCE COMPANY	Capital Advantage Insurance Company	seniorblueppo.capbluecross.com	MA - ER with Rx (PPO)	01	04		1			H3923	801	0	2012	National		1	3783	2			2						seniorblueppo.capbluecross.com	https://seniorblueppo.capbluecross.com/PharmacyInformation/	https://seniorblueppo.capbluecross.com/PharmacyInformation/	(866)-987-4213		(866)-987-4213		(800)-990-4201		(800)-990-4201		(866)-987-4213		(866)-987-4213		(800)-990-4201		(800)-990-4201		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		2	2	2
H3923	802	0	1	04	01	H3923_802_0	6	1		07/07/2011	2012.02	07/07/2011 10:04:05 AM Eastern Daylight Time	06/07/2011 02:25:18 AM Eastern Daylight Time			07/07/2011 10:12:18 AM Eastern Daylight Time	CAPITAL ADVANTAGE INSURANCE COMPANY	Capital Advantage Insurance Company	seniorblueppo.capbluecross.com	MA - ER w/o Rx (PPO)	01	04		1			H3923	802	0	2012	National		1	3783	2			2						seniorblueppo.capbluecross.com	https://seniorblueppo.capbluecross.com/PharmacyInformation/	https://seniorblueppo.capbluecross.com/PharmacyInformation/	(866)-987-4213		(866)-987-4213		(800)-990-4201		(800)-990-4201										(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961										2	2	2
H3923	803	0	1	04	01	H3923_803_0	7	1		07/07/2011	2012.02	07/07/2011 10:04:13 AM Eastern Daylight Time	06/07/2011 02:28:14 AM Eastern Daylight Time			07/07/2011 10:12:18 AM Eastern Daylight Time	CAPITAL ADVANTAGE INSURANCE COMPANY	Capital Advantage Insurance Company	seniorblueppo.capbluecross.com	MA - ER Non-Calendar w Rx (PPO)	01	04		1			H3923	803	0	2012	National		1	3783	2			2						seniorblueppo.capbluecross.com	https://seniorblueppo.capbluecross.com/PharmacyInformation/	https://seniorblueppo.capbluecross.com/PharmacyInformation/	(866)-987-4213		(866)-987-4213		(800)-990-4201		(800)-990-4201		(866)-987-4213		(866)-987-4213		(800)-990-4201		(800)-990-4201		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		2	2	2
H3924	001	0	1	04	01	H3924_001_0	5	1		07/18/2011	2012.02	07/18/2011 06:09:38 PM Eastern Daylight Time	07/15/2011 03:32:56 PM Eastern Daylight Time			07/20/2011 09:33:14 PM Eastern Daylight Time	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	Geisinger Gold Preferred 1 (PPO)	01	04		1			H3924	001	0	2012	Central PA		2		2			2						www.geisingergold.com	https://www.thehealthplan.com/formulary/formulary_search.cfm	www.geisingergold.com	(800)-498-9731		(570)-271-8771		(800)-514-0138		(800)-514-0138										(711)		(711)		(711)		(711)										2	2	2
H3924	003	0	1	04	01	H3924_003_0	5	1		07/15/2011	2012.02	07/15/2011 04:37:35 PM Eastern Daylight Time	08/04/2011 06:37:05 PM Eastern Daylight Time	08/04/2011 06:44:14 PM Eastern Daylight Time		08/05/2011 05:08:23 PM Eastern Daylight Time	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	Geisinger Gold Preferred 1 $0 Deductible Rx (PPO)	01	04		1			H3924	003	0	2012	Central PA		2		2			2						www.geisingergold.com	https://www.thehealthplan.com/formulary/formulary_search.cfm	www.geisingergold.com	(800)-498-9731		(570)-271-8771		(800)-514-0138		(800)-514-0138		(800)-988-4861		(570)-271-8771		(800)-514-0138		(800)-514-0138		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3924	021	0	1	04	01	H3924_021_0	4	1		07/13/2011	2012.02	07/13/2011 05:26:18 PM Eastern Daylight Time	07/15/2011 03:42:30 PM Eastern Daylight Time			07/20/2011 09:33:14 PM Eastern Daylight Time	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	Geisinger Gold Preferred 1 (PPO)	01	04		1			H3924	021	0	2012	Counties: Adams, Berks, Dauph, Lanca, Leban, York		2		2			2						www.geisingergold.com	https://www.thehealthplan.com/formulary/formulary_search.cfm	www.geisingergold.com	(800)-498-9731		(570)-271-8771		(800)-514-0138		(800)-514-0138										(711)		(711)		(711)		(711)										2	2	2
H3924	023	0	1	04	01	H3924_023_0	5	1		07/13/2011	2012.02	07/13/2011 05:30:43 PM Eastern Daylight Time	08/04/2011 05:19:08 PM Eastern Daylight Time	08/04/2011 06:48:47 PM Eastern Daylight Time		08/05/2011 05:08:23 PM Eastern Daylight Time	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	Geisinger Gold Preferred 1 $0 Deductible Rx (PPO)	01	04		1			H3924	023	0	2012	Counties: Adams, Berks, Dauph, Lanca, Leban, York		2		2			2						www.geisingergold.com	https://www.thehealthplan.com/formulary/formulary_search.cfm	www.geisingergold.com	(800)-498-9731		(570)-271-8771		(800)-514-0138		(800)-514-0138		(800)-988-4861		(570)-271-8771		(800)-514-0138		(800)-514-0138		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3924	045	0	1	04	01	H3924_045_0	3	1		07/15/2011	2012.02	07/15/2011 12:43:22 PM Eastern Daylight Time	07/15/2011 03:53:33 PM Eastern Daylight Time			07/20/2011 09:33:14 PM Eastern Daylight Time	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	Geisinger Gold Preferred 2 (PPO)	01	04		1			H3924	045	0	2012	Central PA - Region 1		2		2			2						www.geisingergold.com	https://www.thehealthplan.com/formulary/formulary_search.cfm	www.geisingergold.com	(800)-498-9731		(570)-271-8771		(800)-514-0138		(800)-514-0138										(711)		(711)		(711)		(711)										2	2	2
H3924	046	0	1	04	01	H3924_046_0	6	1		07/15/2011	2012.02	07/15/2011 12:53:55 PM Eastern Daylight Time	08/04/2011 05:24:19 PM Eastern Daylight Time	08/04/2011 06:50:29 PM Eastern Daylight Time		08/05/2011 05:08:23 PM Eastern Daylight Time	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	Geisinger Gold Preferred 2 $0 Deductible Rx (PPO)	01	04		1			H3924	046	0	2012	Central PA - Region 1		2		2			2						www.geisingergold.com	https://www.thehealthplan.com/formulary/formulary_search.cfm	www.geisingergold.com	(800)-498-9731		(570)-271-8771		(800)-514-0138		(800)-514-0138		(800)-988-4861		(570)-271-8771		(800)-514-0138		(800)-514-0138		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3924	047	0	1	04	01	H3924_047_0	4	1		07/15/2011	2012.02	07/15/2011 12:54:25 PM Eastern Daylight Time	07/15/2011 04:00:11 PM Eastern Daylight Time			07/20/2011 09:33:14 PM Eastern Daylight Time	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	Geisinger Gold Preferred 2 (PPO)	01	04		1			H3924	047	0	2012	Central PA - Region 2		2		2			2						www.geisingergold.com	https://www.thehealthplan.com/formulary/formulary_search.cfm	www.geisingergold.com	(800)-498-9731		(570)-271-8771		(800)-514-0138		(800)-514-0138										(711)		(711)		(711)		(711)										2	2	2
H3924	048	0	1	04	01	H3924_048_0	6	1		07/15/2011	2012.02	07/15/2011 12:54:51 PM Eastern Daylight Time	08/04/2011 05:28:09 PM Eastern Daylight Time	08/04/2011 06:51:56 PM Eastern Daylight Time		08/05/2011 05:08:23 PM Eastern Daylight Time	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	Geisinger Gold Preferred 2 $0 Deductible Rx (PPO)	01	04		1			H3924	048	0	2012	Central PA - Region 2		2		2			2						www.geisingergold.com	https://www.thehealthplan.com/formulary/formulary_search.cfm	www.geisingergold.com	(800)-498-9731		(570)-271-8771		(800)-514-0138		(800)-514-0138		(800)-988-4861		(570)-271-8771		(800)-514-0138		(800)-514-0138		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3924	051	0	1	04	01	H3924_051_0	3	1		07/15/2011	2012.02	07/15/2011 12:55:15 PM Eastern Daylight Time	07/19/2011 10:12:17 AM Eastern Daylight Time			07/20/2011 09:33:14 PM Eastern Daylight Time	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	Geisinger Gold Preferred 2 (PPO)	01	04		1			H3924	051	0	2012	Carbon, Lehigh and Northampton Counties		2		2			2						www.geisingergold.com	https://www.thehealthplan.com/formulary/formulary_search.cfm	www.geisingergold.com	(800)-498-9731		(570)-271-8771		(800)-514-0138		(800)-514-0138										(711)		(711)		(711)		(711)										2	2	2
H3924	052	0	1	04	01	H3924_052_0	6	1		07/15/2011	2012.02	07/15/2011 12:55:40 PM Eastern Daylight Time	08/04/2011 05:33:03 PM Eastern Daylight Time	08/04/2011 06:54:25 PM Eastern Daylight Time		08/05/2011 05:08:23 PM Eastern Daylight Time	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	Geisinger Gold Preferred 2 $0 Deductible Rx (PPO)	01	04		1			H3924	052	0	2012	Carbon, Lehigh, and Northampton Counties		2		2			2						www.geisingergold.com	https://www.thehealthplan.com/formulary/formulary_search.cfm	www.geisingergold.com	(800)-498-9731		(570)-271-8771		(800)-514-0138		(800)-514-0138		(800)-988-4861		(570)-271-8771		(800)-514-0138		(800)-514-0138		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3924	053	0	1	04	01	H3924_053_0	3	1		07/15/2011	2012.02	07/15/2011 01:14:13 PM Eastern Daylight Time	07/19/2011 10:38:19 AM Eastern Daylight Time			07/20/2011 09:33:14 PM Eastern Daylight Time	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	Geisinger Gold Preferred 3 (PPO)	01	04		1			H3924	053	0	2012	Carbon, Lehigh, and Northampton Counties		2		2			2						www.geisingergold.com	https://www.thehealthplan.com/formulary/formulary_search.cfm	www.geisingergold.com	(800)-498-9731		(570)-271-8771		(800)-514-0138		(800)-514-0138										(711)		(711)		(711)		(711)										2	2	2
H3924	054	0	1	04	01	H3924_054_0	4	1		07/17/2011	2012.02	07/17/2011 07:47:46 PM Eastern Daylight Time	08/04/2011 05:38:53 PM Eastern Daylight Time	08/04/2011 06:56:10 PM Eastern Daylight Time		08/05/2011 05:08:23 PM Eastern Daylight Time	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	Geisinger Gold Preferred 3 $0 Deductible Rx (PPO)	01	04		1			H3924	054	0	2012	Carbon, Lehigh, and Northampton Counties		2		2			2						www.geisingergold.com	https://www.thehealthplan.com/formulary/formulary_search.cfm	www.geisingergold.com	(800)-498-9731		(570)-271-8771		(800)-514-0138		(800)-514-0138		(800)-988-4861		(570)-271-8771		(800)-514-0138		(800)-514-0138		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3924	801	0	1	04	01	H3924_801_0	3	1		07/15/2011	2012.02	07/15/2011 01:22:23 PM Eastern Daylight Time	07/20/2011 06:45:03 PM Eastern Daylight Time			07/20/2011 09:33:14 PM Eastern Daylight Time	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	Geisinger Gold Preferred (Employer Group) (PPO)	01	04		1			H3924	801	0	2012	Pennsylvania		1		2			2						www.geisingergold.com	https://www.thehealthplan.com/formulary/formulary_search.cfm	www.geisingergold.com	(800)-498-9731		(570)-271-8771		(800)-514-0138		(800)-514-0138										(711)		(711)		(711)		(711)										2	2	2
H3924	802	0	1	04	01	H3924_802_0	3	1		07/15/2011	2012.02	07/15/2011 01:23:18 PM Eastern Daylight Time	07/20/2011 06:49:15 PM Eastern Daylight Time			07/20/2011 09:33:14 PM Eastern Daylight Time	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	Geisinger Gold Preferred Rx (Employer Group) (PPO)	01	04		1			H3924	802	0	2012	Pennsylvania		1	50	2			2						www.geisingergold.com	https://www.thehealthplan.com/formulary/formulary_search.cfm	www.geisingergold.com	(800)-498-9731		(570)-271-8771		(800)-514-0138		(800)-514-0138		(800)-988-4861		(570)-271-8771		(800)-514-0138		(800)-514-0138		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3925	001	0	1	20	08	H3925_001_0	2	1		05/19/2011	2012.01	05/19/2011 03:29:51 PM Eastern Daylight Time		05/24/2011 06:54:19 PM Eastern Daylight Time		05/24/2011 07:17:07 PM Eastern Daylight Time	PENNSYLVANIA PACE, INC.	Senior LIFE Johnstown	www.seniorlifejohnstown.com	PA PACE 001 (PACE)	08	20		1			H3925	001	0	2012	Cambria Somerset PACE Senior LIFE JTown		2	190	2			2							NA	NA									(877)-998-5433	102	(814)-535-6000	102	(877)-998-5433	102	(814)-535-6000	102									(877)-998-5433		(814)-535-6000		(877)-998-5433		(814)-535-6000				
H3925	002	0	1	20	08	H3925_002_0	2	1		05/19/2011	2012.01	05/19/2011 03:30:07 PM Eastern Daylight Time		05/24/2011 06:54:19 PM Eastern Daylight Time		05/24/2011 07:17:07 PM Eastern Daylight Time	PENNSYLVANIA PACE, INC.	Senior LIFE Johnstown	www.seniorlifejohnstown.com	PA PACE 002 (PACE)	08	20		1			H3925	002	0	2012	Cambria Somerset PACE Senior LIFE JTown		2	1	2			2							NA	NA									(877)-998-5433	102	(814)-535-6000	102	(877)-998-5433	102	(814)-535-6000	102									(877)-998-5433		(814)-535-6000		(877)-998-5433		(814)-535-6000				
H3931	004	0	1	01	01	H3931_004_0	4	1		07/08/2011	2012.02	07/08/2011 11:02:42 AM Central Daylight Time	08/04/2011 11:42:41 AM Central Daylight Time	08/04/2011 09:51:01 AM Central Daylight Time		08/08/2011 09:51:11 AM Central Daylight Time	AETNA HEALTH INC	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (HMO)	01	01		1			H3931	004	0	2012	Bucks, Chester, Delaware and Montgomery Counties		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H3931	054	0	1	01	01	H3931_054_0	2	1		07/08/2011	2012.02	07/08/2011 11:02:58 AM Central Daylight Time	07/15/2011 10:56:11 AM Central Daylight Time			07/18/2011 09:45:56 AM Central Daylight Time	AETNA HEALTH INC	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Basic Plan (HMO)	01	01		1			H3931	054	0	2012	Philadelphia County and Central and NE PA		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748										2	2	2
H3931	055	0	1	01	01	H3931_055_0	2	1		07/08/2011	2012.02	07/08/2011 11:03:09 AM Central Daylight Time	07/15/2011 10:58:47 AM Central Daylight Time			07/18/2011 09:45:56 AM Central Daylight Time	AETNA HEALTH INC	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Basic Plan (HMO)	01	01		1			H3931	055	0	2012	Bucks, Chester, Delaware and Montgomery Counties		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748										2	2	2
H3931	058	0	1	01	01	H3931_058_0	5	1		07/12/2011	2012.02	07/12/2011 03:02:14 PM Central Daylight Time	08/04/2011 11:45:03 AM Central Daylight Time	08/04/2011 09:51:30 AM Central Daylight Time		08/08/2011 09:51:11 AM Central Daylight Time	AETNA HEALTH INC	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (HMO)	01	01		1			H3931	058	0	2012	Philadelphia County		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H3931	064	0	1	01	01	H3931_064_0	3	1		07/08/2011	2012.02	07/08/2011 11:03:32 AM Central Daylight Time	08/04/2011 11:55:28 AM Central Daylight Time	08/04/2011 09:51:59 AM Central Daylight Time		08/08/2011 09:51:11 AM Central Daylight Time	AETNA HEALTH INC	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Standard Plan (HMO)	01	01		1			H3931	064	0	2012	Bucks, Chester, Delaware and Montgomery Counties		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H3931	065	0	1	01	01	H3931_065_0	3	1		07/08/2011	2012.02	07/08/2011 11:03:42 AM Central Daylight Time	08/04/2011 12:06:00 PM Central Daylight Time	08/04/2011 09:52:27 AM Central Daylight Time		08/08/2011 09:51:11 AM Central Daylight Time	AETNA HEALTH INC	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Standard Plan (HMO)	01	01		1			H3931	065	0	2012	Philadelphia County		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H3931	070	0	1	01	01	H3931_070_0	5	1		07/12/2011	2012.02	07/12/2011 03:04:16 PM Central Daylight Time	08/04/2011 12:49:50 PM Central Daylight Time	08/04/2011 09:53:03 AM Central Daylight Time		08/08/2011 09:51:11 AM Central Daylight Time	AETNA HEALTH INC	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Standard Plan (HMO)	01	01		1			H3931	070	0	2012	Central and NE PA		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H3931	801	0	1	01	01	H3931_801_0	1	1		06/03/2011	2012.02	06/03/2011 05:54:27 PM Eastern Daylight Time	06/02/2011 11:12:22 AM Eastern Daylight Time			06/03/2011 05:58:15 PM Eastern Daylight Time	AETNA HEALTH INC	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan (HMO)	01	01		1			H3931	801	0	2012	Pennsylvania		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748										1	1	1
H3931	804	0	1	01	01	H3931_804_0	1	1		04/22/2011	2012.02	04/22/2011 09:55:59 AM Eastern Daylight Time	06/02/2011 11:15:57 AM Eastern Daylight Time			06/03/2011 05:58:15 PM Eastern Daylight Time	AETNA HEALTH INC	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan w/Rx CY (HMO)	01	01		1			H3931	804	0	2012	Pennsylvania		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		1	1	1
H3942	001	0	1	20	08	H3942_001_0	1	1		05/23/2011	2012.01	05/23/2011 01:24:23 PM Eastern Daylight Time		05/23/2011 02:11:50 PM Eastern Daylight Time		05/23/2011 02:13:36 PM Eastern Daylight Time	ELDERHAUS INC.	Elderhaus PACE	www.elderhaus.com	Elderhaus PACE (PACE)	08	20		1			H3942	001	0	2012	Elderhaus PACE		2		2			2							www.elderhaus.com	www.elderhaus.com									(888)-343-8209		(910)-343-8209		(888)-343-8209		(910)-343-8209										(888)-343-8209		(910)-343-8209		(888)-343-8209		(910)-343-8209				
H3942	002	0	1	20	08	H3942_002_0	1	1		05/23/2011	2012.01	05/23/2011 01:22:48 PM Eastern Daylight Time		05/23/2011 02:11:50 PM Eastern Daylight Time		05/23/2011 02:13:36 PM Eastern Daylight Time	ELDERHAUS INC.	Elderhaus PACE	http://www.elderhaus.com	Elderhaus PACE (PACE)	08	20		1			H3942	002	0	2012	Elderhaus PACE		2		2			2							www.elderhaus.com	www.elderhaus.com									(888)-343-8209		(910)-343-8209		(888)-343-8209		(910)-343-8209										(888)-343-8209		(910)-343-8209		(888)-343-8209		(910)-343-8209				
H3949	002	0	1	01	01	H3949_002_0	7	1		07/12/2011	2012.02	07/12/2011 01:46:42 PM Eastern Daylight Time	08/08/2011 09:03:06 AM Central Daylight Time	08/04/2011 04:52:21 PM Central Daylight Time		08/09/2011 04:46:11 PM Central Daylight Time	BRAVO HEALTH PENNSYLVANIA INC.	Bravo Health	www.mybravohealth.com	Bravo Classic (HMO)	01	01		1			H3949	002	0	2012	Pennsylvania Counties		2		2			2						www.mybravohealth.com	www.mybravohealth.com/formulary	www.mybravohealth.com	(800)-291-0396		(800)-291-0396		(888)-313-4267		(888)-313-4267		(800)-291-0396		(800)-291-0396		(888)-313-4267		(888)-313-4267		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3949	009	0	1	01	01	H3949_009_0	7	1	2	07/12/2011	2012.02	07/12/2011 01:47:26 PM Eastern Daylight Time	08/08/2011 09:03:58 AM Central Daylight Time	08/04/2011 04:53:17 PM Central Daylight Time		08/09/2011 04:46:11 PM Central Daylight Time	BRAVO HEALTH PENNSYLVANIA INC.	Bravo Health	www.mybravohealth.com	Bravo Select (HMO SNP)	01	01		1			H3949	009	0	2012	Pennsylvania Counties		2		2			1	3		1	2		www.mybravohealth.com	www.mybravohealth.com/formulary	www.mybravohealth.com	(800)-291-0396		(800)-291-0396		(888)-313-4267		(888)-313-4267		(800)-291-0396		(800)-291-0396		(888)-313-4267		(888)-313-4267		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3949	013	0	1	01	01	H3949_013_0	7	1		07/19/2011	2012.02	07/19/2011 12:39:10 PM Central Daylight Time	08/08/2011 09:04:47 AM Central Daylight Time	08/04/2011 04:54:03 PM Central Daylight Time		08/09/2011 04:46:11 PM Central Daylight Time	BRAVO HEALTH PENNSYLVANIA INC.	Bravo Health	www.mybravohealth.com	Bravo Premier (HMO)	01	01		1			H3949	013	0	2012	Philadelphia and Pittsburgh Metro Areas		2		2			2						www.mybravohealth.com	www.mybravohealth.com/formulary	www.mybravohealth.com	(800)-291-0396		(800)-291-0396		(888)-313-4267		(888)-313-4267		(800)-291-0396		(800)-291-0396		(888)-313-4267		(888)-313-4267		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3949	016	0	1	01	01	H3949_016_0	7	1		07/12/2011	2012.02	07/12/2011 01:48:20 PM Eastern Daylight Time	08/08/2011 09:05:37 AM Central Daylight Time	08/04/2011 04:54:56 PM Central Daylight Time		08/09/2011 04:46:11 PM Central Daylight Time	BRAVO HEALTH PENNSYLVANIA INC.	Bravo Health	www.mybravohealth.com	Bravo Traditions (HMO SNP)	01	01		1			H3949	016	0	2012	Select PA counties		2		2			1	1	1	1			www.mybravohealth.com	www.mybravohealth.com/formulary	www.mybravohealth.com	(800)-291-0396		(800)-291-0396		(888)-313-4267		(888)-313-4267		(800)-291-0396		(800)-291-0396		(888)-313-4267		(888)-313-4267		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3949	024	0	1	01	01	H3949_024_0	7	1		08/05/2011	2012.02	08/05/2011 03:06:51 PM Eastern Daylight Time	08/08/2011 09:06:26 AM Central Daylight Time	08/04/2011 04:55:44 PM Central Daylight Time		08/09/2011 04:46:11 PM Central Daylight Time	BRAVO HEALTH PENNSYLVANIA INC.	Bravo Health	www.mybravohealth.com	Bravo Achieve (HMO SNP)	01	01		1			H3949	024	0	2012	Select Pennsylvania Counties		2		2			1	4		1		00000010000000000000	www.mybravohealth.com	www.mybravohealth.com/formulary	www.mybravohealth.com	(800)-291-0396		(800)-291-0396		(888)-313-4267		(888)-313-4267		(800)-291-0396		(800)-291-0396		(888)-313-4267		(888)-313-4267		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3952	008	0	1	01	01	H3952_008_0	5	1		07/14/2011	2012.02	07/14/2011 09:25:47 AM Eastern Daylight Time	06/15/2011 09:36:30 AM Eastern Daylight Time			07/14/2011 03:15:56 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN EAST, INC.	Keystone 65	www.ibxmedicare.com	Keystone 65 Preferred Medical Only (HMO)	01	01		1			H3952	008	0	2012	Bucks, Philadelphia Counties		2	8234	2			2						www.ibxmedicare.com	http://www.ibxmedicare.com/prescription_drugs/formulary.html	http://www.ibxmedicare.com/prescription_drugs/rx_network.html	(800)-645-3965		(800)-645-3965		(877)-393-6733		(877)-393-6733										(888)-857-4816		(888)-857-4816		(877)-219-5457		(877)-219-5457										2	2	2
H3952	020	0	1	01	01	H3952_020_0	7	1		07/13/2011	2012.02	07/13/2011 02:32:23 PM Eastern Daylight Time	08/04/2011 02:31:16 PM Eastern Daylight Time	08/04/2011 01:48:20 PM Eastern Daylight Time		08/05/2011 05:36:25 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN EAST, INC.	Keystone 65	www.ibxmedicare.com	Keystone 65 Preferred Rx (HMO)	01	01		1			H3952	020	0	2012	Bucks, Philadelphia Counties		2	20921	2			2						www.ibxmedicare.com	http://www.ibxmedicare.com/prescription_drugs/formulary.html	http://www.ibxmedicare.com/prescription_drugs/rx_network.html	(800)-645-3965		(800)-645-3965		(877)-393-6733		(877)-393-6733		(800)-645-3965		(800)-645-3965		(877)-393-6733		(877)-393-6733		(888)-857-4816		(888)-857-4816		(877)-219-5457		(877)-219-5457		(888)-857-4816		(888)-857-4816		(877)-219-5457		(877)-219-5457		2	2	2
H3952	044	0	1	01	01	H3952_044_0	5	1		07/13/2011	2012.02	07/13/2011 02:32:41 PM Eastern Daylight Time	06/15/2011 09:39:19 AM Eastern Daylight Time			07/14/2011 03:15:56 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN EAST, INC.	Keystone 65	www.ibxmedicare.com	Keystone 65 Preferred Medical Only (HMO)	01	01		1			H3952	044	0	2012	Chester, Delaware, Montgomery Counties		2	4806	2			2						www.ibxmedicare.com	http://www.ibxmedicare.com/prescription_drugs/formulary.html	http://www.ibxmedicare.com/prescription_drugs/rx_network.html	(800)-645-3965		(800)-645-3965		(877)-393-6733		(877)-393-6733										(888)-857-4816		(888)-857-4816		(877)-219-5457		(877)-219-5457										2	2	2
H3952	045	0	1	01	01	H3952_045_0	6	1		07/13/2011	2012.02	07/13/2011 02:33:05 PM Eastern Daylight Time	08/04/2011 02:33:15 PM Eastern Daylight Time	08/04/2011 01:47:14 PM Eastern Daylight Time		08/05/2011 05:36:25 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN EAST, INC.	Keystone 65	www.ibxmedicare.com	Keystone 65 Preferred Rx (HMO)	01	01		1			H3952	045	0	2012	Chester, Delaware, Montgomery Counties		2	14898	2			2						www.ibxmedicare.com	http://www.ibxmedicare.com/prescription_drugs/formulary.html	http://www.ibxmedicare.com/prescription_drugs/rx_network.html	(800)-645-3965		(800)-645-3965		(877)-393-6733		(877)-393-6733		(800)-645-3965		(800)-645-3965		(877)-393-6733		(877)-393-6733		(888)-857-4816		(888)-857-4816		(877)-219-5457		(877)-219-5457		(888)-857-4816		(888)-857-4816		(877)-219-5457		(877)-219-5457		2	2	2
H3952	048	0	1	01	01	H3952_048_0	5	1		07/13/2011	2012.02	07/13/2011 02:33:26 PM Eastern Daylight Time	06/15/2011 09:58:40 AM Eastern Daylight Time			07/14/2011 03:15:56 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN EAST, INC.	Keystone 65	www.ibxmedicare.com	Keystone 65 Select Medical Only (HMO)	01	01		1			H3952	048	0	2012	Philadelphia and Bucks Counties		2		2			2						www.ibxmedicare.com	http://www.ibxmedicare.com/prescription_drugs/formulary.html	http://www.ibxmedicare.com/prescription_drugs/rx_network.html	(800)-645-3965		(800)-645-3965		(877)-393-6733		(877)-393-6733										(888)-857-4816		(888)-857-4816		(877)-219-5457		(877)-219-5457										2	2	2
H3952	049	0	1	01	01	H3952_049_0	7	1		07/13/2011	2012.02	07/13/2011 02:33:45 PM Eastern Daylight Time	08/04/2011 02:26:02 PM Eastern Daylight Time	08/04/2011 01:54:36 PM Eastern Daylight Time		08/05/2011 05:36:25 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN EAST, INC.	Keystone 65	www.ibxmedicare.com	Keystone 65 Select Rx (HMO)	01	01		1			H3952	049	0	2012	Philadelphia and Bucks Counties		2		2			2						www.ibxmedicare.com	http://www.ibxmedicare.com/prescription_drugs/formulary.html	http://www.ibxmedicare.com/prescription_drugs/rx_network.html	(800)-645-3965		(800)-645-3965		(877)-393-6733		(877)-393-6733		(800)-645-3965		(800)-645-3965		(877)-393-6733		(877)-393-6733		(888)-857-4816		(888)-857-4816		(877)-219-5457		(877)-219-5457		(888)-857-4816		(888)-857-4816		(877)-219-5457		(877)-219-5457		2	2	2
H3952	050	0	1	01	01	H3952_050_0	5	1		07/13/2011	2012.02	07/13/2011 02:34:03 PM Eastern Daylight Time	06/15/2011 09:53:25 AM Eastern Daylight Time			07/14/2011 03:15:56 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN EAST, INC.	Keystone 65	www.ibxmedicare.com	Keystone 65 Select Medical Only (HMO)	01	01		1			H3952	050	0	2012	Chester, Deleware, and Montgomery Counties		2		2			2						www.ibxmedicare.com	http://www.ibxmedicare.com/prescription_drugs/formulary.html	http://www.ibxmedicare.com/prescription_drugs/rx_network.html	(800)-645-3965		(800)-645-3965		(877)-393-6733		(877)-393-6733										(888)-857-4816		(888)-857-4816		(877)-219-5457		(877)-219-5457										2	2	2
H3952	051	0	1	01	01	H3952_051_0	6	1		07/13/2011	2012.02	07/13/2011 02:34:26 PM Eastern Daylight Time	08/04/2011 02:29:20 PM Eastern Daylight Time	08/04/2011 01:52:25 PM Eastern Daylight Time		08/05/2011 05:36:25 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN EAST, INC.	Keystone 65	www.ibxmedicare.com	Keystone 65 Select Rx (HMO)	01	01		1			H3952	051	0	2012	Chester, Delaware, and Montgomery Counties		2		2			2						www.ibxmedicare.com	http://www.ibxmedicare.com/prescription_drugs/formulary.html	http://www.ibxmedicare.com/prescription_drugs/rx_network.html	(800)-645-3965		(800)-645-3965		(877)-393-6733		(877)-393-6733		(800)-645-3965		(800)-645-3965		(877)-393-6733		(877)-393-6733		(888)-857-4816		(888)-857-4816		(877)-219-5457		(877)-219-5457		(888)-857-4816		(888)-857-4816		(877)-219-5457		(877)-219-5457		2	2	2
H3952	802	0	1	01	01	H3952_802_0	5	1		07/18/2011	2012.02	07/18/2011 10:22:44 PM Eastern Daylight Time	08/18/2011 03:11:16 PM Eastern Daylight Time			08/18/2011 04:31:31 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN EAST, INC.	Keystone 65	www.ibxmedicare.com	Keystone 65 Group Medical Only (HMO)	01	01		1			H3952	802	0	2012	Bucks,Chester,Delaware,Montgomery,Phila Cty		1		2			2						www.ibxmedicare.com	http://www.ibxmedicare.com/prescription_drugs/formulary.html	http://www.ibxmedicare.com/prescription_drugs/rx_network.html	(800)-645-3965		(800)-645-3965		(877)-393-6733		(877)-393-6733										(888)-857-4816		(888)-857-4816		(877)-219-5457		(877)-219-5457										2	2	2
H3952	804	0	1	01	01	H3952_804_0	5	1		07/18/2011	2012.02	07/18/2011 10:24:31 PM Eastern Daylight Time	08/18/2011 03:12:25 PM Eastern Daylight Time			08/18/2011 04:31:31 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN EAST, INC.	Keystone 65	www.ibxmedicare.com	Keystone 65 Group Rx (HMO)	01	01		1			H3952	804	0	2012	Bucks,Chester,Delaware, Montgomery,Phila Cty		1		2			2						www.ibxmedicare.com	http://www.ibxmedicare.com/prescription_drugs/formulary.html	http://www.ibxmedicare.com/prescription_drugs/rx_network.html	(800)-645-3965		(800)-645-3965		(877)-393-6733		(877)-393-6733		(800)-645-3965		(800)-645-3965		(877)-393-6733		(877)-393-6733		(888)-857-4816		(888)-857-4816		(877)-219-5457		(877)-219-5457		(888)-857-4816		(888)-857-4816		(877)-219-5457		(877)-219-5457		2	2	2
H3954	003	0	1	01	01	H3954_003_0	4	1		07/15/2011	2012.02	07/15/2011 03:05:52 PM Eastern Daylight Time	07/15/2011 04:33:33 PM Eastern Daylight Time			07/20/2011 09:33:14 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	Geisinger Gold Classic 1 (HMO)	01	01		1			H3954	003	0	2012	Central PA - Region 1		2		2			2						https://www.thehealthplan.com/providersearch/selectsearch.cfm	https://www.thehealthplan.com/formulary/formulary_search.cfm	www.geisingergold.com	(800)-498-9731		(570)-271-8771		(800)-514-0138		(800)-514-0138										(711)		(711)		(711)		(711)										2	2	2
H3954	005	0	1	01	01	H3954_005_0	4	1		07/15/2011	2012.02	07/15/2011 03:06:07 PM Eastern Daylight Time	07/15/2011 04:38:12 PM Eastern Daylight Time			07/20/2011 09:33:14 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	Geisinger Gold Classic 1 (HMO)	01	01		1			H3954	005	0	2012	Lackawanna and Luzerne County		2		2			2						https://www.thehealthplan.com/providersearch/selectsearch.cfm	https://www.thehealthplan.com/formulary/formulary_search.cfm	www.geisingergold.com	(800)-498-9731		(570)-271-8771		(800)-514-0138		(800)-514-0138										(711)		(711)		(711)		(711)										2	2	2
H3954	007	0	1	01	01	H3954_007_0	4	1		07/15/2011	2012.02	07/15/2011 03:06:23 PM Eastern Daylight Time	07/15/2011 04:43:01 PM Eastern Daylight Time			07/20/2011 09:33:14 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	Geisinger Gold Classic 1 (HMO)	01	01		1			H3954	007	0	2012	Central PA - Region 2		2		2			2						https://www.thehealthplan.com/providersearch/selectsearch.cfm	https://www.thehealthplan.com/formulary/formulary_search.cfm	www.geisingergold.com	(800)-498-9731		(570)-271-8771		(800)-514-0138		(800)-514-0138										(711)		(711)		(711)		(711)										2	2	2
H3954	021	0	1	01	01	H3954_021_0	5	1		07/14/2011	2012.02	07/14/2011 10:07:06 AM Eastern Daylight Time	08/04/2011 05:43:30 PM Eastern Daylight Time	08/04/2011 06:57:45 PM Eastern Daylight Time		08/05/2011 05:08:23 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	Geisinger Gold Classic 1 $0 Deductible Rx (HMO)	01	01		1			H3954	021	0	2012	Central PA - Region 1		2		2			2						https://www.thehealthplan.com/providersearch/selectsearch.cfm	https://www.thehealthplan.com/formulary/formulary_search.cfm	www.geisingergold.com	(800)-498-9731		(570)-271-8771		(800)-514-0138		(800)-514-0138		(800)-988-4861		(570)-271-8771		(800)-514-0138		(800)-514-0138		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3954	027	0	1	01	01	H3954_027_0	5	1		07/15/2011	2012.02	07/15/2011 03:06:43 PM Eastern Daylight Time	08/04/2011 05:47:22 PM Eastern Daylight Time	08/04/2011 07:00:02 PM Eastern Daylight Time		08/05/2011 05:08:23 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	Geisinger Gold Classic 1 $0 Deductible Rx (HMO)	01	01		1			H3954	027	0	2012	Lackawanna and Luzerne County		2		2			2						https://www.thehealthplan.com/providersearch/selectsearch.cfm	https://www.thehealthplan.com/formulary/formulary_search.cfm	www.geisingergold.com	(800)-498-9731		(570)-271-8771		(800)-514-0138		(800)-514-0138		(800)-988-4861		(570)-271-8771		(800)-514-0138		(800)-514-0138		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3954	033	0	1	01	01	H3954_033_0	5	1		07/15/2011	2012.02	07/15/2011 03:07:00 PM Eastern Daylight Time	08/04/2011 05:52:12 PM Eastern Daylight Time	08/04/2011 07:01:44 PM Eastern Daylight Time		08/05/2011 05:08:23 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	Geisinger Gold Classic 1 $0 Deductible Rx (HMO)	01	01		1			H3954	033	0	2012	Central PA - Region 2		2		2			2						https://www.thehealthplan.com/providersearch/selectsearch.cfm	https://www.thehealthplan.com/formulary/formulary_search.cfm	www.geisingergold.com	(800)-498-9731		(570)-271-8771		(800)-514-0138		(800)-514-0138		(800)-988-4861		(570)-271-8771		(800)-514-0138		(800)-514-0138		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3954	097	0	1	01	01	H3954_097_0	4	1	2	08/08/2011	2012.02	08/08/2011 03:44:24 PM Eastern Daylight Time	08/04/2011 04:14:17 PM Eastern Daylight Time	08/04/2011 05:03:58 PM Eastern Daylight Time		08/08/2011 04:09:25 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	Geisinger Gold Secure 1 (HMO SNP)	01	01		1			H3954	097	0	2012	Central Pennsylvania		2		2			1	3		1	2		https://www.thehealthplan.com/providersearch/selectsearch.cfm	https://www.thehealthplan.com/formulary/formulary_search.cfm	www.geisingergold.com	(800)-498-9731		(570)-271-8771		(800)-514-0138		(800)-514-0138		(800)-988-4861		(570)-271-8771		(800)-514-0138		(800)-514-0138		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3954	098	0	1	01	01	H3954_098_0	3	1		07/15/2011	2012.02	07/15/2011 03:11:19 PM Eastern Daylight Time	07/15/2011 05:10:35 PM Eastern Daylight Time			07/20/2011 09:33:14 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	Geisinger Gold Classic 3 (HMO)	01	01		1			H3954	098	0	2012	Central Pennsylvania		2		2			2						https://www.thehealthplan.com/providersearch/selectsearch.cfm	https://www.thehealthplan.com/formulary/formulary_search.cfm	www.geisingergold.com	(800)-498-9731		(570)-271-8771		(800)-514-0138		(800)-514-0138										(711)		(711)		(711)		(711)										2	2	2
H3954	100	0	1	01	01	H3954_100_0	5	1		07/14/2011	2012.02	07/14/2011 10:09:11 AM Eastern Daylight Time	08/04/2011 05:57:15 PM Eastern Daylight Time	08/04/2011 07:03:19 PM Eastern Daylight Time		08/05/2011 05:08:23 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	Geisinger Gold Classic 3 $0 Deductible Rx (HMO)	01	01		1			H3954	100	0	2012	Central Pennsylvania		2		2			2						https://www.thehealthplan.com/providersearch/selectsearch.cfm	https://www.thehealthplan.com/formulary/formulary_search.cfm	www.geisingergold.com	(800)-498-9731		(570)-271-8771		(800)-514-0138		(800)-514-0138		(800)-988-4861		(570)-271-8771		(800)-514-0138		(800)-514-0138		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3954	134	0	1	01	01	H3954_134_0	7	1		08/12/2011	2012.02	08/12/2011 09:29:21 AM Eastern Daylight Time	08/04/2011 06:01:37 PM Eastern Daylight Time	08/04/2011 07:04:37 PM Eastern Daylight Time		08/12/2011 10:19:58 AM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	Geisinger Gold Secure 3 (HMO SNP)	01	01		1			H3954	134	0	2012	Central PA - Region 1		2		2			1	4		1		00000000000000000100	https://www.thehealthplan.com/providersearch/selectsearch.cfm	https://www.thehealthplan.com/formulary/formulary_search.cfm	www.geisingergold.com	(800)-498-9731		(570)-271-8771		(800)-514-0138		(800)-514-0138		(800)-988-4861		(570)-271-8771		(800)-514-0138		(800)-514-0138		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3954	135	0	1	01	01	H3954_135_0	5	1		08/12/2011	2012.02	08/12/2011 09:30:39 AM Eastern Daylight Time	08/04/2011 06:09:52 PM Eastern Daylight Time	08/04/2011 07:05:58 PM Eastern Daylight Time		08/12/2011 10:19:58 AM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	Geisinger Gold Secure 3 (HMO SNP)	01	01		1			H3954	135	0	2012	Central PA - Region 2		2		2			1	4		1		00000000000000000100	https://www.thehealthplan.com/providersearch/selectsearch.cfm	https://www.thehealthplan.com/formulary/formulary_search.cfm	www.geisingergold.com	(800)-498-9731		(570)-271-8771		(800)-514-0138		(800)-514-0138		(800)-988-4861		(570)-271-8771		(800)-514-0138		(800)-514-0138		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3954	136	0	1	01	01	H3954_136_0	4	1		07/15/2011	2012.02	07/15/2011 03:17:54 PM Eastern Daylight Time	07/19/2011 12:14:25 PM Eastern Daylight Time			07/20/2011 09:33:14 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	Geisinger Gold Classic 1 (HMO)	01	01		1			H3954	136	0	2012	Carbon, Lehigh and Northampton Counties		2		2			2						https://www.thehealthplan.com/providersearch/selectsearch.cfm	https://www.thehealthplan.com/formulary/formulary_search.cfm	www.geisingergold.com	(800)-498-9731		(570)-271-8771		(800)-514-0138		(800)-514-0138										(711)		(711)		(711)		(711)										2	2	2
H3954	137	0	1	01	01	H3954_137_0	8	1		07/15/2011	2012.02	07/15/2011 03:18:14 PM Eastern Daylight Time	08/04/2011 06:14:21 PM Eastern Daylight Time	08/04/2011 07:07:20 PM Eastern Daylight Time		08/05/2011 05:08:23 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	Geisinger Gold Classic 1 $0 Deductible Rx (HMO)	01	01		1			H3954	137	0	2012	Carbon, Lehigh and Northampton Counties		2		2			2						https://www.thehealthplan.com/providersearch/selectsearch.cfm	https://www.thehealthplan.com/formulary/formulary_search.cfm	www.geisingergold.com	(800)-498-9731		(570)-271-8771		(800)-514-0138		(800)-514-0138		(800)-988-4861		(570)-271-8771		(800)-514-0138		(800)-514-0138		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3954	138	0	1	01	01	H3954_138_0	3	1		07/15/2011	2012.02	07/15/2011 03:35:32 PM Eastern Daylight Time	07/19/2011 01:23:52 PM Eastern Daylight Time			07/20/2011 09:33:14 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	Geisinger Gold Classic 4 (HMO)	01	01		1			H3954	138	0	2012	Carbon, Lehigh and Northampton Counties		2		2			2						https://www.thehealthplan.com/providersearch/selectsearch.cfm	https://www.thehealthplan.com/formulary/formulary_search.cfm	www.geisingergold.com	(800)-498-9731		(570)-271-8771		(800)-514-0138		(800)-514-0138										(711)		(711)		(711)		(711)										2	2	2
H3954	139	0	1	01	01	H3954_139_0	4	1		07/14/2011	2012.02	07/14/2011 09:36:31 AM Eastern Daylight Time	08/04/2011 06:23:06 PM Eastern Daylight Time	08/04/2011 07:08:32 PM Eastern Daylight Time		08/05/2011 05:08:23 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	Geisinger Gold Classic 4 $0 Deductible Rx (HMO)	01	01		1			H3954	139	0	2012	Carbon, Lehigh and Northampton Counties		2		2			2						https://www.thehealthplan.com/providersearch/selectsearch.cfm	https://www.thehealthplan.com/formulary/formulary_search.cfm	www.geisingergold.com	(800)-498-9731		(570)-271-8771		(800)-514-0138		(800)-514-0138		(800)-988-4861		(570)-271-8771		(800)-514-0138		(800)-514-0138		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3954	801	0	1	01	01	H3954_801_0	3	1		07/15/2011	2012.02	07/15/2011 03:37:41 PM Eastern Daylight Time	07/18/2011 09:18:10 AM Eastern Daylight Time			07/20/2011 09:33:14 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	Geisinger Gold Classic (Employer Group) (HMO)	01	01		1			H3954	801	0	2012	Central Pennsylvania		1		2			2						https://www.thehealthplan.com/providersearch/selectsearch.cfm	https://www.thehealthplan.com/formulary/formulary_search.cfm	www.geisingergold.com	(800)-498-9731		(570)-271-8771		(800)-514-0138		(800)-514-0138										(711)		(711)		(711)		(711)										2	2	2
H3954	802	0	1	01	01	H3954_802_0	3	1		07/15/2011	2012.02	07/15/2011 03:38:36 PM Eastern Daylight Time	07/18/2011 09:14:48 AM Eastern Daylight Time			07/20/2011 09:33:14 PM Eastern Daylight Time	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	Geisinger Gold Classic Rx (Employer Group) (HMO)	01	01		1			H3954	802	0	2012	Central Pennsylvania		1		2			2						https://www.thehealthplan.com/providersearch/selectsearch.cfm	https://www.thehealthplan.com/formulary/formulary_search.cfm	www.geisingergold.com	(800)-498-9731		(570)-271-8771		(800)-514-0138		(800)-514-0138		(800)-988-4861		(570)-271-8771		(800)-514-0138		(800)-514-0138		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3957	003	0	1	01	01	H3957_003_0	10	1		07/18/2011	2012.02	07/18/2011 01:17:52 PM Eastern Daylight Time	08/04/2011 02:25:09 PM Eastern Daylight Time	08/04/2011 01:16:43 PM Eastern Daylight Time		08/05/2011 01:50:22 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN WEST, INC.	Keystone Health Plan West, Inc.	www.highmarkbcbs.com	SecurityBlue Standard (HMO)	01	01		1			H3957	003	0	2012	Southwestern PA		2		2			2						www.highmarkbcbs.com	http://highmark.medicare-approvedformularies.com/	www.highmarkbcbs.com	(800)-935-2583		(800)-935-2583		(866)-682-7970		(866)-682-7970		(800)-935-2583		(800)-935-2583		(866)-682-7970		(866)-682-7970		(800)-988-0668		(800)-988-0668		(711)		(711)		(800)-988-0668		(800)-988-0668		(711)		(711)		2	2	2
H3957	006	0	1	01	01	H3957_006_0	11	1		07/19/2011	2012.02	07/19/2011 12:41:44 PM Eastern Daylight Time	08/04/2011 02:25:25 PM Eastern Daylight Time	08/04/2011 01:17:43 PM Eastern Daylight Time		08/05/2011 02:08:26 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN WEST, INC.	Keystone Health Plan West, Inc.	www.highmarkbcbs.com	SecurityBlue Standard (HMO)	01	01		1			H3957	006	0	2012	West Central PA		2		2			2						www.highmarkbcbs.com	http://highmark.medicare-approvedformularies.com/	www.highmarkbcbs.com	(800)-935-2583		(800)-935-2583		(866)-682-7970		(866)-682-7970		(800)-935-2583		(800)-935-2583		(866)-682-7970		(866)-682-7970		(800)-988-0668		(800)-988-0668		(711)		(711)		(800)-988-0668		(800)-988-0668		(711)		(711)		2	2	2
H3957	020	0	1	01	01	H3957_020_0	11	1		07/19/2011	2012.02	07/19/2011 12:47:40 PM Eastern Daylight Time	08/04/2011 02:25:41 PM Eastern Daylight Time	08/04/2011 01:18:35 PM Eastern Daylight Time		08/05/2011 02:08:26 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN WEST, INC.	Keystone Health Plan West, Inc.	www.highmarkbcbs.com	SecurityBlue Deluxe (HMO)	01	01		1			H3957	020	0	2012	Southwestern PA		2		2			2						www.highmarkbcbs.com	http://highmark.medicare-approvedformularies.com/	www.highmarkbcbs.com	(800)-935-2583		(800)-935-2583		(866)-682-7970		(866)-682-7970		(800)-935-2583		(800)-935-2583		(866)-682-7970		(866)-682-7970		(800)-988-0668		(800)-988-0668		(711)		(711)		(800)-988-0668		(800)-988-0668		(711)		(711)		2	2	2
H3957	021	0	1	01	01	H3957_021_0	11	1		07/19/2011	2012.02	07/19/2011 12:53:43 PM Eastern Daylight Time	08/04/2011 02:25:56 PM Eastern Daylight Time	08/04/2011 01:19:32 PM Eastern Daylight Time		08/05/2011 02:08:26 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN WEST, INC.	Keystone Health Plan West, Inc.	www.highmarkbcbs.com	SecurityBlue Deluxe (HMO)	01	01		1			H3957	021	0	2012	West Central PA		2		2			2						www.highmarkbcbs.com	http://highmark.medicare-approvedformularies.com/	www.highmarkbcbs.com	(800)-935-2583		(800)-935-2583		(866)-682-7970		(866)-682-7970		(800)-935-2583		(800)-935-2583		(866)-682-7970		(866)-682-7970		(800)-988-0668		(800)-988-0668		(711)		(711)		(800)-988-0668		(800)-988-0668		(711)		(711)		2	2	2
H3957	024	0	1	01	01	H3957_024_0	9	1		07/19/2011	2012.02	07/19/2011 12:57:41 PM Eastern Daylight Time	06/04/2011 12:21:19 PM Eastern Daylight Time			07/20/2011 02:52:06 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN WEST, INC.	Keystone Health Plan West, Inc.	www.highmarkbcbs.com	SecurityBlue Value (HMO)	01	01		1			H3957	024	0	2012	Southwestern PA		2		2			2						www.highmarkbcbs.com	http://highmark.medicare-approvedformularies.com/	www.highmarkbcbs.com	(800)-935-2583		(800)-935-2583		(866)-682-7970		(866)-682-7970										(800)-988-0668		(800)-988-0668		(711)		(711)										2	2	2
H3957	025	0	1	01	01	H3957_025_0	9	1		07/19/2011	2012.02	07/19/2011 12:58:07 PM Eastern Daylight Time	06/04/2011 12:21:37 PM Eastern Daylight Time			07/20/2011 02:52:06 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN WEST, INC.	Keystone Health Plan West, Inc.	www.highmarkbcbs.com	SecurityBlue Value (HMO)	01	01		1			H3957	025	0	2012	West Central PA		2		2			2						www.highmarkbcbs.com	http://highmark.medicare-approvedformularies.com/	www.highmarkbcbs.com	(800)-935-2583		(800)-935-2583		(866)-682-7970		(866)-682-7970										(800)-988-0668		(800)-988-0668		(711)		(711)										2	2	2
H3957	030	0	1	01	01	H3957_030_0	11	1	2	07/19/2011	2012.02	07/19/2011 01:00:12 PM Eastern Daylight Time	08/04/2011 02:26:10 PM Eastern Daylight Time	08/04/2011 01:20:42 PM Eastern Daylight Time		08/05/2011 02:08:26 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN WEST, INC.	Keystone Health Plan West, Inc.	www.highmarkbcbs.com	SecurityBlue Care (HMO SNP)	01	01		1			H3957	030	0	2012	Western Region		2		2			1	3		1	3		www.highmarkbcbs.com	http://highmark.medicare-approvedformularies.com/	www.highmarkbcbs.com	(800)-652-9491		(800)-652-9491		(866)-682-7970		(866)-682-7970		(800)-652-9491		(800)-652-9491		(866)-682-7970		(866)-682-7970		(800)-988-0668		(800)-988-0668		(711)		(711)		(800)-988-0668		(800)-988-0668		(711)		(711)		2	2	2
H3957	031	0	1	01	01	H3957_031_0	11	1		07/19/2011	2012.02	07/19/2011 01:04:22 PM Eastern Daylight Time	08/04/2011 02:26:24 PM Eastern Daylight Time	08/04/2011 01:21:35 PM Eastern Daylight Time		08/05/2011 02:08:26 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN WEST, INC.	Keystone Health Plan West, Inc.	www.highmarkbcbs.com	SecurityBlue ValueRx (HMO)	01	01		1			H3957	031	0	2012	Southwestern PA		2		2			2						www.highmarkbcbs.com	http://highmark.medicare-approvedformularies.com/	www.highmarkbcbs.com	(800)-935-2583		(800)-935-2583		(866)-682-7970		(866)-682-7970		(800)-935-2583		(800)-935-2583		(866)-682-7970		(866)-682-7970		(800)-988-0668		(800)-988-0668		(711)		(711)		(800)-988-0668		(800)-988-0668		(711)		(711)		2	2	2
H3957	032	0	1	01	01	H3957_032_0	11	1		07/19/2011	2012.02	07/19/2011 01:06:24 PM Eastern Daylight Time	08/04/2011 02:26:39 PM Eastern Daylight Time	08/04/2011 01:26:23 PM Eastern Daylight Time		08/05/2011 02:08:26 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN WEST, INC.	Keystone Health Plan West, Inc.	www.highmarkbcbs.com	SecurityBlue ValueRx (HMO)	01	01		1			H3957	032	0	2012	West Central PA		2		2			2						www.highmarkbcbs.com	http://highmark.medicare-approvedformularies.com/	www.highmarkbcbs.com	(800)-935-2583		(800)-935-2583		(866)-682-7970		(866)-682-7970		(800)-935-2583		(800)-935-2583		(866)-682-7970		(866)-682-7970		(800)-988-0668		(800)-988-0668		(711)		(711)		(800)-988-0668		(800)-988-0668		(711)		(711)		2	2	2
H3957	036	0	1	01	01	H3957_036_0	11	1		07/19/2011	2012.02	07/19/2011 01:09:37 PM Eastern Daylight Time	08/04/2011 02:26:58 PM Eastern Daylight Time	08/04/2011 01:27:18 PM Eastern Daylight Time		08/05/2011 02:08:26 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN WEST, INC.	Keystone Health Plan West, Inc.	www.highmarkbcbs.com	SecurityBlue HD (HMO)	01	01		1			H3957	036	0	2012	Southwestern PA		2		2			2						www.highmarkbcbs.com	http://highmark.medicare-approvedformularies.com/	www.highmarkbcbs.com	(800)-935-2583		(800)-935-2583		(866)-682-7970		(866)-682-7970		(800)-935-2583		(800)-935-2583		(866)-682-7970		(866)-682-7970		(800)-988-0668		(800)-988-0668		(711)		(711)		(800)-988-0668		(800)-988-0668		(711)		(711)		2	2	2
H3957	037	0	1	01	01	H3957_037_0	11	1		07/20/2011	2012.02	07/20/2011 10:43:15 AM Eastern Daylight Time	08/04/2011 02:27:21 PM Eastern Daylight Time	08/04/2011 01:28:09 PM Eastern Daylight Time		08/05/2011 02:08:26 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN WEST, INC.	Keystone Health Plan West, Inc.	www.highmarkbcbs.com	SecurityBlue HD (HMO)	01	01		1			H3957	037	0	2012	West Central PA		2		2			2						www.highmarkbcbs.com	http://highmark.medicare-approvedformularies.com/	www.highmarkbcbs.com	(800)-935-2583		(800)-935-2583		(866)-682-7970		(866)-682-7970		(800)-935-2583		(800)-935-2583		(866)-682-7970		(866)-682-7970		(800)-988-0668		(800)-988-0668		(711)		(711)		(800)-988-0668		(800)-988-0668		(711)		(711)		2	2	2
H3957	805	0	1	01	01	H3957_805_0	8	1		04/21/2011	2012.02	04/21/2011 04:43:07 PM Eastern Daylight Time	06/04/2011 12:38:34 PM Eastern Daylight Time			06/06/2011 02:43:49 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN WEST, INC.	Keystone Health Plan West, Inc.	www.highmarkbcbs.com	SecurityBlue MA (HMO)	01	01		1			H3957	805	0	2012	Western PA		1		2			2						www.highmarkbcbs.com	http://highmark.medicare-approvedformularies.com/	www.highmarkbcbs.com	(800)-935-2583		(800)-935-2583		(866)-682-7970		(866)-682-7970										(800)-988-0668		(800)-988-0668		(711)		(711)										1	1	1
H3957	806	0	1	01	01	H3957_806_0	8	1		04/21/2011	2012.02	04/21/2011 04:43:34 PM Eastern Daylight Time	06/04/2011 12:23:14 PM Eastern Daylight Time			06/06/2011 02:43:49 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN WEST, INC.	Keystone Health Plan West, Inc.	www.highmarkbcbs.com	SecurityBlue MA-PD (HMO)	01	01		1			H3957	806	0	2012	Western PA		1		2			2						www.highmarkbcbs.com	http://highmark.medicare-approvedformularies.com/	www.highmarkbcbs.com	(800)-935-2583		(800)-935-2583		(866)-682-7970		(866)-682-7970		(800)-935-2583		(800)-935-2583		(866)-682-7970		(866)-682-7970		(800)-988-0668		(800)-988-0668		(711)		(711)		(800)-988-0668		(800)-988-0668		(711)		(711)		1	1	1
H3957	808	0	1	01	01	H3957_808_0	8	1		04/25/2011	2012.02	04/25/2011 10:14:51 AM Eastern Daylight Time	06/04/2011 12:23:32 PM Eastern Daylight Time			06/06/2011 02:43:49 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN WEST, INC.	Keystone Health Plan West, Inc.	www.highmarkbcbs.com	SecurityBlue MA-PD Non-Calendar (HMO)	01	01		1			H3957	808	0	2012	Western PA		1		2			2						www.highmarkbcbs.com	http://highmark.medicare-approvedformularies.com/	www.highmarkbcbs.com	(800)-935-2583		(800)-935-2583		(866)-682-7970		(866)-682-7970		(800)-935-2583		(800)-935-2583		(866)-682-7970		(866)-682-7970		(800)-988-0668		(800)-988-0668		(711)		(711)		(800)-988-0668		(800)-988-0668		(711)		(711)		1	1	1
H3959	001	0	1	01	01	H3959_001_0	11	1		08/09/2011	2012.02	08/09/2011 10:53:57 AM Eastern Daylight Time	08/08/2011 02:39:10 PM Eastern Daylight Time	08/04/2011 10:58:16 AM Eastern Daylight Time		08/09/2011 11:53:51 AM Eastern Daylight Time	HEALTHAMERICA PENNSYLVANIA, INC.	HealthAmerica	http://www.pa.chcadvantra.com	Advantra Gold (HMO)	01	01		1			H3959	001	0	2012	Allegheny County		2		2			2						http://www.pa.chcadvantra.com	http://PAFormulary.coventry-medicare.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator	(800)-290-0190		(800)-290-0190		(877)-887-5787		(877)-887-5787		(866)-290-6660		(866)-290-6660		(877)-887-5787		(877)-887-5787		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3959	002	0	1	01	01	H3959_002_0	12	1		08/08/2011	2012.02	08/08/2011 01:33:52 PM Eastern Daylight Time	08/08/2011 02:45:04 PM Eastern Daylight Time	08/04/2011 11:03:48 AM Eastern Daylight Time		08/09/2011 11:53:51 AM Eastern Daylight Time	HEALTHAMERICA PENNSYLVANIA, INC.	HealthAmerica	http://www.pa.chcadvantra.com	Advantra Gold (HMO)	01	01		1			H3959	002	0	2012	Western Pennsylvania		2		2			2						http://www.pa.chcadvantra.com	http://PAFormulary.coventry-medicare.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator	(800)-290-0190		(800)-290-0190		(877)-887-5787		(877)-887-5787		(866)-290-6660		(866)-290-6660		(877)-887-5787		(877)-887-5787		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3959	010	0	1	01	01	H3959_010_0	12	1		08/08/2011	2012.02	08/08/2011 01:34:16 PM Eastern Daylight Time	08/08/2011 04:10:56 PM Eastern Daylight Time	08/04/2011 11:09:46 AM Eastern Daylight Time		08/09/2011 11:53:51 AM Eastern Daylight Time	HEALTHAMERICA PENNSYLVANIA, INC.	HealthAmerica	http://www.pa.chcadvantra.com	Advantra Silver (HMO)	01	01		1			H3959	010	0	2012	Allegheny County		2		2			2						http://www.pa.chcadvantra.com	http://PAFormulary.coventry-medicare.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator	(800)-290-0190		(800)-290-0190		(877)-887-5787		(877)-887-5787		(866)-290-6660		(866)-290-6660		(877)-887-5787		(877)-887-5787		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3959	011	0	1	01	01	H3959_011_0	12	1		08/08/2011	2012.02	08/08/2011 01:34:27 PM Eastern Daylight Time	08/08/2011 04:13:46 PM Eastern Daylight Time	08/04/2011 11:17:52 AM Eastern Daylight Time		08/09/2011 11:53:51 AM Eastern Daylight Time	HEALTHAMERICA PENNSYLVANIA, INC.	HealthAmerica	http://www.pa.chcadvantra.com	Advantra Silver (HMO)	01	01		1			H3959	011	0	2012	Central and Western Pennsylvania		2		2			2						http://www.pa.chcadvantra.com	http://PAFormulary.coventry-medicare.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator	(800)-290-0190		(800)-290-0190		(877)-887-5787		(877)-887-5787		(866)-290-6660		(866)-290-6660		(877)-887-5787		(877)-887-5787		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3959	031	0	1	01	01	H3959_031_0	10	1		08/08/2011	2012.02	08/08/2011 01:34:34 PM Eastern Daylight Time	08/08/2011 04:15:54 PM Eastern Daylight Time	08/04/2011 11:23:26 AM Eastern Daylight Time		08/09/2011 11:53:51 AM Eastern Daylight Time	HEALTHAMERICA PENNSYLVANIA, INC.	HealthAmerica	http://www.pa.chcadvantra.com	Advantra Silver (HMO)	01	01		1			H3959	031	0	2012	Philadelphia and Delaware Counties		2		2			2						http://www.pa.chcadvantra.com	http://PAFormulary.coventry-medicare.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator	(800)-290-0190		(800)-290-0190		(877)-886-2944		(877)-886-2944		(866)-290-6660		(866)-290-6660		(877)-886-2944		(877)-886-2944		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3959	032	0	1	01	01	H3959_032_0	10	1		08/08/2011	2012.02	08/08/2011 01:34:47 PM Eastern Daylight Time	08/08/2011 03:00:08 PM Eastern Daylight Time	08/04/2011 11:47:48 AM Eastern Daylight Time		08/09/2011 11:53:51 AM Eastern Daylight Time	HEALTHAMERICA PENNSYLVANIA, INC.	HealthAmerica	http://www.pa.chcadvantra.com	Advantra Silver Plus (HMO)	01	01		1			H3959	032	0	2012	Northwestern Pennsylvania		2		2			2						http://www.pa.chcadvantra.com	http://PAFormulary.coventry-medicare.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator	(800)-290-0190		(800)-290-0190		(877)-886-2944		(877)-886-2944		(866)-290-6660		(866)-290-6660		(877)-886-2944		(877)-886-2944		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3959	803	0	1	01	01	H3959_803_0	7	1		05/25/2011	2012.02	05/25/2011 01:22:29 PM Eastern Daylight Time	07/25/2011 12:19:40 PM Eastern Daylight Time			07/27/2011 11:24:21 AM Eastern Daylight Time	HEALTHAMERICA PENNSYLVANIA, INC.	HealthAmerica	http://www.pa.chcadvantra.com	Advantra MA Only (HMO)	01	01		1			H3959	803	0	2012	Pennsylvania		1		2			2						http://www.pa.chcadvantra.com	http://PAFormulary.coventry-medicare.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator	(800)-290-0190		(800)-290-0190		(800)-470-4272		(800)-470-4272										(711)		(711)		(711)		(711)										1	1	1
H3959	804	0	1	01	01	H3959_804_0	8	1		05/25/2011	2012.02	05/25/2011 01:20:43 PM Eastern Daylight Time	07/25/2011 12:25:38 PM Eastern Daylight Time			07/27/2011 11:24:21 AM Eastern Daylight Time	HEALTHAMERICA PENNSYLVANIA, INC.	HealthAmerica	http://www.pa.chcadvantra.com	Advantra Gold (HMO)	01	01		1			H3959	804	0	2012	Pennsylvania		1		2			2						http://www.pa.chcadvantra.com	http://PAFormulary.coventry-medicare.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator	(800)-290-0190		(800)-290-0190		(800)-470-4272		(800)-470-4272		(866)-290-6660		(866)-290-6660		(800)-470-4272		(800)-470-4272		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H3959	806	0	1	01	01	H3959_806_0	7	1		05/25/2011	2012.02	05/25/2011 01:21:10 PM Eastern Daylight Time	07/25/2011 12:55:00 PM Eastern Daylight Time			07/27/2011 11:24:21 AM Eastern Daylight Time	HEALTHAMERICA PENNSYLVANIA, INC.	HealthAmerica	http://www.pa.chcadvantra.com	Advantra Gold (HMO)	01	01		1			H3959	806	0	2012	Pennsylvania		1		2			2						http://www.pa.chcadvantra.com	http://PAFormulary.coventry-medicare.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator	(800)-290-0190		(800)-290-0190		(800)-470-4272		(800)-470-4272		(866)-290-6660		(866)-290-6660		(800)-470-4272		(800)-470-4272		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H3962	001	0	1	01	01	H3962_001_0	7	1		07/21/2011	2012.02	07/21/2011 11:23:02 AM Eastern Daylight Time	07/08/2011 05:16:29 PM Eastern Daylight Time	07/20/2011 04:29:05 PM Eastern Daylight Time		07/21/2011 06:27:40 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN CENTRAL,INC.	Keystone Health Plan Central, Inc.	seniorbluehmo.capbluecross.com	SeniorBlue - Option 1 (HMO)	01	01		1			H3962	001	0	2012	16 Counties in Central PA		2	11858	2			2						seniorbluehmo.capbluecross.com	https://seniorbluehmo.capbluecross.com/PharmacyInformation/	https://seniorbluehmo.capbluecross.com/PharmacyInformation/	(800)-779-6962		(800)-779-6962		(800)-990-4201		(800)-990-4201		(800)-779-6962		(800)-779-6962		(800)-990-4201		(800)-990-4201		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		2	2	2
H3962	004	0	1	01	01	H3962_004_0	6	1		07/21/2011	2012.02	07/21/2011 11:24:28 AM Eastern Daylight Time	07/08/2011 05:19:26 PM Eastern Daylight Time	07/20/2011 04:29:45 PM Eastern Daylight Time		07/21/2011 06:27:40 PM Eastern Daylight Time	KEYSTONE HEALTH PLAN CENTRAL,INC.	Keystone Health Plan Central, Inc.	seniorbluehmo.capbluecross.com	SeniorBlue - Option 2 (HMO)	01	01		1			H3962	004	0	2012	16 Counties in Central PA		2	1459	2			2						seniorbluehmo.capbluecross.com	https://seniorbluehmo.capbluecross.com/PharmacyInformation/	https://seniorbluehmo.capbluecross.com/PharmacyInformation/	(800)-779-6962		(800)-779-6962		(800)-990-4201		(800)-990-4201		(800)-779-6962		(800)-779-6962		(800)-990-4201		(800)-990-4201		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		2	2	2
H3962	007	0	1	01	01	H3962_007_0	9	1		08/09/2011	2012.02	08/09/2011 10:44:12 AM Eastern Daylight Time	08/08/2011 03:05:28 PM Eastern Daylight Time	08/08/2011 11:47:39 AM Eastern Daylight Time		08/09/2011 11:50:30 AM Eastern Daylight Time	KEYSTONE HEALTH PLAN CENTRAL,INC.	Keystone Health Plan Central, Inc.	seniorbluehmo.capbluecross.com	SeniorBlue - Option 3 (HMO)	01	01		1			H3962	007	0	2012	16 Counties in Central PA		2	500	2			2						seniorbluehmo.capbluecross.com	https://seniorbluehmo.capbluecross.com/PharmacyInformation/	https://seniorbluehmo.capbluecross.com/PharmacyInformation/	(800)-779-6962		(800)-779-6962		(800)-990-4201		(800)-990-4201		(800)-779-6962		(800)-779-6962		(800)-990-4201		(800)-990-4201		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		2	2	2
H3962	801	0	1	01	01	H3962_801_0	5	1		05/24/2011	2012.02	05/24/2011 03:39:00 PM Eastern Daylight Time	06/07/2011 02:15:32 AM Eastern Daylight Time			06/07/2011 02:42:28 AM Eastern Daylight Time	KEYSTONE HEALTH PLAN CENTRAL,INC.	Keystone Health Plan Central, Inc.	seniorbluehmo.capbluecross.com	SeniorBlue ER - With Rx (HMO)	01	01		1			H3962	801	0	2012	National		1	3051	2			2						seniorbluehmo.capbluecross.com	https://seniorbluehmo.capbluecross.com/PharmacyInformation/	https://seniorbluehmo.capbluecross.com/PharmacyInformation/	(800)-779-6962		(800)-779-6962		(800)-990-4201		(800)-990-4201		(800)-779-6962		(800)-779-6962		(800)-990-4201		(800)-990-4201		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		2	2	2
H3962	802	0	1	01	01	H3962_802_0	5	1		05/24/2011	2012.02	05/24/2011 03:39:12 PM Eastern Daylight Time	06/07/2011 02:17:49 AM Eastern Daylight Time			06/07/2011 02:42:28 AM Eastern Daylight Time	KEYSTONE HEALTH PLAN CENTRAL,INC.	Keystone Health Plan Central, Inc.	seniorbluehmo.capbluecross.com	SeniorBlue ER - w/o Rx (HMO)	01	01		1			H3962	802	0	2012	National		1	3051	2			2						seniorbluehmo.capbluecross.com	https://seniorbluehmo.capbluecross.com/PharmacyInformation/	https://seniorbluehmo.capbluecross.com/PharmacyInformation/	(800)-779-6962		(800)-779-6962		(800)-990-4201		(800)-990-4201										(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961										2	2	2
H3962	803	0	1	01	01	H3962_803_0	6	1		05/24/2011	2012.02	05/24/2011 03:39:26 PM Eastern Daylight Time	06/07/2011 02:20:08 AM Eastern Daylight Time			06/07/2011 02:42:28 AM Eastern Daylight Time	KEYSTONE HEALTH PLAN CENTRAL,INC.	Keystone Health Plan Central, Inc.	seniorbluehmo.capbluecross.com	SeniorBlue ER - Non-Calendar - with Rx (HMO)	01	01		1			H3962	803	0	2012	National		1	3051	2			2						seniorbluehmo.capbluecross.com	https://seniorbluehmo.capbluecross.com/PharmacyInformation/	https://seniorbluehmo.capbluecross.com/PharmacyInformation/	(800)-779-6962		(800)-779-6962		(800)-990-4201		(800)-990-4201		(800)-779-6962		(800)-779-6962		(800)-990-4201		(800)-990-4201		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961		2	2	2
H3964	001	0	1	01	01	H3964_001_0	5	1		07/18/2011	2012.02	07/18/2011 03:21:30 PM Eastern Daylight Time	07/19/2011 10:41:33 AM Central Daylight Time			07/22/2011 05:07:43 PM Central Daylight Time	BRAVO HEALTH PENNSYLVANIA, INC.	Bravo Health	www.mybravohealth.com	Bravo Gold (HMO)	01	01		1			H3964	001	0	2012	Philadelphia, Montgomery and Bucks Counties		2		2			2						www.mybravohealth.com	www.mybravohealth.com/formulary	www.mybravohealth.com/	(800)-291-0396		(800)-291-0396		(888)-776-9466		(888)-776-9466										(711)		(711)		(711)		(711)										2	2	2
H3964	002	0	1	01	01	H3964_002_0	7	1	2	07/12/2011	2012.02	07/12/2011 01:49:39 PM Eastern Daylight Time	08/08/2011 09:07:17 AM Central Daylight Time	08/04/2011 04:56:32 PM Central Daylight Time		08/09/2011 04:46:11 PM Central Daylight Time	BRAVO HEALTH PENNSYLVANIA, INC.	Bravo Health	www.mybravohealth.com	Bravo Silver (HMO SNP)	01	01		1			H3964	002	0	2012	Philadelphia, Bucks and Montgomery Counties		2		2			1	3		1	2		www.mybravohealth.com	www.mybravohealth.com/formulary	www.mybravohealth.com/	(800)-291-0396		(800)-291-0396		(888)-776-9466		(888)-776-9466		(800)-291-0396		(800)-291-0396		(888)-776-9466		(888)-776-9466		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H3964	003	0	1	02	01	H3964_003_0	7	1		07/22/2011	2012.02	07/22/2011 08:27:35 AM Central Daylight Time	08/08/2011 09:08:02 AM Central Daylight Time	08/04/2011 04:57:20 PM Central Daylight Time		08/09/2011 04:46:11 PM Central Daylight Time	BRAVO HEALTH PENNSYLVANIA, INC.	Bravo Health	www.mybravohealth.com	Bravo Gold Rx (HMO-POS)	01	02		1			H3964	003	0	2012	Philadelphia, Montgomery and Bucks Counties		2		2			2						www.mybravohealth.com	www.mybravohealth.com/formulary	www.mybravohealth.com/	(800)-291-0396		(800)-291-0396		(888)-776-9466		(888)-776-9466		(800)-291-0396		(800)-291-0396		(888)-776-9466		(888)-776-9466		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4003	001	0	1	02	01	H4003_001_0	6	1		08/09/2011	2012.02	08/09/2011 05:47:51 PM SA Western Standard Time	08/09/2011 05:20:28 PM SA Western Standard Time	08/09/2011 05:37:10 PM SA Western Standard Time		08/09/2011 06:03:51 PM SA Western Standard Time	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.mmm-pr.com	Medicare y Mucho Mas - ELITE (HMO-POS)	01	02		1			H4003	001	0	2012	Puerto Rico		2		2			2						www.mmm-pr.com	www.mmm-pr.com	www.mmm-pr.com	(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396		(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		2	2	2
H4003	009	0	1	01	01	H4003_009_0	5	1		08/09/2011	2012.02	08/09/2011 05:48:04 PM SA Western Standard Time	08/09/2011 05:20:35 PM SA Western Standard Time	08/09/2011 05:37:15 PM SA Western Standard Time		08/09/2011 06:03:51 PM SA Western Standard Time	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.mmm-pr.com	Medicare y Mucho Mas - SUPREMO (HMO SNP)	01	01		1			H4003	009	0	2012	Puerto Rico		2		2			1	4		1		00000000000000000010	www.mmm-pr.com	www.mmm-pr.com	www.mmm-pr.com	(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396		(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		2	2	2
H4003	015	0	1	01	01	H4003_015_0	5	1		08/09/2011	2012.02	08/09/2011 05:48:18 PM SA Western Standard Time	08/09/2011 05:20:40 PM SA Western Standard Time	08/09/2011 05:37:21 PM SA Western Standard Time		08/09/2011 06:03:51 PM SA Western Standard Time	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.mmm-pr.com	Medicare y Mucho Mas - BASICO SELECT (HMO)	01	01		1			H4003	015	0	2012	Puerto Rico		2		2			2						www.mmm-pr.com	www.mmm-pr.com	www.mmm-pr.com	(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396		(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		2	2	2
H4003	017	0	1	01	01	H4003_017_0	4	1	1	08/09/2011	2012.02	08/09/2011 05:48:32 PM SA Western Standard Time	08/09/2011 05:20:45 PM SA Western Standard Time	08/09/2011 05:37:25 PM SA Western Standard Time		08/09/2011 06:03:51 PM SA Western Standard Time	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.mmm-pr.com	Medicare y Mucho Mas - DIAMANTE CHOICE (HMO SNP)	01	01		1			H4003	017	0	2012	Puerto Rico		2		2		1	1	3		1	3		www.mmm-pr.com	www.mmm-pr.com	www.mmm-pr.com	(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396		(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		2	2	2
H4003	018	0	1	01	01	H4003_018_0	4	1		07/26/2011	2012.02	07/26/2011 03:41:37 PM SA Western Standard Time	08/12/2011 03:21:54 PM SA Western Standard Time			08/12/2011 05:06:37 PM SA Western Standard Time	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.mmm-pr.com	Medicare y Mucho Mas - Original (HMO)	01	01		1			H4003	018	0	2012	Puerto Rico		2		2			2						www.mmm-pr.com	www.mmm-pr.com	www.mmm-pr.com	(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396										(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469										2	2	2
H4003	019	0	1	01	01	H4003_019_0	6	1		08/09/2011	2012.02	08/09/2011 05:49:00 PM SA Western Standard Time	08/09/2011 05:20:50 PM SA Western Standard Time	08/09/2011 05:37:29 PM SA Western Standard Time		08/09/2011 06:03:51 PM SA Western Standard Time	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.mmm-pr.com	Medicare y Mucho Mas - Unico (HMO)	01	01		1			H4003	019	0	2012	Puerto Rico		2		2			2						www.mmm-pr.com	www.mmm-pr.com	www.mmm-pr.com	(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396		(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		2	2	2
H4003	021	0	1	01	01	H4003_021_0	5	1	1	07/12/2011	2012.02	07/12/2011 06:38:13 PM SA Western Standard Time	08/09/2011 05:20:54 PM SA Western Standard Time	08/09/2011 05:37:33 PM SA Western Standard Time		08/09/2011 06:03:51 PM SA Western Standard Time	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.mmm-pr.com	Medicare y Mucho Mas - DIAMANTE EXTRA (HMO SNP)	01	01		1			H4003	021	0	2012	Puerto Rico		2		2		1	1	3		1	3		www.mmm-pr.com	www.mmm-pr.com	www.mmm-pr.com	(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396		(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		2	2	2
H4003	801	0	1	02	01	H4003_801_0	4	1		07/20/2011	2012.02	07/20/2011 09:59:02 AM SA Western Standard Time	07/27/2011 06:16:20 PM SA Western Standard Time			07/27/2011 06:33:12 PM SA Western Standard Time	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.mmm-pr.com	Medicare y Mucho Mas - MA FLEX (HMO-POS)	01	02		1			H4003	801	0	2012	Puerto Rico		1		2			2						www.mmm-pr.com	www.mmm-pr.com	www.mmm-pr.com	(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396										(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469										2	2	2
H4003	803	0	1	02	01	H4003_803_0	5	1		07/20/2011	2012.02	07/20/2011 10:12:09 AM SA Western Standard Time	07/27/2011 06:16:23 PM SA Western Standard Time			07/27/2011 06:33:12 PM SA Western Standard Time	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.mmm-pr.com	Medicare y Mucho Mas - MAPD FLEX (HMO-POS)	01	02		1			H4003	803	0	2012	Puerto Rico		1		2			2						www.mmm-pr.com	www.mmm-pr.com	www.mmm-pr.com	(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396		(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		2	2	2
H4003	804	0	1	02	01	H4003_804_0	4	1		07/20/2011	2012.02	07/20/2011 10:12:13 AM SA Western Standard Time	07/27/2011 06:16:27 PM SA Western Standard Time			07/27/2011 06:33:12 PM SA Western Standard Time	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.mmm-pr.com	Medicare y Mucho Mas - MAPD FLEX I (HMO-POS)	01	02		1			H4003	804	0	2012	Puerto Rico		1		2			2						www.mmm-pr.com	www.mmm-pr.com	www.mmm-pr.com	(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396		(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		2	2	2
H4003	805	0	1	02	01	H4003_805_0	4	1		07/20/2011	2012.02	07/20/2011 10:12:16 AM SA Western Standard Time	07/27/2011 06:16:32 PM SA Western Standard Time			07/27/2011 06:33:12 PM SA Western Standard Time	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.mmm-pr.com	Medicare y Mucho Mas - MA Flex II (HMO-POS)	01	02		1			H4003	805	0	2012	Puerto Rico		1		2			2						www.mmm-pr.com	www.mmm-pr.com	www.mmm-pr.com	(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396										(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469										2	2	2
H4003	806	0	1	02	01	H4003_806_0	4	1		07/20/2011	2012.02	07/20/2011 10:12:19 AM SA Western Standard Time	07/27/2011 06:16:35 PM SA Western Standard Time			07/27/2011 06:33:12 PM SA Western Standard Time	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.mmm-pr.com	Medicare y Mucho Mas - MAPD Flex II (HMO-POS)	01	02		1			H4003	806	0	2012	Puerto Rico		1		2			2						www.mmm-pr.com	www.mmm-pr.com	www.mmm-pr.com	(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396		(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		2	2	2
H4003	807	0	1	02	01	H4003_807_0	4	1		07/20/2011	2012.02	07/20/2011 10:12:23 AM SA Western Standard Time	07/27/2011 06:16:38 PM SA Western Standard Time			07/27/2011 06:33:12 PM SA Western Standard Time	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.mmm-pr.com	Medicare y Mucho Mas - MAPD Flex III (HMO-POS)	01	02		1			H4003	807	0	2012	Puerto Rico		1		2			2						www.mmm-pr.com	www.mmm-pr.com	www.mmm-pr.com	(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396		(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		2	2	2
H4003	808	0	1	02	01	H4003_808_0	4	1		07/20/2011	2012.02	07/20/2011 10:12:26 AM SA Western Standard Time	07/27/2011 06:16:42 PM SA Western Standard Time			07/27/2011 06:33:12 PM SA Western Standard Time	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.mmm-pr.com	MMM Healthcare, Inc. -MA Flex III (HMO-POS)	01	02		1			H4003	808	0	2012	MMM Healthcare, Inc.		1		2			2						www.mmm-pr.com	www.mmm-pr.com	www.mmm-pr.com	(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396										(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469										2	2	2
H4003	809	0	1	02	01	H4003_809_0	4	1		07/20/2011	2012.02	07/20/2011 10:12:30 AM SA Western Standard Time	07/27/2011 06:16:45 PM SA Western Standard Time			07/27/2011 06:33:12 PM SA Western Standard Time	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.mmm-pr.com	MMM Healthcare, Inc - MA Flex IV (HMO-POS)	01	02		1			H4003	809	0	2012	MMM Healthcare, Inc.		1		2			2						www.mmm-pr.com	www.mmm-pr.com	www.mmm-pr.com	(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396										(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469										2	2	2
H4003	810	0	1	01	01	H4003_810_0	3	1		06/03/2011	2012.02	06/03/2011 01:32:49 PM SA Western Standard Time	07/27/2011 06:16:48 PM SA Western Standard Time			07/27/2011 06:33:12 PM SA Western Standard Time	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.mmm-pr.com	Medicare y Mucho Mas - MA Flex (HMO)	01	01		1			H4003	810	0	2012	Puerto Rico		1		2			2						www.mmm-pr.com	www.mmm-pr.com	www.mmm-pr.com	(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396										(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469										2	2	2
H4003	811	0	1	01	01	H4003_811_0	2	1		06/03/2011	2012.02	06/03/2011 01:32:58 PM SA Western Standard Time	07/27/2011 06:16:52 PM SA Western Standard Time			07/27/2011 06:33:12 PM SA Western Standard Time	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.mmm-pr.com	Medicare y Mucho Mas - MAPD FLEX (HMO)	01	01		1			H4003	811	0	2012	PUERTO RICO		1		2			2						www.mmm-pr.com	www.mmm-pr.com	www.mmm-pr.com	(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396		(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		2	2	2
H4003	812	0	1	01	01	H4003_812_0	2	1		06/03/2011	2012.02	06/03/2011 01:33:06 PM SA Western Standard Time	07/27/2011 06:16:56 PM SA Western Standard Time			07/27/2011 06:33:12 PM SA Western Standard Time	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.mmm-pr.com	Medicare y Mucho Mas - MAPD FLEX I (HMO)	01	01		1			H4003	812	0	2012	PUERTO RICO		1		2			2						www.mmm-pr.com	www.mmm-pr.com	www.mmm-pr.com	(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396		(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		2	2	2
H4003	813	0	1	01	01	H4003_813_0	2	1		06/03/2011	2012.02	06/03/2011 01:33:17 PM SA Western Standard Time	07/27/2011 06:17:00 PM SA Western Standard Time			07/27/2011 06:33:12 PM SA Western Standard Time	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.mmm-pr.com	Medicare y Mucho Mas - MA Flex II (HMO)	01	01		1			H4003	813	0	2012	PUERTO RICO		1		2			2						www.mmm-pr.com	www.mmm-pr.com	www.mmm-pr.com	(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396										(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469										2	2	2
H4003	814	0	1	01	01	H4003_814_0	2	1		06/03/2011	2012.02	06/03/2011 01:33:26 PM SA Western Standard Time	07/27/2011 06:17:05 PM SA Western Standard Time			07/27/2011 06:33:12 PM SA Western Standard Time	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.mmm-pr.com	Medicare y Mucho Mas - MAPD Flex II (HMO)	01	01		1			H4003	814	0	2012	PUERTO RICO		1		2			2						www.mmm-pr.com	www.mmm-pr.com	www.mmm-pr.com	(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396		(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		2	2	2
H4003	815	0	1	01	01	H4003_815_0	2	1		06/03/2011	2012.02	06/03/2011 01:34:00 PM SA Western Standard Time	07/27/2011 06:17:08 PM SA Western Standard Time			07/27/2011 06:33:12 PM SA Western Standard Time	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.mmm-pr.com	Medicare y Mucho Mas - MAPD Flex III (HMO)	01	01		1			H4003	815	0	2012	PUERTO RICO		1		2			2						www.mmm-pr.com	www.mmm-pr.com	www.mmm-pr.com	(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396		(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469		2	2	2
H4003	816	0	1	01	01	H4003_816_0	2	1		06/03/2011	2012.02	06/03/2011 01:34:09 PM SA Western Standard Time	07/27/2011 06:17:12 PM SA Western Standard Time			07/27/2011 06:33:12 PM SA Western Standard Time	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.mmm-pr.com	MMM Healthcare, Inc. -MA Flex III (HMO)	01	01		1			H4003	816	0	2012	PUERTO RICO		1		2			2						www.mmm-pr.com	www.mmm-pr.com	www.mmm-pr.com	(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396										(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469										2	2	2
H4003	817	0	1	01	01	H4003_817_0	2	1		06/03/2011	2012.02	06/03/2011 01:34:17 PM SA Western Standard Time	07/27/2011 06:17:15 PM SA Western Standard Time			07/27/2011 06:33:12 PM SA Western Standard Time	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.mmm-pr.com	MMM Healthcare, Inc - MA Flex IV (HMO)	01	01		1			H4003	817	0	2012	PUERTO RICO		1		2			2						www.mmm-pr.com	www.mmm-pr.com	www.mmm-pr.com	(866)-333-5470		(787)-620-2397		(866)-333-5471		(787)-620-2396										(866)-333-5469		(866)-333-5469		(866)-333-5469		(866)-333-5469										2	2	2
H4004	015	0	1	02	01	H4004_015_0	6	1		08/09/2011	2012.02	08/09/2011 05:49:19 PM SA Western Standard Time	08/09/2011 05:20:57 PM SA Western Standard Time	08/09/2011 05:37:37 PM SA Western Standard Time		08/09/2011 06:03:51 PM SA Western Standard Time	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	Elite Dorado (HMO-POS)	01	02		1			H4004	015	0	2012	PUERTO RICO		2		2			2							http://www.pmcpr.org	http://www.pmcpr.org	(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510		(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		2	2	2
H4004	025	0	1	01	01	H4004_025_0	5	1		07/12/2011	2012.02	07/12/2011 06:48:03 PM SA Western Standard Time	08/12/2011 03:21:54 PM SA Western Standard Time			08/12/2011 05:06:37 PM SA Western Standard Time	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	Dorado (HMO)	01	01		1			H4004	025	0	2012	PUERTO RICO		2		2			2							http://www.pmcpr.org	http://www.pmcpr.org	(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510										(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701										2	2	2
H4004	035	0	1	01	01	H4004_035_0	5	1		08/09/2011	2012.02	08/09/2011 05:49:32 PM SA Western Standard Time	08/09/2011 05:21:01 PM SA Western Standard Time	08/09/2011 05:37:41 PM SA Western Standard Time		08/09/2011 06:03:51 PM SA Western Standard Time	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	Medicare en el Hogar Plus (HMO SNP)	01	01		1			H4004	035	0	2012	PUERTO RICO		2		2			1	1	1	1				http://www.pmcpr.org	http://www.pmcpr.org	(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510		(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		2	2	2
H4004	048	0	1	01	01	H4004_048_0	5	1	1	08/09/2011	2012.02	08/09/2011 05:49:44 PM SA Western Standard Time	08/09/2011 05:21:06 PM SA Western Standard Time	08/09/2011 05:37:45 PM SA Western Standard Time		08/09/2011 06:03:51 PM SA Western Standard Time	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	Premier Preferred (HMO SNP)	01	01		1			H4004	048	0	2012	PUERTO RICO		2		2		1	1	3		1	3			http://www.pmcpr.org	http://www.pmcpr.org	(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510		(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		2	2	2
H4004	050	0	1	01	01	H4004_050_0	5	1		08/09/2011	2012.02	08/09/2011 05:49:59 PM SA Western Standard Time	08/09/2011 05:21:10 PM SA Western Standard Time	08/09/2011 05:37:49 PM SA Western Standard Time		08/09/2011 06:03:51 PM SA Western Standard Time	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	PMC Max (HMO)	01	01		1			H4004	050	0	2012	PUERTO RICO		2		2			2							http://www.pmcpr.org	http://www.pmcpr.org	(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510		(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		2	2	2
H4004	801	0	1	02	01	H4004_801_0	4	1		07/20/2011	2012.02	07/20/2011 10:11:16 AM SA Western Standard Time	07/27/2011 06:17:35 PM SA Western Standard Time			07/27/2011 06:33:12 PM SA Western Standard Time	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	PMC Employer Plan MA C (HMO-POS)	01	02		1			H4004	801	0	2012	PUERTO RICO		1		2			2							http://www.pmcpr.org	http://www.pmcpr.org	(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510										(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701										2	2	2
H4004	802	0	1	02	01	H4004_802_0	4	1		07/20/2011	2012.02	07/20/2011 10:11:22 AM SA Western Standard Time	07/27/2011 06:17:38 PM SA Western Standard Time			07/27/2011 06:33:12 PM SA Western Standard Time	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	PMC Employer MAPD C (HMO-POS)	01	02		1			H4004	802	0	2012	PUERTO RICO		1		2			2							http://www.pmcpr.org	http://www.pmcpr.org	(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510		(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		2	2	2
H4004	803	0	1	02	01	H4004_803_0	4	1		07/20/2011	2012.02	07/20/2011 10:11:26 AM SA Western Standard Time	07/27/2011 06:17:41 PM SA Western Standard Time			07/27/2011 06:33:12 PM SA Western Standard Time	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	PMC Employer MAPD NC (HMO-POS)	01	02		1			H4004	803	0	2012	PUERTO RICO		1		2			2							http://www.pmcpr.org	http://www.pmcpr.org	(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510		(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		2	2	2
H4004	804	0	1	02	01	H4004_804_0	4	1		07/20/2011	2012.02	07/20/2011 10:11:36 AM SA Western Standard Time	07/27/2011 06:17:44 PM SA Western Standard Time			07/27/2011 06:33:12 PM SA Western Standard Time	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	PMC Employer MA C (HMO-POS)	01	02		1			H4004	804	0	2012	PUERTO RICO		1		2			2							http://www.pmcpr.org	http://www.pmcpr.org	(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510										(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701										2	2	2
H4004	805	0	1	02	01	H4004_805_0	4	1		07/20/2011	2012.02	07/20/2011 10:11:41 AM SA Western Standard Time	07/27/2011 06:17:48 PM SA Western Standard Time			07/27/2011 06:33:12 PM SA Western Standard Time	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	PMC Employer MAPD C (HMO-POS)	01	02		1			H4004	805	0	2012	PUERTO RICO		1		2			2							http://www.pmcpr.org	http://www.pmcpr.org	(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510		(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		2	2	2
H4004	806	0	1	02	01	H4004_806_0	4	1		07/20/2011	2012.02	07/20/2011 10:11:46 AM SA Western Standard Time	07/27/2011 06:17:53 PM SA Western Standard Time			07/27/2011 06:33:12 PM SA Western Standard Time	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	PMC Employer MAPD NC (HMO-POS)	01	02		1			H4004	806	0	2012	PUERTO RICO		1		2			2							http://www.pmcpr.org	http://www.pmcpr.org	(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510		(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		2	2	2
H4004	807	0	1	02	01	H4004_807_0	4	1		07/20/2011	2012.02	07/20/2011 10:11:49 AM SA Western Standard Time	07/27/2011 06:17:57 PM SA Western Standard Time			07/27/2011 06:33:12 PM SA Western Standard Time	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	PMC Employer MA NC (HMO-POS)	01	02		1			H4004	807	0	2012	PUERTO RICO		1		2			2							http://www.pmcpr.org	http://www.pmcpr.org	(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510										(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701										2	2	2
H4004	808	0	1	02	01	H4004_808_0	4	1		07/20/2011	2012.02	07/20/2011 10:11:54 AM SA Western Standard Time	07/27/2011 06:18:00 PM SA Western Standard Time			07/27/2011 06:33:12 PM SA Western Standard Time	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	PMC Employer MA NC (HMO-POS)	01	02		1			H4004	808	0	2012	PUERTO RICO		1		2			2							http://www.pmcpr.org	http://www.pmcpr.org	(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510										(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701										2	2	2
H4004	809	0	1	01	01	H4004_809_0	2	1		06/03/2011	2012.02	06/03/2011 01:29:13 PM SA Western Standard Time	07/27/2011 06:18:03 PM SA Western Standard Time			07/27/2011 06:33:12 PM SA Western Standard Time	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	PMC Employer Plan MA C (HMO)	01	01		1			H4004	809	0	2012	PUERTO RICO		1		2			2							http://www.pmcpr.org	http://www.pmcpr.org	(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510										(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701										2	2	2
H4004	810	0	1	01	01	H4004_810_0	2	1		06/03/2011	2012.02	06/03/2011 01:29:22 PM SA Western Standard Time	07/27/2011 06:18:07 PM SA Western Standard Time			07/27/2011 06:33:12 PM SA Western Standard Time	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	PMC Employer MAPD C (HMO)	01	01		1			H4004	810	0	2012	PUERTO RICO		1		2			2							http://www.pmcpr.org	http://www.pmcpr.org	(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510		(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		2	2	2
H4004	811	0	1	01	01	H4004_811_0	2	1		06/03/2011	2012.02	06/03/2011 01:29:32 PM SA Western Standard Time	07/27/2011 06:18:10 PM SA Western Standard Time			07/27/2011 06:33:12 PM SA Western Standard Time	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	PMC Employer MAPD NC (HMO)	01	01		1			H4004	811	0	2012	PUERTO RICO		1		2			2							http://www.pmcpr.org	http://www.pmcpr.org	(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510		(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		2	2	2
H4004	812	0	1	01	01	H4004_812_0	2	1		06/03/2011	2012.02	06/03/2011 01:29:42 PM SA Western Standard Time	07/27/2011 06:18:12 PM SA Western Standard Time			07/27/2011 06:33:12 PM SA Western Standard Time	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	PMC Employer MA C (HMO)	01	01		1			H4004	812	0	2012	PUERTO RICO		1		2			2							http://www.pmcpr.org	http://www.pmcpr.org	(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510										(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701										2	2	2
H4004	813	0	1	01	01	H4004_813_0	2	1		06/03/2011	2012.02	06/03/2011 01:29:53 PM SA Western Standard Time	07/27/2011 06:18:16 PM SA Western Standard Time			07/27/2011 06:33:12 PM SA Western Standard Time	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	PMC Employer MAPD C (HMO)	01	01		1			H4004	813	0	2012	PUERTO RICO		1		2			2							http://www.pmcpr.org	http://www.pmcpr.org	(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510		(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		2	2	2
H4004	814	0	1	01	01	H4004_814_0	2	1		06/03/2011	2012.02	06/03/2011 01:30:03 PM SA Western Standard Time	07/27/2011 06:18:20 PM SA Western Standard Time			07/27/2011 06:33:12 PM SA Western Standard Time	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	PMC Employer MAPD NC (HMO)	01	01		1			H4004	814	0	2012	PUERTO RICO		1		2			2							http://www.pmcpr.org	http://www.pmcpr.org	(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510		(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701		2	2	2
H4004	815	0	1	01	01	H4004_815_0	2	1		06/03/2011	2012.02	06/03/2011 01:30:11 PM SA Western Standard Time	07/27/2011 06:18:23 PM SA Western Standard Time			07/27/2011 06:33:12 PM SA Western Standard Time	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	PMC Employer MA NC (HMO)	01	01		1			H4004	815	0	2012	PUERTO RICO		1		2			2							http://www.pmcpr.org	http://www.pmcpr.org	(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510										(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701										2	2	2
H4004	816	0	1	01	01	H4004_816_0	2	1		06/03/2011	2012.02	06/03/2011 01:30:21 PM SA Western Standard Time	07/27/2011 06:18:27 PM SA Western Standard Time			07/27/2011 06:33:12 PM SA Western Standard Time	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	PMC Employer MA NC (HMO)	01	01		1			H4004	816	0	2012	PUERTO RICO		1		2			2							http://www.pmcpr.org	http://www.pmcpr.org	(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510										(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701										2	2	2
H4005	001	0	1	04	01	H4005_001_0	7	1		07/15/2011	2012.02	07/15/2011 10:55:00 AM SA Western Standard Time	07/18/2011 03:16:57 PM SA Western Standard Time			07/18/2011 03:20:56 PM SA Western Standard Time	TRIPLE-S SALUD,  INC.	Triple-S Salud, Inc.	www.sssplanesmedicare.com	Triple-S Medicare Optimo (PPO)	01	04		1			H4005	001	0	2012	Island of Puerto Rico		2		2			2						http://www.ssspr.com/SSSPortal/ProviderSearch.aspx	www.ssspr.com	www.ssspr.com	(800)-510-0722		(787)-774-6083		(877)-207-8777		(877)-207-8777										(800)-383-4457		(787)-749-4059		(800)-383-4457		(787)-749-4059										2	2	2
H4005	004	0	1	04	01	H4005_004_0	12	1		08/01/2011	2012.02	08/01/2011 01:08:21 PM SA Western Standard Time	08/05/2011 05:15:28 PM SA Western Standard Time	08/04/2011 10:28:32 AM SA Western Standard Time		08/08/2011 04:54:04 PM SA Western Standard Time	TRIPLE-S SALUD,  INC.	Triple-S Salud, Inc.	www.sssplanesmedicare.com	Triple-S Medicare Optimo Plus (PPO)	01	04		1			H4005	004	0	2012	Island of Puerto Rico		2		2			2						http://www.ssspr.com/SSSPortal/ProviderSearch.aspx	www.ssspr.com	www.ssspr.com	(800)-510-0722		(787)-774-6083		(877)-207-8777		(877)-207-8777		(800)-510-0722		(787)-774-6083		(877)-207-8777		(877)-207-8777		(800)-383-4457		(787)-749-4059		(800)-383-4457		(787)-749-4059		(800)-383-4457		(787)-749-4059		(800)-383-4457		(787)-749-4059		2	2	2
H4005	801	0	1	04	01	H4005_801_0	4	1		07/12/2011	2012.02	07/12/2011 08:36:46 AM SA Western Standard Time	06/06/2011 04:14:40 PM SA Western Standard Time			07/12/2011 09:03:07 AM SA Western Standard Time	TRIPLE-S SALUD,  INC.	Triple-S Salud, Inc.	www.sssplanesmedicare.com	Triple-S Medicare Optimo (PPO)	01	04		1			H4005	801	0	2012	Island of Puerto Rico		1		2			2						http://www.ssspr.com/SSSPortal/ProviderSearch.aspx	www.ssspr.com	www.ssspr.com	(800)-510-0722		(787)-774-6083		(877)-207-8777		(877)-207-8777										(800)-383-4457		(787)-749-4059		(800)-383-4457		(787)-749-4059										2	2	2
H4005	802	0	1	04	01	H4005_802_0	4	1		07/12/2011	2012.02	07/12/2011 08:37:13 AM SA Western Standard Time	06/06/2011 04:15:16 PM SA Western Standard Time			07/12/2011 09:03:07 AM SA Western Standard Time	TRIPLE-S SALUD,  INC.	Triple-S Salud, Inc.	www.sssplanesmedicare.com	Triple-S Medicare Optimo Plus A (PPO)	01	04		1			H4005	802	0	2012	Island of Puerto Rico		1		2			2						http://www.ssspr.com/SSSPortal/ProviderSearch.aspx	www.ssspr.com	www.ssspr.com	(800)-510-0722		(787)-774-6083		(877)-207-8777		(877)-207-8777		(800)-510-0722		(787)-774-6083		(877)-207-8777		(877)-207-8777		(800)-383-4457		(787)-749-4059		(800)-383-4457		(787)-749-4059		(800)-383-4457		(787)-749-4059		(800)-383-4457		(787)-749-4059		2	2	2
H4005	804	0	1	04	01	H4005_804_0	4	1		07/12/2011	2012.02	07/12/2011 08:37:33 AM SA Western Standard Time	06/06/2011 04:15:41 PM SA Western Standard Time			07/12/2011 09:03:07 AM SA Western Standard Time	TRIPLE-S SALUD,  INC.	Triple-S Salud, Inc.	www.sssplanesmedicare.com	Triple-S Medicare Optimo Plus B (PPO)	01	04		1			H4005	804	0	2012	Island of Puerto Rico		1		2			2						http://www.ssspr.com/SSSPortal/ProviderSearch.aspx	www.ssspr.com	www.ssspr.com	(800)-510-0722		(787)-774-6083		(877)-207-8777		(877)-207-8777		(800)-510-0722		(787)-774-6083		(877)-207-8777		(877)-207-8777		(800)-383-4457		(787)-749-4059		(800)-383-4457		(787)-749-4059		(800)-383-4457		(787)-749-4059		(800)-383-4457		(787)-749-4059		2	2	2
H4005	807	0	1	04	01	H4005_807_0	4	1		07/12/2011	2012.02	07/12/2011 08:37:55 AM SA Western Standard Time	06/06/2011 04:16:14 PM SA Western Standard Time			07/12/2011 09:03:07 AM SA Western Standard Time	TRIPLE-S SALUD,  INC.	Triple-S Salud, Inc.	www.sssplanesmedicare.com	Triple-S Medicare Optimo Plus C (PPO)	01	04		1			H4005	807	0	2012	Island of Puerto Rico		1		2			2						http://www.ssspr.com/SSSPortal/ProviderSearch.aspx	www.ssspr.com	www.ssspr.com	(800)-510-0722		(787)-774-6083		(877)-207-8777		(877)-207-8777		(800)-510-0722		(787)-774-6083		(877)-207-8777		(877)-207-8777		(800)-383-4457		(787)-749-4059		(800)-383-4457		(787)-749-4059		(800)-383-4457		(787)-749-4059		(800)-383-4457		(787)-749-4059		2	2	2
H4006	001	0	1	01	01	H4006_001_0	6	1		07/19/2011	2012.02	07/19/2011 03:04:06 PM SA Western Standard Time	06/05/2011 11:09:06 PM SA Western Standard Time			07/19/2011 04:03:11 PM SA Western Standard Time	MCS ADVANTAGE INC.	MCS Classicare	www.mcsclassicare.com	MCS Classicare MA (HMO)	01	01		1			H4006	001	0	2012	Puerto Rico		2	1653	2			2						www.mcsclassicare.com	www.mcsclassicare.com	www.mcsclassicare.com	(866)-627-8183		(787)-620-2530		(866)-627-8181		(787)-620-2528										(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182										2	2	2
H4006	007	0	1	01	01	H4006_007_0	7	1		07/19/2011	2012.02	07/19/2011 03:03:54 PM SA Western Standard Time	08/05/2011 04:52:00 PM SA Western Standard Time	08/08/2011 09:25:00 AM SA Western Standard Time		08/09/2011 09:55:49 AM SA Western Standard Time	MCS ADVANTAGE INC.	MCS Classicare	www.mcsclassicare.com	MCS Classicare Premium Health (HMO)	01	01		1			H4006	007	0	2012	Puerto Rico		2	41136	2			2						www.mcsclassicare.com	www.mcsclassicare.com	www.mcsclassicare.com	(866)-627-8183		(787)-620-2530		(866)-627-8181		(787)-620-2528		(866)-627-8183		(787)-620-2530		(866)-627-8181		(787)-620-2528		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		2	2	2
H4006	008	0	1	02	01	H4006_008_0	9	1		07/19/2011	2012.02	07/19/2011 03:04:20 PM SA Western Standard Time	08/05/2011 04:52:48 PM SA Western Standard Time	08/08/2011 09:25:40 AM SA Western Standard Time		08/09/2011 09:55:49 AM SA Western Standard Time	MCS ADVANTAGE INC.	MCS Classicare	www.mcsclassicare.com	MCS Classicare Advanced Health (HMO-POS)	01	02		1			H4006	008	0	2012	Puerto Rico		2	3170	2			2						www.mcsclassicare.com	www.mcsclassicare.com	www.mcsclassicare.com	(866)-627-8183		(787)-620-2530		(866)-627-8181		(787)-620-2528		(866)-627-8183		(787)-620-2530		(866)-627-8181		(787)-620-2528		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		2	2	2
H4006	013	0	1	01	01	H4006_013_0	7	1	1	07/19/2011	2012.02	07/19/2011 03:04:52 PM SA Western Standard Time	08/05/2011 04:53:36 PM SA Western Standard Time	08/08/2011 09:26:12 AM SA Western Standard Time		08/09/2011 09:55:49 AM SA Western Standard Time	MCS ADVANTAGE INC.	MCS Classicare	www.mcsclassicare.com	MCS Classicare Especial (HMO SNP)	01	01		1			H4006	013	0	2012	Puerto Rico		2	7002	2		1	1	3		1	3		www.mcsclassicare.com	www.mcsclassicare.com	www.mcsclassicare.com	(866)-627-8183		(787)-620-2530		(866)-627-8181		(787)-620-2528		(866)-627-8183		(787)-620-2530		(866)-627-8181		(787)-620-2528		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		2	2	2
H4006	025	0	1	01	01	H4006_025_0	4	1		07/19/2011	2012.02	07/19/2011 03:05:01 PM SA Western Standard Time	08/05/2011 04:54:24 PM SA Western Standard Time	08/08/2011 11:35:36 AM SA Western Standard Time		08/09/2011 09:55:49 AM SA Western Standard Time	MCS ADVANTAGE INC.	MCS Classicare	www.mcsclassicare.com	MCS Classicare B-Max (HMO)	01	01		1			H4006	025	0	2012	Puerto Rico		2	3000	2			2						www.mcsclassicare.com	www.mcsclassicare.com	www.mcsclassicare.com	(866)-627-8183		(787)-620-2530		(866)-627-8181		(787)-620-2528		(866)-627-8183		(787)-620-2530		(866)-627-8181		(787)-620-2528		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		2	2	2
H4006	803	0	1	01	01	H4006_803_0	3	1		06/02/2011	2012.02	06/02/2011 03:12:19 PM SA Western Standard Time	06/05/2011 04:27:40 PM SA Western Standard Time			06/06/2011 11:42:40 AM SA Western Standard Time	MCS ADVANTAGE INC.	MCS Classicare	www.mcsclassicare.com	MCS Classicare MA Group (HMO)	01	01		1			H4006	803	0	2012	Puerto Rico		1	60	2			2						www.mcsclassicare.com	www.mcsclassicare.com	www.mcsclassicare.com	(866)-627-8183		(787)-620-2530		(866)-627-8181		(787)-620-2528										(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182										1	1	1
H4006	807	0	1	01	01	H4006_807_0	4	1		06/02/2011	2012.02	06/02/2011 03:12:05 PM SA Western Standard Time	06/05/2011 09:24:18 PM SA Western Standard Time			06/06/2011 11:42:40 AM SA Western Standard Time	MCS ADVANTAGE INC.	MCS Classicare	www.mcsclassicare.com	MCS Classicare MA-PD Group (C) (HMO)	01	01		1			H4006	807	0	2012	Puerto Rico		1	11200	2			2						www.mcsclassicare.com	www.mcsclassicare.com	www.mcsclassicare.com	(866)-627-8183		(787)-620-2530		(866)-627-8181		(787)-620-2528		(866)-627-8183		(787)-620-2530		(866)-627-8181		(787)-620-2528		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		1	1	1
H4006	809	0	1	01	01	H4006_809_0	3	1		06/02/2011	2012.02	06/02/2011 03:12:30 PM SA Western Standard Time	06/05/2011 04:29:36 PM SA Western Standard Time			06/06/2011 11:42:40 AM SA Western Standard Time	MCS ADVANTAGE INC.	MCS Classicare	www.mcsclassicare.com	MCS Classicare MA-PD Group 40 (C) (HMO)	01	01		1			H4006	809	0	2012	Puerto Rico		1	20	2			2						www.mcsclassicare.com	www.mcsclassicare.com	www.mcsclassicare.com	(866)-627-8183		(787)-620-2530		(866)-627-8181		(787)-620-2528		(866)-627-8183		(787)-620-2530		(866)-627-8181		(787)-620-2528		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		1	1	1
H4006	811	0	1	01	01	H4006_811_0	3	1		06/02/2011	2012.02	06/02/2011 03:12:38 PM SA Western Standard Time	06/05/2011 05:35:18 PM SA Western Standard Time			06/06/2011 11:42:40 AM SA Western Standard Time	MCS ADVANTAGE INC.	MCS Classicare	www.mcsclassicare.com	MCS Classicare MA-PD Group 50 (C) (HMO)	01	01		1			H4006	811	0	2012	Puerto Rico		1	10030	2			2						www.mcsclassicare.com	www.mcsclassicare.com	www.mcsclassicare.com	(866)-627-8183		(787)-620-2530		(866)-627-8181		(787)-620-2528		(866)-627-8183		(787)-620-2530		(866)-627-8181		(787)-620-2528		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		1	1	1
H4006	813	0	1	01	01	H4006_813_0	3	1		06/02/2011	2012.02	06/02/2011 03:12:47 PM SA Western Standard Time	06/05/2011 04:31:28 PM SA Western Standard Time			06/06/2011 11:42:40 AM SA Western Standard Time	MCS ADVANTAGE INC.	MCS Classicare	www.mcsclassicare.com	MCS Classicare MA-PD Group PF (C) (HMO)	01	01		1			H4006	813	0	2012	Puerto Rico		1	20	2			2						www.mcsclassicare.com	www.mcsclassicare.com	www.mcsclassicare.com	(866)-627-8183		(787)-620-2530		(866)-627-8181		(787)-620-2528		(866)-627-8183		(787)-620-2530		(866)-627-8181		(787)-620-2528		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		1	1	1
H4006	816	0	1	01	01	H4006_816_0	2	1		06/05/2011	2012.02	06/05/2011 01:49:09 PM SA Western Standard Time	06/05/2011 04:32:24 PM SA Western Standard Time			06/06/2011 11:42:40 AM SA Western Standard Time	MCS ADVANTAGE INC.	MCS Classicare	www.mcsclassicare.com	MCS Classicare MA-PD Group 30 (C) (HMO) (HMO)	01	01		1			H4006	816	0	2012	Puerto Rico		1	1000	2			2						www.mcsclassicare.com	www.mcsclassicare.com	www.mcsclassicare.com	(866)-627-8183		(787)-620-2530		(866)-627-8181		(787)-620-2528		(866)-627-8183		(787)-620-2530		(866)-627-8181		(787)-620-2528		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		1	1	1
H4007	005	0	1	01	01	H4007_005_0	5	1	1	07/08/2011	2012.02	07/08/2011 02:04:47 PM Eastern Daylight Time	08/08/2011 10:21:10 AM Eastern Daylight Time	08/04/2011 12:17:23 PM Eastern Daylight Time		08/08/2011 05:34:50 PM Eastern Daylight Time	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	www.humana-medicare.com	Humana Gold Plus SNP-DE H4007-005 (HMO SNP)	01	01		1			H4007	005	0	2012	Puerto Rico Island Wide		2		2		1	1	3		1	2			http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625		(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4007	012	0	1	01	01	H4007_012_0	5	1		08/08/2011	2012.02	08/08/2011 09:06:13 AM Eastern Daylight Time	08/08/2011 10:21:48 AM Eastern Daylight Time	08/04/2011 12:17:43 PM Eastern Daylight Time		08/08/2011 05:34:50 PM Eastern Daylight Time	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	www.humana-medicare.com	Humana Gold Plus H4007-012 (HMO)	01	01		1			H4007	012	0	2012	Puerto Rico Island Wide		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625		(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4007	013	0	1	01	01	H4007_013_0	5	1		08/30/2011	2012.02	08/30/2011 09:06:20 AM Eastern Daylight Time	08/08/2011 11:06:31 AM Eastern Daylight Time	08/04/2011 12:18:03 PM Eastern Daylight Time		08/30/2011 09:29:41 AM Eastern Daylight Time	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	www.humana-medicare.com	Humana Gold Plus H4007-013 (HMO)	01	01		1			H4007	013	0	2012	Puerto Rico Island Wide		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625		(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4007	801	0	1	01	01	H4007_801_0	2	1		07/06/2011	2012.02	07/06/2011 10:56:01 AM Eastern Daylight Time	05/27/2011 03:23:21 PM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	Humana Health Plans Of Puerto Rico Inc	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H4007	801	0	2012	Puerto Rico Island Wide		1		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625		(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H4007	802	0	1	01	01	H4007_802_0	2	1		07/06/2011	2012.02	07/06/2011 10:56:07 AM Eastern Daylight Time	05/27/2011 05:23:15 PM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	Humana Health Plans Of Puerto Rico Inc	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H4007	802	0	2012	Puerto Rico Island Wide		1		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625										(711)		(711)		(711)		(711)										2	1	1
H4007	803	0	1	01	01	H4007_803_0	2	1		07/06/2011	2012.02	07/06/2011 10:56:11 AM Eastern Daylight Time	05/27/2011 05:24:18 PM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	Humana Health Plans Of Puerto Rico Inc	www.humana-medicare.com	Humana Employer Sponsored Non-CY (HMO)	01	01		1			H4007	803	0	2012	Puerto Rico Island Wide		1		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625		(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H4007	805	0	1	01	01	H4007_805_0	5	1		07/06/2011	2012.02	07/06/2011 10:56:15 AM Eastern Daylight Time	06/01/2011 10:49:11 AM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	Humana Health Plans Of Puerto Rico Inc	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H4007	805	0	2012	Puerto Rico Island Wide		1		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625		(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H4007	806	0	1	01	01	H4007_806_0	2	1		07/06/2011	2012.02	07/06/2011 10:56:21 AM Eastern Daylight Time	05/27/2011 06:44:32 PM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	Humana Health Plans Of Puerto Rico Inc	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H4007	806	0	2012	Puerto Rico Island Wide		1		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625										(711)		(711)		(711)		(711)										2	1	1
H4007	807	0	1	01	01	H4007_807_0	5	1		07/06/2011	2012.02	07/06/2011 10:56:25 AM Eastern Daylight Time	06/01/2011 10:50:16 AM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	Humana Health Plans Of Puerto Rico Inc	www.humana-medicare.com	Humana Employer Sponsored Non-CY (HMO)	01	01		1			H4007	807	0	2012	Puerto Rico Island Wide		1		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625		(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H4011	001	0	1	04	01	H4011_001_0	3	1		07/13/2011	2012.02	07/13/2011 10:24:23 AM SA Western Standard Time	06/04/2011 06:15:24 PM SA Western Standard Time			07/13/2011 11:26:37 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	First+Plus Advantage (PPO)	01	04		1			H4011	001	0	2012	Entire Island Puerto Rico		2		2			2						www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242										(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242										2	2	2
H4011	003	0	1	04	01	H4011_003_0	5	1		07/13/2011	2012.02	07/13/2011 10:26:47 AM SA Western Standard Time	08/08/2011 09:25:33 AM SA Western Standard Time	08/08/2011 09:25:00 AM SA Western Standard Time		08/08/2011 09:27:14 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	First+Plus Advantage Plus (PPO)	01	04		1			H4011	003	0	2012	Enitre Island Puerto Rico		2		2			2						www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		2	2	2
H4011	801	0	1	04	01	H4011_801_0	2	1		06/01/2011	2012.02	06/01/2011 06:17:15 PM SA Western Standard Time	06/04/2011 11:05:40 AM SA Western Standard Time			06/06/2011 09:52:09 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	Employer Group Plan 1 (PPO)	01	04		1			H4011	801	0	2012	Entire Island Puerto Rico		1		2			2						www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		1	1	1
H4011	802	0	1	04	01	H4011_802_0	2	1		06/01/2011	2012.02	06/01/2011 06:09:51 PM SA Western Standard Time	06/04/2011 11:05:58 AM SA Western Standard Time			06/06/2011 09:52:09 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	Employer Group Plan 2 (PPO)	01	04		1			H4011	802	0	2012	Entire Island Puerto Rico		1		2			2						www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242										(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242										1	1	1
H4011	803	0	1	04	01	H4011_803_0	2	1		06/01/2011	2012.02	06/01/2011 06:10:00 PM SA Western Standard Time	06/04/2011 11:06:16 AM SA Western Standard Time			06/06/2011 09:52:09 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	Employer Group Plan 3 (PPO)	01	04		1			H4011	803	0	2012	Entire Island Puerto Rico		1		2			2						www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		1	1	1
H4011	805	0	1	04	01	H4011_805_0	2	1		06/01/2011	2012.02	06/01/2011 06:10:10 PM SA Western Standard Time	06/04/2011 11:06:36 AM SA Western Standard Time			06/06/2011 09:52:09 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	Employer Group Plan 5 (PPO)	01	04		1			H4011	805	0	2012	Entire Island Puerto Rico		1		2			2						www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		1	1	1
H4011	806	0	1	04	01	H4011_806_0	2	1		06/01/2011	2012.02	06/01/2011 06:10:17 PM SA Western Standard Time	06/04/2011 11:06:58 AM SA Western Standard Time			06/06/2011 09:52:09 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	Employer Group Plan 6 (PPO)	01	04		1			H4011	806	0	2012	Entire Island Puerto Rico		1		2			2						www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242										(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242										1	1	1
H4011	807	0	1	04	01	H4011_807_0	2	1		06/01/2011	2012.02	06/01/2011 06:10:24 PM SA Western Standard Time	06/04/2011 11:07:18 AM SA Western Standard Time			06/06/2011 09:52:09 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	Employer Group Plan 7 (PPO)	01	04		1			H4011	807	0	2012	Entire Island Puerto Rico		1		2			2						www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		1	1	1
H4011	809	0	1	04	01	H4011_809_0	2	1		06/01/2011	2012.02	06/01/2011 06:10:33 PM SA Western Standard Time	06/04/2011 11:07:38 AM SA Western Standard Time			06/06/2011 09:52:09 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	Employer Group Plan 9 (PPO)	01	04		1			H4011	809	0	2012	Entire Island Puerto Rico		1		2			2						www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		1	1	1
H4011	810	0	1	04	01	H4011_810_0	2	1		06/01/2011	2012.02	06/01/2011 06:10:41 PM SA Western Standard Time	06/04/2011 11:07:56 AM SA Western Standard Time			06/06/2011 09:52:09 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	Employer Group Plan 10 (PPO)	01	04		1			H4011	810	0	2012	Entire Island Puerto Rico		1		2			2						www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242										(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242										1	1	1
H4011	811	0	1	04	01	H4011_811_0	2	1		06/01/2011	2012.02	06/01/2011 06:10:48 PM SA Western Standard Time	06/04/2011 11:08:16 AM SA Western Standard Time			06/06/2011 09:52:09 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	Employer Group Plan 11 (PPO)	01	04		1			H4011	811	0	2012	Entire Island Puerto Rico		1		2			2						www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		1	1	1
H4011	813	0	1	04	01	H4011_813_0	2	1		06/01/2011	2012.02	06/01/2011 06:10:55 PM SA Western Standard Time	06/04/2011 11:08:34 AM SA Western Standard Time			06/06/2011 09:52:09 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	Employer Group Plan 13 (PPO)	01	04		1			H4011	813	0	2012	Entire Island Puerto Rico		1		2			2						www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		1	1	1
H4011	814	0	1	04	01	H4011_814_0	2	1		06/01/2011	2012.02	06/01/2011 06:11:03 PM SA Western Standard Time	06/04/2011 11:09:02 AM SA Western Standard Time			06/06/2011 09:52:09 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	Employer Group Plan 14 (PPO)	01	04		1			H4011	814	0	2012	Entire Island Puerto Rico		1		2			2						www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242										(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242										1	1	1
H4011	815	0	1	04	01	H4011_815_0	2	1		06/01/2011	2012.02	06/01/2011 06:11:12 PM SA Western Standard Time	06/04/2011 11:09:22 AM SA Western Standard Time			06/06/2011 09:52:09 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	Employer Group Plan 15 (PPO)	01	04		1			H4011	815	0	2012	Entire Island Puerto Rico		1		2			2						www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		1	1	1
H4011	817	0	1	04	01	H4011_817_0	2	1		06/01/2011	2012.02	06/01/2011 06:11:19 PM SA Western Standard Time	06/04/2011 11:09:46 AM SA Western Standard Time			06/06/2011 09:52:09 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	Employer Group Plan 17 (PPO)	01	04		1			H4011	817	0	2012	Entire Island Puerto Rico		1		2			2						www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		1	1	1
H4011	818	0	1	04	01	H4011_818_0	2	1		06/01/2011	2012.02	06/01/2011 06:11:26 PM SA Western Standard Time	06/04/2011 11:10:08 AM SA Western Standard Time			06/06/2011 09:52:09 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	Employer Group Plan 18 (PPO)	01	04		1			H4011	818	0	2012	Entire Island Puerto Rico		1		2			2						www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242										(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242										1	1	1
H4011	819	0	1	04	01	H4011_819_0	2	1		06/01/2011	2012.02	06/01/2011 06:11:35 PM SA Western Standard Time	06/04/2011 11:10:26 AM SA Western Standard Time			06/06/2011 09:52:09 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	Employer Group Plan 19 (PPO)	01	04		1			H4011	819	0	2012	Entire Island Puerto Rico		1		2			2						www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		1	1	1
H4012	003	0	1	01	01	H4012_003_0	10	1	1	08/08/2011	2012.02	08/08/2011 02:01:28 PM SA Western Standard Time	08/08/2011 01:32:20 PM SA Western Standard Time	08/04/2011 10:31:44 AM SA Western Standard Time		08/08/2011 04:46:43 PM SA Western Standard Time	TRIPLE-S SALUD, INC.	Triple-S Salud, Inc.	www.sssplanesmedicare.com	Triple-S Medicare Selecto with Medicare Platino (HMO SNP)	01	01		1			H4012	003	0	2012	Island of Puerto Rico		2		2		1	1	3		1	3			www.ssspr.com	www.ssspr.com	(800)-510-0722		(787)-774-6083		(877)-207-8777		(877)-207-8777		(800)-510-0722		(787)-774-6083		(877)-207-8777		(877)-207-8777		(800)-383-4457		(787)-749-4059		(800)-383-4457		(787)-749-4059		(800)-383-4457		(787)-749-4059		(800)-383-4457		(787)-749-4059		2	2	2
H4012	008	0	1	01	01	H4012_008_0	13	1		08/01/2011	2012.02	08/01/2011 01:48:50 PM SA Western Standard Time	08/08/2011 01:32:30 PM SA Western Standard Time	08/04/2011 10:34:42 AM SA Western Standard Time		08/08/2011 04:46:43 PM SA Western Standard Time	TRIPLE-S SALUD, INC.	Triple-S Salud, Inc.	www.sssplanesmedicare.com	Triple-S Medicare Optimo Select (HMO) (HMO)	01	01		1			H4012	008	0	2012	Island of Puerto Rico		2		2			2							www.ssspr.com	www.ssspr.com	(800)-510-0722		(787)-774-6083		(877)-207-8777		(877)-207-8777		(800)-510-0722		(787)-774-6083		(877)-207-8777		(877)-207-8777		(800)-383-4457		(787)-749-4059		(800)-383-4457		(787)-749-4059		(800)-383-4457		(787)-749-4059		(800)-383-4457		(787)-749-4059		2	2	2
H4012	009	0	1	01	01	H4012_009_0	11	1	1	08/01/2011	2012.02	08/01/2011 01:51:10 PM SA Western Standard Time	08/08/2011 01:32:38 PM SA Western Standard Time	08/04/2011 10:40:30 AM SA Western Standard Time		08/08/2011 04:46:43 PM SA Western Standard Time	TRIPLE-S SALUD, INC.	Triple-S Salud, Inc.	www.sssplanesmedicare.com	Triple-S Medicare Selecto with Medicare Platino 2 (HMO SNP)	01	01		1			H4012	009	0	2012	Island of Puerto Rico		2		2		1	1	3		1	3			www.ssspr.com	www.ssspr.com	(800)-510-0722		(787)-774-6083		(877)-207-8777		(877)-207-8777		(800)-510-0722		(787)-774-6083		(877)-207-8777		(877)-207-8777		(800)-383-4457		(787)-749-4059		(800)-383-4457		(787)-749-4059		(800)-383-4457		(787)-749-4059		(800)-383-4457		(787)-749-4059		2	2	2
H4036	003	0	1	04	01	H4036_003_0	11	1		08/08/2011	2012.02	08/08/2011 05:09:05 PM Eastern Daylight Time	08/08/2011 11:49:37 PM Eastern Daylight Time	08/08/2011 11:50:57 PM Eastern Daylight Time		08/09/2011 12:02:14 AM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred Select (PPO)	01	04		1			H4036	003	0	2012	East and Southeast Wisconsin		2	2349	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(800)-467-1199		(800)-467-1199		(800)-797-5940		(800)-797-5940		(800)-467-1199		(800)-467-1199		(800)-797-5940		(800)-797-5940		(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894		(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894		2	2	2
H4036	004	0	1	04	01	H4036_004_0	11	1		08/04/2011	2012.02	08/04/2011 02:59:49 PM Eastern Daylight Time	08/08/2011 11:49:55 PM Eastern Daylight Time	08/08/2011 11:51:07 PM Eastern Daylight Time		08/09/2011 12:02:14 AM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred Core (PPO)	01	04		1			H4036	004	0	2012	East and Southeast Wisconsin		2	10214	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(800)-467-1199		(800)-467-1199		(800)-797-5940		(800)-797-5940		(800)-467-1199		(800)-467-1199		(800)-797-5940		(800)-797-5940		(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894		(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894		2	2	2
H4036	801	0	1	04	01	H4036_801_0	5	1		07/12/2011	2012.02	07/12/2011 09:17:52 AM Eastern Daylight Time	07/26/2011 11:21:27 AM Eastern Daylight Time			07/26/2011 11:49:55 AM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred (PPO)	01	04		1			H4036	801	0	2012	Wisconsin		1	1381	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608		(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		2	2	2
H4036	802	0	1	04	01	H4036_802_0	5	1		07/12/2011	2012.02	07/12/2011 09:18:22 AM Eastern Daylight Time	07/26/2011 11:21:28 AM Eastern Daylight Time			07/26/2011 11:49:55 AM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred (PPO)	01	04		1			H4036	802	0	2012	Wisconsin		1	50	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608										(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754										2	2	2
H4036	803	0	1	04	01	H4036_803_0	5	1		07/12/2011	2012.02	07/12/2011 09:18:59 AM Eastern Daylight Time	07/26/2011 11:21:28 AM Eastern Daylight Time			07/26/2011 11:49:55 AM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred (PPO)	01	04		1			H4036	803	0	2012	Wisconsin		1	50	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608		(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		2	2	2
H4036	804	0	1	04	01	H4036_804_0	5	1		07/12/2011	2012.02	07/12/2011 09:19:31 AM Eastern Daylight Time	07/26/2011 11:21:29 AM Eastern Daylight Time			07/26/2011 11:49:55 AM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred (PPO)	01	04		1			H4036	804	0	2012	Wisconsin		1	50	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608										(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754										2	2	2
H4074	001	0	1	20	08	H4074_001_0	1	1		10/31/2011	2012.02	10/31/2011 09:35:24 AM Mountain Daylight Time		10/24/2011 02:48:49 PM Mountain Daylight Time		10/31/2011 09:36:47 AM Mountain Daylight Time	MERCY LIFE OF ALABAMA	Mercy LIFE of Alabama	www.mercymedical.com/pace	Mercy LIFE of Alabama (PACE)	08	20		1			H4074	001	0	2012	Mercy LIFE of Alabama		2		2			2							www.mercymedical.com/pace	www.mercymedical.com/pace									(800)-000-0000		(251)-287-8420		(800)-000-0000		(251)-287-8420										(800)-287-8420		(251)-287-8420		(800)-287-8420		(251)-287-8420				
H4074	002	0	1	20	08	H4074_002_0	1	1		10/31/2011	2012.02	10/31/2011 09:35:43 AM Mountain Daylight Time		10/24/2011 02:48:49 PM Mountain Daylight Time		10/31/2011 09:36:47 AM Mountain Daylight Time	MERCY LIFE OF ALABAMA	Mercy LIFE of Alabama	www.mercymedical.com/pace	Mercy LIFE of Alabama (PACE)	08	20		1			H4074	002	0	2012	Mercy LIFE of Alabama		2		2			2							www.mercymedical.com/pace	www.mercymedical.com/pace									(800)-000-0000		(251)-287-8420		(800)-000-0000		(251)-287-8420										(800)-287-8420		(251)-287-8420		(800)-287-8420		(251)-287-8420				
H4102	001	0	1	02	01	H4102_001_0	5	1		08/09/2011	2012.02	08/09/2011 10:58:31 AM Central Daylight Time	08/08/2011 11:32:32 AM Central Daylight Time	08/05/2011 01:34:58 PM Central Daylight Time		08/09/2011 04:28:20 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H4102	001	0	2012	All counties in Rhode Island		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4102	025	0	1	01	01	H4102_025_0	4	1		07/20/2011	2012.02	07/20/2011 02:00:40 PM Central Daylight Time	07/22/2011 12:40:46 PM Central Daylight Time			07/25/2011 02:24:26 PM Central Daylight Time	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Essential (HMO)	01	01		1			H4102	025	0	2012	All counties in Rhode Island		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514										(711)		(711)		(711)		(711)										2	2	2
H4102	801	0	1	01	01	H4102_801_0	2	1		07/06/2011	2012.02	07/06/2011 04:47:34 PM Central Daylight Time	06/03/2011 02:49:30 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H4102	801	0	2012	State of Rhode Island		1		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4102	802	0	1	01	01	H4102_802_0	2	1		07/06/2011	2012.02	07/06/2011 04:47:40 PM Central Daylight Time	06/03/2011 02:50:40 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H4102	802	0	2012	Rhode Island		1		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548										(711)		(711)		(711)		(711)										2	2	2
H4102	803	0	1	01	01	H4102_803_0	2	1		07/06/2011	2012.02	07/06/2011 04:47:44 PM Central Daylight Time	06/03/2011 02:51:48 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H4102	803	0	2012	Select counties in RI		1		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4105	001	0	1	20	08	H4105_001_0	1	1		05/24/2011	2012.02	05/24/2011 03:58:31 PM Eastern Daylight Time		05/20/2011 06:11:48 PM Eastern Daylight Time		05/24/2011 04:00:44 PM Eastern Daylight Time	PACE ORGANIZATION OF RHODE ISLAND	Pace Organization Of Rhode Island	www.pace-ri.org	PACE Organization of Rhode Island (PACE)	08	20		1			H4105	001	0	2012	PACE Organization of Rhode Island		2		1	1		2							www.pace-ri.org	www.pace-ri.org									(877)-781-7223		(401)-490-6566		(877)-781-7223		(401)-490-6566										(866)-883-1631		(401)-490-4597		(866)-883-1631		(401)-490-4597				
H4105	002	0	1	20	08	H4105_002_0	2	1		05/25/2011	2012.02	05/25/2011 09:23:32 AM Eastern Daylight Time		05/20/2011 06:11:48 PM Eastern Daylight Time		05/25/2011 09:25:41 AM Eastern Daylight Time	PACE ORGANIZATION OF RHODE ISLAND	Pace Organization Of Rhode Island	www.pace-ri.org	PACE Organization of Rhode Island (PACE)	08	20		1			H4105	002	0	2012	PACE Organization of Rhode Island		2		2			2							www.pace-ri.org	www.pace-ri.org									(877)-781-7223		(401)-490-6566		(877)-781-7223		(401)-490-6566										(866)-883-1631		(401)-490-4597		(866)-883-1631		(401)-490-4597				
H4123	001	0	1	01	01	H4123_001_0	8	1		08/09/2011	2012.02	08/09/2011 11:23:27 AM Central Daylight Time	08/09/2011 09:20:44 AM Central Daylight Time	08/09/2011 09:19:52 AM Central Daylight Time		08/09/2011 08:43:18 PM Central Daylight Time	MERCYCARE HMO INC	MercyCare Health Plans	http://www.mercycarehealthplans.com	MercyCare Advantage Elite 30 (HMO)	01	01		1			H4123	001	0	2012	Rock and Walworth Counties		2	1425	2			2						www.mercycarehealthplans.com	www.mercycarehealthplans.com.	www.mercycarehealthplans.com.	(855)-517-6280		(608)-752-3431		(855)-517-6280		(608)-752-3431		(855)-517-6280		(608)-752-3431		(855)-517-6280		(608)-752-3431		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		2	2	2
H4123	002	0	1	01	01	H4123_002_0	5	1	2	08/09/2011	2012.02	08/09/2011 11:25:40 AM Central Daylight Time	08/09/2011 09:19:36 AM Central Daylight Time	08/09/2011 09:18:34 AM Central Daylight Time		08/10/2011 08:08:38 AM Central Daylight Time	MERCYCARE HMO INC	MercyCare Health Plans	http://www.mercycarehealthplans.com	MercyCare Advantage Premier (HMO SNP)	01	01		1			H4123	002	0	2012	Rock and Walworth Counties		2	200	2			1	3		1	1		www.mercycarehealthplans.com	www.mercycarehealthplans.com.	www.mercycarehealthplans.com.	(855)-517-6280		(608)-752-3431		(855)-517-6280		(608)-752-3431		(855)-517-6280		(608)-752-3431		(855)-517-6280		(608)-752-3431		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		2	2	2
H4123	003	0	1	01	01	H4123_003_0	5	1		07/19/2011	2012.02	07/19/2011 02:16:58 PM Central Daylight Time	07/19/2011 10:05:00 AM Central Daylight Time			07/19/2011 02:35:16 PM Central Daylight Time	MERCYCARE HMO INC	MercyCare Health Plans	http://www.mercycarehealthplans.com	MercyCare Advantage Classic (HMO)	01	01		1			H4123	003	0	2012	Rock and Walworth Counties		2	100	2			2						www.mercycarehealthplans.com	www.mercycarehealthplans.com.	www.mercycarehealthplans.com.	(855)-517-6280		(608)-752-3431		(855)-517-6280		(608)-752-3431										(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529										2	2	2
H4123	004	0	1	01	01	H4123_004_0	8	1		08/26/2011	2012.02	08/26/2011 02:54:14 PM Central Daylight Time	08/09/2011 09:21:34 AM Central Daylight Time	08/09/2011 09:21:02 AM Central Daylight Time		08/26/2011 02:56:41 PM Central Daylight Time	MERCYCARE HMO INC	MercyCare Health Plans	http://www.mercycarehealthplans.com	MercyCare Advantage Elite 20 (HMO)	01	01		1			H4123	004	0	2012	Rock and Walworth Counties		2	475	2			2						www.mercycarehealthplans.com	www.mercycarehealthplans.com.	www.mercycarehealthplans.com.	(855)-517-6280		(608)-752-3431		(855)-517-6280		(608)-752-3431		(855)-517-6280		(608)-752-3431		(855)-517-6280		(608)-752-3431		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		2	2	2
H4125	001	0	1	01	01	H4125_001_0	10	1		08/08/2011	2012.02	08/08/2011 10:02:21 AM Central Daylight Time	08/07/2011 12:41:07 PM Central Daylight Time	08/04/2011 12:45:12 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARCADIAN HEALTH PLAN	Arcadian Health Plan	www.ahpofok.com	Arcadian Health Plan - Plus (HMO)	01	01		1			H4125	001	0	2012	Fort Smith - OK		2		2			2							www.ahpofok.com	www.ahpofok.com	(800)-573-8597		(800)-573-8597		(800)-705-0766		(501)-223-9088		(800)-573-8597		(800)-573-8597		(800)-705-0766		(501)-223-9088		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H4141	001	0	1	01	01	H4141_001_0	7	1		07/06/2011	2012.02	07/06/2011 01:41:29 PM Eastern Daylight Time	08/05/2011 08:49:47 AM Eastern Daylight Time	08/04/2011 12:18:36 PM Eastern Daylight Time		08/08/2011 07:29:32 PM Eastern Daylight Time	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Humana Employers Health Plan of Georgia, Inc.	www.humana-medicare.com	Humana Gold Plus H4141-001 (HMO)	01	01		1			H4141	001	0	2012	Atlanta Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4141	003	0	1	01	01	H4141_003_0	9	1	2	07/06/2011	2012.02	07/06/2011 01:43:37 PM Eastern Daylight Time	08/05/2011 12:30:36 PM Eastern Daylight Time	08/04/2011 12:18:55 PM Eastern Daylight Time		08/09/2011 09:54:58 AM Eastern Daylight Time	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Humana Employers Health Plan of Georgia, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H4141-003 (HMO SNP)	01	01		1			H4141	003	0	2012	Columbia and Richmond counties		2		2			1	3		1	5		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4141	004	0	1	01	01	H4141_004_0	8	1		07/06/2011	2012.02	07/06/2011 01:46:47 PM Eastern Daylight Time	08/05/2011 09:10:49 AM Eastern Daylight Time	08/04/2011 12:19:15 PM Eastern Daylight Time		08/09/2011 09:54:58 AM Eastern Daylight Time	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Humana Employers Health Plan of Georgia, Inc.	www.humana-medicare.com	Humana Gold Plus H4141-004 (HMO)	01	01		1			H4141	004	0	2012	Columbia and Richmond Counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4141	005	0	1	01	01	H4141_005_0	9	1	2	07/06/2011	2012.02	07/06/2011 01:48:41 PM Eastern Daylight Time	08/05/2011 12:31:55 PM Eastern Daylight Time	08/04/2011 12:19:34 PM Eastern Daylight Time		08/09/2011 09:54:58 AM Eastern Daylight Time	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Humana Employers Health Plan of Georgia, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H4141-005 (HMO SNP)	01	01		1			H4141	005	0	2012	Richmond and Columbia counties		2		2			1	3		1	5		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4141	006	0	1	01	01	H4141_006_0	8	1		07/06/2011	2012.02	07/06/2011 01:50:12 PM Eastern Daylight Time	08/05/2011 09:12:06 AM Eastern Daylight Time	08/04/2011 12:19:53 PM Eastern Daylight Time		08/09/2011 09:54:58 AM Eastern Daylight Time	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Humana Employers Health Plan of Georgia, Inc.	www.humana-medicare.com	Humana Gold Plus H4141-006 (HMO)	01	01		1			H4141	006	0	2012	Catoosa, Dade, and Walker Counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4141	007	0	1	01	01	H4141_007_0	6	1	2	08/08/2011	2012.02	08/08/2011 10:28:52 AM Eastern Daylight Time	08/05/2011 04:27:20 PM Eastern Daylight Time	08/04/2011 12:20:13 PM Eastern Daylight Time		08/09/2011 10:09:55 AM Eastern Daylight Time	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Humana Employers Health Plan of Georgia, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H4141-007 (HMO SNP)	01	01		1			H4141	007	0	2012	Catoosa, Dade, and Walker Counties		2		2			1	3		1	5		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4141	008	0	1	01	01	H4141_008_0	8	1		07/06/2011	2012.02	07/06/2011 01:53:03 PM Eastern Daylight Time	08/05/2011 09:15:16 AM Eastern Daylight Time	08/04/2011 12:20:33 PM Eastern Daylight Time		08/09/2011 09:54:58 AM Eastern Daylight Time	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Humana Employers Health Plan of Georgia, Inc.	www.humana-medicare.com	Humana Gold Plus H4141-008 (HMO)	01	01		1			H4141	008	0	2012	Catoosa, Dade, and Walker counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4141	801	0	1	01	01	H4141_801_0	3	1		07/06/2011	2012.02	07/06/2011 10:56:31 AM Eastern Daylight Time	07/19/2011 09:51:52 AM Eastern Daylight Time			07/22/2011 12:05:25 PM Eastern Daylight Time	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Humana Employers Health Plan of Georgia, Inc.	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H4141	801	0	2012	Select counties in Georgia		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H4141	802	0	1	01	01	H4141_802_0	3	1		07/06/2011	2012.02	07/06/2011 10:56:38 AM Eastern Daylight Time	07/19/2011 09:52:57 AM Eastern Daylight Time			07/22/2011 12:05:25 PM Eastern Daylight Time	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Humana Employers Health Plan of Georgia, Inc.	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H4141	802	0	2012	Select counties in Georgia		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
H4141	803	0	1	01	01	H4141_803_0	3	1		07/06/2011	2012.02	07/06/2011 10:56:42 AM Eastern Daylight Time	07/19/2011 09:54:53 AM Eastern Daylight Time			07/22/2011 12:05:25 PM Eastern Daylight Time	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Humana Employers Health Plan of Georgia, Inc.	www.humana-medicare.com	Humana Employer Sponsored Non-CY (HMO)	01	01		1			H4141	803	0	2012	Select counties in Georgia		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H4142	001	0	1	20	08	H4142_001_0	1	1		05/23/2011	2012.02	05/23/2011 10:41:31 AM Central Daylight Time		05/23/2011 09:56:24 AM Central Daylight Time		05/23/2011 10:43:40 AM Central Daylight Time	CHEROKEE NATION COMPREHENSIVE CARE AGENCY	Cherokee Elder Care	eldercare.cherokee.org	Cherokee Elder Care (PACE)	08	20		1			H4142	001	0	2012	Cherokee, Delaware, Mayes, Muskogee counties		2		2			2							eldercare.cherokee.org	eldercare.cherokee.org									(800)-256-0671	5554	(918)-453-5554		(800)-256-0671	5554	(918)-453-5554										(800)-256-0671	5554	(918)-453-5554		(800)-256-0671	5554	(918)-453-5554				
H4142	002	0	1	20	08	H4142_002_0	1	1		05/23/2011	2012.02	05/23/2011 10:42:20 AM Central Daylight Time		05/23/2011 09:56:28 AM Central Daylight Time		05/23/2011 10:43:40 AM Central Daylight Time	CHEROKEE NATION COMPREHENSIVE CARE AGENCY	Cherokee Elder Care	eldercare.cherokee.org	Cherokee Elder Care (PACE)	08	20		1			H4142	002	0	2012	Cherokee,Delaware,Mayes, Muskogee counties		2		2			2							eldercare.cherokee.org	eldercare.cherokee.org									(800)-256-0671	5554	(918)-453-5554		(800)-256-0671	5554	(918)-453-5554										(800)-256-0671	5554	(918)-453-5554		(800)-256-0671	5554	(918)-453-5554				
H4152	004	0	1	01	01	H4152_004_0	9	1		07/20/2011	2012.02	07/20/2011 10:06:55 AM Eastern Daylight Time	07/11/2011 05:04:08 PM Eastern Daylight Time			07/20/2011 10:32:41 AM Eastern Daylight Time	BLUE CROSS  BLUE SHIELD OF RHODE ISLAND	Blue Cross  Blue Shield of Rhode Island	www.bcbsri.com	BlueCHiP for Medicare Core (HMO)	01	01		1			H4152	004	0	2012	State of Rhode Island		2	1302	2			2						www.bcbsri.com	www.bcbsri.com	bcbsri.com	(800)-267-0439		(401)-277-2958		(800)-505-2583		(401)-351-2583										(877)-232-8432		(401)-831-2202		(877)-232-8432		(401)-831-2202										2	2	2
H4152	005	0	1	01	01	H4152_005_0	13	1		07/25/2011	2012.02	07/25/2011 10:36:04 AM Eastern Daylight Time	08/04/2011 04:06:08 PM Eastern Daylight Time	08/04/2011 04:12:46 PM Eastern Daylight Time		08/05/2011 01:46:24 PM Eastern Daylight Time	BLUE CROSS  BLUE SHIELD OF RHODE ISLAND	Blue Cross  Blue Shield of Rhode Island	www.bcbsri.com	BlueCHiP for Medicare Plus (HMO)	01	01		1			H4152	005	0	2012	State of Rhode Island		2	6589	2			2						www.bcbsri.com	www.bcbsri.com	bcbsri.com	(800)-267-0439		(401)-277-2958		(800)-505-2583		(401)-351-2583		(800)-267-0439		(401)-277-2958		(800)-505-2583		(401)-351-2583		(877)-232-8432		(401)-831-2202		(877)-232-8432		(401)-831-2202		(877)-232-8432		(401)-831-2202		(877)-232-8432		(401)-831-2202		2	2	2
H4152	007	0	1	02	01	H4152_007_0	11	1		08/01/2011	2012.02	08/01/2011 11:39:57 AM Eastern Daylight Time	08/04/2011 04:07:00 PM Eastern Daylight Time	08/04/2011 04:14:16 PM Eastern Daylight Time		08/05/2011 01:46:24 PM Eastern Daylight Time	BLUE CROSS  BLUE SHIELD OF RHODE ISLAND	Blue Cross  Blue Shield of Rhode Island	www.bcbsri.com	BlueCHiP for Medicare Preferred (HMO-POS)	01	02		1			H4152	007	0	2012	State of Rhode Island		2	3195	2			2						www.bcbsri.com	www.bcbsri.com	bcbsri.com	(800)-267-0439		(401)-277-2958		(800)-505-2583		(401)-351-2583		(800)-267-0439		(401)-277-2958		(800)-505-2583		(401)-351-2583		(877)-232-8432		(401)-831-2202		(877)-232-8432		(401)-831-2202		(877)-232-8432		(401)-831-2202		(877)-232-8432		(401)-831-2202		2	2	2
H4152	013	0	1	01	01	H4152_013_0	9	1		08/05/2011	2012.02	08/05/2011 09:49:54 AM Eastern Daylight Time	08/04/2011 04:07:46 PM Eastern Daylight Time	08/04/2011 04:16:32 PM Eastern Daylight Time		08/05/2011 01:46:24 PM Eastern Daylight Time	BLUE CROSS  BLUE SHIELD OF RHODE ISLAND	Blue Cross  Blue Shield of Rhode Island	www.bcbsri.com	BlueCHiP for Medicare Standard with Drugs (HMO)	01	01		1			H4152	013	0	2012	State of Rhode Island		2	13890	2			2						www.bcbsri.com	www.bcbsri.com	bcbsri.com	(800)-267-0439		(401)-277-2958		(800)-505-2583		(401)-351-2583		(800)-267-0439		(401)-277-2958		(800)-505-2583		(401)-351-2583		(877)-232-8432		(401)-831-2202		(877)-232-8432		(401)-831-2202		(877)-232-8432		(401)-831-2202		(877)-232-8432		(401)-831-2202		2	2	2
H4152	016	0	1	02	01	H4152_016_0	10	1		08/01/2011	2012.02	08/01/2011 03:52:53 PM Eastern Daylight Time	08/04/2011 04:08:46 PM Eastern Daylight Time	08/04/2011 04:17:46 PM Eastern Daylight Time		08/05/2011 01:46:24 PM Eastern Daylight Time	BLUE CROSS  BLUE SHIELD OF RHODE ISLAND	Blue Cross  Blue Shield of Rhode Island	www.bcbsri.com	BlueCHiP for Medicare Value (HMO-POS)	01	02		1			H4152	016	0	2012	State of Rhode Island		2	5764	2			2						www.bcbsri.com	www.bcbsri.com	bcbsri.com	(800)-267-0439		(401)-277-2958		(800)-505-2583		(401)-351-2583		(800)-267-0439		(401)-277-2958		(800)-505-2583		(401)-351-2583		(877)-232-8432		(401)-831-2202		(877)-232-8432		(401)-831-2202		(877)-232-8432		(401)-831-2202		(877)-232-8432		(401)-831-2202		2	2	2
H4152	815	0	1	02	01	H4152_815_0	8	1		07/21/2011	2012.02	07/21/2011 04:08:41 PM Eastern Daylight Time	06/06/2011 11:17:14 AM Eastern Daylight Time			07/21/2011 04:14:34 PM Eastern Daylight Time	BLUE CROSS  BLUE SHIELD OF RHODE ISLAND	Blue Cross  Blue Shield of Rhode Island	www.bcbsri.com	BlueCHiP for Medicare Group Preferred (HMO-POS)	01	02		1			H4152	815	0	2012	RI, Bristol Cty MA, Partial New London Cty CT		1	1368	2			2						www.bcbsri.com	www.bcbsri.com	bcbsri.com	(800)-267-0439		(401)-277-2958		(800)-505-2583		(401)-351-2583		(800)-267-0439		(401)-277-2958		(800)-505-2583		(401)-351-2583		(877)-232-8432		(401)-831-2202		(877)-232-8432		(401)-831-2202		(877)-232-8432		(401)-831-2202		(877)-232-8432		(401)-831-2202		2	2	2
H4152	817	0	1	01	01	H4152_817_0	7	1		07/20/2011	2012.02	07/20/2011 10:09:04 AM Eastern Daylight Time	06/06/2011 11:18:06 AM Eastern Daylight Time			07/20/2011 10:32:41 AM Eastern Daylight Time	BLUE CROSS  BLUE SHIELD OF RHODE ISLAND	Blue Cross  Blue Shield of Rhode Island	www.bcbsri.com	BlueCHiP for Medicare Group Plus (HMO)	01	01		1			H4152	817	0	2012	RI, Bristol Cty MA, Partial New London Cty CT		1	479	2			2						www.bcbsri.com	www.bcbsri.com	bcbsri.com	(800)-267-0439		(401)-277-2958		(800)-505-2583		(401)-351-2583		(800)-267-0439		(401)-277-2958		(800)-505-2583		(401)-351-2583		(877)-232-8432		(401)-831-2202		(877)-232-8432		(401)-831-2202		(877)-232-8432		(401)-831-2202		(877)-232-8432		(401)-831-2202		2	2	2
H4152	821	0	1	02	01	H4152_821_0	8	1		07/21/2011	2012.02	07/21/2011 04:08:55 PM Eastern Daylight Time	06/06/2011 11:19:22 AM Eastern Daylight Time			07/21/2011 04:14:34 PM Eastern Daylight Time	BLUE CROSS  BLUE SHIELD OF RHODE ISLAND	Blue Cross  Blue Shield of Rhode Island	www.bcbsri.com	BlueCHiP for Medicare Group Preferred Unlimited (HMO-POS)	01	02		1			H4152	821	0	2012	RI, Bristol Cty MA, Partial New London Cty CT		1	1002	2			2						www.bcbsri.com	www.bcbsri.com	bcbsri.com	(800)-267-0439		(401)-277-2958		(800)-505-2583		(401)-351-2583		(800)-267-0439		(401)-277-2958		(800)-505-2583		(401)-351-2583		(877)-232-8432		(401)-831-2202		(877)-232-8432		(401)-831-2202		(877)-232-8432		(401)-831-2202		(877)-232-8432		(401)-831-2202		2	2	2
H4155	001	0	1	01	01	H4155_001_0	11	1		08/04/2011	2012.02	08/04/2011 06:52:05 PM Eastern Daylight Time	08/04/2011 06:14:49 PM Eastern Daylight Time	08/04/2011 06:14:49 PM Eastern Daylight Time		08/04/2011 06:55:51 PM Eastern Daylight Time	PUBLIC HEALTH TRUST OF MIAMI-DADE COUNTY	JMH Health Plan	www.jmhhp.com	JacksonHealth for Life (HMO)	01	01		1			H4155	001	0	2012	Miami Dade County		2	2400	2			2						JMHHP.com	www.jmhhp.com	www.jmhhp.com	(877)-547-2279		(305)-575-3777		(877)-547-2279		(305)-575-3730		(877)-547-2279		(305)-575-3777		(877)-547-2279		(305)-575-3730		(800)-955-8770		(800)-955-8770		(800)-955-8770		(800)-955-8770		(800)-955-8770		(800)-955-8770		(800)-955-8770		(800)-955-8770		2	2	2
H4155	003	0	1	01	01	H4155_003_0	5	1	2	08/04/2011	2012.02	08/04/2011 06:52:15 PM Eastern Daylight Time	08/04/2011 06:14:49 PM Eastern Daylight Time	08/04/2011 06:14:49 PM Eastern Daylight Time		08/04/2011 06:55:51 PM Eastern Daylight Time	PUBLIC HEALTH TRUST OF MIAMI-DADE COUNTY	JMH Health Plan	www.jmhhp.com	JacksonHealth Secure (HMO SNP)	01	01		1			H4155	003	0	2012	Miami Dade County		2	500	2			1	3		1	5		JMHHP.com	www.jmhhp.com	www.jmhhp.com	(877)-547-2279		(305)-575-3777		(877)-547-2279		(305)-575-3730		(877)-547-2279		(305)-575-3777		(877)-547-2279		(305)-575-3730		(800)-955-8770		(800)-955-8770		(800)-955-8770		(800)-955-8770		(800)-955-8770		(800)-955-8770		(800)-955-8770		(800)-955-8770		2	2	2
H4199	001	0	1	01	01	H4199_001_0	17	1		08/09/2011	2012.02	08/09/2011 01:53:45 PM Eastern Daylight Time	08/09/2011 02:02:47 PM Eastern Daylight Time	08/07/2011 11:29:42 PM Eastern Daylight Time		08/09/2011 02:17:26 PM Eastern Daylight Time	FLORIDA HEALTHCARE PLUS, INC.	FLORIDA HEALTHCARE PLUS	www.FloridaHealthCarePlus.com	Healthy Advantage Plus (HMO)	01	01		1			H4199	001	0	2012	Miami-Dade		2	500	2			2						www.floridahealthcareplus.com	www.floridahealthcareplus.com	www.floridahealthcareplus.com	(305)-888-2210		(305)-888-2210		(305)-888-2210		(305)-888-2210		(305)-888-2210		(305)-888-2210		(305)-888-2210		(305)-888-2210		(305)-888-2210		(305)-888-2210		(305)-888-2210		(305)-888-2210		(305)-888-2210		(305)-888-2210		(305)-888-2210		(305)-888-2210		2	2	2
H4199	002	0	1	01	01	H4199_002_0	19	1		08/09/2011	2012.02	08/09/2011 01:53:09 PM Eastern Daylight Time	08/09/2011 02:03:45 PM Eastern Daylight Time	08/07/2011 11:28:37 PM Eastern Daylight Time		08/09/2011 02:17:26 PM Eastern Daylight Time	FLORIDA HEALTHCARE PLUS, INC.	FLORIDA HEALTHCARE PLUS	www.FloridaHealthCarePlus.com	Healthy Advantage Refund (HMO)	01	01		1			H4199	002	0	2012	Miami-Dade		2	375	2			2						www.floridahealthcareplus.com	www.floridahealthcareplus.com	www.floridahealthcareplus.com	(305)-888-2210		(305)-888-2210		(305)-888-2210		(305)-888-2210		(305)-888-2210		(305)-888-2210		(305)-888-2210		(305)-888-2210		(305)-888-2210		(305)-888-2210		(305)-888-2210		(305)-888-2210		(305)-888-2210		(305)-888-2210		(305)-888-2210		(305)-888-2210		2	2	2
H4199	004	0	1	01	01	H4199_004_0	14	1		07/18/2011	2012.02	07/18/2011 04:38:45 PM Eastern Daylight Time	07/25/2011 10:52:02 AM Eastern Daylight Time			07/25/2011 03:01:57 PM Eastern Daylight Time	FLORIDA HEALTHCARE PLUS, INC.	FLORIDA HEALTHCARE PLUS	www.FloridaHealthCarePlus.com	Healthy Advantage (HMO)	01	01		1			H4199	004	0	2012	Miami-Dade		2	72	2			2						www.floridahealthcareplus.com	www.floridahealthcareplus.com	www.floridahealthcareplus.com	(305)-888-2210		(305)-888-2210		(305)-888-2210		(305)-888-2210										(305)-888-2210		(305)-888-2210		(305)-888-2210		(305)-888-2210										2	2	2
H4203	001	0	1	20	08	H4203_001_0	1	1		05/23/2011	2012.01	05/23/2011 01:44:10 PM Eastern Daylight Time		05/23/2011 01:39:54 PM Eastern Daylight Time		05/23/2011 01:46:27 PM Eastern Daylight Time	PALMETTO HEALTH ALLIANCE	Palmetto SeniorCare	www.palmettohealth.org	Palmetto Health - Palmetto SeniorCare (PACE)	08	20		1			H4203	001	0	2012	Richland and  Lexington Counties		2		2			2							n/a	N/A									(803)-931-8175		(803)-931-8175		(803)-931-8175		(803)-931-8175	245									(803)-434-7000		(803)-434-7000		(803)-434-7000		(803)-434-7000				
H4203	002	0	1	20	08	H4203_002_0	1	1		05/23/2011	2012.01	05/23/2011 01:44:36 PM Eastern Daylight Time		05/23/2011 01:40:02 PM Eastern Daylight Time		05/23/2011 01:46:27 PM Eastern Daylight Time	PALMETTO HEALTH ALLIANCE	Palmetto SeniorCare	www.palmettohealth.org	Palmetto Health - Palmetto SeniorCare (PACE)	08	20		1			H4203	002	0	2012	Richland and Lexington Counties		2		2			2							n/a	N/A									(803)-931-8175		(803)-931-8175		(803)-931-8175		(803)-931-8175	245									(803)-434-7000		(803)-434-7000		(803)-434-7000		(803)-434-7000				
H4209	001	0	1	04	01	H4209_001_0	8	1		09/19/2011	2012.02	09/19/2011 09:28:19 AM Eastern Daylight Time	06/04/2011 03:37:04 PM Eastern Daylight Time	09/14/2011 11:34:08 AM Eastern Daylight Time		09/19/2011 11:54:17 AM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.scbluesmedadvantage.com/mb12	Medicare Blue (PPO)	01	04		1			H4209	001	0	2012	Upstate and Midlands		2		2			2						www.scbluesmedadvantage.com/medb12	www.scbluesmedadvantage.com/medb12	www.scbluesmedadvantage.com/medb12	(888)-645-6025		(888)-645-6025		(800)-930-2912		(800)-930-2912		(888)-645-6025		(888)-645-6025		(800)-930-2836		(800)-930-2836		(888)-645-6023		(888)-645-6023		(800)-681-3846		(800)-681-3846		(888)-645-6023		(888)-645-6023		(800)-681-3846		(800)-681-3846		2	2	2
H4209	003	0	1	04	01	H4209_003_0	8	1		09/19/2011	2012.02	09/19/2011 09:28:48 AM Eastern Daylight Time	06/04/2011 03:37:46 PM Eastern Daylight Time	09/14/2011 11:34:52 AM Eastern Daylight Time		09/19/2011 11:54:17 AM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.scbluesmedadvantage.com/mb12	Medicare Blue (PPO)	01	04		1			H4209	003	0	2012	Coastal and Rural		2		2			2						www.scbluesmedadvantage.com/medb12	www.scbluesmedadvantage.com/medb12	www.scbluesmedadvantage.com/medb12	(888)-645-6025		(888)-645-6025		(800)-930-2912		(800)-930-2912		(888)-645-6025		(888)-645-6025		(800)-930-2836		(800)-930-2836		(888)-645-6023		(888)-645-6023		(800)-681-3846		(800)-681-3846		(888)-645-6023		(888)-645-6023		(800)-681-3846		(800)-681-3846		2	2	2
H4209	004	0	1	04	01	H4209_004_0	9	1		09/19/2011	2012.02	09/19/2011 09:29:09 AM Eastern Daylight Time	06/04/2011 03:38:22 PM Eastern Daylight Time	09/14/2011 11:36:08 AM Eastern Daylight Time		09/19/2011 11:54:17 AM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.scbluesmedadvantage.com/mbplus12	Medicare Blue Plus (PPO)	01	04		1			H4209	004	0	2012	Upstate and Midlands		2		2			2						www.scbluesmedadvantage.com/medb12	www.scbluesmedadvantage.com/medb12	www.scbluesmedadvantage.com/medb12	(888)-645-6025		(888)-645-6025		(800)-930-2912		(800)-930-2912		(888)-645-6025		(888)-645-6025		(800)-930-2836		(800)-930-2836		(888)-645-6023		(888)-645-6023		(800)-681-3846		(800)-681-3846		(888)-645-6023		(888)-645-6023		(800)-681-3846		(800)-681-3846		2	2	2
H4209	006	0	1	04	01	H4209_006_0	9	1		09/19/2011	2012.02	09/19/2011 09:29:27 AM Eastern Daylight Time	06/04/2011 03:39:02 PM Eastern Daylight Time	09/14/2011 11:37:04 AM Eastern Daylight Time		09/19/2011 11:54:17 AM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.scbluesmedadvantage.com/mbplus12	Medicare Blue Plus (PPO)	01	04		1			H4209	006	0	2012	Coastal and Rural		2		2			2						www.scbluesmedadvantage.com/medb12	www.scbluesmedadvantage.com/medb12	www.scbluesmedadvantage.com/medb12	(888)-645-6025		(888)-645-6025		(800)-930-2912		(800)-930-2912		(888)-645-6025		(888)-645-6025		(800)-930-2836		(800)-930-2836		(888)-645-6023		(888)-645-6023		(800)-681-3846		(800)-681-3846		(888)-645-6023		(888)-645-6023		(800)-681-3846		(800)-681-3846		2	2	2
H4209	007	0	1	04	01	H4209_007_0	7	1		09/19/2011	2012.02	09/19/2011 09:30:19 AM Eastern Daylight Time	06/04/2011 02:58:04 PM Eastern Daylight Time			09/19/2011 11:54:17 AM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.scbluesmedadvantage.com/mbs12	Medicare Blue Saver (PPO)	01	04		1			H4209	007	0	2012	Upstate and Midlands		2		2			2						www.scbluesmedadvantage.com/medb12	www.scbluesmedadvantage.com/medb12	www.scbluesmedadvantage.com/medb12	(888)-645-6025		(888)-645-6025		(800)-930-2912		(800)-930-2912										(888)-645-6023		(888)-645-6023		(800)-681-3846		(800)-681-3846										2	2	2
H4209	008	0	1	04	01	H4209_008_0	7	1		09/19/2011	2012.02	09/19/2011 09:30:43 AM Eastern Daylight Time	06/04/2011 02:58:46 PM Eastern Daylight Time			09/19/2011 11:54:17 AM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.scbluesmedadvantage.com/mbs12	Medicare Blue Saver (PPO)	01	04		1			H4209	008	0	2012	Coastal and Rural		2		2			2						www.scbluesmedadvantage.com/medb12	www.scbluesmedadvantage.com/medb12	www.scbluesmedadvantage.com/medb12	(888)-645-6025		(888)-645-6025		(800)-930-2912		(800)-930-2912										(888)-645-6023		(888)-645-6023		(800)-681-3846		(800)-681-3846										2	2	2
H4209	809	0	1	04	01	H4209_809_0	3	1		04/29/2011	2012.02	04/29/2011 09:15:32 AM Eastern Daylight Time	07/14/2011 11:28:58 AM Eastern Daylight Time			07/18/2011 11:54:29 AM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.scbluesmedadvantage.com/medb12	Group Blue (PPO)	01	04		1			H4209	809	0	2012	South Carolina		1		2			2						www.scbluesmedadvantage.com/medb12	www.scbluesmedadvantage.com/medb12	www.scbluesmedadvantage.com/medb12	(888)-645-6025		(888)-645-6025		(800)-930-2912		(803)-264-9482		(888)-645-6025		(888)-645-6025		(800)-930-2836		(803)-264-9482		(888)-645-6023		(888)-645-6023		(800)-681-3846		(800)-681-3846		(888)-645-6023		(888)-645-6023		(800)-681-3846		(800)-681-3846		1	1	1
H4209	810	0	1	04	01	H4209_810_0	3	1		04/29/2011	2012.02	04/29/2011 09:22:27 AM Eastern Daylight Time	07/14/2011 11:30:14 AM Eastern Daylight Time			07/18/2011 11:54:29 AM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.scbluesmedadvantage.com/medb12	Group Blue (PPO)	01	04		1			H4209	810	0	2012	South Carolina		1		2			2						www.scbluesmedadvantage.com/medb12	www.scbluesmedadvantage.com/medb12	www.scbluesmedadvantage.com/medb12	(888)-645-6025		(888)-645-6025		(800)-930-2912		(803)-264-9482		(888)-645-6025		(888)-645-6025		(800)-930-2836		(803)-264-9482		(888)-645-6023		(888)-645-6023		(800)-681-3846		(800)-681-3846		(888)-645-6023		(888)-645-6023		(800)-681-3846		(800)-681-3846		1	1	1
H4209	811	0	1	04	01	H4209_811_0	3	1		04/27/2011	2012.02	04/27/2011 03:03:03 PM Eastern Daylight Time	07/14/2011 11:31:28 AM Eastern Daylight Time			07/18/2011 11:54:29 AM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.scbluesmedadvantage.com/medb12	Group Blue (PPO)	01	04		1			H4209	811	0	2012	South Carolina		1		2			2						www.scbluesmedadvantage.com/medb12	www.scbluesmedadvantage.com/medb12	www.scbluesmedadvantage.com/medb12	(888)-645-6025		(888)-645-6025		(800)-930-2912		(803)-264-9482										(888)-645-6023		(888)-645-6023		(800)-681-3846		(800)-681-3846										1	1	1
H4209	812	0	1	04	01	H4209_812_0	3	1		04/29/2011	2012.02	04/29/2011 09:22:58 AM Eastern Daylight Time	07/14/2011 11:32:42 AM Eastern Daylight Time			07/18/2011 11:54:29 AM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.scbluesmedadvantage.com/medb12	Group Blue (PPO)	01	04		1			H4209	812	0	2012	South Carolina		1		2			2						www.scbluesmedadvantage.com/medb12	www.scbluesmedadvantage.com/medb12	www.scbluesmedadvantage.com/medb12	(888)-645-6025		(888)-645-6025		(800)-930-2912		(803)-264-9482										(888)-645-6023		(888)-645-6023		(800)-681-3846		(800)-681-3846										1	1	1
H4211	001	0	1	01	01	H4211_001_0	7	1	2	08/05/2011	2012.02	08/05/2011 10:22:58 AM Eastern Daylight Time	08/05/2011 09:51:00 AM Eastern Daylight Time	08/04/2011 05:26:00 PM Eastern Daylight Time		08/09/2011 05:31:53 PM Eastern Daylight Time	AMERIGROUP GEORGIA MANAGED CARE COMPANY, INC.	Amerigroup Community Care	www.myamerigroup.com	Amerivantage Specialty + Rx Plan (HMO SNP)	01	01		1			H4211	001	0	2012	Fulton / Chatham Counties		2	150	2			1	3		1	1		www.myamerigroup.com	https://members.realsolutions.com/Pages/MedicareFormulary.aspx	www.myamerigroup.com	(866)-805-4589		(866)-805-4589		(877)-470-4131		(877)-470-4131		(866)-805-4589		(866)-805-4589		(877)-470-4131		(877)-470-4131		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		2	2	2
H4211	003	0	1	02	01	H4211_003_0	9	1		07/19/2011	2012.02	07/19/2011 07:51:48 AM Eastern Daylight Time	08/08/2011 01:51:00 PM Eastern Daylight Time	08/04/2011 05:26:00 PM Eastern Daylight Time		08/09/2011 05:31:53 PM Eastern Daylight Time	AMERIGROUP GEORGIA MANAGED CARE COMPANY, INC.	Amerigroup Community Care	www.myamerigroup.com	Amerivantage Choice + Rx Plan (HMO-POS)	01	02		1			H4211	003	0	2012	Fulton / Chatham Counties		2	61	2			2						www.myamerigroup.com	https://members.realsolutions.com/Pages/MedicareFormulary.aspx	www.myamerigroup.com	(866)-805-4589		(866)-805-4589		(877)-470-4131		(877)-470-4131		(866)-805-4589		(866)-805-4589		(877)-470-4131		(877)-470-4131		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		2	2	2
H4213	001	0	1	09	04	H4213_001_0	6	1		07/06/2011	2012.02	07/06/2011 04:23:58 PM Central Daylight Time	07/20/2011 05:10:09 PM Central Daylight Time			07/21/2011 08:10:50 AM Central Daylight Time	USABLE MUTUAL INSURANCE COMPANY	ARKANSAS BLUE CROSS AND BLUE SHIELD	www.arkansasbluecross.com	AR Blue Cross - Medi-Pak Advantage MA (PFFS)	04	09	1	1			H4213	001	0	2012	Northwest, Some Eastern and Southern AR Counties		2	1750	2			2							http://www.arkansasbluecross.com	http://www.arkansasbluecross.com	(877)-233-7022		(877)-233-7022		(888)-242-5017		(888)-242-5017										(888)-844-5530		(888)-844-5530		(800)-370-5869		(800)-370-5869										2	2	2
H4213	002	0	1	09	04	H4213_002_0	5	1		07/06/2011	2012.02	07/06/2011 10:09:15 AM Central Daylight Time	07/20/2011 05:10:11 PM Central Daylight Time			07/21/2011 08:10:50 AM Central Daylight Time	USABLE MUTUAL INSURANCE COMPANY	ARKANSAS BLUE CROSS AND BLUE SHIELD	www.arkansasbluecross.com	AR Blue Cross - Medi-Pak Advantage  MA (PFFS)	04	09	1	1			H4213	002	0	2012	Some Central, Southern and Eastern  AR Counties		2	1450	2			2							http://www.arkansasbluecross.com	http://www.arkansasbluecross.com	(877)-233-7022		(877)-233-7022		(888)-242-5017		(888)-242-5017										(888)-844-5530		(888)-844-5530		(800)-370-5869		(800)-370-5869										2	2	2
H4213	003	0	1	09	04	H4213_003_0	5	1		07/06/2011	2012.02	07/06/2011 10:09:32 AM Central Daylight Time	07/20/2011 05:10:12 PM Central Daylight Time			07/21/2011 08:10:50 AM Central Daylight Time	USABLE MUTUAL INSURANCE COMPANY	ARKANSAS BLUE CROSS AND BLUE SHIELD	www.arkansasbluecross.com	AR Blue Cross - Medi-Pak Advantage  MA (PFFS)	04	09	1	1			H4213	003	0	2012	Some Northeast, Central, and Southern AR Counties		2	500	2			2							http://www.arkansasbluecross.com	http://www.arkansasbluecross.com	(877)-233-7022		(877)-233-7022		(888)-242-5017		(888)-242-5017										(888)-844-5530		(888)-844-5530		(800)-370-5869		(800)-370-5869										2	2	2
H4213	004	0	1	09	04	H4213_004_0	8	1		08/05/2011	2012.02	08/05/2011 04:51:45 PM Central Daylight Time	08/05/2011 04:54:09 PM Central Daylight Time	08/08/2011 09:17:36 AM Central Daylight Time		08/08/2011 09:24:37 AM Central Daylight Time	USABLE MUTUAL INSURANCE COMPANY	ARKANSAS BLUE CROSS AND BLUE SHIELD	www.arkansasbluecross.com	AR Blue Cross - Medi-Pak Advantage MA-PD Option 1 (PFFS)	04	09	1	1			H4213	004	0	2012	Northwest, Some Eastern, and Southern AR Counties		2	5400	2			2							http://www.arkansasbluecross.com	http://www.arkansasbluecross.com	(877)-233-7022		(877)-233-7022		(888)-242-5017		(888)-242-5017		(866)-390-3369		(866)-390-3369		(888)-242-5017		(888)-242-5017		(888)-844-5530		(888)-844-5530		(800)-370-5869		(800)-370-5869		(888)-844-5530		(888)-844-5530		(800)-370-5869		(800)-370-5869		2	2	2
H4213	005	0	1	09	04	H4213_005_0	6	1		07/06/2011	2012.02	07/06/2011 10:10:00 AM Central Daylight Time	07/20/2011 05:10:15 PM Central Daylight Time	07/20/2011 05:10:18 PM Central Daylight Time		07/21/2011 08:10:50 AM Central Daylight Time	USABLE MUTUAL INSURANCE COMPANY	ARKANSAS BLUE CROSS AND BLUE SHIELD	www.arkansasbluecross.com	AR Blue Cross - Medi-Pak Advantage MA-PD (PFFS)	04	09	1	1			H4213	005	0	2012	Some Central, Southern, and Eastern AR Counties		2	1500	2			2							http://www.arkansasbluecross.com	http://www.arkansasbluecross.com	(877)-233-7022		(877)-233-7022		(888)-242-5017		(888)-242-5017		(866)-390-3369		(866)-390-3369		(888)-242-5017		(888)-242-5017		(888)-844-5530		(888)-844-5530		(800)-370-5869		(800)-370-5869		(888)-844-5530		(888)-844-5530		(800)-370-5869		(800)-370-5869		2	2	2
H4213	006	0	1	09	04	H4213_006_0	6	1		07/06/2011	2012.02	07/06/2011 10:10:14 AM Central Daylight Time	07/20/2011 05:10:16 PM Central Daylight Time	07/20/2011 05:10:19 PM Central Daylight Time		07/21/2011 08:10:50 AM Central Daylight Time	USABLE MUTUAL INSURANCE COMPANY	ARKANSAS BLUE CROSS AND BLUE SHIELD	www.arkansasbluecross.com	AR Blue Cross - Medi-Pak Advantage MA-PD (PFFS)	04	09	1	1			H4213	006	0	2012	Some Northeast, Central, and Southern AR Counties		2	500	2			2							http://www.arkansasbluecross.com	http://www.arkansasbluecross.com	(877)-233-7022		(877)-233-7022		(888)-242-5017		(888)-242-5017		(866)-390-3369		(866)-390-3369		(888)-242-5017		(888)-242-5017		(888)-844-5530		(888)-844-5530		(800)-370-5869		(800)-370-5869		(888)-844-5530		(888)-844-5530		(800)-370-5869		(800)-370-5869		2	2	2
H4213	007	0	1	09	04	H4213_007_0	5	1		07/06/2011	2012.02	07/06/2011 10:10:27 AM Central Daylight Time	07/20/2011 05:10:08 PM Central Daylight Time	06/02/2011 04:00:32 PM Central Daylight Time		07/21/2011 08:10:50 AM Central Daylight Time	USABLE MUTUAL INSURANCE COMPANY	ARKANSAS BLUE CROSS AND BLUE SHIELD	www.arkansasbluecross.com	AR Blue Cross - Medi-Pak Advantage MA-PD Option 2 (PFFS)	04	09	1	1			H4213	007	0	2012	Northwest, Some Eastern, and Southern AR Counties		2	3400	2			2							http://www.arkansasbluecross.com	http://www.arkansasbluecross.com	(877)-233-7022		(877)-233-7022		(888)-242-5017		(888)-242-5017		(866)-390-3369		(866)-390-3369		(888)-242-5017		(888)-242-5017		(888)-844-5530		(888)-844-5530		(800)-370-5869		(800)-370-5869		(888)-844-5530		(888)-844-5530		(800)-370-5869		(800)-370-5869		2	2	2
H4268	001	0	1	09	04	H4268_001_0	6	1		07/06/2011	2012.02	07/06/2011 04:40:31 PM Eastern Daylight Time	07/08/2011 03:45:54 PM Eastern Daylight Time			07/18/2011 04:23:21 PM Eastern Daylight Time	AMERICA'S 1ST CHOICE INSURANCE COMPANY OF NC, INC.	America's 1st Choice Insurance Company of NC	www.Americas1stChoice.com	Patriot (PFFS)	04	09	1	1			H4268	001	0	2012	Select Counties in NC		2	1	2			2							www.americas1stchoice.com	www.americas1stchoice.com	(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947										(800)-735-2962		(800)-735-2962		(800)-735-2962		(800)-735-2962										2	2	2
H4268	002	0	1	09	04	H4268_002_0	7	1		07/01/2011	2012.02	07/01/2011 01:52:20 PM Eastern Daylight Time	08/05/2011 03:01:25 PM Eastern Daylight Time	08/05/2011 03:01:25 PM Eastern Daylight Time		08/05/2011 04:51:31 PM Eastern Daylight Time	AMERICA'S 1ST CHOICE INSURANCE COMPANY OF NC, INC.	America's 1st Choice Insurance Company of NC	www.Americas1stChoice.com	Patriot Plus (PFFS)	04	09	1	1			H4268	002	0	2012	Select Counties in NC		2	1	2			2							www.americas1stchoice.com	www.americas1stchoice.com	(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947		(800)-735-2962		(800)-735-2962		(800)-735-2962		(800)-735-2962		(800)-735-2962		(800)-735-2962		(800)-735-2962		(800)-735-2962		2	2	2
H4270	001	0	1	02	01	H4270_001_0	11	1		08/02/2011	2012.02	08/02/2011 10:22:50 AM Central Daylight Time	07/08/2011 08:36:56 AM Central Daylight Time			08/02/2011 10:34:54 AM Central Daylight Time	UCARE WISCONSIN, INC.	UCare	www.ucare.org	UCare for Seniors Value (HMO-POS)	01	02		1			H4270	001	0	2012	Western Wisconsin - 26 Counties		2		2			2						www.ucare.org	www.ucare.org	www.ucare.org	(877)-523-1515		(612)-676-3600		(877)-523-1518		(612)-676-3500										(800)-688-2534		(612)-676-6810		(800)-688-2534		(612)-676-6810										2	2	2
H4270	002	0	1	02	01	H4270_002_0	11	1		08/02/2011	2012.02	08/02/2011 10:23:13 AM Central Daylight Time	08/03/2011 05:33:05 PM Central Daylight Time	08/08/2011 10:37:50 AM Central Daylight Time		08/08/2011 01:09:47 PM Central Daylight Time	UCARE WISCONSIN, INC.	UCare	www.ucare.org	UCare for Seniors Classic (HMO-POS)	01	02		1			H4270	002	0	2012	Western Wisconsin - 26 Counties		2		2			2						www.ucare.org	www.ucare.org	www.ucare.org	(877)-523-1515		(612)-676-3600		(877)-523-1518		(612)-676-3500		(877)-523-1515		(612)-676-3600		(877)-523-1518		(612)-676-3500		(800)-688-2534		(612)-676-6810		(800)-688-2534		(612)-676-6810		(800)-688-2534		(612)-676-6810		(800)-688-2534		(612)-676-6810		2	2	2
H4270	003	0	1	02	01	H4270_003_0	11	1		08/02/2011	2012.02	08/02/2011 10:23:33 AM Central Daylight Time	08/03/2011 05:35:58 PM Central Daylight Time	08/08/2011 10:39:54 AM Central Daylight Time		08/08/2011 01:09:47 PM Central Daylight Time	UCARE WISCONSIN, INC.	UCare	www.ucare.org	UCare for Seniors Value Plus (HMO-POS)	01	02		1			H4270	003	0	2012	Western Wisconsin - 26 Counties		2		2			2						www.ucare.org	www.ucare.org	www.ucare.org	(877)-523-1515		(612)-676-3600		(877)-523-1518		(612)-676-3500		(877)-523-1515		(612)-676-3600		(877)-523-1518		(612)-676-3500		(800)-688-2534		(612)-676-6810		(800)-688-2534		(612)-676-6810		(800)-688-2534		(612)-676-6810		(800)-688-2534		(612)-676-6810		2	2	2
H4270	004	0	1	02	01	H4270_004_0	14	1		08/02/2011	2012.02	08/02/2011 10:23:53 AM Central Daylight Time	08/03/2011 05:40:10 PM Central Daylight Time	08/11/2011 04:31:01 PM Central Daylight Time		08/12/2011 09:28:26 AM Central Daylight Time	UCARE WISCONSIN, INC.	UCare	www.ucare.org	UCare for Seniors Standard D (HMO-POS)	01	02		1			H4270	004	0	2012	Western Wisconsin - 26 Counties		2		2			2						www.ucare.org	www.ucare.org	www.ucare.org	(877)-523-1515		(612)-676-3600		(877)-523-1518		(612)-676-3500		(877)-523-1515		(612)-676-3600		(877)-523-1518		(612)-676-3500		(800)-688-2534		(612)-676-6810		(800)-688-2534		(612)-676-6810		(800)-688-2534		(612)-676-6810		(800)-688-2534		(612)-676-6810		2	2	2
H4270	801	0	1	02	01	H4270_801_0	8	1		05/12/2011	2012.02	05/12/2011 11:46:25 AM Central Daylight Time	06/06/2011 04:50:36 PM Central Daylight Time			06/06/2011 05:09:03 PM Central Daylight Time	UCARE WISCONSIN, INC.	UCare	www.ucare.org	Group UCare for Seniors (HMO-POS)	01	02		1			H4270	801	0	2012	Minnesota and 26 Wisconsin counties		1		2			2						www.ucare.org	www.ucare.org	www.ucare.org	(877)-447-4385		(612)-676-6840		(877)-598-6574		(612)-676-6900		(877)-447-4385		(612)-676-6840		(877)-598-6574		(612)-676-6900		(800)-688-2534		(612)-676-6810		(800)-688-2534		(612)-676-6810		(800)-688-2534		(612)-676-6810		(800)-688-2534		(612)-676-6810		1	1	1
H4270	803	0	1	02	01	H4270_803_0	8	1		05/12/2011	2012.02	05/12/2011 11:46:45 AM Central Daylight Time	06/06/2011 04:51:21 PM Central Daylight Time			06/06/2011 05:09:03 PM Central Daylight Time	UCARE WISCONSIN, INC.	UCare	www.ucare.org	Group UCare for Seniors MA Only (HMO-POS)	01	02		1			H4270	803	0	2012	Minnesota and 26 Wisconsin counties		1		2			2						www.ucare.org	www.ucare.org	www.ucare.org	(877)-447-4385		(612)-676-6840		(877)-598-6574		(612)-676-6900										(800)-688-2534		(612)-676-6810		(800)-688-2534		(612)-676-6810										1	1	1
H4279	001	0	1	01	01	H4279_001_0	6	1	2	08/09/2011	2012.02	08/09/2011 08:50:34 AM Eastern Daylight Time	08/09/2011 07:09:41 AM Eastern Daylight Time	08/09/2011 07:00:12 AM Eastern Daylight Time		08/09/2011 11:07:02 AM Eastern Daylight Time	UPMC FOR YOU, INC	UPMC for You Advantage	http://www.upmchealthplan.com/	UPMC for You Advantage (HMO SNP)	01	01		1			H4279	001	0	2012	Western PA		2	11200	2			1	3		1	1		http://www.upmchealthplan.com/medicare	www.upmchealthplan.com/medicare/partd.html	www.upmchealthplan.com/medicare/partd.html	(800)-606-8648		(800)-606-8648		(866)-405-8762		(866)-405-8762		(800)-606-8648		(800)-606-8648		(866)-405-8762		(866)-405-8762		(866)-407-8762		(866)-407-8762		(866)-407-8762		(866)-407-8762		(866)-407-8762		(866)-407-8762		(866)-407-8762		(866)-407-8762		2	2	2
H4305	001	0	1	20	08	H4305_001_0	1	1		05/24/2011	2012.02	05/24/2011 12:28:39 PM Central Daylight Time		05/24/2011 11:02:42 AM Central Daylight Time		05/24/2011 12:33:26 PM Central Daylight Time	TOTAL LIFE HEALTHCARE	Total Life Healthcare	www.totallifehealthcare.com	Total Life Healthcare Dual (PACE)	08	20		1			H4305	001	0	2012	Counties: Craighead Cross Greene Law MS Poin Rand		2		2			2							www.totallifehealthcare.com	www.totallifehealthcare.com									(855)-207-7500		(870)-207-7500		(855)-207-7500		(870)-207-7500										(800)-336-0117		(870)-336-0117		(800)-336-0017		(870)-336-0017				
H4305	002	0	1	20	08	H4305_002_0	1	1		05/24/2011	2012.02	05/24/2011 12:30:01 PM Central Daylight Time		05/24/2011 11:03:02 AM Central Daylight Time		05/24/2011 12:33:26 PM Central Daylight Time	TOTAL LIFE HEALTHCARE	Total Life Healthcare	www.totallifehealthcare.com	Total Life Healthcare Medicare only (PACE)	08	20		1			H4305	002	0	2012	Counties:Craighead Cross Greene Law MS Poin Rand		2		2			2							www.totallifehealthcare.com	www.totallifehealthcare.com									(855)-207-7500		(870)-207-7500		(855)-207-7500		(870)-207-7500										(800)-336-0117		(870)-336-0117		(800)-336-0017		(870)-336-0017				
H4326	001	0	1	20	08	H4326_001_0	2	1		09/26/2011	2012.02	09/26/2011 03:17:25 PM Eastern Daylight Time		10/17/2011 03:07:00 PM Eastern Daylight Time		10/17/2011 03:10:10 PM Eastern Daylight Time	PACE @ HOME	PACE@Home	www.pace-at-home.org	PACE at Home - dual (PACE)	08	20		1			H4326	001	0	2012	PACE at Home - dual		2		2			2							www.pace-at-home.org	www.seniorscript.com									(828)-468-3980		(828)-468-3980		(828)-468-3980		(828)-468-3980										(828)-468-3980		(828)-468-3980		(828)-468-3980		(828)-468-3980				
H4326	002	0	1	20	08	H4326_002_0	1	1		09/26/2011	2012.02	09/26/2011 03:18:05 PM Eastern Daylight Time		09/26/2011 03:15:00 PM Eastern Daylight Time		09/26/2011 03:21:19 PM Eastern Daylight Time	PACE @ HOME	PACE@Home	www.pace-at-home.org	PACE at Home - medicare only (PACE)	08	20		1			H4326	002	0	2012	PACE at Home - medicare only		2		2			2							www.pace-at-home.org	www.seniorscript.com									(828)-468-3980		(828)-468-3980		(828)-468-3980		(828)-468-3980										(828)-468-3980		(828)-468-3980		(828)-468-3980		(828)-468-3980				
H4346	001	0	1	01	01	H4346_001_0	6	1		08/08/2011	2012.02	08/08/2011 12:39:17 PM Pacific Daylight Time	08/08/2011 03:37:50 PM Pacific Daylight Time	08/08/2011 01:01:46 PM Pacific Daylight Time		08/08/2011 05:34:01 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF NEVADA	CareMore Health Plan of Nevada	http://www.caremore.com	CareMore Value Plus (HMO)	01	01		1			H4346	001	0	2012	Clark County (partial)		2	2279	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)-822-6991		(800)-822-6991		(866)-622-2820		(866)-622-2820		(888)-357-4187		(888)-357-4187		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H4346	003	0	1	01	01	H4346_003_0	7	1		08/06/2011	2012.02	08/06/2011 10:48:33 AM Pacific Daylight Time	08/08/2011 03:38:23 PM Pacific Daylight Time	08/08/2011 01:01:49 PM Pacific Daylight Time		08/08/2011 05:34:01 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF NEVADA	CareMore Health Plan of Nevada	http://www.caremore.com	CareMore Touch (HMO SNP)	01	01		1			H4346	003	0	2012	Clark County (partial)		2	246	2			1	1	3	1			www.caremore.com	www.caremore.com	www.caremore.com	(800)-589-3147		(800)-589-3147		(866)-622-2820		(866)-622-2820		(800)-589-3147		(800)-589-3147		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H4346	005	0	1	01	01	H4346_005_0	6	1		08/06/2011	2012.02	08/06/2011 11:08:20 AM Pacific Daylight Time	08/08/2011 03:38:15 PM Pacific Daylight Time	08/08/2011 01:01:50 PM Pacific Daylight Time		08/08/2011 05:34:01 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF NEVADA	CareMore Health Plan of Nevada	http://www.caremore.com	CareMore Breathe (HMO SNP)	01	01		1			H4346	005	0	2012	Clark County (partial)		2	543	2			1	4		1		00000000000100000000	www.caremore.com	www.caremore.com	www.caremore.com	(888)-357-4166		(888)-357-4166		(866)-622-2820		(866)-622-2820		(888)-357-4166		(888)-357-4166		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H4346	006	0	1	01	01	H4346_006_0	6	1		08/06/2011	2012.02	08/06/2011 11:08:00 AM Pacific Daylight Time	08/08/2011 03:37:58 PM Pacific Daylight Time	08/08/2011 01:01:54 PM Pacific Daylight Time		08/08/2011 05:34:01 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF NEVADA	CareMore Health Plan of Nevada	http://www.caremore.com	CareMore Diabetes (HMO SNP)	01	01		1			H4346	006	0	2012	Clark County (partial)		2	1086	2			1	4		1		00000010000000000000	www.caremore.com	www.caremore.com	www.caremore.com	(888)-357-4187		(888)-357-4187		(866)-622-2820		(866)-622-2820		(888)-357-4187		(888)-357-4187		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H4346	007	0	1	01	01	H4346_007_0	6	1		08/08/2011	2012.02	08/08/2011 12:39:38 PM Pacific Daylight Time	08/08/2011 03:38:06 PM Pacific Daylight Time	08/08/2011 01:01:54 PM Pacific Daylight Time		08/08/2011 05:34:01 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF NEVADA	CareMore Health Plan of Nevada	http://www.caremore.com	StartSmart with CareMore (HMO)	01	01		1			H4346	007	0	2012	Clark County (partial)		2	160	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)-822-8720		(800)-822-8720		(866)-622-2820		(866)-622-2820		(800)-822-8720		(800)-822-8720		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H4346	008	0	1	01	01	H4346_008_0	6	1		08/06/2011	2012.02	08/06/2011 11:08:54 AM Pacific Daylight Time	08/08/2011 03:38:31 PM Pacific Daylight Time	08/08/2011 01:01:56 PM Pacific Daylight Time		08/08/2011 05:34:01 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF NEVADA	CareMore Health Plan of Nevada	caremore.com	CareMore Heart (HMO SNP)	01	01		1			H4346	008	0	2012	Clark County (partial)		2	167	2			1	4		1		00000000000000000010	www.caremore.com	www.caremore.com	www.caremore.com	(888)-494-8280		(888)-494-8280		(866)-622-2820		(866)-622-2820		(888)-494-8280		(888)-494-8280		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		2	2	2
H4346	801	0	1	01	01	H4346_801_0	2	1		05/28/2011	2012.02	05/28/2011 11:20:05 AM Pacific Daylight Time	06/03/2011 12:01:31 PM Pacific Daylight Time			07/22/2011 04:58:08 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF NEVADA	CareMore Health Plan of Nevada	caremore.com	CareMore EGWP (HMO)	01	01		1			H4346	801	0	2012	Nevada		1	14	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)-822-6991		(800)-822-6991		(866)-622-2820		(866)-622-2820										(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586										1	1	1
H4346	802	0	1	01	01	H4346_802_0	2	1		05/28/2011	2012.02	05/28/2011 11:19:45 AM Pacific Daylight Time	06/03/2011 12:01:11 PM Pacific Daylight Time			07/22/2011 04:58:08 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF NEVADA	CareMore Health Plan of Nevada	caremore.com	CareMore EGWP MAPD (HMO)	01	01		1			H4346	802	0	2012	Nevada		1	14	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)-822-6991		(800)-822-6991		(866)-622-2820		(866)-622-2820		(800)-822-6991		(800)-822-6991		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		1	1	1
H4346	803	0	1	01	01	H4346_803_0	2	1		05/28/2011	2012.02	05/28/2011 11:20:45 AM Pacific Daylight Time	06/03/2011 12:02:12 PM Pacific Daylight Time			07/22/2011 04:58:08 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF NEVADA	CareMore Health Plan of Nevada	caremore.com	CareMore EGWP (HMO)	01	01		1			H4346	803	0	2012	Nevada		1	5	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)-822-6991		(800)-822-6991		(866)-622-2820		(866)-622-2820										(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586										1	1	1
H4346	804	0	1	01	01	H4346_804_0	2	1		05/28/2011	2012.02	05/28/2011 11:20:22 AM Pacific Daylight Time	06/03/2011 12:01:53 PM Pacific Daylight Time			07/22/2011 04:58:08 PM Pacific Daylight Time	CAREMORE HEALTH PLAN OF NEVADA	CareMore Health Plan of Nevada	caremore.com	CareMore EGWP MAPD (HMO)	01	01		1			H4346	804	0	2012	Nevada		1	5	2			2						www.caremore.com	www.caremore.com	www.caremore.com	(800)-822-6991		(800)-822-6991		(866)-622-2820		(866)-622-2820		(800)-822-6991		(800)-822-6991		(866)-622-2820		(866)-622-2820		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		(800)-577-5586		1	1	1
H4393	001	0	1	20	08	H4393_001_0	1	1		05/23/2011	2012.01	05/23/2011 01:14:32 PM Eastern Daylight Time		05/23/2011 07:54:31 AM Eastern Daylight Time		05/23/2011 01:29:48 PM Eastern Daylight Time	CATHOLIC MANAGED LONG TERM CARE, INC.	ArchCare Senior Life	http://www.archcare.org/	ArchCare Senior Life - Dual (PACE)	08	20		1			H4393	001	0	2012	New York and Bronx counties		2		2			2							www.archcare.org	www.archcare.org									(212)-752-2404		(212)-752-2404		(212)-752-2404		(212)-752-2404										(800)-662-1200		(646)-289-7744		(800)-662-1200		(800)-662-1200				
H4393	002	0	1	20	08	H4393_002_0	1	1		05/23/2011	2012.01	05/23/2011 01:15:04 PM Eastern Daylight Time		05/23/2011 07:54:31 AM Eastern Daylight Time		05/23/2011 01:29:48 PM Eastern Daylight Time	CATHOLIC MANAGED LONG TERM CARE, INC.	ArchCare Senior Life	http://www.archcare.org/	ArchCare Senior Life - Medicare only (PACE)	08	20		1			H4393	002	0	2012	New York and Bronx counties		2		2			2							www.archcare.org	www.archcare.org									(212)-752-2404		(212)-752-2404		(212)-752-2404		(212)-752-2404										(800)-662-1200		(800)-662-1200		(800)-662-1200		(800)-662-1200				
H4402	001	0	1	20	08	H4402_001_0	1	1		05/23/2011	2012.02	05/23/2011 01:15:06 PM Eastern Daylight Time		05/23/2011 11:42:10 AM Eastern Daylight Time		05/23/2011 01:17:28 PM Eastern Daylight Time	ALEXIAN BROTHERS COMMUNITY SERVICES	Alexian Brothers Community Services	WWW.alexianbrotherssoutheast.com.com	Alexian Brothers Community Services (PACE)	08	20		1			H4402	001	0	2012	Hamilton County Area		2		2			2							None	None									(800)-443-8883		(423)-698-0802		(800)-443-8883		(423)-698-0802										(800)-443-8883		(423)-698-0802		(800)-443-8883		(423)-698-0802				
H4402	002	0	1	20	08	H4402_002_0	1	1		05/23/2011	2012.02	05/23/2011 01:15:14 PM Eastern Daylight Time		05/23/2011 11:42:10 AM Eastern Daylight Time		05/23/2011 01:17:28 PM Eastern Daylight Time	ALEXIAN BROTHERS COMMUNITY SERVICES	Alexian Brothers Community Services	WWW.alexianbrotherssoutheast.com.com	Alexian Brothers Community Services (PACE)	08	20		1			H4402	002	0	2012	Hamilton County Area		2		2			2							None	None									(800)-441-8883		(423)-698-0802		(800)-443-8883		(423)-698-0802										(800)-441-8883		(423)-698-0802		(800)-443-8883		(423)-698-0802				
H4406	001	0	1	02	01	H4406_001_0	7	1		08/12/2011	2012.02	08/12/2011 02:33:08 PM Central Daylight Time	08/04/2011 08:59:45 PM Central Daylight Time	08/05/2011 01:35:14 PM Central Daylight Time		08/12/2011 02:48:29 PM Central Daylight Time	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H4406	001	0	2012	Select counties in TN		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4406	801	0	1	01	01	H4406_801_0	2	1		07/06/2011	2012.02	07/06/2011 04:47:51 PM Central Daylight Time	06/03/2011 01:21:58 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H4406	801	0	2012	Davidson,DeKalb,Hickman and Rutherford Counties		1		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4406	803	0	1	01	01	H4406_803_0	2	1		07/06/2011	2012.02	07/06/2011 04:47:56 PM Central Daylight Time	06/03/2011 01:21:22 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H4406	803	0	2012	Davidson,DeKalb,Hickman and Rutherford Counties		1		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548										(711)		(711)		(711)		(711)										2	2	2
H4406	804	0	1	01	01	H4406_804_0	2	1		07/06/2011	2012.02	07/06/2011 04:48:02 PM Central Daylight Time	06/03/2011 01:20:43 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H4406	804	0	2012	Select counties in TN		1		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4407	002	0	1	01	01	H4407_002_0	7	1		08/05/2011	2012.02	08/05/2011 03:32:54 PM Central Daylight Time	08/05/2011 02:23:56 PM Central Daylight Time	08/04/2011 05:37:55 PM Central Daylight Time		08/09/2011 04:56:32 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Healthspring, Inc.	www.healthspring.com	HealthyAdvantage Preferred SMS (HMO)	01	01		1			H4407	002	0	2012	Southern		2		2			2						www.healthspring.com	www.healthspring.com	www.healthspring.com	(888)-201-4963		(888)-201-4963		(888)-767-1879		(888)-767-1879		(888)-501-3965		(888)-501-3965		(888)-767-1879		(888)-767-1879		(877)-262-9090		(877)-262-9090		(877)-262-9090		(877)-262-9090		(866)-206-5565		(866)-206-5565		(866)-845-7230		(866)-845-7230		2	2	2
H4407	004	0	1	01	01	H4407_004_0	7	1	2	08/08/2011	2012.02	08/08/2011 11:13:11 AM Central Daylight Time	08/08/2011 10:00:16 AM Central Daylight Time	08/04/2011 05:38:50 PM Central Daylight Time		08/09/2011 04:56:32 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Healthspring, Inc.	www.healthspring.com	TotalCare SMS (HMO SNP)	01	01		1			H4407	004	0	2012	Southern		2		2			1	3		1	2		www.healthspring.com	www.healthspring.com	www.healthspring.com	(888)-201-4963		(888)-201-4963		(888)-767-1879		(888)-767-1879		(888)-501-3965		(888)-501-3965		(888)-767-1879		(888)-767-1879		(877)-262-9090		(877)-262-9090		(877)-262-9090		(877)-262-9090		(866)-206-5565		(866)-206-5565		(866)-845-7230		(866)-845-7230		2	2	2
H4407	005	0	1	01	01	H4407_005_0	4	1		07/27/2011	2012.02	07/27/2011 03:01:15 PM Central Daylight Time	05/31/2011 05:10:39 PM Central Daylight Time			07/28/2011 06:06:50 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Healthspring, Inc.	www.healthspring.com	HealthyAdvantage NMS (HMO)	01	01		1			H4407	005	0	2012	Northwest Mississippi		2		2			2						www.healthspring.com	www.healthspring.com	www.healthspring.com	(888)-501-3965		(888)-501-3965		(866)-593-4468		(866)-593-4468										(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565										2	2	2
H4407	011	0	1	01	01	H4407_011_0	4	1		07/27/2011	2012.02	07/27/2011 03:45:51 PM Central Daylight Time	05/27/2011 06:44:26 PM Central Daylight Time			07/28/2011 06:06:50 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Healthspring, Inc.	www.healthspring.com	HealthyAdvantage SMS (HMO)	01	01		1			H4407	011	0	2012	Southern		2		2			2						www.healthspring.com	www.healthspring.com	www.healthspring.com	(888)-201-4963		(888)-201-4963		(888)-767-1879		(888)-767-1879										(877)-262-9090		(877)-262-9090		(877)-262-9090		(877)-262-9090										2	2	2
H4407	022	0	1	02	01	H4407_022_0	8	1		08/08/2011	2012.02	08/08/2011 08:36:35 AM Central Daylight Time	07/21/2011 10:06:37 PM Central Daylight Time	08/04/2011 05:39:38 PM Central Daylight Time		08/09/2011 04:56:32 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Healthspring, Inc.	www.healthspring.com	HealthyAdvantage Premier NMS (HMO-POS)	01	02		1			H4407	022	0	2012	Northwest Mississippi		2		2			2						www.healthspring.com	www.healthspring.com	www.healthspring.com	(800)-331-6293		(800)-331-6293		(866)-593-4468		(866)-593-4468		(888)-501-3965		(888)-501-3965		(888)-767-1879		(888)-767-1879		(866)-845-7230		(866)-845-7230		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-845-7230		(866)-845-7230		2	2	2
H4407	023	0	1	02	01	H4407_023_0	7	1		08/05/2011	2012.02	08/05/2011 03:35:54 PM Central Daylight Time	08/05/2011 02:24:57 PM Central Daylight Time	08/04/2011 05:40:21 PM Central Daylight Time		08/09/2011 04:56:32 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Healthspring, Inc.	www.healthspring.com	HealthyAdvantage Premier SMS (HMO-POS)	01	02		1			H4407	023	0	2012	Southern Mississippi		2		2			2						www.healthspring.com	www.healthspring.com	www.healthspring.com	(888)-201-4963		(888)-201-4963		(888)-767-1879		(888)-767-1879		(800)-952-1992		(800)-952-1992		(888)-767-1879		(888)-767-1879		(877)-262-9090		(877)-262-9090		(877)-262-9090		(877)-262-9090		(877)-262-9090		(877)-262-9090		(866)-845-7230		(866)-845-7230		2	2	2
H4407	802	0	1	01	01	H4407_802_0	5	1		07/29/2011	2012.02	07/29/2011 11:35:17 AM Central Daylight Time	05/31/2011 05:59:46 PM Central Daylight Time			07/29/2011 11:38:47 AM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Healthspring, Inc.	www.healthspring.com	Retiree Advantage (HMO)	01	01		1			H4407	802	0	2012	Mississippi		1		2			2						www.healthspring.com	www.healthspring.com	www.healthspring.com	(888)-501-3965		(888)-501-3965		(866)-593-4468		(866)-593-4468										(866)-206-5565		(866)-206-5565		(800)-391-9806		(800)-391-9806										2	1	2
H4407	807	0	1	01	01	H4407_807_0	5	1		07/29/2011	2012.02	07/29/2011 11:35:26 AM Central Daylight Time	05/31/2011 06:01:21 PM Central Daylight Time			07/29/2011 11:38:47 AM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Healthspring, Inc.	www.healthspring.com	Retiree Advantage Preferred (HMO)	01	01		1			H4407	807	0	2012	Mississippi		1		2			2						www.healthspring.com	www.healthspring.com	www.healthspring.com	(888)-501-3965		(888)-501-3965		(866)-593-4468		(866)-593-4468		(888)-501-3965		(888)-501-3965		(800)-331-6293		(800)-331-6293		(866)-206-5565		(866)-206-5565		(800)-391-9806		(800)-391-9806		(866)-206-5565		(866)-206-5565		(866)-845-7230		(866)-845-7230		2	1	2
H4408	001	0	1	04	01	H4408_001_0	9	1		07/12/2011	2012.02	07/12/2011 10:41:46 AM Eastern Daylight Time	08/05/2011 09:05:56 AM Eastern Daylight Time	08/04/2011 12:20:53 PM Eastern Daylight Time		08/08/2011 04:28:45 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H4408-001 (PPO)	01	04		1			H4408	001	0	2012	Memphis Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4408	002	0	1	04	01	H4408_002_0	9	1		07/12/2011	2012.02	07/12/2011 10:42:15 AM Eastern Daylight Time	05/27/2011 04:27:12 PM Eastern Daylight Time	08/04/2011 12:21:12 PM Eastern Daylight Time		08/08/2011 04:28:45 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H4408-002 (PPO)	01	04		1			H4408	002	0	2012	Nashville Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4408	006	0	1	04	01	H4408_006_0	9	1		07/12/2011	2012.02	07/12/2011 10:42:45 AM Eastern Daylight Time	08/05/2011 08:53:20 AM Eastern Daylight Time	08/04/2011 12:21:31 PM Eastern Daylight Time		08/08/2011 04:28:45 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H4408-006 (PPO)	01	04		1			H4408	006	0	2012	Chattanooga Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4408	007	0	1	04	01	H4408_007_0	9	1		07/12/2011	2012.02	07/12/2011 10:43:16 AM Eastern Daylight Time	05/27/2011 04:16:10 PM Eastern Daylight Time	08/04/2011 12:22:01 PM Eastern Daylight Time		08/08/2011 04:28:45 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H4408-007 (PPO)	01	04		1			H4408	007	0	2012	Knoxville Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4408	008	0	1	04	01	H4408_008_0	9	1		07/12/2011	2012.02	07/12/2011 10:43:33 AM Eastern Daylight Time	08/05/2011 09:00:14 AM Eastern Daylight Time	08/04/2011 12:22:36 PM Eastern Daylight Time		08/08/2011 04:28:45 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H4408-008 (PPO)	01	04		1			H4408	008	0	2012	Select TN and VA Counties in the Tri-Cities Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4454	002	0	1	01	01	H4454_002_0	7	1		08/05/2011	2012.02	08/05/2011 03:59:00 PM Central Daylight Time	08/05/2011 04:50:33 PM Central Daylight Time	08/04/2011 05:41:14 PM Central Daylight Time		08/08/2011 06:14:25 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Healthspring	www.healthspring.com	HealthyAdvantage Preferred (HMO)	01	01		1			H4454	002	0	2012	Middle, West and East Tennessee		2		2			2						healthspring.com	www.healthspring.com	www.healthspring.com	(888)-501-3965		(615)-401-4501		(866)-593-4468		(615)-401-4500		(888)-501-3965		(888)-501-3965		(866)-593-4468		(866)-593-4468		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-845-7230		(866)-845-7230		2	2	2
H4454	012	0	1	01	01	H4454_012_0	4	1		07/27/2011	2012.02	07/27/2011 02:56:53 PM Central Daylight Time	05/31/2011 05:13:48 PM Central Daylight Time			07/28/2011 06:06:50 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Healthspring	www.healthspring.com	HealthyAdvantage (HMO)	01	01		1			H4454	012	0	2012	Middle, West and East Tennessee		2		2			2						healthspring.com	www.healthspring.com	www.healthspring.com	(888)-501-3965		(615)-401-4501		(866)-593-4468		(615)-401-4500										(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565										2	2	2
H4454	020	0	1	01	01	H4454_020_0	8	1	2	08/05/2011	2012.02	08/05/2011 03:59:51 PM Central Daylight Time	07/28/2011 10:37:18 AM Central Daylight Time	08/04/2011 05:41:55 PM Central Daylight Time		08/09/2011 04:56:32 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Healthspring	www.healthspring.com	TotalCare (HMO SNP)	01	01		1			H4454	020	0	2012	Middle and West Tennessee		2		2			1	3		1	2		healthspring.com	www.healthspring.com	www.healthspring.com	(888)-501-3965		(615)-401-4501		(866)-593-4468		(615)-401-4500		(888)-501-3965		(888)-501-3965		(866)-593-4468		(866)-593-4468		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-845-7230		(866)-845-7230		2	2	2
H4454	028	0	1	01	01	H4454_028_0	6	1		08/05/2011	2012.02	08/05/2011 04:00:07 PM Central Daylight Time	08/05/2011 04:04:32 PM Central Daylight Time	08/04/2011 05:42:49 PM Central Daylight Time		08/08/2011 06:14:25 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Healthspring	www.healthspring.com	HealthyAdvantage Primary Plan (HMO)	01	01		1			H4454	028	0	2012	East Tennessee		2		2			2						healthspring.com	www.healthspring.com	www.healthspring.com	(888)-501-3965		(615)-401-4501		(866)-593-4468		(615)-401-4500		(888)-501-3965		(888)-501-3965		(866)-593-4468		(866)-593-4468		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-845-7230		(866)-845-7230		2	2	2
H4454	030	0	1	02	01	H4454_030_0	7	1		08/05/2011	2012.02	08/05/2011 04:00:19 PM Central Daylight Time	08/08/2011 08:41:26 AM Central Daylight Time	08/04/2011 05:43:32 PM Central Daylight Time		08/09/2011 04:56:32 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Healthspring	www.healthspring.com	HealthyAdvantage Premier (HMO-POS)	01	02		1			H4454	030	0	2012	Middle, West and East Tennessee		2		2			2						healthspring.com	www.healthspring.com	www.healthspring.com	(888)-501-3965		(615)-401-4501		(866)-593-4468		(615)-401-4500		(888)-501-3965		(888)-501-3965		(866)-593-4468		(866)-593-4468		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-845-7230		(866)-845-7230		2	2	2
H4454	031	0	1	01	01	H4454_031_0	7	1		08/05/2011	2012.02	08/05/2011 04:00:31 PM Central Daylight Time	05/31/2011 05:17:23 PM Central Daylight Time	08/04/2011 05:44:18 PM Central Daylight Time		08/09/2011 04:56:32 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Healthspring	www.healthspring.com	HealthyAdvantage Preferred ETN (HMO)	01	01		1			H4454	031	0	2012	Knoxville		2		2			2						healthspring.com	www.healthspring.com	www.healthspring.com	(888)-501-3965		(615)-401-4501		(866)-593-4468		(615)-401-4500		(888)-501-3965		(888)-501-3965		(866)-593-4468		(866)-593-4468		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-845-7230		(866)-845-7230		2	2	2
H4454	032	0	1	02	01	H4454_032_0	7	1		08/05/2011	2012.02	08/05/2011 04:00:44 PM Central Daylight Time	05/31/2011 05:18:24 PM Central Daylight Time	08/04/2011 05:45:04 PM Central Daylight Time		08/09/2011 04:56:32 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Healthspring	www.healthspring.com	HealthyAdvantage Premier ETN (HMO-POS)	01	02		1			H4454	032	0	2012	Knoxville		2		2			2						healthspring.com	www.healthspring.com	www.healthspring.com	(888)-501-3965		(615)-401-4501		(866)-593-4468		(615)-401-4500		(888)-501-3965		(888)-501-3965		(866)-593-4468		(866)-593-4468		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-845-7230		(866)-845-7230		2	2	2
H4454	803	0	1	01	01	H4454_803_0	1	1		06/01/2011	2012.02	06/01/2011 12:42:18 PM Central Daylight Time	05/31/2011 05:19:18 PM Central Daylight Time			06/03/2011 12:27:00 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Healthspring	www.healthspring.com	Retiree Advantage (HMO)	01	01		1			H4454	803	0	2012	Tennessee		1		2			2						healthspring.com	www.healthspring.com	www.healthspring.com	(888)-501-3965		(615)-401-4501		(866)-593-4468		(615)-401-4500										(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565										1	1	1
H4454	805	0	1	01	01	H4454_805_0	1	1		06/01/2011	2012.02	06/01/2011 12:43:31 PM Central Daylight Time	05/31/2011 05:20:17 PM Central Daylight Time			06/03/2011 12:27:00 PM Central Daylight Time	HEALTHSPRING OF TENNESSEE, INC.	Healthspring	www.healthspring.com	Retiree Advantage Preferred (HMO)	01	01		1			H4454	805	0	2012	Tennessee		1	159	2			2						healthspring.com	www.healthspring.com	www.healthspring.com	(888)-501-3965		(615)-401-4501		(866)-593-4468		(615)-401-4500		(888)-501-3965		(888)-501-3965		(800)-331-6293		(800)-331-6293		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-206-5565		(866)-845-7230		(866)-845-7230		1	1	1
H4456	010	0	1	02	01	H4456_010_0	4	1		08/04/2011	2012.02	08/04/2011 07:42:58 PM Central Daylight Time	08/05/2011 09:26:08 AM Central Daylight Time	08/05/2011 01:09:02 PM Central Daylight Time		08/09/2011 12:48:01 PM Central Daylight Time	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus Plan 1 (HMO-POS)	01	02		1			H4456	010	0	2012	Select counties in Illinois		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4456	013	0	1	02	01	H4456_013_0	4	1		08/09/2011	2012.02	08/09/2011 11:01:43 AM Central Daylight Time	08/05/2011 09:26:45 AM Central Daylight Time	08/05/2011 01:09:23 PM Central Daylight Time		08/09/2011 04:41:25 PM Central Daylight Time	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus Plan 1 (HMO-POS)	01	02		1			H4456	013	0	2012	Eastern Tennessee and Southwestern Virginia		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4456	015	0	1	01	01	H4456_015_0	5	1		08/04/2011	2012.02	08/04/2011 08:16:12 PM Central Daylight Time	08/05/2011 09:27:20 AM Central Daylight Time	08/05/2011 01:09:43 PM Central Daylight Time		08/09/2011 12:48:01 PM Central Daylight Time	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H4456	015	0	2012	Select counties in Iowa and Illinois		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4456	020	0	1	01	01	H4456_020_0	4	1		07/20/2011	2012.02	07/20/2011 02:30:54 PM Central Daylight Time	07/22/2011 01:58:41 PM Central Daylight Time			07/25/2011 02:24:26 PM Central Daylight Time	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Essential (HMO)	01	01		1			H4456	020	0	2012	Eastern Tennessee and Southwestern Virginia		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514										(711)		(711)		(711)		(711)										2	2	2
H4456	021	0	1	01	01	H4456_021_0	6	1		08/08/2011	2012.02	08/08/2011 09:44:42 AM Central Daylight Time	08/05/2011 09:27:57 AM Central Daylight Time	08/05/2011 01:10:04 PM Central Daylight Time		08/09/2011 04:41:25 PM Central Daylight Time	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 2 (HMO)	01	01		1			H4456	021	0	2012	Eastern Tennessee and Southwestern Virginia		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4456	025	0	1	02	01	H4456_025_0	5	1		08/04/2011	2012.02	08/04/2011 08:16:26 PM Central Daylight Time	08/05/2011 09:28:34 AM Central Daylight Time	08/05/2011 01:10:24 PM Central Daylight Time		08/09/2011 12:48:01 PM Central Daylight Time	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus Plan 1 (HMO-POS)	01	02		1			H4456	025	0	2012	Counties in IA		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4456	026	0	1	02	01	H4456_026_0	5	1		08/05/2011	2012.02	08/05/2011 08:54:09 AM Central Daylight Time	08/05/2011 09:29:08 AM Central Daylight Time	08/05/2011 01:10:45 PM Central Daylight Time		08/09/2011 04:41:25 PM Central Daylight Time	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus Plan 1 (HMO-POS)	01	02		1			H4456	026	0	2012	Bradley, Hamilton, and McMinn counties		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4456	801	0	1	01	01	H4456_801_0	2	1		07/06/2011	2012.02	07/06/2011 04:48:10 PM Central Daylight Time	06/03/2011 03:16:04 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H4456	801	0	2012	Eastern Tennessee and Southwestern Virginia		1		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4456	805	0	1	01	01	H4456_805_0	2	1		07/06/2011	2012.02	07/06/2011 04:48:17 PM Central Daylight Time	06/03/2011 03:17:19 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H4456	805	0	2012	Eastern Tennessee and Southwestern Virginia		1		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548										(711)		(711)		(711)		(711)										2	2	2
H4456	810	0	1	01	01	H4456_810_0	2	1		07/06/2011	2012.02	07/06/2011 04:48:23 PM Central Daylight Time	06/03/2011 03:18:30 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H4456	810	0	2012	Select counties in IL		1		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4461	001	0	1	01	01	H4461_001_0	7	1		07/14/2011	2012.02	07/14/2011 01:55:09 PM Eastern Daylight Time	08/05/2011 08:57:16 AM Eastern Daylight Time	08/04/2011 12:22:55 PM Eastern Daylight Time		08/08/2011 04:28:45 PM Eastern Daylight Time	CARITEN HEALTH PLAN, INC.	Cariten Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H4461-001 (HMO)	01	01		1			H4461	001	0	2012	East Tennessee		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4461	004	0	1	01	01	H4461_004_0	4	1		07/14/2011	2012.02	07/14/2011 01:55:52 PM Eastern Daylight Time	05/27/2011 04:21:17 PM Eastern Daylight Time			07/18/2011 09:40:59 AM Eastern Daylight Time	CARITEN HEALTH PLAN, INC.	Cariten Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H4461-004 (HMO)	01	01		1			H4461	004	0	2012	East Tennessee		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H4461	011	0	1	01	01	H4461_011_0	6	1	2	08/08/2011	2012.02	08/08/2011 03:02:11 PM Eastern Daylight Time	08/05/2011 04:07:00 PM Eastern Daylight Time	08/04/2011 12:23:15 PM Eastern Daylight Time		08/09/2011 09:47:53 AM Eastern Daylight Time	CARITEN HEALTH PLAN, INC.	Cariten Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H4461-011 (HMO SNP)	01	01		1			H4461	011	0	2012	East Tennessee		2		2			1	3		1	2		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4461	015	0	1	01	01	H4461_015_0	7	1		07/14/2011	2012.02	07/14/2011 01:56:26 PM Eastern Daylight Time	08/05/2011 08:58:03 AM Eastern Daylight Time	08/04/2011 12:23:33 PM Eastern Daylight Time		08/08/2011 04:28:45 PM Eastern Daylight Time	CARITEN HEALTH PLAN, INC.	Cariten Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H4461-015 (HMO)	01	01		1			H4461	015	0	2012	East Tennessee		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4461	018	0	1	02	01	H4461_018_0	8	1		07/21/2011	2012.02	07/21/2011 03:15:48 PM Eastern Daylight Time	08/05/2011 08:59:30 AM Eastern Daylight Time	08/04/2011 12:23:52 PM Eastern Daylight Time		08/08/2011 04:28:45 PM Eastern Daylight Time	CARITEN HEALTH PLAN, INC.	Cariten Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H4461-018 (HMO-POS)	01	02		1			H4461	018	0	2012	Nashville Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4461	022	0	1	01	01	H4461_022_0	6	1	2	07/18/2011	2012.02	07/18/2011 09:18:22 AM Eastern Daylight Time	08/05/2011 01:17:13 PM Eastern Daylight Time	08/04/2011 12:24:12 PM Eastern Daylight Time		08/08/2011 03:35:45 PM Eastern Daylight Time	CARITEN HEALTH PLAN, INC.	Cariten Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H4461-022 (HMO SNP)	01	01		1			H4461	022	0	2012	East Tennessee		2		2			1	3		1	5		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4461	025	0	1	01	01	H4461_025_0	5	1		07/14/2011	2012.02	07/14/2011 01:57:54 PM Eastern Daylight Time	08/05/2011 09:03:58 AM Eastern Daylight Time	08/04/2011 12:24:33 PM Eastern Daylight Time		08/08/2011 04:28:45 PM Eastern Daylight Time	CARITEN HEALTH PLAN, INC.	Cariten Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H4461-025 (HMO)	01	01		1			H4461	025	0	2012	Fayette, Shelby and Tipton counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4461	026	0	1	01	01	H4461_026_0	5	1		07/14/2011	2012.02	07/14/2011 01:58:29 PM Eastern Daylight Time	08/05/2011 01:37:45 PM Eastern Daylight Time	08/04/2011 12:24:52 PM Eastern Daylight Time		08/08/2011 04:28:45 PM Eastern Daylight Time	CARITEN HEALTH PLAN, INC.	Cariten Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H4461-026 (HMO)	01	01		1			H4461	026	0	2012	Fayette, Shelby and Tipton counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4461	806	0	1	01	01	H4461_806_0	6	1		07/06/2011	2012.02	07/06/2011 10:56:46 AM Eastern Daylight Time	06/02/2011 04:53:12 PM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	CARITEN HEALTH PLAN, INC.	Cariten Health Plan, Inc.	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H4461	806	0	2012	Select counties in East Tennessee area		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H4461	807	0	1	01	01	H4461_807_0	6	1		07/06/2011	2012.02	07/06/2011 10:56:52 AM Eastern Daylight Time	05/27/2011 05:42:11 PM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	CARITEN HEALTH PLAN, INC.	Cariten Health Plan, Inc.	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H4461	807	0	2012	Select counties in East Tennessee area		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
H4461	808	0	1	01	01	H4461_808_0	6	1		07/06/2011	2012.02	07/06/2011 10:56:56 AM Eastern Daylight Time	05/27/2011 05:43:05 PM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	CARITEN HEALTH PLAN, INC.	Cariten Health Plan, Inc.	www.humana-medicare.com	Humana Employer Sponsored Non-CY (HMO)	01	01		1			H4461	808	0	2012	Select counties in East Tennessee area		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H4506	003	0	1	01	01	H4506_003_0	8	1		08/05/2011	2012.02	08/05/2011 11:20:25 AM Central Daylight Time	08/04/2011 04:53:00 PM Central Daylight Time	08/04/2011 08:48:38 AM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	SELECTCARE OF TEXAS, L.L.C.	Universal American	www.TexanPlus.com	TexanPlus Classic (HMO)	01	01		1			H4506	003	0	2012	Southeast Texas		2	100	2			2						www.TexanPlus.com	www.TexanPlus.com	www.TexanPlus.com	(866)-230-2513		(866)-230-2513		(866)-556-4607		(866)-556-4607		(866)-230-2513		(866)-230-2513		(866)-556-4607		(866)-556-4607		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		2	2	2
H4506	010	0	1	01	01	H4506_010_0	7	1		07/08/2011	2012.02	07/08/2011 10:25:35 AM Central Daylight Time	07/20/2011 04:03:13 PM Central Daylight Time			07/20/2011 04:21:38 PM Central Daylight Time	SELECTCARE OF TEXAS, L.L.C.	Universal American	www.TexanPlus.com	TexanPlus Value (HMO)	01	01		1			H4506	010	0	2012	Southeast Texas		2	100	2			2						www.TexanPlus.com	www.TexanPlus.com	www.TexanPlus.com	(866)-230-2513		(866)-230-2513		(866)-556-4607		(866)-556-4607										(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089										2	2	2
H4506	027	0	1	01	01	H4506_027_0	10	1		07/13/2011	2012.02	07/13/2011 03:07:19 PM Central Daylight Time	08/04/2011 04:53:00 PM Central Daylight Time	08/04/2011 08:56:42 AM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	SELECTCARE OF TEXAS, L.L.C.	Universal American	www.TexanPlus.com	TexanPlus Select (HMO)	01	01		1			H4506	027	0	2012	Southeast Texas		2	100	2			2						www.TexanPlus.com	www.TexanPlus.com	www.TexanPlus.com	(866)-230-2513		(866)-230-2513		(866)-556-4607		(866)-556-4607		(866)-230-2513		(866)-230-2513		(866)-556-4607		(866)-556-4607		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		2	2	2
H4506	801	0	1	01	01	H4506_801_0	6	1		06/02/2011	2012.02	06/02/2011 03:48:57 PM Central Daylight Time	07/02/2011 08:43:00 PM Central Daylight Time			07/08/2011 04:40:04 PM Central Daylight Time	SELECTCARE OF TEXAS, L.L.C.	Universal American	www.TexanPlus.com	H4506 - Retiree - MA-PD non-CY (HMO)	01	01		1			H4506	801	0	2012	TexanPlus-Employer Group (MAPD nonCY)		1	100	2			2						www.TexanPlus.com	www.TexanPlus.com	www.TexanPlus.com	(866)-230-2513		(866)-230-2513		(866)-556-4607		(866)-556-4607		(866)-230-2513		(866)-230-2513		(866)-556-4607		(866)-556-4607		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		1	1	1
H4506	806	0	1	01	01	H4506_806_0	5	1		06/02/2011	2012.02	06/02/2011 03:49:20 PM Central Daylight Time	06/05/2011 07:55:34 PM Central Daylight Time			06/05/2011 08:52:55 PM Central Daylight Time	SELECTCARE OF TEXAS, L.L.C.	Universal American	www.TexanPlus.com	H4506 - Retiree - MA-PD CY (HMO)	01	01		1			H4506	806	0	2012	TexanPlus-Employer Group (MAPD CY)		1	100	2			2						www.TexanPlus.com	www.TexanPlus.com	www.TexanPlus.com	(866)-230-2513		(866)-230-2513		(866)-556-4607		(866)-556-4607		(866)-230-2513		(866)-230-2513		(866)-556-4607		(866)-556-4607		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		1	1	1
H4506	808	0	1	01	01	H4506_808_0	6	1		06/02/2011	2012.02	06/02/2011 03:49:43 PM Central Daylight Time	07/07/2011 06:02:42 PM Central Daylight Time			07/08/2011 04:40:04 PM Central Daylight Time	SELECTCARE OF TEXAS, L.L.C.	Universal American	www.TexanPlus.com	H4506 - Retiree MA (HMO)	01	01		1			H4506	808	0	2012	TexanValue-Employer Group (MA Only)		1	100	2			2						www.TexanPlus.com	www.TexanPlus.com	www.TexanPlus.com	(866)-230-2513		(866)-230-2513		(866)-556-4607		(866)-556-4607										(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089										1	1	1
H4510	012	0	1	01	01	H4510_012_0	5	1		07/22/2011	2012.02	07/22/2011 11:38:24 AM Eastern Daylight Time	08/07/2011 12:54:15 PM Eastern Daylight Time	08/04/2011 12:25:10 PM Eastern Daylight Time		08/08/2011 04:57:59 PM Eastern Daylight Time	HUMANA HEALTH PLAN OF TEXAS, INC.	HUMANA HEALTH PLAN OF TEXAS, INC.	www.humana-medicare.com	Humana Gold Plus H4510-012 (HMO)	01	01		1			H4510	012	0	2012	Corpus Christi Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4510	015	0	1	01	01	H4510_015_0	7	1		07/05/2011	2012.02	07/05/2011 11:13:12 AM Eastern Daylight Time	08/07/2011 12:56:08 PM Eastern Daylight Time	08/04/2011 12:25:44 PM Eastern Daylight Time		08/08/2011 04:57:59 PM Eastern Daylight Time	HUMANA HEALTH PLAN OF TEXAS, INC.	HUMANA HEALTH PLAN OF TEXAS, INC.	www.humana-medicare.com	Humana Gold Plus H4510-015 (HMO)	01	01		1			H4510	015	0	2012	San Antonio Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4510	018	0	1	01	01	H4510_018_0	4	1		07/05/2011	2012.02	07/05/2011 11:14:24 AM Eastern Daylight Time	08/07/2011 12:57:41 PM Eastern Daylight Time	08/04/2011 12:26:02 PM Eastern Daylight Time		08/08/2011 04:57:59 PM Eastern Daylight Time	HUMANA HEALTH PLAN OF TEXAS, INC.	HUMANA HEALTH PLAN OF TEXAS, INC.	www.humana-medicare.com	Humana Reader's Digest Healthy Living Plan (HMO)	01	01		1			H4510	018	0	2012	Dallas Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4510	020	0	1	01	01	H4510_020_0	4	1		07/05/2011	2012.02	07/05/2011 11:15:13 AM Eastern Daylight Time	08/07/2011 12:59:11 PM Eastern Daylight Time	08/04/2011 12:26:20 PM Eastern Daylight Time		08/08/2011 04:57:59 PM Eastern Daylight Time	HUMANA HEALTH PLAN OF TEXAS, INC.	HUMANA HEALTH PLAN OF TEXAS, INC.	www.humana-medicare.com	Humana Reader's Digest Healthy Living Plan (HMO)	01	01		1			H4510	020	0	2012	Select Counties of Texas		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4510	021	0	1	01	01	H4510_021_0	3	1	2	08/08/2011	2012.02	08/08/2011 03:58:22 PM Eastern Daylight Time	08/08/2011 03:06:44 PM Eastern Daylight Time	08/04/2011 12:26:52 PM Eastern Daylight Time		08/09/2011 10:37:38 AM Eastern Daylight Time	HUMANA HEALTH PLAN OF TEXAS, INC.	HUMANA HEALTH PLAN OF TEXAS, INC.	www.humana-medicare.com	Humana Gold Plus SNP-DE H4510-021 (HMO SNP)	01	01		1			H4510	021	0	2012	El Paso County		2		2			1	3		1	5		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4510	022	0	1	01	01	H4510_022_0	4	1		07/05/2011	2012.02	07/05/2011 11:30:46 AM Eastern Daylight Time	08/07/2011 01:06:38 PM Eastern Daylight Time	08/04/2011 12:27:11 PM Eastern Daylight Time		08/08/2011 04:57:59 PM Eastern Daylight Time	HUMANA HEALTH PLAN OF TEXAS, INC.	HUMANA HEALTH PLAN OF TEXAS, INC.	www.humana-medicare.com	Humana Gold Plus H4510-022 (HMO)	01	01		1			H4510	022	0	2012	El Paso County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4510	023	0	1	01	01	H4510_023_0	3	1	2	08/05/2011	2012.02	08/05/2011 04:28:22 PM Eastern Daylight Time	08/08/2011 10:11:17 AM Eastern Daylight Time	08/04/2011 12:27:30 PM Eastern Daylight Time		08/08/2011 04:57:59 PM Eastern Daylight Time	HUMANA HEALTH PLAN OF TEXAS, INC.	HUMANA HEALTH PLAN OF TEXAS, INC.	www.humana-medicare.com	Humana Gold Plus SNP-DE H4510-023 (HMO SNP)	01	01		1			H4510	023	0	2012	Dallas Metro Area		2		2			1	3		1	5		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4510	024	0	1	01	01	H4510_024_0	3	1	2	07/05/2011	2012.02	07/05/2011 11:35:27 AM Eastern Daylight Time	08/07/2011 04:01:42 PM Eastern Daylight Time	08/04/2011 12:28:04 PM Eastern Daylight Time		08/08/2011 04:57:59 PM Eastern Daylight Time	HUMANA HEALTH PLAN OF TEXAS, INC.	HUMANA HEALTH PLAN OF TEXAS, INC.	www.humana-medicare.com	Humana Gold Plus SNP-DE H4510-024 (HMO SNP)	01	01		1			H4510	024	0	2012	Corpus Christi/San Antonio area		2		2			1	3		1	5		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4510	027	0	1	01	01	H4510_027_0	4	1		07/05/2011	2012.02	07/05/2011 11:37:11 AM Eastern Daylight Time	08/07/2011 01:01:37 PM Eastern Daylight Time	08/04/2011 12:28:22 PM Eastern Daylight Time		08/08/2011 04:57:59 PM Eastern Daylight Time	HUMANA HEALTH PLAN OF TEXAS, INC.	HUMANA HEALTH PLAN OF TEXAS, INC.	www.humana-medicare.com	Humana Gold Plus H4510-027 (HMO)	01	01		1			H4510	027	0	2012	Hays, Travis and Williamson		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4510	801	0	1	01	01	H4510_801_0	3	1		07/06/2011	2012.02	07/06/2011 10:57:00 AM Eastern Daylight Time	06/02/2011 04:11:15 PM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA HEALTH PLAN OF TEXAS, INC.	HUMANA HEALTH PLAN OF TEXAS,INC.	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H4510	801	0	2012	Select counties in Texas		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H4510	802	0	1	01	01	H4510_802_0	3	1		07/06/2011	2012.02	07/06/2011 10:57:06 AM Eastern Daylight Time	06/02/2011 04:12:34 PM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA HEALTH PLAN OF TEXAS, INC.	HUMANA HEALTH PLAN OF TEXAS,INC.	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H4510	802	0	2012	Select counties in Texas		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
H4510	803	0	1	01	01	H4510_803_0	3	1		07/06/2011	2012.02	07/06/2011 10:57:10 AM Eastern Daylight Time	06/02/2011 04:13:50 PM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA HEALTH PLAN OF TEXAS, INC.	HUMANA HEALTH PLAN OF TEXAS,INC.	www.humana-medicare.com	Humana Employer Sponsored Non-CY (HMO)	01	01		1			H4510	803	0	2012	Select counties in Texas		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H4513	001	0	1	01	01	H4513_001_0	7	1		08/08/2011	2012.02	08/08/2011 10:49:35 AM Central Daylight Time	08/05/2011 02:51:52 PM Central Daylight Time	08/04/2011 05:45:48 PM Central Daylight Time		08/08/2011 06:14:25 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring	www.healthspring.com	HealthyAdvantage Preferred (HMO)	01	01		1			H4513	001	0	2012	Texas HealthSpring Counties		2		2			2							www.healthspring.com	www.healthspring.com	(800)-280-8888		(800)-280-8888		(800)-846-2098		(800)-846-2098		(800)-280-8888		(800)-280-8888		(800)-846-2098		(800)-846-2098		(877)-893-1504		(877)-893-1504		(877)-893-1504		(877)-893-1504		(877)-893-1504		(877)-893-1504		(866)-845-7230		(866)-845-7230		2	2	2
H4513	009	0	1	01	01	H4513_009_0	5	1		07/26/2011	2012.02	07/26/2011 01:25:04 PM Central Daylight Time	05/27/2011 02:55:12 PM Central Daylight Time			07/28/2011 06:06:50 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring	www.healthspring.com	HealthyAdvantage (HMO)	01	01		1			H4513	009	0	2012	Texas HealthSpring Counties		2		2			2							www.healthspring.com	www.healthspring.com	(800)-280-8888		(800)-280-8888		(800)-846-2098		(800)-846-2098										(877)-893-1504		(877)-893-1504		(877)-893-1504		(877)-893-1504										2	2	2
H4513	010	0	1	01	01	H4513_010_0	6	1	2	08/08/2011	2012.02	08/08/2011 10:51:00 AM Central Daylight Time	08/05/2011 02:54:08 PM Central Daylight Time	08/04/2011 05:46:31 PM Central Daylight Time		08/08/2011 06:14:25 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring	www.healthspring.com	TotalCare (HMO SNP)	01	01		1			H4513	010	0	2012	Texas HealthSpring Counties		2		2			1	3		1	2			www.healthspring.com	www.healthspring.com	(800)-846-2098		(800)-846-2098		(800)-846-2098		(800)-846-2098		(800)-280-8888		(800)-280-8888		(800)-331-6293		(800)-331-6293		(877)-893-1504		(877)-893-1504		(877)-893-1504		(877)-893-1504		(877)-893-1504		(877)-893-1504		(866)-845-7230		(866)-845-7230		2	2	2
H4513	802	0	1	01	01	H4513_802_0	2	1		06/01/2011	2012.02	06/01/2011 10:49:39 AM Central Daylight Time	06/03/2011 01:06:19 PM Central Daylight Time			06/06/2011 02:58:32 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring	www.healthspring.com	Retiree Advantage (HMO)	01	01		1			H4513	802	0	2012	Texas		1		2			2							www.healthspring.com	www.healthspring.com	(800)-280-8888		(800)-280-8888		(800)-846-2098		(800)-846-2098										(877)-893-1504		(877)-893-1504		(877)-893-1504		(877)-893-1504										1	1	1
H4513	804	0	1	01	01	H4513_804_0	5	1		06/01/2011	2012.02	06/01/2011 10:51:58 AM Central Daylight Time	07/28/2011 12:25:34 PM Central Daylight Time			07/28/2011 06:06:50 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring	www.healthspring.com	Retiree Advantage Preferred (HMO)	01	01		1			H4513	804	0	2012	Texas		1		2			2							www.healthspring.com	www.healthspring.com	(800)-280-8888		(800)-280-8888		(800)-846-2098		(800)-846-2098		(800)-280-8888		(800)-280-8888		(800)-331-6293		(800)-331-6293		(877)-893-1504		(877)-893-1504		(877)-893-1504		(877)-893-1504		(877)-893-1504		(877)-893-1504		(866)-845-7230		(866)-845-7230		1	1	1
H4514	001	0	1	01	01	H4514_001_0	5	1	2	07/22/2011	2012.02	07/22/2011 01:56:56 PM Central Daylight Time	08/04/2011 08:28:46 PM Central Daylight Time	08/05/2011 01:11:06 PM Central Daylight Time		08/09/2011 11:01:12 AM Central Daylight Time	EVERCARE OF TEXAS, LLC	Evercare by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H4514	001	0	2012	Houston and Austin Surrounding Counties		2		2			1	3		1	2		www.EvercareHealthPlans.com	EvercareHealthPlans.com/prescription_drug_coverage.jsp	www.PrescriptionSolutions.com	(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4514	007	0	1	02	01	H4514_007_0	4	1		08/05/2011	2012.02	08/05/2011 09:01:58 AM Central Daylight Time	08/04/2011 08:29:32 PM Central Daylight Time	08/05/2011 01:35:28 PM Central Daylight Time		08/09/2011 11:01:12 AM Central Daylight Time	EVERCARE OF TEXAS, LLC	Evercare by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H4514	007	0	2012	Houston area		2		2			2						www.EvercareHealthPlans.com	EvercareHealthPlans.com/prescription_drug_coverage.jsp	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4514	801	0	1	01	01	H4514_801_0	2	1		07/06/2011	2012.02	07/06/2011 04:48:28 PM Central Daylight Time	06/03/2011 02:06:11 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	EVERCARE OF TEXAS, LLC	Evercare by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H4514	801	0	2012	TX Employer Sponsored Plan Service Area		1		2			2						www.EvercareHealthPlans.com	EvercareHealthPlans.com/prescription_drug_coverage.jsp	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4514	803	0	1	01	01	H4514_803_0	2	1		07/06/2011	2012.02	07/06/2011 04:48:33 PM Central Daylight Time	06/03/2011 02:06:45 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	EVERCARE OF TEXAS, LLC	Evercare by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H4514	803	0	2012	TX Employer Sponsored Plan Service Area		1		2			2						www.EvercareHealthPlans.com	EvercareHealthPlans.com/prescription_drug_coverage.jsp	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548										(711)		(711)		(711)		(711)										2	2	2
H4514	806	0	1	01	01	H4514_806_0	2	1		07/06/2011	2012.02	07/06/2011 04:48:38 PM Central Daylight Time	06/03/2011 02:07:18 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	EVERCARE OF TEXAS, LLC	Evercare by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H4514	806	0	2012	TX Employer Sponsored Plan Service Area		1		2			2						www.EvercareHealthPlans.com	EvercareHealthPlans.com/prescription_drug_coverage.jsp	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4517	001	0	1	20	08	H4517_001_0	1	1		05/20/2011	2012.02	05/20/2011 02:01:14 PM Central Daylight Time		05/20/2011 01:53:17 PM Central Daylight Time		05/20/2011 02:04:48 PM Central Daylight Time	AMARILLO MULTISVC CTR FR THE AGING INC	Amarillo Multisvc Ctr For The Aging Inc	alana@janwerneradultdaycare.org	DUAL ELIGIBLE (PACE)	08	20		1			H4517	001	0	2012	Potter, TX and Randall, TX Counties		2		2			2							N/A	N/A									(888)-299-6401		(806)-374-5516		(888)-299-6401		(806)-374-5516										(800)-735-2989		(806)-374-5516		(800)-735-2989		(806)-374-5516				
H4517	002	0	1	20	08	H4517_002_0	1	1		05/20/2011	2012.02	05/20/2011 02:01:36 PM Central Daylight Time		05/20/2011 01:53:17 PM Central Daylight Time		05/20/2011 02:04:48 PM Central Daylight Time	AMARILLO MULTISVC CTR FR THE AGING INC	Amarillo Multisvc Ctr For The Aging Inc	alana@janwerneradultdaycare.org	MEDICARE ONLY (PACE)	08	20		1			H4517	002	0	2012	Potter, TX and Randall, TX Counties		2		2			2							N/A	N/A									(888)-299-6401		(806)-374-5516		(888)-299-6401		(806)-374-5516										(800)-735-2989		(806)-374-5516		(800)-735-2989		(806)-374-5516				
H4518	001	0	1	20	08	H4518_001_0	1	1		05/23/2011	2012.02	05/23/2011 07:40:51 AM Mountain Daylight Time		05/20/2011 02:21:46 PM Mountain Daylight Time		05/23/2011 07:44:17 AM Mountain Daylight Time	BIENVIVIR SENIOR HEALTH SERVICES	Bienvivir Senior Health Services	www.Bienvivir.org	BSHS Part D, Dual Eligibles (PACE)	08	20		1			H4518	001	0	2012	El Paso, Texas and El Paso County		2		2			2							www.bienvivir.org	www.bienvivir.org									(915)-562-3444	1801	(915)-562-3444	1801	(915)-562-3444	1801	(915)-562-3444	1801									(915)-562-3444	1801	(915)-562-3444	1801	(915)-562-3444	1801	(915)-562-3444	1801			
H4518	002	0	1	20	08	H4518_002_0	1	1		05/23/2011	2012.02	05/23/2011 07:41:32 AM Mountain Daylight Time		05/20/2011 02:22:02 PM Mountain Daylight Time		05/23/2011 07:44:17 AM Mountain Daylight Time	BIENVIVIR SENIOR HEALTH SERVICES	Bienvivir Senior Health Services	www.Bienvivir.org	BSHS Part D, Medicare Only (PACE)	08	20		1			H4518	002	0	2012	El Paso, Texas and El Paso County		2		2			2							www.bienvivir.org	www.bienvivir.org									(915)-562-3444	1801	(915)-562-3444	1801	(915)-562-3444	1801	(915)-562-3444	1801									(915)-562-3444	1801	(915)-562-3444	1801	(915)-562-3444	1801	(915)-562-3444	1801			
H4520	006	0	1	04	01	H4520_006_0	7	1		07/18/2011	2012.02	07/18/2011 10:06:26 AM Eastern Daylight Time	08/07/2011 04:03:30 PM Eastern Daylight Time	08/04/2011 12:28:41 PM Eastern Daylight Time		08/08/2011 03:49:43 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H4520-006 (PPO)	01	04		1			H4520	006	0	2012	Select Counties of Texas and Arkansas		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4522	001	0	1	04	01	H4522_001_0	4	1		08/08/2011	2012.02	08/08/2011 05:33:13 PM Central Daylight Time	08/04/2011 08:36:23 PM Central Daylight Time	08/05/2011 01:35:43 PM Central Daylight Time		08/09/2011 11:01:12 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice (PPO)	01	04		1			H4522	001	0	2012	Dona Ana, Grant, Hidalgo, Luna, Sierra, El Paso		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4522	007	0	1	04	01	H4522_007_0	5	1	2	07/22/2011	2012.02	07/22/2011 12:10:33 PM Central Daylight Time	08/04/2011 08:37:56 PM Central Daylight Time	08/05/2011 01:11:26 PM Central Daylight Time		08/09/2011 12:48:01 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Dual Complete (PPO SNP)	01	04		1			H4522	007	0	2012	El Paso County		2		2			1	3		1	2		www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4522	010	0	1	04	01	H4522_010_0	5	1	2	07/22/2011	2012.02	07/22/2011 12:11:33 PM Central Daylight Time	08/04/2011 08:38:42 PM Central Daylight Time	08/05/2011 01:36:00 PM Central Daylight Time		08/09/2011 12:48:01 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Dual Complete (PPO SNP)	01	04		1			H4522	010	0	2012	Dona Ana, Grant, Hidalgo, Luna and Sierra counties		2		2			1	3		1	2		www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(888)-834-3721		(888)-834-3721		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4523	001	0	1	01	01	H4523_001_0	5	1		07/12/2011	2012.02	07/12/2011 03:05:47 PM Central Daylight Time	08/04/2011 01:32:29 PM Central Daylight Time	08/04/2011 09:53:31 AM Central Daylight Time		08/08/2011 08:23:16 AM Central Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (HMO)	01	01		1			H4523	001	0	2012	Bexar and Comal Counties		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H4523	005	0	1	01	01	H4523_005_0	5	1		07/12/2011	2012.02	07/12/2011 03:07:36 PM Central Daylight Time	08/04/2011 01:39:44 PM Central Daylight Time	08/04/2011 09:53:56 AM Central Daylight Time		08/08/2011 08:23:16 AM Central Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (HMO)	01	01		1			H4523	005	0	2012	Collin, Dallas, Denton and Tarrant Counties		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H4523	015	0	1	01	01	H4523_015_0	5	1		07/12/2011	2012.02	07/12/2011 03:08:57 PM Central Daylight Time	08/04/2011 01:49:06 PM Central Daylight Time	08/04/2011 09:58:46 AM Central Daylight Time		08/08/2011 08:23:16 AM Central Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (HMO)	01	01		1			H4523	015	0	2012	Harris and Montgomery Counties		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H4523	801	0	1	01	01	H4523_801_0	1	1		04/22/2011	2012.02	04/22/2011 09:56:30 AM Eastern Daylight Time	06/01/2011 02:19:14 PM Eastern Daylight Time			06/03/2011 10:51:30 AM Eastern Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan (HMO)	01	01		1			H4523	801	0	2012	Texas		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748										1	1	1
H4523	802	0	1	01	01	H4523_802_0	3	1		04/22/2011	2012.02	04/22/2011 09:56:49 AM Eastern Daylight Time	06/01/2011 02:24:04 PM Eastern Daylight Time			06/03/2011 10:51:30 AM Eastern Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan w/Rx CY (HMO)	01	01		1			H4523	802	0	2012	Texas		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		1	1	1
H4524	001	0	1	04	01	H4524_001_0	5	1		07/18/2011	2012.02	07/18/2011 10:14:26 AM Central Daylight Time	08/04/2011 01:55:45 PM Central Daylight Time	08/04/2011 09:59:15 AM Central Daylight Time		08/08/2011 08:23:16 AM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (PPO)	01	04		1			H4524	001	0	2012	Bexar and Comal Counties		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H4524	007	0	1	04	01	H4524_007_0	5	1		07/12/2011	2012.02	07/12/2011 03:11:26 PM Central Daylight Time	08/04/2011 02:02:40 PM Central Daylight Time	08/04/2011 09:59:58 AM Central Daylight Time		08/08/2011 08:23:16 AM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (PPO)	01	04		1			H4524	007	0	2012	Collin, Dallas, Denton and Tarrant Counties		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H4524	013	0	1	04	01	H4524_013_0	5	1		07/12/2011	2012.02	07/12/2011 03:12:43 PM Central Daylight Time	08/04/2011 02:12:06 PM Central Daylight Time	08/04/2011 10:00:32 AM Central Daylight Time		08/08/2011 08:23:16 AM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (PPO)	01	04		1			H4524	013	0	2012	Harris and Montgomery Counties		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H4524	801	0	1	04	01	H4524_801_0	1	1		05/09/2011	2012.02	05/09/2011 07:36:42 AM Central Daylight Time	06/01/2011 02:49:14 PM Eastern Daylight Time			06/03/2011 10:51:30 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan (PPO)	01	04		1			H4524	801	0	2012	National		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748										1	1	1
H4524	802	0	1	04	01	H4524_802_0	1	1		06/02/2011	2012.02	06/02/2011 05:24:15 PM Eastern Daylight Time	06/01/2011 02:53:52 PM Eastern Daylight Time			06/03/2011 10:51:30 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan w/Rx CY (PPO)	01	04		1			H4524	802	0	2012	National		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		1	1	1
H4524	805	0	2	04	01	H4524_805_0	1	1		04/22/2011	2012.02	04/22/2011 09:59:24 AM Eastern Daylight Time	06/01/2011 02:43:13 PM Eastern Daylight Time			06/03/2011 10:51:30 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Part B Only Plan (PPO)	01	04		2	2		H4524	805	0	2012	National		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748										1	1	1
H4524	806	0	2	04	01	H4524_806_0	1	1		04/22/2011	2012.02	04/22/2011 10:00:52 AM Eastern Daylight Time	06/01/2011 02:38:53 PM Eastern Daylight Time			06/03/2011 10:51:30 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Part B Only Plan w/Rx CY (PPO)	01	04		2	2		H4524	806	0	2012	National		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		1	1	1
H4525	001	0	1	01	01	H4525_001_0	8	1		08/04/2011	2012.02	08/04/2011 10:27:57 AM Central Daylight Time	08/09/2011 12:09:04 PM Central Daylight Time	08/09/2011 12:09:16 PM Central Daylight Time		08/09/2011 12:14:10 PM Central Daylight Time	SHA, L.L.C	FirstCare Advantage	www.firstcare.com/advantage	FirstCare Advantage Gold (HMO)	01	01		1			H4525	001	0	2012	FirstCare Advantage Gold (Abilene Region)		2	57	2			2						www.firstcare.com/advantage	http://www.firstcare.com/advantage	www.firstcare.com/advantage	(866)-229-4969		(866)-229-4969		(866)-245-1580		(866)-245-1580		(866)-229-4969		(866)-229-4969		(866)-245-1580		(866)-245-1580		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		2	2	2
H4525	002	0	1	01	01	H4525_002_0	7	1		07/28/2011	2012.02	07/28/2011 09:25:34 AM Central Daylight Time	08/09/2011 12:09:48 PM Central Daylight Time	08/09/2011 12:09:56 PM Central Daylight Time		08/09/2011 12:25:39 PM Central Daylight Time	SHA, L.L.C	FirstCare Advantage	www.firstcare.com/advantage	FirstCare Advantage Gold (HMO)	01	01		1			H4525	002	0	2012	FirstCare Advantage Gold (Lubbock Region)		2	502	2			2						www.firstcare.com/advantage	http://www.firstcare.com/advantage	www.firstcare.com/advantage	(866)-229-4969		(866)-229-4969		(866)-245-1580		(866)-245-1580		(866)-229-4969		(866)-229-4969		(866)-245-1580		(866)-245-1580		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		2	2	2
H4525	003	0	1	01	01	H4525_003_0	8	1	2	08/09/2011	2012.02	08/09/2011 12:05:44 PM Central Daylight Time	08/09/2011 12:08:07 PM Central Daylight Time	08/09/2011 12:08:41 PM Central Daylight Time		08/09/2011 12:31:43 PM Central Daylight Time	SHA, L.L.C	FirstCare Advantage	www.firstcare.com/advantage	FirstCare Advantage Select (HMO SNP)	01	01		1			H4525	003	0	2012	FirstCare Advantage Select		2	1835	2			1	3		1	2		www.firstcare.com/advantage	http://www.firstcare.com/advantage	www.firstcare.com/advantage	(866)-229-4969		(866)-229-4969		(866)-245-1580		(866)-245-1580		(866)-229-4969		(866)-229-4969		(866)-245-1580		(866)-245-1580		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		2	2	2
H4525	004	0	1	01	01	H4525_004_0	5	1		07/28/2011	2012.02	07/28/2011 09:26:12 AM Central Daylight Time	07/28/2011 09:20:55 AM Central Daylight Time			07/28/2011 09:42:26 AM Central Daylight Time	SHA, L.L.C	FirstCare Advantage	www.firstcare.com/advantage	FirstCare Advantage Silver (HMO)	01	01		1			H4525	004	0	2012	FirstCare Advantage Silver (Abilene Region)		2	14	2			2						www.firstcare.com/advantage	http://www.firstcare.com/advantage	www.firstcare.com/advantage	(866)-229-4969		(866)-229-4969		(866)-245-1580		(866)-245-1580										(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259										2	2	2
H4525	005	0	1	01	01	H4525_005_0	6	1		07/28/2011	2012.02	07/28/2011 09:26:12 AM Central Daylight Time	07/28/2011 09:21:15 AM Central Daylight Time			07/28/2011 09:46:25 AM Central Daylight Time	SHA, L.L.C	FirstCare Advantage	www.firstcare.com/advantage	FirstCare Advantage Silver (HMO)	01	01		1			H4525	005	0	2012	FirstCare Advantage Silver (Lubbock Region)		2	56	2			2						www.firstcare.com/advantage	http://www.firstcare.com/advantage	www.firstcare.com/advantage	(866)-229-4969		(866)-229-4969		(866)-245-1580		(866)-245-1580										(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259										2	2	2
H4525	008	0	1	01	01	H4525_008_0	8	1		08/04/2011	2012.02	08/04/2011 10:30:39 AM Central Daylight Time	08/10/2011 02:54:14 PM Central Daylight Time	08/10/2011 02:54:29 PM Central Daylight Time		08/10/2011 02:55:41 PM Central Daylight Time	SHA, L.L.C	FirstCare Advantage	www.firstcare.com/advantage	FirstCare Advantage Elite (HMO)	01	01		1			H4525	008	0	2012	FirstCare Advantage Elite (Abilene Region)		2	108	2			2						www.firstcare.com/advantage	http://www.firstcare.com/advantage	www.firstcare.com/advantage	(866)-229-4969		(866)-229-4969		(866)-245-1580		(866)-245-1580		(866)-229-4969		(866)-229-4969		(866)-245-1580		(866)-245-1580		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		2	2	2
H4525	009	0	1	01	01	H4525_009_0	7	1		07/28/2011	2012.02	07/28/2011 09:26:12 AM Central Daylight Time	08/09/2011 12:11:02 PM Central Daylight Time	08/09/2011 12:11:12 PM Central Daylight Time		08/09/2011 12:43:11 PM Central Daylight Time	SHA, L.L.C	FirstCare Advantage	www.firstcare.com/advantage	FirstCare Advantage Elite (HMO)	01	01		1			H4525	009	0	2012	FirstCare Advantage Elite (Lubbock Region)		2	915	2			2						www.firstcare.com/advantage	http://www.firstcare.com/advantage	www.firstcare.com/advantage	(866)-229-4969		(866)-229-4969		(866)-245-1580		(866)-245-1580		(866)-229-4969		(866)-229-4969		(866)-245-1580		(866)-245-1580		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		2	2	2
H4525	802	0	1	01	01	H4525_802_0	2	1		06/03/2011	2012.02	06/03/2011 11:03:47 AM Central Daylight Time	06/06/2011 04:13:34 PM Central Daylight Time			06/06/2011 04:49:48 PM Central Daylight Time	SHA, L.L.C	FirstCare Advantage	www.firstcare.com/advantage	FirstCare Advantage Employer (D) (HMO)	01	01		1			H4525	802	0	2012	FirstCare Advantage Employer (D)		1	100	2			2						www.firstcare.com/advantage	http://www.firstcare.com/advantage	www.firstcare.com/advantage	(866)-229-4969		(866)-229-4969		(866)-245-1580		(866)-245-1580		(866)-229-4969		(866)-229-4969		(866)-245-1580		(866)-245-1580		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		1	1	1
H4525	803	0	1	01	01	H4525_803_0	2	1		05/27/2011	2012.02	05/27/2011 10:37:49 AM Central Daylight Time	06/06/2011 04:13:04 PM Central Daylight Time			06/06/2011 04:54:27 PM Central Daylight Time	SHA, L.L.C	FirstCare Advantage	www.firstcare.com/advantage	FirstCare Advantage Employer (HMO)	01	01		1			H4525	803	0	2012	FirstCare Advantage Employer		1	100	2			2						www.firstcare.com/advantage	http://www.firstcare.com/advantage	www.firstcare.com/advantage	(866)-229-4969		(866)-229-4969		(866)-245-1580		(866)-245-1580										(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259										1	1	1
H4525	804	0	1	01	01	H4525_804_0	2	1		05/27/2011	2012.02	05/27/2011 10:38:02 AM Central Daylight Time	06/06/2011 04:12:43 PM Central Daylight Time			06/06/2011 05:01:11 PM Central Daylight Time	SHA, L.L.C	FirstCare Advantage	www.firstcare.com/advantage	FirstCare Advantage Employer (D) (HMO)	01	01		1			H4525	804	0	2012	FirstCare Advantage Employer (D)		1	100	2			2						www.firstcare.com/advantage	http://www.firstcare.com/advantage	www.firstcare.com/advantage	(866)-229-4969		(866)-229-4969		(866)-245-1580		(866)-245-1580		(866)-229-4969		(866)-229-4969		(866)-245-1580		(866)-245-1580		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259		1	1	1
H4525	805	0	1	01	01	H4525_805_0	2	1		05/27/2011	2012.02	05/27/2011 10:38:42 AM Central Daylight Time	06/06/2011 04:12:20 PM Central Daylight Time			06/06/2011 05:04:38 PM Central Daylight Time	SHA, L.L.C	FirstCare Advantage	www.firstcare.com/advantage	FirstCare Advantage Employer (HMO)	01	01		1			H4525	805	0	2012	FirstCare Advantage Employer		1	100	2			2						www.firstcare.com/advantage	http://www.firstcare.com/advantage	www.firstcare.com/advantage	(866)-229-4969		(866)-229-4969		(866)-245-1580		(866)-245-1580										(800)-562-5259		(800)-562-5259		(800)-562-5259		(800)-562-5259										1	1	1
H4527	001	0	1	01	01	H4527_001_0	3	1		08/07/2011	2012.02	08/07/2011 01:34:55 PM Central Daylight Time	08/08/2011 10:42:30 AM Central Daylight Time	08/05/2011 01:36:15 PM Central Daylight Time		08/09/2011 11:01:12 AM Central Daylight Time	PHYSICIANS HEALTH CHOICE OF TEXAS LLC	PHYSICIANS HEALTH CHOICE	www.PHCcares.com	Physicians Health Choice Total (HMO)	01	01		1			H4527	001	0	2012	Nueces, San Patricio, Aransas, Kleberg		2		2			2						www.PHCcares.com	http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/members-formulary.html	(866)-550-4736		(866)-550-4736		(877)-886-7310		(877)-886-7310		(866)-550-4736		(866)-550-4736		(877)-886-7310		(877)-886-7310		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4527	002	0	1	01	01	H4527_002_0	4	1		08/08/2011	2012.02	08/08/2011 05:31:31 PM Central Daylight Time	08/08/2011 10:43:07 AM Central Daylight Time	08/05/2011 01:36:31 PM Central Daylight Time		08/09/2011 11:01:12 AM Central Daylight Time	PHYSICIANS HEALTH CHOICE OF TEXAS LLC	PHYSICIANS HEALTH CHOICE	www.PHCcares.com	Physicians Health Choice Total (HMO)	01	01		1			H4527	002	0	2012	Travis, Hays, and Williamson Counties		2		2			2						www.PHCcares.com	http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/members-formulary.html	(866)-550-4736		(866)-550-4736		(877)-886-7310		(877)-886-7310		(866)-550-4736		(866)-550-4736		(877)-886-7310		(877)-886-7310		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4527	003	0	1	01	01	H4527_003_0	4	1	2	07/20/2011	2012.02	07/20/2011 02:33:05 PM Central Daylight Time	08/08/2011 10:43:33 AM Central Daylight Time	08/05/2011 01:36:47 PM Central Daylight Time		08/09/2011 11:01:12 AM Central Daylight Time	PHYSICIANS HEALTH CHOICE OF TEXAS LLC	PHYSICIANS HEALTH CHOICE	www.PHCcares.com	Physicians Health Choice Select (HMO SNP)	01	01		1			H4527	003	0	2012	Travis, Hays, and Williamson Counties		2		2			1	3		1	5		www.PHCcares.com	http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/members-formulary.html	(866)-550-4736		(866)-550-4736		(877)-886-7310		(877)-886-7310		(866)-550-4736		(866)-550-4736		(877)-886-7310		(877)-886-7310		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4527	004	0	1	01	01	H4527_004_0	4	1	2	07/20/2011	2012.02	07/20/2011 02:33:40 PM Central Daylight Time	08/08/2011 10:45:34 AM Central Daylight Time	08/05/2011 01:37:02 PM Central Daylight Time		08/09/2011 11:01:12 AM Central Daylight Time	PHYSICIANS HEALTH CHOICE OF TEXAS LLC	PHYSICIANS HEALTH CHOICE	www.PHCcares.com	Physicians Health Choice Select (HMO SNP)	01	01		1			H4527	004	0	2012	Nueces, San Patricio, Aransas, Kleberg		2		2			1	3		1	5		www.PHCcares.com	http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/members-formulary.html	(866)-550-4736		(866)-550-4736		(877)-886-7310		(877)-886-7310		(866)-550-4736		(866)-550-4736		(877)-886-7310		(877)-886-7310		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4527	005	0	1	01	01	H4527_005_0	4	1		08/08/2011	2012.02	08/08/2011 05:31:43 PM Central Daylight Time	08/08/2011 10:46:04 AM Central Daylight Time	08/05/2011 01:37:18 PM Central Daylight Time		08/09/2011 11:01:12 AM Central Daylight Time	PHYSICIANS HEALTH CHOICE OF TEXAS LLC	PHYSICIANS HEALTH CHOICE	www.PHCcares.com	Physicians Health Choice Total (HMO)	01	01		1			H4527	005	0	2012	El Paso County		2		2			2						www.PHCcares.com	http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/members-formulary.html	(866)-550-4736		(866)-550-4736		(877)-886-7310		(877)-886-7310		(866)-550-4736		(866)-550-4736		(877)-886-7310		(877)-886-7310		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4527	006	0	1	01	01	H4527_006_0	4	1	2	07/20/2011	2012.02	07/20/2011 02:38:09 PM Central Daylight Time	08/08/2011 10:47:14 AM Central Daylight Time	08/05/2011 01:37:34 PM Central Daylight Time		08/09/2011 11:01:12 AM Central Daylight Time	PHYSICIANS HEALTH CHOICE OF TEXAS LLC	PHYSICIANS HEALTH CHOICE	www.PHCcares.com	Physicians Health Choice Select (HMO SNP)	01	01		1			H4527	006	0	2012	El Paso County		2		2			1	3		1	5		www.PHCcares.com	http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/members-formulary.html	(866)-550-4736		(866)-550-4736		(877)-886-7310		(877)-886-7310		(866)-550-4736		(866)-550-4736		(877)-886-7310		(877)-886-7310		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4527	013	0	1	01	01	H4527_013_0	4	1		08/07/2011	2012.02	08/07/2011 01:38:06 PM Central Daylight Time	08/08/2011 10:49:06 AM Central Daylight Time	08/05/2011 01:37:49 PM Central Daylight Time		08/09/2011 11:01:12 AM Central Daylight Time	PHYSICIANS HEALTH CHOICE OF TEXAS LLC	PHYSICIANS HEALTH CHOICE	www.PHCcares.com	Physicians Health Choice Total (HMO)	01	01		1			H4527	013	0	2012	Cameron, Hidalgo, and Willacy Counties		2		2			2						www.PHCcares.com	http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/members-formulary.html	(866)-550-4736		(866)-550-4736		(877)-886-7310		(877)-886-7310		(866)-550-4736		(866)-550-4736		(877)-886-7310		(877)-886-7310		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4527	015	0	1	01	01	H4527_015_0	4	1	2	07/20/2011	2012.02	07/20/2011 02:38:32 PM Central Daylight Time	08/08/2011 10:49:41 AM Central Daylight Time	08/05/2011 01:38:05 PM Central Daylight Time		08/09/2011 11:01:12 AM Central Daylight Time	PHYSICIANS HEALTH CHOICE OF TEXAS LLC	PHYSICIANS HEALTH CHOICE	www.PHCcares.com	Physicians Health Choice Select (HMO SNP)	01	01		1			H4527	015	0	2012	Cameron, Hidalgo, and Willacy Counties		2		2			1	3		1	5		www.PHCcares.com	http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/members-formulary.html	(866)-550-4736		(866)-550-4736		(877)-886-7310		(877)-886-7310		(866)-550-4736		(866)-550-4736		(877)-886-7310		(877)-886-7310		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4527	024	0	1	01	01	H4527_024_0	3	1		07/20/2011	2012.02	07/20/2011 02:38:42 PM Central Daylight Time	07/22/2011 02:24:49 PM Central Daylight Time			07/25/2011 12:00:32 PM Central Daylight Time	PHYSICIANS HEALTH CHOICE OF TEXAS LLC	PHYSICIANS HEALTH CHOICE	www.PHCcares.com	Physicians Health Choice Basic (HMO)	01	01		1			H4527	024	0	2012	El Paso County		2		2			2						www.PHCcares.com	http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/members-formulary.html	(866)-550-4736		(866)-550-4736		(877)-886-7310		(877)-886-7310										(711)		(711)		(711)		(711)										2	2	2
H4528	001	0	1	02	01	H4528_001_0	6	1		07/18/2011	2012.02	07/18/2011 03:27:32 PM Eastern Daylight Time	08/08/2011 09:08:51 AM Central Daylight Time	08/04/2011 04:58:06 PM Central Daylight Time		08/09/2011 04:46:11 PM Central Daylight Time	BRAVO HEALTH TEXAS, INC.	Bravo Health	www.mybravohealth.com	Bravo Classic Plus (HMO-POS)	01	02		1			H4528	001	0	2012	Select Texas Counties		2		2			2						www.mybravohealth.com	www.mybravohealth.com/formulary	www.mybravohealth.com	(800)-291-0396		(800)-291-0396		(888)-318-2827		(888)-318-2827		(800)-291-0396		(800)-291-0396		(888)-318-2827		(888)-318-2827		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4528	002	0	1	01	01	H4528_002_0	6	1	2	08/05/2011	2012.02	08/05/2011 03:10:17 PM Eastern Daylight Time	08/08/2011 09:09:43 AM Central Daylight Time	08/04/2011 04:58:51 PM Central Daylight Time		08/09/2011 04:46:11 PM Central Daylight Time	BRAVO HEALTH TEXAS, INC.	Bravo Health	www.mybravohealth.com	Bravo Select (HMO SNP)	01	01		1			H4528	002	0	2012	Select Texas Counties		2		2			1	3		1	2		www.mybravohealth.com	www.mybravohealth.com/formulary	www.mybravohealth.com	(800)-291-0396		(800)-291-0396		(888)-318-2827		(888)-318-2827		(800)-291-0396		(800)-291-0396		(888)-318-2827		(888)-318-2827		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4528	013	0	1	01	01	H4528_013_0	7	1		08/05/2011	2012.02	08/05/2011 03:09:37 PM Eastern Daylight Time	08/08/2011 09:10:31 AM Central Daylight Time	08/04/2011 04:59:40 PM Central Daylight Time		08/09/2011 04:46:11 PM Central Daylight Time	BRAVO HEALTH TEXAS, INC.	Bravo Health	www.mybravohealth.com	Bravo Traditions (HMO SNP)	01	01		1			H4528	013	0	2012	Select TX counties		2		2			1	1	1	1			www.mybravohealth.com	www.mybravohealth.com/formulary	www.mybravohealth.com	(800)-291-0396		(800)-291-0396		(888)-318-2827		(888)-318-2827		(800)-291-0396		(800)-291-0396		(888)-318-2827		(888)-318-2827		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4528	014	0	1	01	01	H4528_014_0	6	1		08/05/2011	2012.02	08/05/2011 03:16:37 PM Eastern Daylight Time	08/08/2011 09:11:21 AM Central Daylight Time	08/04/2011 05:00:20 PM Central Daylight Time		08/09/2011 04:46:11 PM Central Daylight Time	BRAVO HEALTH TEXAS, INC.	Bravo Health	www.mybravohealth.com	Bravo Achieve (HMO SNP)	01	01		1			H4528	014	0	2012	Select Tx counties		2		2			1	4		1		00000010000000000000	www.mybravohealth.com	www.mybravohealth.com/formulary	www.mybravohealth.com	(800)-291-0396		(800)-291-0396		(888)-318-2827		(888)-318-2827		(800)-291-0396		(800)-291-0396		(888)-318-2827		(888)-318-2827		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4528	801	0	1	01	01	H4528_801_0	2	1		05/31/2011	2012.02	05/31/2011 04:25:56 PM Eastern Daylight Time	05/30/2011 01:29:18 PM Central Daylight Time			06/03/2011 04:53:41 PM Central Daylight Time	BRAVO HEALTH TEXAS, INC.	Bravo Health	www.mybravohealth.com	EGWP (CY) (HMO)	01	01		1			H4528	801	0	2012	Nationwide		1		2			2						www.mybravohealth.com	www.mybravohealth.com/formulary	www.mybravohealth.com	(800)-291-0396		(800)-291-0396		(888)-318-2827		(888)-318-2827		(800)-291-0396		(800)-291-0396		(888)-318-2827		(888)-318-2827		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4528	802	0	1	01	01	H4528_802_0	2	1		05/31/2011	2012.02	05/31/2011 04:26:32 PM Eastern Daylight Time	05/30/2011 01:30:20 PM Central Daylight Time			06/03/2011 04:53:41 PM Central Daylight Time	BRAVO HEALTH TEXAS, INC.	Bravo Health	www.mybravohealth.com	EGWP (non-CY) (HMO)	01	01		1			H4528	802	0	2012	Nationwide		1		2			2						www.mybravohealth.com	www.mybravohealth.com/formulary	www.mybravohealth.com	(800)-291-0396		(800)-291-0396		(888)-318-2827		(888)-318-2827		(800)-291-0396		(800)-291-0396		(888)-318-2827		(888)-318-2827		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4528	803	0	1	02	01	H4528_803_0	2	1		05/31/2011	2012.02	05/31/2011 04:26:57 PM Eastern Daylight Time	05/30/2011 01:31:23 PM Central Daylight Time			06/03/2011 04:53:41 PM Central Daylight Time	BRAVO HEALTH TEXAS, INC.	Bravo Health	www.mybravohealth.com	EGWP (CY) (HMO-POS)	01	02		1			H4528	803	0	2012	Nationwide		1		2			2						www.mybravohealth.com	www.mybravohealth.com/formulary	www.mybravohealth.com	(800)-291-0396		(800)-291-0396		(888)-318-2827		(888)-318-2827		(800)-291-0396		(800)-291-0396		(888)-318-2827		(888)-318-2827		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4528	804	0	1	02	01	H4528_804_0	2	1		05/31/2011	2012.02	05/31/2011 04:27:23 PM Eastern Daylight Time	05/30/2011 01:32:27 PM Central Daylight Time			06/03/2011 04:53:41 PM Central Daylight Time	BRAVO HEALTH TEXAS, INC.	Bravo Health	www.mybravohealth.com	EGWP (non-CY) (HMO-POS)	01	02		1			H4528	804	0	2012	Nationwide		1		2			2						www.mybravohealth.com	www.mybravohealth.com/formulary	www.mybravohealth.com	(800)-291-0396		(800)-291-0396		(888)-318-2827		(888)-318-2827		(800)-291-0396		(800)-291-0396		(888)-318-2827		(888)-318-2827		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4529	002	0	1	02	01	H4529_002_0	9	1		08/08/2011	2012.02	08/08/2011 10:03:19 AM Central Daylight Time	08/07/2011 09:31:13 PM Central Daylight Time	08/04/2011 12:48:59 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARCADIAN HEALTH PLAN, INC.	Texas Community Care	www.texascommunitycare.com	Texas Community Care- Plus Point (HMO-POS)	01	02		1			H4529	002	0	2012	El Paso County		2		2			2							www.texascommunitycare.com	www.texascommunitycare.com	(800)-573-8597		(800)-573-8597		(800)-658-5161		(915)-843-4043		(800)-573-8597		(800)-573-8597		(800)-658-5161		(915)-843-4043		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H4529	004	0	1	01	01	H4529_004_0	8	1		08/08/2011	2012.02	08/08/2011 10:04:41 AM Central Daylight Time	08/07/2011 12:43:55 PM Central Daylight Time	08/04/2011 12:57:36 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARCADIAN HEALTH PLAN, INC.	Texas Community Care	www.texascommunitycare.com	Texas Community Care- Plus (HMO)	01	01		1			H4529	004	0	2012	Travis / Williamson		2		2			2							www.texascommunitycare.com	www.texascommunitycare.com	(800)-573-8597		(800)-573-8597		(800)-658-3704		(512)-795-8092		(800)-573-8597		(800)-573-8597		(800)-658-3704		(512)-795-8092		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H4529	007	0	1	01	01	H4529_007_0	7	1	2	07/07/2011	2012.02	07/07/2011 10:58:54 AM Central Daylight Time	07/17/2011 05:37:28 PM Central Daylight Time	07/19/2011 07:40:07 PM Central Daylight Time		07/20/2011 04:17:07 PM Central Daylight Time	ARCADIAN HEALTH PLAN, INC.	Texas Community Care	www.texascommunitycare.com	Texas Community Care - Dual Plus (HMO SNP)	01	01		1			H4529	007	0	2012	El Paso County		2		2			1	3		1	1			www.texascommunitycare.com	www.texascommunitycare.com	(800)-573-8597		(800)-573-8597		(800)-658-5161		(915)-843-4043		(800)-573-8597		(800)-573-8597		(800)-658-5161		(915)-843-4043		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H4529	014	0	1	01	01	H4529_014_0	8	1		08/08/2011	2012.02	08/08/2011 10:06:20 AM Central Daylight Time	08/07/2011 12:45:18 PM Central Daylight Time	08/04/2011 01:01:12 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARCADIAN HEALTH PLAN, INC.	Texas Community Care	www.texascommunitycare.com	Texas Community Care -  Plus (HMO)	01	01		1			H4529	014	0	2012	East Texas		2		2			2							www.texascommunitycare.com	www.texascommunitycare.com	(800)-573-8597		(800)-573-8597		(800)-658-3704		(512)-795-8092		(800)-573-8597		(800)-573-8597		(800)-658-3704		(512)-795-8092		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H4529	027	0	1	01	01	H4529_027_0	10	1		08/08/2011	2012.02	08/08/2011 10:06:45 AM Central Daylight Time	08/07/2011 12:46:41 PM Central Daylight Time	08/04/2011 01:02:38 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARCADIAN HEALTH PLAN, INC.	Texas Community Care	www.texascommunitycare.com	Texas Community Care - Plus (HMO)	01	01		1			H4529	027	0	2012	Amarillo		2		2			2							www.texascommunitycare.com	www.texascommunitycare.com	(800)-573-8597		(800)-573-8597		(800)-658-3704		(512)-795-8092		(800)-573-8597		(800)-573-8597		(800)-658-3704		(512)-795-8092		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H4529	028	0	1	01	01	H4529_028_0	10	1		08/08/2011	2012.02	08/08/2011 10:07:14 AM Central Daylight Time	08/07/2011 12:48:08 PM Central Daylight Time	08/04/2011 01:08:31 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARCADIAN HEALTH PLAN, INC.	Texas Community Care	www.texascommunitycare.com	Texas Community Care - Plus (HMO)	01	01		1			H4529	028	0	2012	Beaumont		2		2			2							www.texascommunitycare.com	www.texascommunitycare.com	(800)-573-8597		(800)-573-8597		(800)-658-3704		(512)-795-8092		(800)-573-8597		(800)-573-8597		(800)-658-3704		(512)-795-8092		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H4529	030	0	1	01	01	H4529_030_0	9	1		08/08/2011	2012.02	08/08/2011 10:07:37 AM Central Daylight Time	08/07/2011 12:49:34 PM Central Daylight Time	08/04/2011 01:11:08 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARCADIAN HEALTH PLAN, INC.	Texas Community Care	www.texascommunitycare.com	Texas Community Care - Plus (HMO)	01	01		1			H4529	030	0	2012	Gregg / Henderson		2		2			2							www.texascommunitycare.com	www.texascommunitycare.com	(800)-573-8597		(800)-573-8597		(800)-658-3704		(512)-795-8092		(800)-573-8597		(800)-573-8597		(800)-658-3704		(512)-795-8092		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H4529	031	0	1	01	01	H4529_031_0	8	1	2	07/07/2011	2012.02	07/07/2011 10:59:58 AM Central Daylight Time	07/17/2011 05:45:51 PM Central Daylight Time	07/19/2011 07:42:53 PM Central Daylight Time		07/20/2011 04:17:07 PM Central Daylight Time	ARCADIAN HEALTH PLAN, INC.	Texas Community Care	www.texascommunitycare.com	Texas Community Care - Dual Plus (HMO SNP)	01	01		1			H4529	031	0	2012	Texas		2		2			1	3		1	5			www.texascommunitycare.com	www.texascommunitycare.com	(800)-573-8597		(800)-573-8597		(800)-658-3704		(512)-795-8092		(800)-573-8597		(800)-573-8597		(800)-658-3704		(512)-795-8092		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H4564	001	0	1	18	06	H4564_001_0	9	1		07/19/2011	2012.02	07/19/2011 04:31:16 PM Central Daylight Time		08/09/2011 11:43:10 AM Central Daylight Time		08/09/2011 03:55:37 PM Central Daylight Time	SCOTT AND WHITE HEALTH PLAN	Scott and White Health Plan SeniorCare	www.swhp.org	SeniorCare Sr Premium - Basic Rx (Cost)	06	18		1			H4564	001	0	2012	Central Texas		2		2			2							www.swhp.org	www.swhp.org	(866)-334-3141		(254)-298-3141		(800)-782-5068		(254)-298-3366		(866)-334-3141		(254)-298-3141		(888)-333-3980		(254)-298-3366		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		2	2	2
H4564	002	0	1	18	06	H4564_002_0	9	1		07/19/2011	2012.02	07/19/2011 04:31:30 PM Central Daylight Time		08/09/2011 11:39:06 AM Central Daylight Time		08/09/2011 03:55:37 PM Central Daylight Time	SCOTT AND WHITE HEALTH PLAN	Scott and White Health Plan SeniorCare	www.swhp.org	SeniorCare Sr Preferred - Basic Rx (Cost)	06	18		1			H4564	002	0	2012	Central Texas		2		2			2							www.swhp.org	www.swhp.org	(866)-334-3141		(254)-298-3141		(800)-782-5068		(254)-298-3366		(866)-334-3141		(254)-298-3141		(888)-333-3980		(254)-298-3366		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		2	2	2
H4564	003	0	1	18	06	H4564_003_0	10	1		07/19/2011	2012.02	07/19/2011 04:32:59 PM Central Daylight Time		08/09/2011 11:37:20 AM Central Daylight Time		08/09/2011 03:55:37 PM Central Daylight Time	SCOTT AND WHITE HEALTH PLAN	Scott and White Health Plan SeniorCare	www.swhp.org	SeniorCare Sr Select - Basic Rx (Cost)	06	18		1			H4564	003	0	2012	Central Texas		2		2			2							www.swhp.org	www.swhp.org	(866)-334-3141		(254)-298-3141		(800)-782-5068		(254)-298-3366		(866)-334-3141		(254)-298-3141		(888)-333-3980		(254)-298-3366		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		2	2	2
H4564	004	0	1	18	06	H4564_004_0	8	1		07/19/2011	2012.02	07/19/2011 04:33:11 PM Central Daylight Time		08/09/2011 11:34:48 AM Central Daylight Time		08/09/2011 03:55:37 PM Central Daylight Time	SCOTT AND WHITE HEALTH PLAN	Scott and White Health Plan SeniorCare	www.swhp.org	SeniorCare Sr Premium - Enhanced Rx (Cost)	06	18		1			H4564	004	0	2012	Central Texas		2		2			2							www.swhp.org	www.swhp.org	(866)-334-3141		(254)-298-3141		(800)-782-5068		(254)-298-3366		(866)-334-3141		(254)-298-3141		(888)-333-3980		(254)-298-3366		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		2	2	2
H4564	005	0	1	18	06	H4564_005_0	8	1		07/19/2011	2012.02	07/19/2011 04:33:26 PM Central Daylight Time		08/09/2011 11:34:00 AM Central Daylight Time		08/09/2011 03:55:37 PM Central Daylight Time	SCOTT AND WHITE HEALTH PLAN	Scott and White Health Plan SeniorCare	www.swhp.org	SeniorCare Sr Preferred - Enhanced Rx (Cost)	06	18		1			H4564	005	0	2012	Central Texas		2		2			2							www.swhp.org	www.swhp.org	(866)-334-3141		(254)-298-3141		(800)-782-5068		(254)-298-3366		(866)-334-3141		(254)-298-3141		(888)-333-3980		(254)-298-3366		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		2	2	2
H4564	006	0	1	18	06	H4564_006_0	9	1		07/19/2011	2012.02	07/19/2011 04:33:39 PM Central Daylight Time		08/09/2011 11:32:10 AM Central Daylight Time		08/09/2011 03:55:37 PM Central Daylight Time	SCOTT AND WHITE HEALTH PLAN	Scott and White Health Plan SeniorCare	www.swhp.org	SeniorCare Sr Select - Enhanced Rx (Cost)	06	18		1			H4564	006	0	2012	Central Texas		2		2			2							www.swhp.org	www.swhp.org	(866)-334-3141		(254)-298-3141		(800)-782-5068		(254)-298-3366		(866)-334-3141		(254)-298-3141		(888)-333-3980		(254)-298-3366		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		2	2	2
H4564	010	0	1	18	06	H4564_010_0	3	1		07/19/2011	2012.02	07/19/2011 04:33:49 PM Central Daylight Time				07/20/2011 09:47:04 AM Central Daylight Time	SCOTT AND WHITE HEALTH PLAN	Scott and White Health Plan SeniorCare	www.swhp.org	SeniorCare Sr Premium-Medical Only (Cost)	06	18		1			H4564	010	0	2012	Central Texas		2		2			2							www.swhp.org	www.swhp.org	(866)-334-3141		(254)-298-3141		(800)-782-5068		(254)-298-3366										(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989										2	2	2
H4564	011	0	1	18	06	H4564_011_0	4	1		07/19/2011	2012.02	07/19/2011 04:34:31 PM Central Daylight Time				07/20/2011 09:47:04 AM Central Daylight Time	SCOTT AND WHITE HEALTH PLAN	Scott and White Health Plan SeniorCare	www.swhp.org	SeniorCare Sr Preferred-Medical Only (Cost)	06	18		1			H4564	011	0	2012	Central Texas		2		2			2							www.swhp.org	www.swhp.org	(866)-334-3141		(254)-298-3141		(800)-782-5068		(254)-298-3366										(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989										2	2	2
H4564	012	0	1	18	06	H4564_012_0	5	1		07/19/2011	2012.02	07/19/2011 04:34:41 PM Central Daylight Time				07/20/2011 09:47:04 AM Central Daylight Time	SCOTT AND WHITE HEALTH PLAN	Scott and White Health Plan SeniorCare	www.swhp.org	SeniorCare Sr Select-Medical Only (Cost)	06	18		1			H4564	012	0	2012	Central Texas		2		2			2							www.swhp.org	www.swhp.org	(866)-334-3141		(254)-298-3141		(800)-782-5068		(254)-298-3366										(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989										2	2	2
H4564	013	0	1	18	06	H4564_013_0	7	1		07/19/2011	2012.02	07/19/2011 04:34:51 PM Central Daylight Time		08/09/2011 11:30:48 AM Central Daylight Time		08/09/2011 03:55:37 PM Central Daylight Time	SCOTT AND WHITE HEALTH PLAN	Scott and White Health Plan SeniorCare	www.swhp.org	SeniorCare Sr Premium - Value Rx (Cost)	06	18		1			H4564	013	0	2012	Central Texas		2		2			2							www.swhp.org	www.swhp.org	(866)-334-3141		(254)-298-3141		(800)-782-5068		(254)-298-3366		(866)-334-3141		(254)-298-3141		(888)-333-3980		(254)-298-3366		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		2	2	2
H4564	014	0	1	18	06	H4564_014_0	7	1		07/19/2011	2012.02	07/19/2011 04:35:00 PM Central Daylight Time		08/09/2011 11:29:20 AM Central Daylight Time		08/09/2011 03:55:37 PM Central Daylight Time	SCOTT AND WHITE HEALTH PLAN	Scott and White Health Plan SeniorCare	www.swhp.org	SeniorCare Sr Preferred - Value Rx (Cost)	06	18		1			H4564	014	0	2012	Central Texas		2		2			2							www.swhp.org	www.swhp.org	(866)-334-3141		(254)-298-3141		(800)-782-5068		(254)-298-3366		(866)-334-3141		(254)-298-3141		(888)-333-3980		(254)-298-3366		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		2	2	2
H4564	015	0	1	18	06	H4564_015_0	8	1		07/29/2011	2012.02	07/29/2011 09:33:50 AM Central Daylight Time		08/09/2011 11:27:54 AM Central Daylight Time		08/09/2011 03:55:37 PM Central Daylight Time	SCOTT AND WHITE HEALTH PLAN	Scott and White Health Plan SeniorCare	www.swhp.org	SeniorCare Sr Select - Value Rx (Cost)	06	18		1			H4564	015	0	2012	Central Texas		2		2			2							www.swhp.org	www.swhp.org	(866)-334-3141		(254)-298-3141		(800)-782-5068		(254)-298-3366		(866)-334-3141		(254)-298-3141		(888)-333-3980		(254)-298-3366		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		2	2	2
H4564	016	0	1	18	06	H4564_016_0	4	1		07/19/2011	2012.02	07/19/2011 04:35:26 PM Central Daylight Time				07/20/2011 09:47:04 AM Central Daylight Time	SCOTT AND WHITE HEALTH PLAN	Scott and White Health Plan SeniorCare	www.swhp.org	SeniorCare Sr VIP - Medical Only (Cost)	06	18		1			H4564	016	0	2012	Central Texas		2		2			2							www.swhp.org	www.swhp.org	(866)-334-3141		(254)-298-3141		(800)-782-5068		(254)-298-3366										(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989										2	2	2
H4564	017	0	1	18	06	H4564_017_0	9	1		07/19/2011	2012.02	07/19/2011 04:35:36 PM Central Daylight Time		08/09/2011 11:23:32 AM Central Daylight Time		08/09/2011 03:55:37 PM Central Daylight Time	SCOTT AND WHITE HEALTH PLAN	Scott and White Health Plan SeniorCare	www.swhp.org	SeniorCare Sr VIP - Basic Rx (Cost)	06	18		1			H4564	017	0	2012	Central Texas		2		2			2							www.swhp.org	www.swhp.org	(866)-334-3141		(254)-298-3141		(800)-782-5068		(254)-298-3366		(866)-334-3141		(254)-298-3141		(888)-333-3980		(254)-298-3366		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		2	2	2
H4564	018	0	1	18	06	H4564_018_0	9	1		07/19/2011	2012.02	07/19/2011 04:35:47 PM Central Daylight Time		08/09/2011 11:18:26 AM Central Daylight Time		08/09/2011 03:55:37 PM Central Daylight Time	SCOTT AND WHITE HEALTH PLAN	Scott and White Health Plan SeniorCare	www.swhp.org	SeniorCare Sr VIP - Enhanced Rx (Cost)	06	18		1			H4564	018	0	2012	Central Texas		2		2			2							www.swhp.org	www.swhp.org	(866)-334-3141		(254)-298-3141		(800)-782-5068		(254)-298-3366		(866)-334-3141		(254)-298-3141		(888)-333-3980		(254)-298-3366		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		2	2	2
H4564	019	0	1	18	06	H4564_019_0	7	1		07/19/2011	2012.02	07/19/2011 04:35:57 PM Central Daylight Time		08/09/2011 12:44:32 PM Central Daylight Time		08/09/2011 01:55:29 PM Central Daylight Time	SCOTT AND WHITE HEALTH PLAN	Scott and White Health Plan SeniorCare	www.swhp.org	SeniorCare Sr VIP - Value Rx (Cost)	06	18		1			H4564	019	0	2012	Central Texas		2		2			2							www.swhp.org	www.swhp.org	(866)-334-3141		(254)-298-3141		(800)-782-5068		(254)-298-3366		(866)-334-3141		(254)-298-3141		(888)-333-3980		(254)-298-3366		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		2	2	2
H4564	020	0	1	18	06	H4564_020_0	4	1		07/19/2011	2012.02	07/19/2011 04:36:07 PM Central Daylight Time				07/20/2011 09:47:04 AM Central Daylight Time	SCOTT AND WHITE HEALTH PLAN	Scott and White Health Plan SeniorCare	www.swhp.org	SeniorCare Sr MedOption - Medical Only (Cost)	06	18		1			H4564	020	0	2012	Central Texas		2		2			2							www.swhp.org	www.swhp.org	(866)-334-3141		(254)-298-3141		(800)-782-5068		(254)-298-3366										(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989										2	2	2
H4564	021	0	1	18	06	H4564_021_0	9	1		07/19/2011	2012.02	07/19/2011 04:36:17 PM Central Daylight Time		08/09/2011 11:11:48 AM Central Daylight Time		08/09/2011 03:55:37 PM Central Daylight Time	SCOTT AND WHITE HEALTH PLAN	Scott and White Health Plan SeniorCare	www.swhp.org	SeniorCare Sr MedOption - Basic Rx (Cost)	06	18		1			H4564	021	0	2012	Central Texas		2		2			2							www.swhp.org	www.swhp.org	(866)-334-3141		(254)-298-3141		(800)-782-5068		(254)-298-3366		(866)-334-3141		(254)-298-3141		(888)-333-3980		(254)-298-3366		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		2	2	2
H4564	022	0	1	18	06	H4564_022_0	8	1		07/19/2011	2012.02	07/19/2011 05:05:43 PM Central Daylight Time		08/09/2011 11:08:32 AM Central Daylight Time		08/09/2011 03:55:37 PM Central Daylight Time	SCOTT AND WHITE HEALTH PLAN	Scott and White Health Plan SeniorCare	www.swhp.org	SeniorCare Sr MedOption - Enhanced Rx (Cost)	06	18		1			H4564	022	0	2012	Central Texas		2		2			2							www.swhp.org	www.swhp.org	(866)-334-3141		(254)-298-3141		(800)-782-5068		(254)-298-3366		(866)-334-3141		(254)-298-3141		(888)-333-3980		(254)-298-3366		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		2	2	2
H4564	023	0	1	18	06	H4564_023_0	7	1		07/19/2011	2012.02	07/19/2011 05:05:28 PM Central Daylight Time		08/09/2011 11:45:54 AM Central Daylight Time		08/09/2011 03:55:37 PM Central Daylight Time	SCOTT AND WHITE HEALTH PLAN	Scott and White Health Plan SeniorCare	www.swhp.org	SeniorCare Sr MedOption - Value Rx (Cost)	06	18		1			H4564	023	0	2012	Central Texas		2		2			2							www.swhp.org	www.swhp.org	(866)-334-3141		(254)-298-3141		(800)-782-5068		(254)-298-3366		(866)-334-3141		(254)-298-3141		(888)-333-3980		(254)-298-3366		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		2	2	2
H4590	010	0	1	01	01	H4590_010_0	5	1		08/07/2011	2012.02	08/07/2011 01:44:11 PM Central Daylight Time	08/08/2011 12:11:16 PM Central Daylight Time	08/05/2011 01:38:21 PM Central Daylight Time		08/09/2011 11:07:45 AM Central Daylight Time	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons (HMO)	01	01		1			H4590	010	0	2012	San Antonio area		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4590	012	0	1	01	01	H4590_012_0	4	1		08/07/2011	2012.02	08/07/2011 01:39:45 PM Central Daylight Time	08/08/2011 12:10:21 PM Central Daylight Time	08/05/2011 01:38:36 PM Central Daylight Time		08/09/2011 11:07:45 AM Central Daylight Time	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons (HMO)	01	01		1			H4590	012	0	2012	Dallas/Fort Worth Metroplex		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4590	020	0	1	01	01	H4590_020_0	4	1	2	07/22/2011	2012.02	07/22/2011 12:12:21 PM Central Daylight Time	08/05/2011 05:37:36 PM Central Daylight Time	08/05/2011 01:11:45 PM Central Daylight Time		08/09/2011 12:48:01 PM Central Daylight Time	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	SecureHorizons by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H4590	020	0	2012	Dallas-Fort Worth Metroplex		2		2			1	3		1	2		www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(866)-846-2762		(866)-846-2762		(888)-834-3721		(888)-834-3721		(866)-846-2762		(866)-846-2762		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4590	022	0	1	01	01	H4590_022_0	5	1	2	07/20/2011	2012.02	07/20/2011 02:41:54 PM Central Daylight Time	08/05/2011 05:38:18 PM Central Daylight Time	08/05/2011 01:12:06 PM Central Daylight Time		08/09/2011 11:07:45 AM Central Daylight Time	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	SecureHorizons by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H4590	022	0	2012	San Antonio area		2		2			1	3		1	2		www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(866)-846-2762		(866)-846-2762		(888)-834-3721		(888)-834-3721		(866)-846-2762		(866)-846-2762		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4590	025	0	1	01	01	H4590_025_0	5	1		08/07/2011	2012.02	08/07/2011 01:40:31 PM Central Daylight Time	08/05/2011 05:39:00 PM Central Daylight Time	08/05/2011 01:38:50 PM Central Daylight Time		08/09/2011 11:07:45 AM Central Daylight Time	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons (HMO)	01	01		1			H4590	025	0	2012	Nueces and San Patricio counties		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4590	027	0	1	01	01	H4590_027_0	3	1		07/20/2011	2012.02	07/20/2011 02:43:09 PM Central Daylight Time	07/22/2011 02:40:56 PM Central Daylight Time			07/25/2011 12:00:32 PM Central Daylight Time	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Essential (HMO)	01	01		1			H4590	027	0	2012	Dallas/Ft Worth Metroplex		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514										(711)		(711)		(711)		(711)										2	2	2
H4590	029	0	1	01	01	H4590_029_0	3	1		07/20/2011	2012.02	07/20/2011 02:44:07 PM Central Daylight Time	07/22/2011 02:41:28 PM Central Daylight Time			07/25/2011 12:00:32 PM Central Daylight Time	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete SecureHorizons Essential (HMO)	01	01		1			H4590	029	0	2012	San Antonio area		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514										(711)		(711)		(711)		(711)										2	2	2
H4590	033	0	1	01	01	H4590_033_0	4	1	2	07/22/2011	2012.02	07/22/2011 12:13:42 PM Central Daylight Time	08/05/2011 05:39:32 PM Central Daylight Time	08/05/2011 01:12:26 PM Central Daylight Time		08/09/2011 12:48:01 PM Central Daylight Time	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	SecureHorizons by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H4590	033	0	2012	Corpus Christi Area		2		2			1	3		1	2		www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(866)-846-2762		(866)-846-2762		(888)-834-3721		(888)-834-3721		(866)-846-2762		(866)-846-2762		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4590	037	0	1	01	01	H4590_037_0	4	1		08/07/2011	2012.02	08/07/2011 01:46:30 PM Central Daylight Time	08/05/2011 05:39:57 PM Central Daylight Time	08/05/2011 01:12:46 PM Central Daylight Time		08/09/2011 11:07:45 AM Central Daylight Time	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	SecureHorizons by UnitedHealthcare	www.EvercareHealthPlans.com	UnitedHealthcare Chronic Complete (HMO SNP)	01	01		1			H4590	037	0	2012	San Antonio area		2		2			1	4		1		00011010000000000000	www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(866)-846-2762		(866)-846-2762		(888)-834-3721		(888)-834-3721		(866)-846-2762		(866)-846-2762		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4590	038	0	1	01	01	H4590_038_0	3	1		07/22/2011	2012.02	07/22/2011 12:35:56 PM Central Daylight Time	08/05/2011 05:40:22 PM Central Daylight Time	08/05/2011 01:39:06 PM Central Daylight Time		08/09/2011 04:41:55 PM Central Daylight Time	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	UnitedHealthcare Nursing Home Plan (HMO SNP)	01	01		1			H4590	038	0	2012	Dallas, Fort Worth Area		2		2			1	1	1	1			www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4590	039	0	1	01	01	H4590_039_0	3	1		07/22/2011	2012.02	07/22/2011 12:36:30 PM Central Daylight Time	08/05/2011 05:40:44 PM Central Daylight Time	08/05/2011 01:39:22 PM Central Daylight Time		08/09/2011 04:41:55 PM Central Daylight Time	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	UnitedHealthcare Nursing Home Plan (HMO SNP)	01	01		1			H4590	039	0	2012	San Antonio Area		2		2			1	1	1	1			www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-393-0993		(800)-393-0993		(800)-393-0993		(800)-393-0993		(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4590	801	0	1	01	01	H4590_801_0	2	1		07/06/2011	2012.02	07/06/2011 04:48:44 PM Central Daylight Time	06/05/2011 11:10:34 AM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H4590	801	0	2012	TX Employer Sponsored Plan Service Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-864-5548		(888)-864-5548		(888)-864-5548		(888)-864-5548										(711)		(711)		(711)		(711)										2	2	2
H4590	803	0	1	01	01	H4590_803_0	2	1		07/06/2011	2012.02	07/06/2011 04:48:48 PM Central Daylight Time	06/05/2011 11:10:53 AM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H4590	803	0	2012	TX Employer Sponsored Plan Service Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-864-5548		(888)-864-5548		(888)-864-5548		(888)-864-5548		(888)-864-5548		(888)-864-5548		(888)-864-5548		(888)-864-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4590	804	0	1	01	01	H4590_804_0	2	1		07/06/2011	2012.02	07/06/2011 04:48:52 PM Central Daylight Time	06/05/2011 11:11:11 AM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H4590	804	0	2012	TX Employer Sponsored Plan Service Area		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-864-5548		(888)-864-5548		(888)-864-5548		(888)-864-5548		(888)-864-5548		(888)-864-5548		(888)-864-5548		(888)-864-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4604	003	0	1	02	01	H4604_003_0	5	1		08/05/2011	2012.02	08/05/2011 08:15:40 AM Central Daylight Time	08/05/2011 10:14:53 AM Central Daylight Time	08/05/2011 01:39:37 PM Central Daylight Time		08/09/2011 01:10:07 PM Central Daylight Time	UNITEDHEALTHCARE OF UTAH, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H4604	003	0	2012	Select counties in Utah		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4604	005	0	1	02	01	H4604_005_0	4	1		07/20/2011	2012.02	07/20/2011 02:35:48 PM Central Daylight Time	07/22/2011 01:21:22 PM Central Daylight Time			07/25/2011 01:32:03 PM Central Daylight Time	UNITEDHEALTHCARE OF UTAH, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus Essential (HMO-POS)	01	02		1			H4604	005	0	2012	Select counties in Utah		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514										(711)		(711)		(711)		(711)										2	2	2
H4604	801	0	1	01	01	H4604_801_0	2	1		07/06/2011	2012.02	07/06/2011 04:48:59 PM Central Daylight Time	06/03/2011 02:25:32 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF UTAH, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H4604	801	0	2012	Salt Lake and Surrounding Counties		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4604	803	0	1	01	01	H4604_803_0	2	1		07/06/2011	2012.02	07/06/2011 04:49:05 PM Central Daylight Time	06/03/2011 02:26:11 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF UTAH, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H4604	803	0	2012	Select Counties In UT		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4604	805	0	1	01	01	H4604_805_0	2	1		07/06/2011	2012.02	07/06/2011 04:49:13 PM Central Daylight Time	06/03/2011 02:26:46 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF UTAH, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H4604	805	0	2012	Select counties in UT		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548										(711)		(711)		(711)		(711)										2	2	2
H4605	001	0	1	04	01	H4605_001_0	6	1		07/20/2011	2012.02	07/20/2011 10:03:30 AM Mountain Daylight Time	08/09/2011 06:31:58 PM Pacific Daylight Time			08/09/2011 06:42:41 PM Pacific Daylight Time	REGENCE BLUECROSS BLUESHIELD OF UT	Regence BlueCross BlueShield of Utah	www.regence.com/medicare	Regence MedAdvantage Basic (PPO)	01	04		1			H4605	001	0	2012	Select Counties in Utah		2		2			2						www.regence.com/medicare	www.regence.com/UT/products/medicare	www.regence.com/UT/products/medicare	(800)-541-8981		(800)-541-8981		(800)-505-6765		(800)-505-6765										(711)		(711)		(711)		(711)										2	2	2
H4605	002	0	1	04	01	H4605_002_0	7	1		07/20/2011	2012.02	07/20/2011 10:04:03 AM Mountain Daylight Time	08/09/2011 11:36:13 AM Pacific Daylight Time	08/09/2011 08:09:10 AM Pacific Daylight Time		08/09/2011 04:15:15 PM Pacific Daylight Time	REGENCE BLUECROSS BLUESHIELD OF UT	Regence BlueCross BlueShield of Utah	www.regence.com/medicare	Regence MedAdvantage + Rx Classic (PPO)	01	04		1			H4605	002	0	2012	Select Counties in Utah		2		2			2						www.regence.com/medicare	www.regence.com/UT/products/medicare	www.regence.com/UT/products/medicare	(800)-541-8981		(800)-541-8981		(800)-505-6765		(800)-505-6765		(800)-541-8981		(800)-541-8981		(800)-505-6765		(800)-505-6765		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4605	004	0	1	04	01	H4605_004_0	6	1		07/20/2011	2012.02	07/20/2011 10:04:38 AM Mountain Daylight Time	08/09/2011 11:33:44 AM Pacific Daylight Time	08/09/2011 08:10:31 AM Pacific Daylight Time		08/09/2011 04:21:08 PM Pacific Daylight Time	REGENCE BLUECROSS BLUESHIELD OF UT	Regence BlueCross BlueShield of Utah	www.regence.com/medicare	Regence MedAdvantage + Rx Enhanced (PPO)	01	04		1			H4605	004	0	2012	Select Counties in Utah		2		2			2						www.regence.com/medicare	www.regence.com/UT/products/medicare	www.regence.com/UT/products/medicare	(800)-541-8981		(800)-541-8981		(800)-505-6765		(800)-505-6765		(800)-541-8981		(800)-541-8981		(800)-505-6765		(800)-505-6765		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4605	801	0	1	04	01	H4605_801_0	4	1		06/03/2011	2012.02	06/03/2011 10:47:59 AM Mountain Daylight Time	08/09/2011 06:18:06 PM Pacific Daylight Time			08/09/2011 06:31:26 PM Pacific Daylight Time	REGENCE BLUECROSS BLUESHIELD OF UT	Regence BlueCross BlueShield of Utah	www.regence.com/medicare	Regence MedAdvantage (PPO)	01	04		1			H4605	801	0	2012	Nationwide except territories		1		2			2						www.regence.com/medicare	www.regence.com/UT/products/medicare	www.regence.com/UT/products/medicare	(888)-319-8904		(888)-319-8904		(800)-505-6765		(800)-505-6765										(711)		(711)		(711)		(711)										2	2	2
H4605	802	0	1	04	01	H4605_802_0	4	1		06/03/2011	2012.02	06/03/2011 10:48:35 AM Mountain Daylight Time	08/09/2011 06:20:11 PM Pacific Daylight Time			08/09/2011 06:33:18 PM Pacific Daylight Time	REGENCE BLUECROSS BLUESHIELD OF UT	Regence BlueCross BlueShield of Utah	www.regence.com/medicare	Regence MedAdvantage + Rx (PPO)	01	04		1			H4605	802	0	2012	Nationwide except territories		1		2			2						www.regence.com/medicare	www.regence.com/UT/products/medicare	www.regence.com/UT/products/medicare	(888)-319-8904		(888)-319-8904		(800)-505-6765		(800)-505-6765		(888)-319-8904		(888)-319-8904		(800)-505-6765		(800)-505-6765		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4606	001	0	1	04	01	H4606_001_0	8	1		07/07/2011	2012.02	07/07/2011 11:04:41 AM Eastern Daylight Time	08/05/2011 04:52:35 PM Eastern Daylight Time	08/04/2011 12:29:00 PM Eastern Daylight Time		08/08/2011 04:46:24 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H4606-001 (PPO)	01	04		1			H4606	001	0	2012	Select Counties in Utah		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4606	006	0	1	04	01	H4606_006_0	3	1		07/07/2011	2012.02	07/07/2011 11:05:25 AM Eastern Daylight Time	06/03/2011 02:10:01 PM Eastern Daylight Time			07/11/2011 12:31:42 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H4606-006 (PPO)	01	04		1			H4606	006	0	2012	Select Counties in Utah		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H4606	007	0	1	04	01	H4606_007_0	8	1		07/11/2011	2012.02	07/11/2011 08:36:17 AM Eastern Daylight Time	08/04/2011 03:32:34 PM Eastern Daylight Time	08/04/2011 12:29:19 PM Eastern Daylight Time		08/08/2011 04:52:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H4606-007 (PPO)	01	04		1			H4606	007	0	2012	Select Counties in Utah		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4738	001	0	1	04	01	H4738_001_0	5	1		07/12/2011	2012.02	07/12/2011 12:56:02 PM Eastern Daylight Time	07/08/2011 04:00:35 PM Eastern Daylight Time			07/13/2011 03:20:10 PM Eastern Daylight Time	AMERICA'S 1ST CHOICE HEALTH PLANS, INC.	America's 1st Choice Health Plans, Inc.	www.Americas1stChoice.com	Ambassador (PPO)	01	04		1			H4738	001	0	2012	Select Counties in SC		2	1	2			2						www.americas1stchoice.com	www.americas1stchoice.com	www.americas1stchoice.com	(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947										(800)-735-8583		(800)-735-8583		(800)-735-8583		(800)-735-8583										2	2	2
H4738	002	0	1	04	01	H4738_002_0	6	1		07/12/2011	2012.02	07/12/2011 12:56:22 PM Eastern Daylight Time	08/05/2011 03:02:57 PM Eastern Daylight Time	08/05/2011 03:02:57 PM Eastern Daylight Time		08/05/2011 04:51:31 PM Eastern Daylight Time	AMERICA'S 1ST CHOICE HEALTH PLANS, INC.	America's 1st Choice Health Plans, Inc.	www.Americas1stChoice.com	Ambassador Plus (PPO)	01	04		1			H4738	002	0	2012	Select Counties in SC		2	1	2			2						www.americas1stchoice.com	www.americas1stchoice.com	www.americas1stchoice.com	(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947		(800)-735-8583		(800)-735-8583		(800)-735-8583		(800)-735-8583		(800)-735-8583		(800)-735-8583		(800)-735-8583		(800)-735-8583		2	2	2
H4754	001	0	1	04	01	H4754_001_0	9	1		07/26/2011	2012.02	07/26/2011 03:21:24 PM Pacific Daylight Time	08/09/2011 02:23:48 PM Pacific Daylight Time	08/09/2011 02:19:36 PM Pacific Daylight Time		08/09/2011 02:31:09 PM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS, INC.	PacificSource Medicare	www.clearonehp.com	PacificSource Medicare Explorer Rx 1 (PPO)	01	04		1			H4754	001	0	2012	Deschutes and Crook Counties		2	200	2			2						http://medicare.pacificsource.com/Tools/ProviderDirectory.aspx	http://medicare.pacificsource.com/Tools/DrugSearch.aspx	https://medicare.pacificsource.com/Tools/PharmacySearch.aspx	(888)-863-3637		(541)-385-5315		(888)-863-3637		(541)-385-5315		(888)-863-3637		(541)-385-5315		(888)-863-3637		(541)-385-5315		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		2	2	2
H4754	002	0	1	04	01	H4754_002_0	7	1		07/26/2011	2012.02	07/26/2011 02:56:43 PM Pacific Daylight Time	08/09/2011 02:23:49 PM Pacific Daylight Time	08/09/2011 02:19:36 PM Pacific Daylight Time		08/09/2011 02:31:09 PM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS, INC.	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare Explorer Rx 2 (PPO)	01	04		1			H4754	002	0	2012	Southwest Idaho		2	200	2			2						http://medicare.pacificsource.com/Tools/ProviderDirectory.aspx	http://medicare.pacificsource.com/Tools/DrugSearch.aspx	https://medicare.pacificsource.com/Tools/PharmacySearch.aspx	(888)-863-3637		(541)-385-5315		(888)-863-3637		(541)-385-5315		(888)-863-3637		(541)-385-5315		(888)-863-3637		(541)-385-5315		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		2	2	2
H4754	004	0	1	04	01	H4754_004_0	7	1		07/26/2011	2012.02	07/26/2011 02:57:10 PM Pacific Daylight Time	08/09/2011 02:23:49 PM Pacific Daylight Time	08/09/2011 02:19:37 PM Pacific Daylight Time		08/09/2011 02:31:09 PM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS, INC.	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare Explorer Rx 4 (PPO)	01	04		1			H4754	004	0	2012	Lane County		2	50	2			2						http://medicare.pacificsource.com/Tools/ProviderDirectory.aspx	http://medicare.pacificsource.com/Tools/DrugSearch.aspx	https://medicare.pacificsource.com/Tools/PharmacySearch.aspx	(888)-863-3637		(541)-385-5315		(888)-863-3637		(541)-385-5315		(888)-863-3637		(541)-385-5315		(888)-863-3637		(541)-385-5315		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		2	2	2
H4754	005	0	1	04	01	H4754_005_0	6	1		07/26/2011	2012.02	07/26/2011 02:58:59 PM Pacific Daylight Time	07/22/2011 08:07:03 AM Pacific Daylight Time			07/26/2011 03:34:42 PM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS, INC.	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare Explorer 5 (PPO)	01	04		1			H4754	005	0	2012	Lane County		2	50	2			2						http://medicare.pacificsource.com/Tools/ProviderDirectory.aspx	http://medicare.pacificsource.com/Tools/DrugSearch.aspx	https://medicare.pacificsource.com/Tools/PharmacySearch.aspx	(888)-863-3637		(541)-385-5315		(888)-863-3637		(541)-385-5315										(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900										2	2	2
H4754	006	0	1	04	01	H4754_006_0	6	1		07/26/2011	2012.02	07/26/2011 02:58:32 PM Pacific Daylight Time	07/22/2011 08:07:04 AM Pacific Daylight Time			07/26/2011 03:34:42 PM Pacific Daylight Time	PACIFICSOURCE COMMUNITY HEALTH PLANS, INC.	PacificSource Medicare	www.Medicare.PacificSource.com	PacificSource Medicare Explorer 6 (PPO)	01	04		1			H4754	006	0	2012	Southwest Idaho		2	200	2			2						http://medicare.pacificsource.com/Tools/ProviderDirectory.aspx	http://medicare.pacificsource.com/Tools/DrugSearch.aspx	https://medicare.pacificsource.com/Tools/PharmacySearch.aspx	(888)-863-3637		(541)-385-5315		(888)-863-3637		(541)-385-5315										(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900										2	2	2
H4785	001	0	1	09	04	H4785_001_0	8	1		07/06/2011	2012.02	07/06/2011 04:01:20 PM Eastern Daylight Time	08/05/2011 04:00:09 PM Eastern Daylight Time	08/04/2011 12:29:39 PM Eastern Daylight Time		08/08/2011 04:05:26 PM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of LA, Inc.	www.humana-medicare.com	Humana Gold Choice H4785-001 (PFFS)	04	09	1	1			H4785	001	0	2012	Select Parishes in Louisiana		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4785	003	0	1	09	04	H4785_003_0	5	1		07/12/2011	2012.02	07/12/2011 11:02:01 AM Eastern Daylight Time	06/05/2011 09:36:53 PM Eastern Daylight Time			07/12/2011 12:21:37 PM Eastern Daylight Time	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Humana Health Benefit Plan of LA, Inc.	www.humana-medicare.com	Humana Gold Choice H4785-003 (PFFS)	04	09	1	1			H4785	003	0	2012	Select Parishes in Louisiana		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H4837	001	0	1	01	01	H4837_001_0	6	1	2	07/22/2011	2012.02	07/22/2011 12:14:17 PM Central Daylight Time	08/05/2011 09:30:25 AM Central Daylight Time	08/05/2011 01:13:06 PM Central Daylight Time		08/09/2011 12:48:01 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN	UnitedHealthcare Community Plan	www.UHCDualComplete.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H4837	001	0	2012	Milwaukee County		2		2			1	3		1	3		www.UHCDualComplete.com	www.americhoice.com	www.prescriptionsolutions.com	(800)-396-1942		(800)-396-1942		(888)-565-8170		(888)-565-8170		(800)-396-1942		(800)-396-1942		(888)-565-8170		(888)-565-8170		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4866	002	0	1	01	01	H4866_002_0	6	1		08/08/2011	2012.02	08/08/2011 02:30:31 PM Central Daylight Time	08/08/2011 02:18:16 PM Central Daylight Time	08/08/2011 02:18:17 PM Central Daylight Time		08/08/2011 02:37:15 PM Central Daylight Time	CUATRO LLC	Access Medicare	www.accessmedicareny.com	Access Medicare Platinum (HMO)	01	01		1			H4866	002	0	2012	Access Medicare -Manhattan, Bronx, Queens Counties		2	1600	2			2							http://www.accessmedicareny.com/documents/H4866_AM_2011_5003_01FORMULARY.pdf	https://www.prescriptionsolutions.com/pdpclientpharmacy/pharmacylocatorclient.asp?var=PDPNTWKinfoid	(877)-696-1121		(718)-899-0053		(877)-696-1109		(718)-899-0053		(800)-772-5149		(718)-899-0053		(877)-696-1109		(718)-899-0053		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		2	2	2
H4866	003	0	1	01	01	H4866_003_0	8	1		06/29/2011	2012.02	06/29/2011 04:11:23 PM Central Daylight Time	08/08/2011 02:18:17 PM Central Daylight Time	08/08/2011 02:18:17 PM Central Daylight Time		08/08/2011 02:37:15 PM Central Daylight Time	CUATRO LLC	Access Medicare	www.accessmediareny.com	Access Medicare Gold (HMO)	01	01		1			H4866	003	0	2012	Access Medicare-Manhattan, Bronx, Queens Counties		2	1600	2			2							http://www.accessmedicareny.com/documents/H4866_AM_2011_5003_01FORMULARY.pdf	https://www.prescriptionsolutions.com/pdpclientpharmacy/pharmacylocatorclient.asp?var=PDPNTWKinfoid	(877)-696-1121		(718)-899-0053		(877)-696-1109		(718)-899-0053		(800)-772-5149		(718)-899-0053		(877)-696-1109		(718)-899-0053		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		2	2	2
H4866	004	0	1	01	01	H4866_004_0	6	1		08/08/2011	2012.02	08/08/2011 02:30:10 PM Central Daylight Time	08/08/2011 02:18:17 PM Central Daylight Time	08/08/2011 02:18:17 PM Central Daylight Time		08/08/2011 02:37:15 PM Central Daylight Time	CUATRO LLC	Access Medicare	www.accessmedicareny.com	Access Medicare Silver (HMO)	01	01		1			H4866	004	0	2012	Access Medicare-Manhattan, Bronx, Queens Counties		2	1600	2			2							http://www.accessmedicareny.com/documents/H4866_AM_2011_5003_01FORMULARY.pdf	https://www.prescriptionsolutions.com/pdpclientpharmacy/pharmacylocatorclient.asp?var=PDPNTWKinfoid	(877)-696-1121		(718)-899-0053		(877)-696-1109		(718)-899-0053		(800)-772-5149		(718)-899-0053		(877)-696-1109		(718)-899-0053		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		2	2	2
H4875	011	0	1	04	01	H4875_011_0	6	1		07/19/2011	2012.02	07/19/2011 12:58:28 PM Eastern Daylight Time	08/05/2011 11:02:46 AM Eastern Daylight Time	08/05/2011 11:03:07 AM Eastern Daylight Time		08/05/2011 11:08:38 AM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Select (PPO)	01	04		1			H4875	011	0	2012	Counties: AG, BR, KN, LN, NW, OW		2	200	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4875	012	0	1	04	01	H4875_012_0	5	1		07/19/2011	2012.02	07/19/2011 01:00:03 PM Eastern Daylight Time	08/05/2011 11:02:47 AM Eastern Daylight Time	08/05/2011 11:03:07 AM Eastern Daylight Time		08/05/2011 11:08:38 AM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Select (PPO)	01	04		1			H4875	012	0	2012	CO: CS,IO,IB,KA,MS,MD,MI,MT,MK,OE,OS,OT,SC,WX		2	318	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4875	013	0	1	04	01	H4875_013_0	5	1		07/19/2011	2012.02	07/19/2011 01:02:32 PM Eastern Daylight Time	08/05/2011 11:02:47 AM Eastern Daylight Time	08/05/2011 11:03:08 AM Eastern Daylight Time		08/05/2011 11:08:38 AM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Select (PPO)	01	04		1			H4875	013	0	2012	CO: AN,BZ,CV,CL,CR,GT,HD,IN,LK,LL,LV,MA,ME,MR		2	214	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4875	014	0	1	04	01	H4875_014_0	5	1		07/19/2011	2012.02	07/19/2011 01:03:53 PM Eastern Daylight Time	08/05/2011 11:02:48 AM Eastern Daylight Time	08/05/2011 11:03:08 AM Eastern Daylight Time		08/05/2011 11:08:38 AM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Select (PPO)	01	04		1			H4875	014	0	2012	Counties: EM, GL, GT, JK, KK, RS, SJ, SN, SH		2	166	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4875	015	0	1	04	01	H4875_015_0	5	1		07/19/2011	2012.02	07/19/2011 01:05:06 PM Eastern Daylight Time	08/05/2011 11:02:41 AM Eastern Daylight Time	08/05/2011 11:03:08 AM Eastern Daylight Time		08/05/2011 11:08:38 AM Eastern Daylight Time	PRIORITY HEALTH	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Select (PPO)	01	04		1			H4875	015	0	2012	Counties: BA, BN, MB, OK, SG, TS, WA, WY		2	76	2			2						www.prioritymedicare.com	www.prioritymedicare.com	www.prioritymedicare.com	(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4909	001	0	1	04	01	H4909_001_0	11	1		08/05/2011	2012.02	08/05/2011 01:17:21 PM Eastern Daylight Time	08/08/2011 11:50:10 PM Eastern Daylight Time	08/08/2011 11:51:35 PM Eastern Daylight Time		08/09/2011 12:02:14 AM Eastern Daylight Time	ANTHEM HEALTH PLANS OF VIRGINIA, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred Standard (PPO)	01	04		1			H4909	001	0	2012	Roanoke and Charlottesville areas and Southeast VA		2	12504	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-827-9866		(866)-827-9866		(800)-797-5937		(800)-797-5937		(866)-827-9866		(866)-827-9866		(800)-797-5937		(800)-797-5937		(800)-828-1120		(800)-828-1120		(800)-241-6894		(800)-241-6894		(800)-828-1120		(800)-828-1120		(800)-241-6894		(800)-241-6894		2	2	2
H4909	004	0	1	04	01	H4909_004_0	11	1		08/05/2011	2012.02	08/05/2011 01:19:11 PM Eastern Daylight Time	08/08/2011 11:50:23 PM Eastern Daylight Time	08/08/2011 11:51:57 PM Eastern Daylight Time		08/09/2011 12:02:14 AM Eastern Daylight Time	ANTHEM HEALTH PLANS OF VIRGINIA, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred Premier (PPO)	01	04		1			H4909	004	0	2012	Roanoke and Charlottesville areas and Southeast VA		2	3897	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-827-9866		(866)-827-9866		(800)-797-5937		(800)-797-5937		(866)-827-9866		(866)-827-9866		(800)-797-5937		(800)-797-5937		(800)-828-1120		(800)-828-1120		(800)-241-6894		(800)-241-6894		(800)-828-1120		(800)-828-1120		(800)-241-6894		(800)-241-6894		2	2	2
H4909	804	0	1	04	01	H4909_804_0	7	1		07/12/2011	2012.02	07/12/2011 09:21:56 AM Eastern Daylight Time	07/22/2011 11:51:55 AM Eastern Daylight Time			07/22/2011 01:46:35 PM Eastern Daylight Time	ANTHEM HEALTH PLANS OF VIRGINIA, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred (PPO)	01	04		1			H4909	804	0	2012	Virginia		1	2550	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608		(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		2	2	2
H4909	805	0	1	04	01	H4909_805_0	5	1		07/12/2011	2012.02	07/12/2011 09:22:27 AM Eastern Daylight Time	07/22/2011 11:51:56 AM Eastern Daylight Time			07/22/2011 01:46:35 PM Eastern Daylight Time	ANTHEM HEALTH PLANS OF VIRGINIA, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred (PPO)	01	04		1			H4909	805	0	2012	Virginia		1	50	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608										(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754										2	2	2
H4909	806	0	1	04	01	H4909_806_0	5	1		07/12/2011	2012.02	07/12/2011 09:22:55 AM Eastern Daylight Time	07/22/2011 11:51:57 AM Eastern Daylight Time			07/22/2011 01:46:35 PM Eastern Daylight Time	ANTHEM HEALTH PLANS OF VIRGINIA, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred (PPO)	01	04		1			H4909	806	0	2012	Virginia		1	50	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608		(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		2	2	2
H4909	807	0	1	04	01	H4909_807_0	5	1		07/12/2011	2012.02	07/12/2011 09:23:38 AM Eastern Daylight Time	07/22/2011 11:51:57 AM Eastern Daylight Time			07/22/2011 01:46:35 PM Eastern Daylight Time	ANTHEM HEALTH PLANS OF VIRGINIA, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred (PPO)	01	04		1			H4909	807	0	2012	Virginia		1	50	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608										(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754										2	2	2
H4910	005	0	1	01	01	H4910_005_0	4	1		07/08/2011	2012.02	07/08/2011 11:18:56 AM Central Daylight Time	08/04/2011 02:09:28 PM Central Daylight Time	08/04/2011 10:01:03 AM Central Daylight Time		08/08/2011 08:57:36 AM Central Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (HMO)	01	01		1			H4910	005	0	2012	Fairfax County and Surrounding Area		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H4910	801	0	1	01	01	H4910_801_0	1	1		04/22/2011	2012.02	04/22/2011 10:02:23 AM Eastern Daylight Time	06/02/2011 08:58:07 AM Eastern Daylight Time			06/03/2011 10:51:30 AM Eastern Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan (HMO)	01	01		1			H4910	801	0	2012	Virginia		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748										1	1	1
H4910	802	0	1	01	01	H4910_802_0	1	1		04/22/2011	2012.02	04/22/2011 10:03:45 AM Eastern Daylight Time	06/02/2011 09:14:05 AM Eastern Daylight Time			06/03/2011 10:51:30 AM Eastern Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan w/Rx CY (HMO)	01	01		1			H4910	802	0	2012	Virginia		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		1	1	1
H4956	001	0	1	04	01	H4956_001_0	7	1		07/06/2011	2012.02	07/06/2011 11:16:08 AM Eastern Daylight Time	08/05/2011 03:55:10 PM Eastern Daylight Time	08/04/2011 12:29:59 PM Eastern Daylight Time		08/08/2011 04:05:26 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H4956-001 (PPO)	01	04		1			H4956	001	0	2012	Gulf Coast / Biloxi Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4956	002	0	1	04	01	H4956_002_0	10	1		07/06/2011	2012.02	07/06/2011 04:03:23 PM Eastern Daylight Time	08/05/2011 03:54:42 PM Eastern Daylight Time	08/04/2011 12:30:17 PM Eastern Daylight Time		08/08/2011 04:05:26 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H4956-002 (PPO)	01	04		1			H4956	002	0	2012	Select Mississippi Counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4956	003	0	1	04	01	H4956_003_0	8	1		07/12/2011	2012.02	07/12/2011 11:00:55 AM Eastern Daylight Time	07/14/2011 10:16:39 AM Eastern Daylight Time	08/04/2011 12:30:36 PM Eastern Daylight Time		08/08/2011 04:05:26 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H4956-003 (PPO)	01	04		1			H4956	003	0	2012	Grenada, Lafayette and Yalobusha Counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4971	001	0	1	02	01	H4971_001_0	5	1		08/04/2011	2012.02	08/04/2011 08:15:19 PM Central Daylight Time	08/05/2011 09:35:16 AM Central Daylight Time	08/05/2011 01:39:54 PM Central Daylight Time		08/09/2011 12:48:01 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	UnitedHealthcare MedicareComplete Plus (HMO-POS)	01	02		1			H4971	001	0	2012	Allegan, Kent and Ottawa Counties		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-711-6088		(800)-711-6088		(800)-555-5757		(800)-555-5757		(800)-711-6088		(800)-711-6088		(800)-555-5757		(800)-555-5757		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H4971	801	0	1	02	01	H4971_801_0	2	1		07/06/2011	2012.02	07/06/2011 04:49:24 PM Central Daylight Time	06/03/2011 03:23:52 PM Central Daylight Time			07/21/2011 08:26:26 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO-POS)	01	02		1			H4971	801	0	2012	Allegan, Kent, and Ottawa Counties		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5005	001	0	1	01	01	H5005_001_0	4	1		07/20/2011	2012.02	07/20/2011 02:37:34 PM Central Daylight Time	08/05/2011 04:02:28 PM Central Daylight Time	08/05/2011 01:40:10 PM Central Daylight Time		08/09/2011 01:10:07 PM Central Daylight Time	UNITEDHEALTHCARE OF WASHINGTON, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H5005	001	0	2012	King, Lewis, Pierce, Thurston Counties		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5005	010	0	1	01	01	H5005_010_0	4	1		08/07/2011	2012.02	08/07/2011 07:18:45 AM Central Daylight Time	08/05/2011 12:32:11 PM Central Daylight Time	08/05/2011 01:40:26 PM Central Daylight Time		08/09/2011 01:10:07 PM Central Daylight Time	UNITEDHEALTHCARE OF WASHINGTON, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H5005	010	0	2012	Clark County		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5005	011	0	1	01	01	H5005_011_0	4	1		08/07/2011	2012.02	08/07/2011 07:19:11 AM Central Daylight Time	08/05/2011 12:32:44 PM Central Daylight Time	08/05/2011 01:40:41 PM Central Daylight Time		08/09/2011 01:10:07 PM Central Daylight Time	UNITEDHEALTHCARE OF WASHINGTON, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H5005	011	0	2012	Island and Snohomish Counties		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5005	018	0	1	01	01	H5005_018_0	3	1		07/20/2011	2012.02	07/20/2011 02:38:15 PM Central Daylight Time	07/22/2011 01:23:58 PM Central Daylight Time			07/25/2011 01:32:03 PM Central Daylight Time	UNITEDHEALTHCARE OF WASHINGTON, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Essential (HMO)	01	01		1			H5005	018	0	2012	Select Counties in Western Washington		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514										(711)		(711)		(711)		(711)										2	2	2
H5005	019	0	1	01	01	H5005_019_0	4	1		08/08/2011	2012.02	08/08/2011 09:35:19 AM Central Daylight Time	08/05/2011 04:30:56 PM Central Daylight Time	08/05/2011 01:40:56 PM Central Daylight Time		08/09/2011 01:10:07 PM Central Daylight Time	UNITEDHEALTHCARE OF WASHINGTON, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 3 (HMO)	01	01		1			H5005	019	0	2012	Select Counties in Western Washington		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(800)-950-9355		(800)-950-9355		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5005	801	0	1	01	01	H5005_801_0	2	1		07/06/2011	2012.02	07/06/2011 04:49:30 PM Central Daylight Time	06/03/2011 02:30:25 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF WASHINGTON, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H5005	801	0	2012	WA Employer Sponsored Plan Service Area		1		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548										(711)		(711)		(711)		(711)										2	2	2
H5005	803	0	1	01	01	H5005_803_0	2	1		07/06/2011	2012.02	07/06/2011 04:49:35 PM Central Daylight Time	06/03/2011 02:31:00 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF WASHINGTON, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H5005	803	0	2012	WA Employer Sponsored Plan Service Area		1		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5005	804	0	1	01	01	H5005_804_0	2	1		07/06/2011	2012.02	07/06/2011 04:49:38 PM Central Daylight Time	06/03/2011 02:31:35 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF WASHINGTON, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H5005	804	0	2012	WA Employer Sponsored Plan Service Area		1		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5006	017	9	1	09	04	H5006_017_9	5	1		07/21/2011	2012.02	07/21/2011 04:39:37 PM Central Daylight Time	08/04/2011 12:30:55 PM Central Daylight Time	08/04/2011 01:32:02 PM Central Daylight Time		08/05/2011 11:12:21 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Access Plan (PFFS)	04	09	2	1			H5006	017	9	2012	Multi-State Area	Arkansas	2	40	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-270-0951		(888)-270-0951		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2		2
H5006	017	10	1	09	04	H5006_017_10	5	1		07/21/2011	2012.02	07/21/2011 04:37:29 PM Central Daylight Time	08/04/2011 12:30:01 PM Central Daylight Time	08/04/2011 01:32:52 PM Central Daylight Time		08/05/2011 11:12:21 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Access Plan (PFFS)	04	09	2	1			H5006	017	10	2012	Multi-State Area	Georgia	2	65	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-270-0951		(888)-270-0951		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2		2
H5006	017	11	1	09	04	H5006_017_11	5	1		07/19/2011	2012.02	07/19/2011 09:30:39 PM Central Daylight Time	08/04/2011 12:29:12 PM Central Daylight Time	08/04/2011 01:33:15 PM Central Daylight Time		08/05/2011 11:12:21 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Access Plan (PFFS)	04	09	2	1			H5006	017	11	2012	Multi-State Area	Idaho	2	69	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-270-0951		(888)-270-0951		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2		2
H5006	017	12	1	09	04	H5006_017_12	5	1		07/19/2011	2012.02	07/19/2011 09:30:49 PM Central Daylight Time	08/04/2011 12:27:59 PM Central Daylight Time	08/04/2011 01:33:34 PM Central Daylight Time		08/05/2011 11:12:21 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Access Plan (PFFS)	04	09	2	1			H5006	017	12	2012	Multi-State Area	Illinois	2	73	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-270-0951		(888)-270-0951		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2		2
H5006	017	13	1	09	04	H5006_017_13	5	1		07/19/2011	2012.02	07/19/2011 09:30:57 PM Central Daylight Time	08/04/2011 12:27:13 PM Central Daylight Time	08/04/2011 01:33:57 PM Central Daylight Time		08/05/2011 11:12:21 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Access Plan (PFFS)	04	09	2	1			H5006	017	13	2012	Multi-State Area	Kansas	2	22	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-270-0951		(888)-270-0951		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2		2
H5006	017	14	1	09	04	H5006_017_14	5	1		07/19/2011	2012.02	07/19/2011 09:31:07 PM Central Daylight Time	08/04/2011 12:26:18 PM Central Daylight Time	08/04/2011 01:34:21 PM Central Daylight Time		08/05/2011 11:12:21 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Access Plan (PFFS)	04	09	2	1			H5006	017	14	2012	Multi-State Area	Kentucky	2	294	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-270-0951		(888)-270-0951		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2		2
H5006	017	15	1	09	04	H5006_017_15	5	1		07/19/2011	2012.02	07/19/2011 09:31:14 PM Central Daylight Time	08/04/2011 12:38:27 PM Central Daylight Time	08/04/2011 01:34:56 PM Central Daylight Time		08/05/2011 11:12:21 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Access Plan (PFFS)	04	09	2	1			H5006	017	15	2012	Multi-State Area	Louisiana	2	104	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-270-0951		(888)-270-0951		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2		2
H5006	017	16	1	09	04	H5006_017_16	5	1		07/19/2011	2012.02	07/19/2011 09:31:20 PM Central Daylight Time	08/04/2011 12:37:40 PM Central Daylight Time	08/04/2011 01:35:16 PM Central Daylight Time		08/05/2011 11:12:21 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Access Plan (PFFS)	04	09	2	1			H5006	017	16	2012	Multi-State Area	Mississippi	2	28	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-270-0951		(888)-270-0951		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2		2
H5006	017	17	1	09	04	H5006_017_17	5	1		07/19/2011	2012.02	07/19/2011 09:31:26 PM Central Daylight Time	08/04/2011 12:36:59 PM Central Daylight Time	08/04/2011 01:35:38 PM Central Daylight Time		08/05/2011 11:12:21 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Access Plan (PFFS)	04	09	2	1			H5006	017	17	2012	Multi-State Area	Missouri	2	83	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-270-0951		(888)-270-0951		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2		2
H5006	017	18	1	09	04	H5006_017_18	5	1		07/19/2011	2012.02	07/19/2011 09:31:35 PM Central Daylight Time	08/04/2011 12:36:17 PM Central Daylight Time	08/04/2011 01:36:00 PM Central Daylight Time		08/05/2011 11:12:21 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Access Plan (PFFS)	04	09	2	1			H5006	017	18	2012	Multi-State Area	Montana	2	94	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-270-0951		(888)-270-0951		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2		2
H5006	017	19	1	09	04	H5006_017_19	5	1		07/19/2011	2012.02	07/19/2011 09:31:46 PM Central Daylight Time	08/04/2011 12:35:36 PM Central Daylight Time	08/04/2011 01:36:20 PM Central Daylight Time		08/05/2011 11:12:21 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Access Plan (PFFS)	04	09	2	1			H5006	017	19	2012	Multi-State Area	North Carolina	2	18	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-270-0951		(888)-270-0951		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2		2
H5006	017	20	1	09	04	H5006_017_20	5	1		07/19/2011	2012.02	07/19/2011 09:31:52 PM Central Daylight Time	08/04/2011 12:34:54 PM Central Daylight Time	08/04/2011 01:36:46 PM Central Daylight Time		08/05/2011 11:12:21 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Access Plan (PFFS)	04	09	2	1			H5006	017	20	2012	Multi-State Area	Oklahoma	2	463	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-270-0951		(888)-270-0951		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2		2
H5006	017	21	1	09	04	H5006_017_21	5	1		07/19/2011	2012.02	07/19/2011 09:31:58 PM Central Daylight Time	08/04/2011 12:34:12 PM Central Daylight Time	08/04/2011 01:37:08 PM Central Daylight Time		08/05/2011 11:12:21 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Access Plan (PFFS)	04	09	2	1			H5006	017	21	2012	Multi-State Area	Tennessee	2	49	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-270-0951		(888)-270-0951		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2		2
H5006	017	22	1	09	04	H5006_017_22	5	1		07/19/2011	2012.02	07/19/2011 09:32:03 PM Central Daylight Time	08/04/2011 12:33:24 PM Central Daylight Time	08/04/2011 01:37:30 PM Central Daylight Time		08/05/2011 11:12:21 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Access Plan (PFFS)	04	09	2	1			H5006	017	22	2012	Multi-State Area	Texas	2	520	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-270-0951		(888)-270-0951		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2		2
H5006	017	23	1	09	04	H5006_017_23	5	1		07/19/2011	2012.02	07/19/2011 09:32:10 PM Central Daylight Time	08/04/2011 12:32:39 PM Central Daylight Time	08/04/2011 01:37:49 PM Central Daylight Time		08/05/2011 11:12:21 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Access Plan (PFFS)	04	09	2	1			H5006	017	23	2012	Multi-State Area	Virginia	2	76	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-270-0951		(888)-270-0951		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2		2
H5006	017	24	1	09	04	H5006_017_24	5	1		07/19/2011	2012.02	07/19/2011 09:32:17 PM Central Daylight Time	08/04/2011 12:31:46 PM Central Daylight Time	08/04/2011 01:38:13 PM Central Daylight Time		08/05/2011 11:12:21 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Access Plan (PFFS)	04	09	2	1			H5006	017	24	2012	Multi-State Area	Washington	2	122	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-270-0951		(888)-270-0951		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2		2
H5006	018	9	1	09	04	H5006_018_9	3	1		07/19/2011	2012.02	07/19/2011 09:32:29 PM Central Daylight Time	07/21/2011 04:35:43 PM Central Daylight Time			07/21/2011 05:45:16 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Silver Access Plan (PFFS)	04	09	2	1			H5006	018	9	2012	Multi-State Area	Arkansas	2	15	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-5495		(888)-303-5495		(888)-858-8572		(888)-858-8572										(711)		(711)		(711)		(711)										2		2
H5006	018	10	1	09	04	H5006_018_10	3	1		07/19/2011	2012.02	07/19/2011 09:32:34 PM Central Daylight Time	07/21/2011 04:30:29 PM Central Daylight Time			07/21/2011 05:45:16 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Silver Access Plan (PFFS)	04	09	2	1			H5006	018	10	2012	Multi-State Area	Georgia	2	162	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-5495		(888)-303-5495		(888)-858-8572		(888)-858-8572										(711)		(711)		(711)		(711)										2		2
H5006	018	11	1	09	04	H5006_018_11	3	1		07/19/2011	2012.02	07/19/2011 09:32:40 PM Central Daylight Time	07/21/2011 04:32:34 PM Central Daylight Time			07/21/2011 05:45:16 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Silver Access Plan (PFFS)	04	09	2	1			H5006	018	11	2012	Multi-State Area	Idaho	2	934	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-5495		(888)-303-5495		(888)-858-8572		(888)-858-8572										(711)		(711)		(711)		(711)										2		2
H5006	018	12	1	09	04	H5006_018_12	3	1		07/19/2011	2012.02	07/19/2011 09:32:45 PM Central Daylight Time	07/21/2011 04:29:45 PM Central Daylight Time			07/21/2011 05:45:16 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Silver Access Plan (PFFS)	04	09	2	1			H5006	018	12	2012	Multi-State Area	Illinois	2	742	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-5495		(888)-303-5495		(888)-858-8572		(888)-858-8572										(711)		(711)		(711)		(711)										2		2
H5006	018	13	1	09	04	H5006_018_13	3	1		07/19/2011	2012.02	07/19/2011 09:32:50 PM Central Daylight Time	07/21/2011 04:28:55 PM Central Daylight Time			07/21/2011 05:45:16 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Silver Access Plan (PFFS)	04	09	2	1			H5006	018	13	2012	Multi-State Area	Kansas	2	16	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-5495		(888)-303-5495		(888)-858-8572		(888)-858-8572										(711)		(711)		(711)		(711)										2		2
H5006	018	14	1	09	04	H5006_018_14	3	1		07/19/2011	2012.02	07/19/2011 09:32:56 PM Central Daylight Time	07/21/2011 04:31:16 PM Central Daylight Time			07/21/2011 05:45:16 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Silver Access Plan (PFFS)	04	09	2	1			H5006	018	14	2012	Multi-State Area	Kentucky	2	768	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-5495		(888)-303-5495		(888)-858-8572		(888)-858-8572										(711)		(711)		(711)		(711)										2		2
H5006	018	15	1	09	04	H5006_018_15	3	1		07/19/2011	2012.02	07/19/2011 09:33:05 PM Central Daylight Time	07/21/2011 04:28:01 PM Central Daylight Time			07/21/2011 05:45:16 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Silver Access Plan (PFFS)	04	09	2	1			H5006	018	15	2012	Multi-State Area	Louisiana	2	420	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-5495		(888)-303-5495		(888)-858-8572		(888)-858-8572										(711)		(711)		(711)		(711)										2		2
H5006	018	16	1	09	04	H5006_018_16	3	1		07/19/2011	2012.02	07/19/2011 09:33:11 PM Central Daylight Time	07/21/2011 04:31:56 PM Central Daylight Time			07/21/2011 05:45:16 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Silver Access Plan (PFFS)	04	09	2	1			H5006	018	16	2012	Multi-State Area	Mississippi	2	76	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-5495		(888)-303-5495		(888)-858-8572		(888)-858-8572										(711)		(711)		(711)		(711)										2		2
H5006	018	17	1	09	04	H5006_018_17	3	1		07/19/2011	2012.02	07/19/2011 09:33:16 PM Central Daylight Time	07/21/2011 04:27:06 PM Central Daylight Time			07/21/2011 05:45:16 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Silver Access Plan (PFFS)	04	09	2	1			H5006	018	17	2012	Multi-State Area	Missouri	2	153	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-5495		(888)-303-5495		(888)-858-8572		(888)-858-8572										(711)		(711)		(711)		(711)										2		2
H5006	018	18	1	09	04	H5006_018_18	3	1		07/19/2011	2012.02	07/19/2011 09:33:30 PM Central Daylight Time	07/21/2011 04:34:09 PM Central Daylight Time			07/21/2011 05:45:16 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Silver Access Plan (PFFS)	04	09	2	1			H5006	018	18	2012	Multi-State Area	Montana	2	1303	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-5495		(888)-303-5495		(888)-858-8572		(888)-858-8572										(711)		(711)		(711)		(711)										2		2
H5006	018	19	1	09	04	H5006_018_19	3	1		07/19/2011	2012.02	07/19/2011 09:33:35 PM Central Daylight Time	07/21/2011 04:36:38 PM Central Daylight Time			07/21/2011 05:45:16 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Silver Access Plan (PFFS)	04	09	2	1			H5006	018	19	2012	Multi-State Area	North Carolina	2	56	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-5495		(888)-303-5495		(888)-858-8572		(888)-858-8572										(711)		(711)		(711)		(711)										2		2
H5006	018	20	1	09	04	H5006_018_20	3	1		07/19/2011	2012.02	07/19/2011 09:33:42 PM Central Daylight Time	07/21/2011 04:26:16 PM Central Daylight Time			07/21/2011 05:45:16 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Silver Access Plan (PFFS)	04	09	2	1			H5006	018	20	2012	Multi-State Area	Oklahoma	2	935	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-5495		(888)-303-5495		(888)-858-8572		(888)-858-8572										(711)		(711)		(711)		(711)										2		2
H5006	018	21	1	09	04	H5006_018_21	3	1		07/19/2011	2012.02	07/19/2011 09:33:52 PM Central Daylight Time	07/21/2011 04:37:15 PM Central Daylight Time			07/21/2011 05:45:16 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Silver Access Plan (PFFS)	04	09	2	1			H5006	018	21	2012	Multi-State Area	Tennessee	2	123	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-5495		(888)-303-5495		(888)-858-8572		(888)-858-8572										(711)		(711)		(711)		(711)										2		2
H5006	018	22	1	09	04	H5006_018_22	3	1		07/19/2011	2012.02	07/19/2011 09:33:59 PM Central Daylight Time	07/21/2011 04:25:17 PM Central Daylight Time			07/21/2011 05:45:16 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Silver Access Plan (PFFS)	04	09	2	1			H5006	018	22	2012	Multi-State Area	Texas	2	1206	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-5495		(888)-303-5495		(888)-858-8572		(888)-858-8572										(711)		(711)		(711)		(711)										2		2
H5006	018	23	1	09	04	H5006_018_23	3	1		07/19/2011	2012.02	07/19/2011 09:34:05 PM Central Daylight Time	07/21/2011 04:34:53 PM Central Daylight Time			07/21/2011 05:45:16 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Silver Access Plan (PFFS)	04	09	2	1			H5006	018	23	2012	Multi-State Area	Virginia	2	639	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-5495		(888)-303-5495		(888)-858-8572		(888)-858-8572										(711)		(711)		(711)		(711)										2		2
H5006	018	24	1	09	04	H5006_018_24	3	1		07/19/2011	2012.02	07/19/2011 09:34:11 PM Central Daylight Time	07/21/2011 04:33:19 PM Central Daylight Time			07/21/2011 05:45:16 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Silver Access Plan (PFFS)	04	09	2	1			H5006	018	24	2012	Multi-State Area	Washington	2	500	2			2							http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-303-5495		(888)-303-5495		(888)-858-8572		(888)-858-8572										(711)		(711)		(711)		(711)										2		2
H5007	001	0	1	20	08	H5007_001_0	1	1		05/31/2011	2012.01	05/31/2011 02:42:02 PM Pacific Daylight Time		05/20/2011 01:51:46 PM Pacific Daylight Time		05/31/2011 02:44:04 PM Pacific Daylight Time	PROVIDENCE HEALTH SYSTEM	Providence Health System	www.providence.org/longtermcare/elderplace	Providence ElderPlace - Seattle (PACE)	08	20		1			H5007	001	0	2012	Seattle - King County Washington		2		2			2							www.providence.org/longtermcare/elderplace	www.providence.org/longtermcare/elderplace									(206)-320-5325		(206)-320-5325		(206)-320-5325		(206)-320-5325										(206)-320-5325		(206)-320-5325		(206)-320-5325		(206)-320-5325				
H5007	002	0	1	20	08	H5007_002_0	1	1		05/31/2011	2012.01	05/31/2011 02:42:32 PM Pacific Daylight Time		05/20/2011 01:51:46 PM Pacific Daylight Time		05/31/2011 02:44:04 PM Pacific Daylight Time	PROVIDENCE HEALTH SYSTEM	Providence Health System	www.providence.org/longtermcare/elderplace	Providence ElderPlace - Seattle (PACE)	08	20		1			H5007	002	0	2012	Seattle - King County Washington		2		2			2							www.providence.org/longtermcare/elderplace	www.providence.org/longtermcare/elderplace									(206)-320-5325		(206)-320-5325		(206)-320-5325		(206)-320-5325										(206)-320-5325		(206)-320-5325		(206)-320-5325		(206)-320-5325				
H5008	001	0	1	01	01	H5008_001_0	3	1		07/22/2011	2012.02	07/22/2011 12:37:14 PM Central Daylight Time	08/05/2011 10:15:44 AM Central Daylight Time	08/05/2011 01:41:12 PM Central Daylight Time		08/09/2011 04:41:55 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	Evercare by UnitedHealthcare	www.EvercareHealthPlans.com	UnitedHealthcare Nursing Home Plan (HMO SNP)	01	01		1			H5008	001	0	2012	Seattle area and Spokane county		2		2			1	1	1	1			www.EvercareHealthPlans.com	EvercareHealthPlans.com/prescription_drug_coverage.jsp	www.PrescriptionSolutions.com	(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5008	002	0	1	01	01	H5008_002_0	5	1	2	07/22/2011	2012.02	07/22/2011 12:14:54 PM Central Daylight Time	08/05/2011 10:16:17 AM Central Daylight Time	08/05/2011 01:13:27 PM Central Daylight Time		08/09/2011 12:48:01 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	Evercare by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H5008	002	0	2012	Seattle area and Spokane county		2		2			1	3		1	2		www.EvercareHealthPlans.com	EvercareHealthPlans.com/prescription_drug_coverage.jsp	www.PrescriptionSolutions.com	(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5009	001	0	1	04	01	H5009_001_0	5	1		07/20/2011	2012.02	07/20/2011 10:05:27 AM Mountain Daylight Time	08/09/2011 06:30:25 PM Pacific Daylight Time			08/09/2011 06:44:33 PM Pacific Daylight Time	REGENCE BLUESHIELD	Regence BlueShield	www.regence.com/medicare	Regence MedAdvantage Basic (PPO)	01	04		1			H5009	001	0	2012	Select Counties in Washington		2		2			2						www.regence.com/medicare	www.regence.com/WARBS/products/medicare	www.regence.com/WARBS/products/medicare	(800)-541-8981		(800)-541-8981		(800)-505-6765		(800)-505-6765										(711)		(711)		(711)		(711)										2	2	2
H5009	002	0	1	04	01	H5009_002_0	7	1		07/20/2011	2012.02	07/20/2011 10:05:53 AM Mountain Daylight Time	08/09/2011 11:37:35 AM Pacific Daylight Time	08/09/2011 08:12:30 AM Pacific Daylight Time		08/09/2011 04:30:00 PM Pacific Daylight Time	REGENCE BLUESHIELD	Regence BlueShield	www.regence.com/medicare	Regence MedAdvantage + Rx Classic (PPO)	01	04		1			H5009	002	0	2012	Select Counties in Washington		2		2			2						www.regence.com/medicare	www.regence.com/WARBS/products/medicare	www.regence.com/WARBS/products/medicare	(800)-541-8981		(800)-541-8981		(800)-505-6765		(800)-505-6765		(800)-541-8981		(800)-541-8981		(800)-505-6765		(800)-505-6765		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5009	004	0	1	04	01	H5009_004_0	6	1		07/20/2011	2012.02	07/20/2011 10:06:47 AM Mountain Daylight Time	08/09/2011 03:10:40 PM Pacific Daylight Time	08/09/2011 08:16:19 AM Pacific Daylight Time		08/09/2011 04:32:13 PM Pacific Daylight Time	REGENCE BLUESHIELD	Regence BlueShield	www.regence.com/medicare	Regence MedAdvantage + Rx Enhanced (PPO)	01	04		1			H5009	004	0	2012	Select Counties in Washington		2		2			2						www.regence.com/medicare	www.regence.com/WARBS/products/medicare	www.regence.com/WARBS/products/medicare	(800)-541-8981		(800)-541-8981		(800)-505-6765		(800)-505-6765		(800)-541-8981		(800)-541-8981		(800)-505-6765		(800)-505-6765		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5009	801	0	1	04	01	H5009_801_0	5	1		06/03/2011	2012.02	06/03/2011 10:49:26 AM Mountain Daylight Time	08/09/2011 06:22:02 PM Pacific Daylight Time			08/09/2011 06:35:20 PM Pacific Daylight Time	REGENCE BLUESHIELD	Regence BlueShield	www.regence.com/medicare	Regence MedAdvantage (PPO)	01	04		1			H5009	801	0	2012	Nationwide except territories		1		2			2						www.regence.com/medicare	www.regence.com/WARBS/products/medicare	www.regence.com/WARBS/products/medicare	(888)-319-8904		(888)-319-8904		(800)-505-6765		(800)-505-6765										(711)		(711)		(711)		(711)										2	2	2
H5009	802	0	1	04	01	H5009_802_0	6	1		06/03/2011	2012.02	06/03/2011 10:49:58 AM Mountain Daylight Time	08/10/2011 09:04:34 AM Pacific Daylight Time			08/10/2011 09:06:23 AM Pacific Daylight Time	REGENCE BLUESHIELD	Regence BlueShield	www.regence.com/medicare	Regence MedAdvantage + Rx (PPO)	01	04		1			H5009	802	0	2012	Nationwide except territories		1		2			2						www.regence.com/medicare	www.regence.com/WARBS/products/medicare	www.regence.com/WARBS/products/medicare	(888)-319-8904		(888)-319-8904		(800)-505-6765		(800)-505-6765		(888)-319-8904		(888)-319-8904		(800)-505-6765		(800)-505-6765		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5010	001	0	1	04	01	H5010_001_0	5	1		07/20/2011	2012.02	07/20/2011 10:07:18 AM Mountain Daylight Time	08/09/2011 06:28:22 PM Pacific Daylight Time			08/09/2011 06:46:31 PM Pacific Daylight Time	ASURIS NORTHWEST HEALTH	Asuris Northwest Health	www.asuris.com/needCoverage/Medicare	Asuris TruAdvantage Basic (PPO)	01	04		1			H5010	001	0	2012	Select Counties in Eastern Washington		2		2			2						www.asuris.com/needCoverage/Medicare	www.asuris.com/needCoverage/medicare	www.asuris.com/needCoverage/medicare	(800)-541-8981		(800)-541-8981		(866)-704-2708		(866)-704-2708										(711)		(711)		(711)		(711)										2	2	2
H5010	002	0	1	04	01	H5010_002_0	7	1		07/20/2011	2012.02	07/20/2011 10:11:16 AM Mountain Daylight Time	08/09/2011 06:27:00 PM Pacific Daylight Time	08/09/2011 08:20:53 AM Pacific Daylight Time		08/09/2011 06:48:36 PM Pacific Daylight Time	ASURIS NORTHWEST HEALTH	Asuris Northwest Health	www.asuris.com/needCoverage/Medicare	Asuris TruAdvantage + Rx Classic (PPO)	01	04		1			H5010	002	0	2012	Select Counties in Eastern Washington		2		2			2						www.asuris.com/needCoverage/Medicare	www.asuris.com/needCoverage/medicare	www.asuris.com/needCoverage/medicare	(800)-541-8981		(800)-541-8981		(866)-704-2708		(866)-704-2708		(800)-541-8981		(800)-541-8981		(866)-704-2708		(866)-704-2708		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5010	004	0	1	04	01	H5010_004_0	6	1		07/20/2011	2012.02	07/20/2011 10:11:44 AM Mountain Daylight Time	08/09/2011 06:34:27 PM Pacific Daylight Time	08/09/2011 08:18:32 AM Pacific Daylight Time		08/09/2011 06:50:38 PM Pacific Daylight Time	ASURIS NORTHWEST HEALTH	Asuris Northwest Health	www.asuris.com/needCoverage/Medicare	Asuris TruAdvantage + Rx Enhanced (PPO)	01	04		1			H5010	004	0	2012	Select Counties in Eastern Washington		2		2			2						www.asuris.com/needCoverage/Medicare	www.asuris.com/needCoverage/medicare	www.asuris.com/needCoverage/medicare	(800)-541-8981		(800)-541-8981		(866)-704-2708		(866)-704-2708		(800)-541-8981		(800)-541-8981		(866)-704-2708		(866)-704-2708		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5016	001	0	1	04	01	H5016_001_0	9	1		08/11/2011	2012.02	08/11/2011 12:35:42 PM Pacific Daylight Time	08/09/2011 02:33:54 PM Pacific Daylight Time	08/08/2011 08:27:34 PM Pacific Daylight Time		08/11/2011 01:25:06 PM Pacific Daylight Time	PROVIDENCE HEALTH PLANS	Providence Health Plans	www.providence.org/healthplans	Providence Medicare Open + RX (PPO)	01	04		1			H5016	001	0	2012	Portland Metro		2		2			2						www.providence.org/healthplans	www.providence.org/healthplans	www.providence.org/healthplans	(800)-603-2340		(503)-574-8000		(800)-457-6064		(503)-574-5551		(800)-603-2340		(503)-574-8000		(800)-457-6064		(503)-574-5551		(888)-244-6642		(503)-574-8702		(888)-244-6642		(503)-574-8702		(888)-244-6642		(503)-574-8702		(888)-244-6642		(503)-574-8702		2	2	2
H5016	002	0	1	04	01	H5016_002_0	8	1		08/11/2011	2012.02	08/11/2011 12:37:31 PM Pacific Daylight Time	07/20/2011 10:43:57 AM Pacific Daylight Time			08/11/2011 01:25:06 PM Pacific Daylight Time	PROVIDENCE HEALTH PLANS	Providence Health Plans	www.providence.org/healthplans	Providence Medicare Open (PPO)	01	04		1			H5016	002	0	2012	Portland Metro		2		2			2						www.providence.org/healthplans	www.providence.org/healthplans	www.providence.org/healthplans	(800)-603-2340		(503)-574-8000		(800)-457-6064		(503)-574-5551										(888)-244-6642		(503)-574-8702		(888)-244-6642		(503)-574-8702										2	2	2
H5037	001	0	1	20	08	H5037_001_0	1	1		05/23/2011	2012.02	05/23/2011 01:14:38 PM Eastern Daylight Time		05/23/2011 12:59:57 PM Eastern Daylight Time		05/23/2011 01:37:37 PM Eastern Daylight Time	MOUNTAIN EMPIRE OLDER CITIZENS, INCX.	Mountain Empire PACE	www.meoc.org	Mountain Empire PACE - Dual (PACE)	08	20		1			H5037	001	0	2012	Lee, Scott, Wise Counties and Norton City		2		2			2							www.meoc.org	www.meoc.org									(866)-793-7223		(276)-523-0599		(866)-793-7223		(276)-523-0599										(866)-793-7223		(276)-523-0599		(866)-793-7223		(276)-523-0599				
H5037	002	0	1	20	08	H5037_002_0	1	1		05/23/2011	2012.02	05/23/2011 01:15:16 PM Eastern Daylight Time		05/23/2011 12:59:51 PM Eastern Daylight Time		05/23/2011 01:37:37 PM Eastern Daylight Time	MOUNTAIN EMPIRE OLDER CITIZENS, INCX.	Mountain Empire PACE	www.meoc.org	Mountain Empire PACE  - Medicare only (PACE)	08	20		1			H5037	002	0	2012	Lee, Scott, Wise Counties and Norton City		2		2			2							www.meoc.org	www.meoc.org									(866)-793-7223		(276)-523-0599		(866)-793-7223		(276)-523-0599										(866)-793-7223		(276)-523-0599		(866)-793-7223		(276)-523-0599				
H5041	001	0	1	04	01	H5041_001_0	12	1		07/11/2011	2012.02	07/11/2011 02:49:53 PM Eastern Daylight Time	08/05/2011 10:39:15 PM Eastern Daylight Time	08/04/2011 12:31:06 PM Eastern Daylight Time		08/09/2011 10:38:31 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H5041-001 (PPO)	01	04		1			H5041	001	0	2012	Charleston-Huntington Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5041	002	0	1	04	01	H5041_002_0	8	1		07/11/2011	2012.02	07/11/2011 02:51:46 PM Eastern Daylight Time	08/05/2011 10:44:50 PM Eastern Daylight Time	08/04/2011 12:31:29 PM Eastern Daylight Time		08/08/2011 04:32:28 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H5041-002 (PPO)	01	04		1			H5041	002	0	2012	Martinsburg Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5041	003	0	1	04	01	H5041_003_0	9	1		07/11/2011	2012.02	07/11/2011 02:52:22 PM Eastern Daylight Time	08/05/2011 10:55:22 PM Eastern Daylight Time	08/04/2011 12:31:48 PM Eastern Daylight Time		08/08/2011 04:36:22 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H5041-003 (PPO)	01	04		1			H5041	003	0	2012	Kanawha, Putnam and Cabell counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5042	001	0	1	04	01	H5042_001_0	8	1		07/20/2011	2012.02	07/20/2011 02:14:49 PM Eastern Daylight Time	08/08/2011 11:49:17 AM Eastern Daylight Time	08/04/2011 05:26:42 PM Eastern Daylight Time		08/08/2011 01:17:20 PM Eastern Daylight Time	CDPHP UNIVERSAL BENEFITS, INC.	CDPHP Medicare Choices	www.cdphp.com	CDPHP Classic Rx (PPO)	01	04		1			H5042	001	0	2012	Capital, Central, Southern Tier, Hudson Valley NY		2	746	2			2						www.cdphp.com	http://www.cdphp.com/medicare	http://www.cdphp.com/medicare	(888)-248-6522		(518)-641-3950		(888)-519-4455		(518)-641-3400		(888)-831-3039		(518)-641-3950		(888)-519-4455		(518)-641-3400		(877)-261-1164		(518)-641-4000		(877)-261-1164		(518)-641-4000		(866)-236-1069		(518)-641-4000		(877)-261-1164		(518)-641-4000		2	2	2
H5042	004	0	1	04	01	H5042_004_0	5	1		07/20/2011	2012.02	07/20/2011 02:15:09 PM Eastern Daylight Time	07/21/2011 04:38:19 PM Eastern Daylight Time			07/21/2011 05:10:44 PM Eastern Daylight Time	CDPHP UNIVERSAL BENEFITS, INC.	CDPHP Medicare Choices	www.cdphp.com	CDPHP Classic (PPO)	01	04		1			H5042	004	0	2012	Capital, Central, Southern Tier, Hudson Valley NY		2	33	2			2						www.cdphp.com	http://www.cdphp.com/medicare	http://www.cdphp.com/medicare	(888)-248-6522		(518)-641-3950		(888)-519-4455		(518)-641-3400										(877)-261-1164		(518)-641-4000		(877)-261-1164		(518)-641-4000										2	2	2
H5042	005	0	1	04	01	H5042_005_0	8	1		07/20/2011	2012.02	07/20/2011 02:15:31 PM Eastern Daylight Time	08/08/2011 11:52:12 AM Eastern Daylight Time	08/04/2011 05:27:28 PM Eastern Daylight Time		08/08/2011 01:17:20 PM Eastern Daylight Time	CDPHP UNIVERSAL BENEFITS, INC.	CDPHP Medicare Choices	www.cdphp.com	CDPHP Core Rx (PPO)	01	04		1			H5042	005	0	2012	Capital, Central, Southern Tier, Hudson Valley NY		2	181	2			2						www.cdphp.com	http://www.cdphp.com/medicare	http://www.cdphp.com/medicare	(888)-248-6522		(518)-641-3950		(888)-519-4455		(518)-641-3400		(888)-831-3039		(518)-641-3950		(888)-519-4455		(518)-641-3400		(877)-261-1164		(518)-641-4000		(877)-261-1164		(518)-641-4000		(866)-236-1069		(518)-641-4000		(877)-261-1164		(518)-641-4000		2	2	2
H5042	007	0	1	04	01	H5042_007_0	8	1		07/20/2011	2012.02	07/20/2011 02:15:49 PM Eastern Daylight Time	08/08/2011 11:53:05 AM Eastern Daylight Time	08/04/2011 05:28:15 PM Eastern Daylight Time		08/08/2011 01:17:20 PM Eastern Daylight Time	CDPHP UNIVERSAL BENEFITS, INC.	CDPHP Medicare Choices	www.cdphp.com	CDPHP Prime Rx (PPO)	01	04		1			H5042	007	0	2012	Capital, Central, Southern Tier, Hudson Valley NY		2	175	2			2						www.cdphp.com	http://www.cdphp.com/medicare	http://www.cdphp.com/medicare	(888)-248-6522		(518)-641-3950		(888)-519-4455		(518)-641-3400		(888)-831-3039		(518)-641-3950		(888)-519-4455		(518)-641-3400		(877)-261-1164		(518)-641-4000		(877)-261-1164		(518)-641-4000		(866)-236-1069		(518)-641-4000		(877)-261-1164		(518)-641-4000		2	2	2
H5042	801	0	1	04	01	H5042_801_0	1	1		05/27/2011	2012.02	05/27/2011 01:58:44 PM Eastern Daylight Time	06/05/2011 07:24:46 AM Eastern Daylight Time			06/05/2011 07:34:08 AM Eastern Daylight Time	CDPHP UNIVERSAL BENEFITS, INC.	CDPHP Medicare Choices	www.cdphp.com	CDPHP Group Medicare Rx (PPO)	01	04		1			H5042	801	0	2012	Upstate New York Region		1	2623	2			2						www.cdphp.com	http://www.cdphp.com/medicare	http://www.cdphp.com/medicare	(888)-248-6522		(518)-641-3950		(888)-519-4455		(518)-641-3400		(888)-831-3039		(518)-641-3950		(888)-519-4455		(518)-641-3400		(877)-261-1164		(518)-641-4000		(877)-261-1164		(518)-641-4000		(866)-236-1069		(518)-641-4000		(877)-261-1164		(518)-641-4000		1	1	1
H5042	802	0	1	04	01	H5042_802_0	3	1		05/27/2011	2012.02	05/27/2011 01:58:55 PM Eastern Daylight Time	07/21/2011 04:41:13 PM Eastern Daylight Time			07/22/2011 11:00:41 AM Eastern Daylight Time	CDPHP UNIVERSAL BENEFITS, INC.	CDPHP Medicare Choices	www.cdphp.com	CDPHP Group Medicare Rx (PPO)	01	04		1			H5042	802	0	2012	Upstate New York Region		1	21120	2			2						www.cdphp.com	http://www.cdphp.com/medicare	http://www.cdphp.com/medicare	(888)-248-6522		(518)-641-3950		(888)-519-4455		(518)-641-3400		(888)-831-3039		(518)-641-3950		(888)-519-4455		(518)-641-3400		(877)-261-1164		(518)-641-4000		(877)-261-1164		(518)-641-4000		(866)-236-1069		(518)-641-4000		(877)-261-1164		(518)-641-4000		1	1	1
H5042	803	0	1	04	01	H5042_803_0	3	1		05/27/2011	2012.02	05/27/2011 02:00:00 PM Eastern Daylight Time	07/21/2011 04:50:12 PM Eastern Daylight Time			07/22/2011 11:00:41 AM Eastern Daylight Time	CDPHP UNIVERSAL BENEFITS, INC.	CDPHP Medicare Choices	www.cdphp.com	CDPHP Group Medicare (PPO)	01	04		1			H5042	803	0	2012	Upstate New York Region		1	25640	2			2						www.cdphp.com	http://www.cdphp.com/medicare	http://www.cdphp.com/medicare	(888)-248-6522		(518)-641-3950		(888)-519-4455		(518)-641-3400										(877)-261-1164		(518)-641-4000		(877)-261-1164		(518)-641-4000										1	1	1
H5050	001	0	1	01	01	H5050_001_0	7	1		07/06/2011	2012.01	07/06/2011 02:53:02 PM Pacific Daylight Time	07/22/2011 03:27:17 PM Pacific Daylight Time			07/26/2011 09:00:54 AM Pacific Daylight Time	GROUP HEALTH COOPERATIVE	Group Health Cooperative	www.ghc.org/medicare	Group Health Cooperative Clear Care Basic (HMO)	01	01		1			H5050	001	0	2012	All Counties Served by Group Health Cooperative		2		2			2						www.ghc.org/medicare	www.ghc.org/health_plans/index.jhtml?reposid=/common/healthPlans/Medicare/aboutPartDFormulary.html	www.ghc.org	(888)-901-4600		(206)-901-4600		(800)-446-8882		(800)-446-8882										(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388										2	2	2
H5050	004	0	1	01	01	H5050_004_0	9	1		08/09/2011	2012.02	08/09/2011 08:39:32 AM Pacific Daylight Time	08/08/2011 07:54:30 PM Pacific Daylight Time	08/08/2011 07:54:39 PM Pacific Daylight Time		08/09/2011 02:31:35 PM Pacific Daylight Time	GROUP HEALTH COOPERATIVE	Group Health Cooperative	www.ghc.org/medicare	Group Health Cooperative Clear Care Optimal (HMO)	01	01		1			H5050	004	0	2012	All Counties Served by Group Health Cooperative		2		2			2						www.ghc.org/medicare	www.ghc.org/health_plans/index.jhtml?reposid=/common/healthPlans/Medicare/aboutPartDFormulary.html	www.ghc.org	(888)-901-4600		(206)-901-4600		(800)-446-8882		(800)-446-8882		(888)-901-4600		(206)-901-4600		(800)-446-8882		(800)-446-8882		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		2	2	2
H5050	009	0	1	01	01	H5050_009_0	9	1		08/09/2011	2012.02	08/09/2011 08:39:41 AM Pacific Daylight Time	08/08/2011 07:54:48 PM Pacific Daylight Time	08/08/2011 07:54:44 PM Pacific Daylight Time		08/09/2011 02:31:35 PM Pacific Daylight Time	GROUP HEALTH COOPERATIVE	Group Health Cooperative	www.ghc.org/medicare	Group Health Cooperative Clear Care Essential (HMO)	01	01		1			H5050	009	0	2012	All Counties Served by Group Health Cooperative		2		2			2						www.ghc.org/medicare	www.ghc.org/health_plans/index.jhtml?reposid=/common/healthPlans/Medicare/aboutPartDFormulary.html	www.ghc.org	(888)-901-4600		(206)-901-4600		(800)-446-8882		(800)-446-8882		(888)-901-4600		(206)-901-4600		(800)-446-8882		(800)-446-8882		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		2	2	2
H5050	012	0	1	01	01	H5050_012_0	9	1		08/09/2011	2012.02	08/09/2011 08:39:49 AM Pacific Daylight Time	08/08/2011 07:54:48 PM Pacific Daylight Time	08/08/2011 07:54:44 PM Pacific Daylight Time		08/09/2011 02:31:35 PM Pacific Daylight Time	GROUP HEALTH COOPERATIVE	Group Health Cooperative	www.ghc.org/medicare	Group Health Cooperative Clear Care Sound (HMO SNP)	01	01		1			H5050	012	0	2012	King/Pierce		2		2			1	4		1		00000010000000000000	www.ghc.org/medicare	www.ghc.org/health_plans/index.jhtml?reposid=/common/healthPlans/Medicare/aboutPartDFormulary.html	www.ghc.org	(888)-901-4600		(206)-901-4600		(800)-446-8882		(800)-446-8882		(888)-901-4600		(206)-901-4600		(800)-446-8882		(800)-446-8882		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		2	2	2
H5050	013	0	1	01	01	H5050_013_0	9	1		08/09/2011	2012.02	08/09/2011 08:40:19 AM Pacific Daylight Time	08/08/2011 07:54:49 PM Pacific Daylight Time	08/08/2011 07:54:52 PM Pacific Daylight Time		08/09/2011 02:31:35 PM Pacific Daylight Time	GROUP HEALTH COOPERATIVE	Group Health Cooperative	www.ghc.org/medicare	Group Health Cooperative Clear Care Vital (HMO)	01	01		1			H5050	013	0	2012	All Counties Served by Group Health		2		2			2						www.ghc.org/medicare	www.ghc.org/health_plans/index.jhtml?reposid=/common/healthPlans/Medicare/aboutPartDFormulary.html	www.ghc.org	(888)-901-4600		(206)-901-4600		(800)-446-8882		(800)-446-8882		(888)-901-4600		(206)-901-4600		(800)-446-8882		(800)-446-8882		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		2	2	2
H5050	801	0	1	01	01	H5050_801_0	6	1		06/03/2011	2012.01	06/03/2011 09:27:34 AM Pacific Daylight Time	07/22/2011 03:27:19 PM Pacific Daylight Time			07/26/2011 09:00:54 AM Pacific Daylight Time	GROUP HEALTH COOPERATIVE	Group Health Cooperative	www.ghc.org/medicare	Group Health Cooperative Clear Care Employer Group (HMO)	01	01		1			H5050	801	0	2012	All Counties Served by Group Health Cooperative		1		2			2						www.ghc.org/medicare	www.ghc.org/health_plans/index.jhtml?reposid=/common/healthPlans/Medicare/aboutPartDFormulary.html	www.ghc.org	(888)-901-4600		(206)-901-4600		(800)-446-8882		(800)-446-8882										(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388										2	2	2
H5050	802	0	1	01	01	H5050_802_0	6	1		06/02/2011	2012.01	06/02/2011 09:02:56 AM Pacific Daylight Time	07/22/2011 03:27:19 PM Pacific Daylight Time			07/26/2011 09:00:54 AM Pacific Daylight Time	GROUP HEALTH COOPERATIVE	Group Health Cooperative	www.ghc.org/medicare	Group Health Clear Care Employer Group with Part D (HMO)	01	01		1			H5050	802	0	2012	All Counties Served by Group Health Cooperative		1		2			2						www.ghc.org/medicare	www.ghc.org/health_plans/index.jhtml?reposid=/common/healthPlans/Medicare/aboutPartDFormulary.html	www.ghc.org	(888)-901-4600		(206)-901-4600		(800)-446-8882		(800)-446-8882		(888)-901-4600		(206)-901-4600		(800)-446-8882		(800)-446-8882		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		(800)-833-6388		2	2	2
H5087	001	0	1	01	01	H5087_001_0	13	1	2	08/08/2011	2012.02	08/08/2011 05:18:12 PM Pacific Daylight Time	08/05/2011 10:01:25 AM Pacific Daylight Time	08/05/2011 10:01:07 AM Pacific Daylight Time		08/08/2011 05:21:41 PM Pacific Daylight Time	EASY CHOICE HEALTH PLAN INC.	Easy Choice Health Plan	www.easychoicehealthplan.com	Easy Choice Freedom Plan (HMO SNP)	01	01		1			H5087	001	0	2012	Easy Choice Freedom Plan		2	8000	2			1	3		1	3		easychoicehealthplan.com	easychoicehealthplan.com	easychoicehealthplan.com	(866)-999-3945		(866)-999-3945		(866)-999-3945		(866)-999-3945		(866)-999-3945		(866)-999-3945		(866)-999-3945		(866)-999-3945		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5087	002	0	1	01	01	H5087_002_0	10	1		07/28/2011	2012.02	07/28/2011 11:12:47 AM Pacific Daylight Time	08/05/2011 10:00:57 AM Pacific Daylight Time	08/05/2011 10:01:28 AM Pacific Daylight Time		08/08/2011 05:21:41 PM Pacific Daylight Time	EASY CHOICE HEALTH PLAN INC.	Easy Choice Health Plan	www.easychoicehealthplan.com	Easy Choice Plus Plan (HMO)	01	01		1			H5087	002	0	2012	Orange County		2	2000	2			2						easychoicehealthplan.com	easychoicehealthplan.com	easychoicehealthplan.com	(866)-999-3945		(866)-999-3945		(866)-999-3945		(866)-999-3945		(866)-999-3945		(866)-999-3945		(866)-999-3945		(866)-999-3945		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5087	005	0	1	01	01	H5087_005_0	16	1		08/08/2011	2012.02	08/08/2011 05:18:53 PM Pacific Daylight Time	08/10/2011 08:22:39 AM Pacific Daylight Time	08/05/2011 10:01:47 AM Pacific Daylight Time		08/10/2011 08:25:17 AM Pacific Daylight Time	EASY CHOICE HEALTH PLAN INC.	Easy Choice Health Plan	www.easychoicehealthplan.com	Easy Choice Best Plan (HMO)	01	01		1			H5087	005	0	2012	Easy Choice Best Plan		2	6000	2			2						easychoicehealthplan.com	easychoicehealthplan.com	easychoicehealthplan.com	(866)-999-3945		(866)-999-3945		(866)-999-3945		(866)-999-3945		(866)-999-3945		(866)-999-3945		(866)-999-3945		(866)-999-3945		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5096	001	0	1	04	01	H5096_001_0	8	1		08/09/2011	2012.02	08/09/2011 10:37:31 AM Eastern Daylight Time	08/09/2011 01:20:13 PM Eastern Daylight Time	08/09/2011 02:42:16 PM Eastern Daylight Time		08/09/2011 06:43:35 PM Eastern Daylight Time	UNIVERSAL HEALTH CARE INSURANCE COMPANY, INC.	Universal Health Care Insurance Company, Inc.	www.univhc.com	Universal Hassle-Free (PPO)	01	04		1			H5096	001	0	2012	National		2		2			2						www.univhc.com	www.univhc.com/medicare/members/medicare-formulary.php	http://www.univhc.com	(866)-690-4842		(866)-690-4842		(800)-965-7034		(800)-965-7034		(877)-204-8149		(877)-204-8149		(800)-965-7034		(800)-965-7034		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-759-1089		(800)-759-1089		(800)-617-0177		(800)-617-0177		2	2	2
H5096	002	0	1	04	01	H5096_002_0	5	1		07/20/2011	2012.02	07/20/2011 04:24:51 PM Eastern Daylight Time	07/22/2011 04:19:25 PM Eastern Daylight Time			07/22/2011 04:38:56 PM Eastern Daylight Time	UNIVERSAL HEALTH CARE INSURANCE COMPANY, INC.	Universal Health Care Insurance Company, Inc.	www.univhc.com	Universal Hassle-Free MA Only (PPO)	01	04		1			H5096	002	0	2012	National		2		2			2						www.univhc.com	www.univhc.com/medicare/members/medicare-formulary.php	http://www.univhc.com	(866)-690-4842		(866)-690-4842		(800)-965-7034		(800)-965-7034										(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-617-0177										2	2	2
H5106	013	0	1	04	01	H5106_013_0	9	1		07/21/2011	2012.02	07/21/2011 01:52:48 PM Eastern Daylight Time	08/04/2011 02:27:37 PM Eastern Daylight Time	08/04/2011 01:29:01 PM Eastern Daylight Time		08/05/2011 01:39:01 PM Eastern Daylight Time	HIGHMARK HEALTH INSURANCE COMPANY	Highmark Health Insurance Company	www.highmarkhealth.com	FreedomBlue PPO Standard (PPO)	01	04		1			H5106	013	0	2012	West Virginia Region 1 counties		2		2			2						www.highmarkhealth.com	http://highmark.medicare-approvedformularies.com/search.asp	http://www.highmarkhealth.com	(888)-459-4020		(888)-459-4020		(866)-682-7972		(866)-682-7972		(888)-459-4020		(888)-459-4020		(866)-682-7972		(866)-682-7972		(800)-855-1155		(800)-855-1155		(711)		(711)		(800)-855-1155		(800)-855-1155		(711)		(711)		2	2	2
H5106	014	0	1	04	01	H5106_014_0	9	1		07/21/2011	2012.02	07/21/2011 01:54:18 PM Eastern Daylight Time	08/04/2011 02:27:54 PM Eastern Daylight Time	08/04/2011 01:30:06 PM Eastern Daylight Time		08/05/2011 01:39:01 PM Eastern Daylight Time	HIGHMARK HEALTH INSURANCE COMPANY	Highmark Health Insurance Company	www.highmarkhealth.com	FreedomBlue PPO Deluxe (PPO)	01	04		1			H5106	014	0	2012	West Virginia Region 1 counties		2		2			2						www.highmarkhealth.com	http://highmark.medicare-approvedformularies.com/search.asp	http://www.highmarkhealth.com	(888)-459-4020		(888)-459-4020		(866)-682-7972		(866)-682-7972		(888)-459-4020		(888)-459-4020		(866)-682-7972		(866)-682-7972		(800)-855-1155		(800)-855-1155		(711)		(711)		(800)-855-1155		(800)-855-1155		(711)		(711)		2	2	2
H5106	015	0	1	04	01	H5106_015_0	9	1		07/21/2011	2012.02	07/21/2011 01:57:04 PM Eastern Daylight Time	08/04/2011 02:28:08 PM Eastern Daylight Time	08/04/2011 01:30:54 PM Eastern Daylight Time		08/05/2011 01:39:01 PM Eastern Daylight Time	HIGHMARK HEALTH INSURANCE COMPANY	Highmark Health Insurance Company	www.highmarkhealth.com	FreedomBlue PPO Standard (PPO)	01	04		1			H5106	015	0	2012	West Virginia Region 2 counties		2		2			2						www.highmarkhealth.com	http://highmark.medicare-approvedformularies.com/search.asp	http://www.highmarkhealth.com	(888)-459-4020		(888)-459-4020		(866)-682-7972		(866)-682-7972		(888)-459-4020		(888)-459-4020		(866)-682-7972		(866)-682-7972		(800)-855-1155		(800)-855-1155		(711)		(711)		(800)-855-1155		(800)-855-1155		(711)		(711)		2	2	2
H5106	016	0	1	04	01	H5106_016_0	9	1		07/21/2011	2012.02	07/21/2011 01:57:10 PM Eastern Daylight Time	08/04/2011 02:28:23 PM Eastern Daylight Time	08/04/2011 01:31:45 PM Eastern Daylight Time		08/05/2011 01:39:01 PM Eastern Daylight Time	HIGHMARK HEALTH INSURANCE COMPANY	Highmark Health Insurance Company	www.highmarkhealth.com	FreedomBlue PPO Deluxe (PPO)	01	04		1			H5106	016	0	2012	West Virginia Region 2 counties		2		2			2						www.highmarkhealth.com	http://highmark.medicare-approvedformularies.com/search.asp	http://www.highmarkhealth.com	(888)-459-4020		(888)-459-4020		(866)-682-7972		(866)-682-7972		(888)-459-4020		(888)-459-4020		(866)-682-7972		(866)-682-7972		(800)-855-1155		(800)-855-1155		(711)		(711)		(800)-855-1155		(800)-855-1155		(711)		(711)		2	2	2
H5106	017	0	1	04	01	H5106_017_0	8	1		07/21/2011	2012.02	07/21/2011 01:55:33 PM Eastern Daylight Time	07/01/2011 08:44:20 AM Eastern Daylight Time			07/21/2011 04:23:25 PM Eastern Daylight Time	HIGHMARK HEALTH INSURANCE COMPANY	Highmark Health Insurance Company	www.highmarkhealth.com	FreedomBlue PPO Value (PPO)	01	04		1			H5106	017	0	2012	West Virginia Region 1 counties		2		2			2						www.highmarkhealth.com	http://highmark.medicare-approvedformularies.com/search.asp	http://www.highmarkhealth.com	(888)-459-4020		(888)-459-4020		(866)-682-7972		(866)-682-7972										(800)-855-1155		(800)-855-1155		(711)		(711)										2	2	2
H5106	018	0	1	04	01	H5106_018_0	8	1		07/21/2011	2012.02	07/21/2011 01:57:21 PM Eastern Daylight Time	07/01/2011 08:44:29 AM Eastern Daylight Time			07/21/2011 04:23:25 PM Eastern Daylight Time	HIGHMARK HEALTH INSURANCE COMPANY	Highmark Health Insurance Company	www.highmarkhealth.com	FreedomBlue PPO Value (PPO)	01	04		1			H5106	018	0	2012	West Virginia Region 2 counties		2		2			2						www.highmarkhealth.com	http://highmark.medicare-approvedformularies.com/search.asp	http://www.highmarkhealth.com	(888)-459-4020		(888)-459-4020		(866)-682-7972		(866)-682-7972										(800)-855-1155		(800)-855-1155		(711)		(711)										2	2	2
H5106	025	0	1	04	01	H5106_025_0	10	1		08/17/2011	2012.02	08/17/2011 02:54:22 PM Eastern Daylight Time	08/04/2011 02:28:38 PM Eastern Daylight Time	08/04/2011 01:32:38 PM Eastern Daylight Time		08/17/2011 03:48:04 PM Eastern Daylight Time	HIGHMARK HEALTH INSURANCE COMPANY	Highmark Health Insurance Company	www.highmarkhealth.com	FreedomBlue PPO HD (PPO)	01	04		1			H5106	025	0	2012	West Virginia Region 1 counties		2		2			2						www.highmarkhealth.com	http://highmark.medicare-approvedformularies.com/search.asp	http://www.highmarkhealth.com	(888)-459-4020		(888)-459-4020		(866)-682-7972		(866)-682-7972		(888)-459-4020		(888)-459-4020		(866)-682-7972		(866)-682-7972		(800)-855-1155		(800)-855-1155		(711)		(711)		(800)-855-1155		(800)-855-1155		(711)		(711)		2	2	2
H5106	026	0	1	04	01	H5106_026_0	11	1		08/17/2011	2012.02	08/17/2011 03:23:13 PM Eastern Daylight Time	08/04/2011 02:28:56 PM Eastern Daylight Time	08/04/2011 01:33:30 PM Eastern Daylight Time		08/17/2011 03:48:04 PM Eastern Daylight Time	HIGHMARK HEALTH INSURANCE COMPANY	Highmark Health Insurance Company	www.highmarkhealth.com	FreedomBlue PPO HD (PPO)	01	04		1			H5106	026	0	2012	West Virginia Region 2 counties		2		2			2						www.highmarkhealth.com	http://highmark.medicare-approvedformularies.com/search.asp	http://www.highmarkhealth.com	(888)-459-4020		(888)-459-4020		(866)-682-7972		(866)-682-7972		(888)-459-4020		(888)-459-4020		(866)-682-7972		(866)-682-7972		(800)-855-1155		(800)-855-1155		(711)		(711)		(800)-855-1155		(800)-855-1155		(711)		(711)		2	2	2
H5106	806	0	1	04	01	H5106_806_0	5	1		04/12/2011	2012.02	04/12/2011 09:59:16 AM Eastern Daylight Time	06/04/2011 12:26:29 PM Eastern Daylight Time			06/04/2011 01:24:19 PM Eastern Daylight Time	HIGHMARK HEALTH INSURANCE COMPANY	Highmark Health Insurance Company	www.highmarkhealth.com	FreedomBlue PPO MA-PDP WV Non-Calendar (PPO)	01	04		1			H5106	806	0	2012	ALL WV COUNTIES		1		2			2						www.highmarkhealth.com	http://highmark.medicare-approvedformularies.com/search.asp	http://www.highmarkhealth.com	(888)-459-4020		(888)-459-4020		(866)-682-7972		(866)-682-7972		(888)-459-4020		(888)-459-4020		(866)-682-7972		(866)-682-7972		(800)-855-1155		(800)-855-1155		(711)		(711)		(800)-855-1155		(800)-855-1155		(711)		(711)		1	1	1
H5106	807	0	1	04	01	H5106_807_0	5	1		04/12/2011	2012.02	04/12/2011 09:59:24 AM Eastern Daylight Time	06/04/2011 12:26:59 PM Eastern Daylight Time			06/04/2011 01:24:19 PM Eastern Daylight Time	HIGHMARK HEALTH INSURANCE COMPANY	Highmark Health Insurance Company	www.highmarkhealth.com	FreedomBlue PPO MA WV (PPO)	01	04		1			H5106	807	0	2012	ALL WV COUNTIES		1		2			2						www.highmarkhealth.com	http://highmark.medicare-approvedformularies.com/search.asp	http://www.highmarkhealth.com	(888)-459-4020		(888)-459-4020		(866)-682-7972		(866)-682-7972										(800)-855-1155		(800)-855-1155		(711)		(711)										1	1	1
H5106	808	0	1	04	01	H5106_808_0	5	1		04/12/2011	2012.02	04/12/2011 09:56:21 AM Eastern Daylight Time	06/04/2011 12:27:31 PM Eastern Daylight Time			06/04/2011 01:24:19 PM Eastern Daylight Time	HIGHMARK HEALTH INSURANCE COMPANY	Highmark Health Insurance Company	www.highmarkhealth.com	FreedomBlue PPO MA-PDP WV (PPO)	01	04		1			H5106	808	0	2012	ALL WV COUNTIES		1		2			2						www.highmarkhealth.com	http://highmark.medicare-approvedformularies.com/search.asp	http://www.highmarkhealth.com	(888)-459-4020		(888)-459-4020		(866)-682-7972		(866)-682-7972		(888)-459-4020		(888)-459-4020		(866)-682-7972		(866)-682-7972		(800)-855-1155		(800)-855-1155		(711)		(711)		(800)-855-1155		(800)-855-1155		(711)		(711)		1	1	1
H5151	002	0	1	01	01	H5151_002_0	7	1		07/22/2011	2012.02	07/22/2011 05:02:20 PM Eastern Daylight Time	08/04/2011 03:20:55 PM Eastern Daylight Time	08/04/2011 03:05:02 PM Eastern Daylight Time		08/05/2011 10:26:34 AM Eastern Daylight Time	HEALTH PLAN OF THE UPPER OHIO VALLEY	The Health Plan	www.healthplan.org	SecureCare - Option II (HMO)	01	01		1			H5151	002	0	2012	East Ohio, Northern WV		2	3730	2			2						www.healthplan.org	www.healthplan.org	www.healthplan.org	(877)-847-7907		(740)-695-7907		(877)-847-7915		(740)-695-7915		(877)-847-7907		(740)-695-7907		(877)-847-7915		(740)-695-7915		(800)-622-3925		(740)-695-7919		(800)-622-3925		(740)-695-7919		(800)-622-3925		(740)-695-7919		(800)-622-3925		(740)-695-7919		2	2	2
H5151	004	0	1	01	01	H5151_004_0	4	1		07/13/2011	2012.02	07/13/2011 04:19:55 PM Eastern Daylight Time	07/14/2011 02:49:44 PM Eastern Daylight Time			07/18/2011 02:11:30 PM Eastern Daylight Time	HEALTH PLAN OF THE UPPER OHIO VALLEY	The Health Plan	www.healthplan.org	SecureCare - Option I (HMO)	01	01		1			H5151	004	0	2012	East Ohio, Northern WV		2	410	2			2						www.healthplan.org	www.healthplan.org	www.healthplan.org	(877)-847-7907		(740)-695-7907		(877)-847-7915		(740)-695-7915										(800)-622-3925		(740)-695-7919		(800)-622-3925		(740)-695-7919										2	2	2
H5151	006	0	1	01	01	H5151_006_0	7	1		07/22/2011	2012.02	07/22/2011 05:02:33 PM Eastern Daylight Time	08/04/2011 03:23:08 PM Eastern Daylight Time	08/04/2011 03:05:42 PM Eastern Daylight Time		08/05/2011 10:26:34 AM Eastern Daylight Time	HEALTH PLAN OF THE UPPER OHIO VALLEY	The Health Plan	www.healthplan.org	SecureCare - Option III (HMO)	01	01		1			H5151	006	0	2012	East Ohio, Northern WV		2	4140	2			2						www.healthplan.org	www.healthplan.org	www.healthplan.org	(877)-847-7907		(740)-695-7907		(877)-847-7915		(740)-695-7915		(877)-847-7907		(740)-695-7907		(877)-847-7915		(740)-695-7915		(800)-622-3925		(740)-695-7919		(800)-622-3925		(740)-695-7919		(800)-622-3925		(740)-695-7919		(800)-622-3925		(740)-695-7919		2	2	2
H5151	802	0	1	01	01	H5151_802_0	5	1		07/13/2011	2012.02	07/13/2011 04:20:04 PM Eastern Daylight Time	08/18/2011 09:08:00 AM Eastern Daylight Time			08/18/2011 11:45:16 AM Eastern Daylight Time	HEALTH PLAN OF THE UPPER OHIO VALLEY	The Health Plan	www.healthplan.org	SecureCare - Employer (HMO)	01	01		1			H5151	802	0	2012	Southeast Ohio, Northern West Virginia		1	40	2			2						www.healthplan.org	www.healthplan.org	www.healthplan.org	(877)-847-7907		(740)-695-7907		(877)-847-7915		(740)-695-7915										(800)-622-3925		(740)-695-7919		(800)-622-3925		(740)-695-7919										2	2	2
H5151	803	0	1	01	01	H5151_803_0	5	1		07/13/2011	2012.02	07/13/2011 04:20:09 PM Eastern Daylight Time	08/18/2011 09:11:42 AM Eastern Daylight Time			08/18/2011 11:45:16 AM Eastern Daylight Time	HEALTH PLAN OF THE UPPER OHIO VALLEY	The Health Plan	www.healthplan.org	SecureCare - Employer (HMO)	01	01		1			H5151	803	0	2012	Southeast Ohio, Northern West Virginia		1	1880	2			2						www.healthplan.org	www.healthplan.org	www.healthplan.org	(877)-847-7907		(740)-695-7907		(877)-847-7915		(740)-695-7915		(877)-847-7907		(740)-695-7907		(877)-847-7915		(740)-695-7915		(800)-622-3925		(740)-695-7919		(800)-622-3925		(740)-695-7919		(800)-622-3925		(740)-695-7919		(800)-622-3925		(740)-695-7919		2	2	2
H5162	004	0	1	04	01	H5162_004_0	9	1		08/05/2011	2012.02	08/05/2011 10:22:20 AM Central Daylight Time	08/04/2011 01:48:29 PM Central Daylight Time	08/04/2011 10:27:58 AM Central Daylight Time		08/05/2011 11:25:20 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Plus Plan (PPO)	01	04		1			H5162	004	0	2012	Peoria		2	58	2			2						http://www.sterlinghealth.com	http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-839-9079		(888)-839-9079		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H5162	006	0	1	04	01	H5162_006_0	7	1		08/05/2011	2012.02	08/05/2011 10:28:08 AM Central Daylight Time	08/04/2011 01:49:51 PM Central Daylight Time	08/04/2011 10:28:19 AM Central Daylight Time		08/05/2011 11:25:20 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Plus Plan (PPO)	01	04		1			H5162	006	0	2012	Kansas City/St. Louis		2	1053	2			2						http://www.sterlinghealth.com	http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-839-9079		(888)-839-9079		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H5162	016	0	1	04	01	H5162_016_0	7	1		08/05/2011	2012.02	08/05/2011 10:28:08 AM Central Daylight Time	08/04/2011 01:51:11 PM Central Daylight Time	08/04/2011 10:28:40 AM Central Daylight Time		08/05/2011 11:25:20 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	http://www.sterlinghealth.com	WindsorSterling Gold Plus Plan (PPO)	01	04		1			H5162	016	0	2012	Oklahoma		2	5	2			2						http://www.sterlinghealth.com	http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-839-9079		(888)-839-9079		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H5162	017	0	1	04	01	H5162_017_0	7	1		08/05/2011	2012.02	08/05/2011 10:28:09 AM Central Daylight Time	08/04/2011 01:52:28 PM Central Daylight Time	08/04/2011 10:29:01 AM Central Daylight Time		08/05/2011 11:25:20 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	http://www.sterlinghealth.com	WindsorSterling Gold Plus Plan (PPO)	01	04		1			H5162	017	0	2012	Texas		2	4	2			2						http://www.sterlinghealth.com	http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-839-9079		(888)-839-9079		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H5162	018	0	1	04	01	H5162_018_0	7	1		08/05/2011	2012.02	08/05/2011 10:28:09 AM Central Daylight Time	08/04/2011 01:53:46 PM Central Daylight Time	08/04/2011 10:29:22 AM Central Daylight Time		08/05/2011 11:25:20 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	http://www.sterlinghealth.com	WindsorSterling Gold Plus Plan (PPO)	01	04		1			H5162	018	0	2012	Kentucky		2	2	2			2						http://www.sterlinghealth.com	http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-839-9079		(888)-839-9079		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H5162	019	0	1	04	01	H5162_019_0	6	1		08/09/2011	2012.02	08/09/2011 10:52:22 AM Central Daylight Time		08/09/2011 10:51:22 AM Central Daylight Time		08/09/2011 11:12:47 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.FMCHP.com	Fresenius Health Partners PPO SNP (PPO SNP)	01	04		1			H5162	019	0	2012	Texas		2	458	2			1	4		1		00000000100000000000	http://www.sterlinghealth.com	http://www.sterlinghealth.com	http://www.sterlinghealth.com	(866)-307-3625		(866)-307-3625		(866)-307-3625		(866)-307-3625		(866)-307-3625		(866)-307-3625		(866)-307-3625		(866)-307-3625		(877)-736-2535		(877)-736-2535		(877)-736-2535		(877)-736-2535		(877)-736-2535		(877)-736-2535		(877)-736-2535		(877)-736-2535		2	2	2
H5167	001	0	1	20	08	H5167_001_0	1	1		05/23/2011	2012.02	05/23/2011 10:30:32 AM Mountain Daylight Time		05/20/2011 01:38:21 PM Mountain Daylight Time		05/23/2011 10:35:25 AM Mountain Daylight Time	ROCKY MOUNTAIN HEALTH CARE SERVICES	Rocky Mountain PACE	rmhcare.org	Rocky Mountain PACE (PACE)	08	20		1			H5167	001	0	2012	Colorado Springs Metro Area		2		2			2							www.rmhcare.org	www.rmhcare.org									(866)-519-5849	335	(719)-314-2327	335	(866)-519-5849	335	(719)-314-2327	335									(800)-659-2656		(719)-314-2327	335	(800)-659-2656		(719)-314-2327	335			
H5167	002	0	1	20	08	H5167_002_0	1	1		05/23/2011	2012.02	05/23/2011 10:31:08 AM Mountain Daylight Time		05/20/2011 01:38:21 PM Mountain Daylight Time		05/23/2011 10:35:25 AM Mountain Daylight Time	ROCKY MOUNTAIN HEALTH CARE SERVICES	Rocky Mountain PACE	rmhcare.org	Rocky Mountain PACE (PACE)	08	20		1			H5167	002	0	2012	Colorado Springs Metro Area		2		2			2							www.rmhcare.org	www.rmhcare.org									(866)-519-5849	335	(719)-314-2327	335	(866)-519-5849	335	(719)-314-2327	335									(800)-659-2656		(719)-314-2327	335	(800)-659-2656		(719)-314-2327	335			
H5206	002	0	1	01	01	H5206_002_0	3	1	2	08/05/2011	2012.02	08/05/2011 04:54:07 PM Central Daylight Time	08/04/2011 12:50:06 PM Central Daylight Time	08/04/2011 12:33:20 PM Central Daylight Time		08/08/2011 12:46:59 PM Central Daylight Time	PARTNERSHIP HEALTH PLAN, INC.	Community Health Partnership	www.communityhealthpartnership.com	Community Health Partnership (HMO SNP)	01	01		1			H5206	002	0	2012	Chippewa, Dunn and Eau Claire Counties		2	16998	2			1	3		1	5		http://www.communityhealthpartnership.com	http://www.communityhealthpartnership.com/members/php/formulary.php	http://www.communityhealthpartnership.com/members/php/pharmacy_wrapper.php	(800)-842-1814		(715)-838-2900		(800)-842-1814		(715)-838-2900		(800)-842-1814		(715)-838-2900		(800)-842-1814		(715)-838-2900		(800)-842-1814		(715)-838-2900		(800)-842-1814		(715)-838-2900		(800)-842-1814		(715)-838-2900		(800)-842-1814		(715)-838-2900		2	1	1
H5206	003	0	1	01	01	H5206_003_0	4	1	2	08/08/2011	2012.02	08/08/2011 12:44:18 PM Central Daylight Time	08/04/2011 12:58:14 PM Central Daylight Time	08/04/2011 12:34:50 PM Central Daylight Time		08/08/2011 12:46:59 PM Central Daylight Time	PARTNERSHIP HEALTH PLAN, INC.	Community Health Partnership	www.communityhealthpartnership.com	Community Health Partnership (HMO SNP)	01	01		1			H5206	003	0	2012	Pierce and St. Croix Counties		2	314	2			1	3		1	5		http://www.communityhealthpartnership.com	http://www.communityhealthpartnership.com/members/php/formulary.php	http://www.communityhealthpartnership.com/members/php/pharmacy_wrapper.php	(800)-842-1814		(715)-838-2900		(800)-842-1814		(715)-838-2900		(800)-842-1814		(715)-838-2900		(800)-842-1814		(715)-838-2900		(800)-842-1814		(715)-838-2900		(800)-842-1814		(715)-838-2900		(800)-842-1814		(715)-838-2900		(800)-842-1814		(715)-838-2900		2	1	1
H5207	001	0	1	01	01	H5207_001_0	6	1	2	08/23/2011	2012.02	08/23/2011 04:03:58 PM Central Daylight Time	08/09/2011 03:11:33 PM Central Daylight Time	08/09/2011 03:11:02 PM Central Daylight Time		08/23/2011 04:12:48 PM Central Daylight Time	COMMUNITY CARE HEALTH PLAN, INC	Community Care	www.CommunityCareInc.org	Community Care's Partnership Program (HMO SNP)	01	01		1			H5207	001	0	2012	Kenosha, Milwaukee, Racine and Waukesha Counties		2	340	2			1	3		1	5		www.CommunityCareInc.org	www.communitycareinc.org/Assets/Formulary.pdf	www.communitycareinc.org	(866)-992-6600		(414)-385-6600		(866)-992-6600		(414)-385-6600		(866)-992-6600		(414)-385-6600		(866)-992-6600		(414)-385-6600		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		2	1	2
H5209	002	0	1	01	01	H5209_002_0	5	1	2	04/22/2011	2012.01	04/22/2011 04:13:07 PM Central Daylight Time	08/04/2011 02:26:28 PM Central Daylight Time	08/04/2011 02:11:56 PM Central Daylight Time		08/05/2011 09:27:21 AM Central Daylight Time	CARE WISCONSIN HEALTH PLAN, INC.	Care Wisconsin Health Plan, Inc.	www.carewisconsinhealthplan.org	Partnership (HMO SNP)	01	01		1			H5209	002	0	2012	Dane County		2		2			1	3		1	5		www.carewisconsinhealthplan.org	www.carewisconsinhealthplan.org	www.carewisconsinhealthplan.org	(800)-963-0035		(608)-240-0035		(800)-963-0035		(608)-245-3075		(800)-963-0035		(608)-240-0035		(800)-963-0035		(608)-245-3075		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		2	1	1
H5211	001	0	1	02	01	H5211_001_0	12	1		09/09/2011	2012.02	09/09/2011 01:06:11 PM Central Daylight Time	07/14/2011 04:14:48 PM Central Daylight Time			09/09/2011 01:08:52 PM Central Daylight Time	SECURITY HEALTH PLAN OF WISCONSIN, INC	Advocare	www.securityhealth.org	Advocare Spirit (HMO-POS)	01	02		1			H5211	001	0	2012	Central, Northern and Western Wisconsin		2	5625	2			2						www.securityhealth.org	http://www.advocareplans.com/Home/AdvocarePlans/PartDInformation/DrugFormulary/tabid/95/Default.aspx	http://www.advocareplans.com/Home/AdvocarePlans/PartDInformation/ListofNetworkPharmacies/tabid/96/De	(877)-998-0998		(715)-221-9897		(877)-998-0998		(715)-221-9897										(877)-727-2232		(877)-727-2232		(877)-727-2232		(877)-727-2232										2	2	2
H5211	002	0	1	02	01	H5211_002_0	13	1		07/21/2011	2012.02	07/21/2011 03:19:05 PM Central Daylight Time	08/08/2011 11:00:34 AM Central Daylight Time	08/08/2011 10:55:09 AM Central Daylight Time		08/08/2011 11:45:30 AM Central Daylight Time	SECURITY HEALTH PLAN OF WISCONSIN, INC	Advocare	www.securityhealth.org	Advocare Essence Rx (HMO-POS)	01	02		1			H5211	002	0	2012	Central, Northern and Western Wisconsin		2	12056	2			2						www.securityhealth.org	http://www.advocareplans.com/Home/AdvocarePlans/PartDInformation/DrugFormulary/tabid/95/Default.aspx	http://www.advocareplans.com/Home/AdvocarePlans/PartDInformation/ListofNetworkPharmacies/tabid/96/De	(877)-998-0998		(715)-221-9897		(877)-998-0998		(715)-221-9897		(877)-998-0998		(715)-221-9897		(877)-998-0998		(715)-221-9897		(877)-727-2232		(877)-727-2232		(877)-727-2232		(877)-727-2232		(877)-727-2232		(877)-727-2232		(877)-727-2232		(877)-727-2232		2	2	2
H5211	003	0	1	02	01	H5211_003_0	12	1		07/21/2011	2012.02	07/21/2011 03:19:13 PM Central Daylight Time	07/14/2011 04:16:22 PM Central Daylight Time			07/21/2011 03:41:23 PM Central Daylight Time	SECURITY HEALTH PLAN OF WISCONSIN, INC	Advocare	www.securityhealth.org	Advocare Essence (HMO-POS)	01	02		1			H5211	003	0	2012	Central, Northern and Western Wisconsin		2	5766	2			2						www.securityhealth.org	http://www.advocareplans.com/Home/AdvocarePlans/PartDInformation/DrugFormulary/tabid/95/Default.aspx	http://www.advocareplans.com/Home/AdvocarePlans/PartDInformation/ListofNetworkPharmacies/tabid/96/De	(877)-998-0998		(715)-221-9897		(877)-998-0998		(715)-221-9897										(877)-727-2232		(877)-727-2232		(877)-727-2232		(877)-727-2232										2	2	2
H5211	004	0	1	02	01	H5211_004_0	13	1		09/09/2011	2012.02	09/09/2011 01:06:25 PM Central Daylight Time	08/08/2011 11:01:22 AM Central Daylight Time	08/08/2011 10:55:38 AM Central Daylight Time		09/09/2011 01:08:52 PM Central Daylight Time	SECURITY HEALTH PLAN OF WISCONSIN, INC	Advocare	www.securityhealth.org	Advocare Spirit Rx (HMO-POS)	01	02		1			H5211	004	0	2012	Central, Northern and Western Wisconsin		2	8137	2			2						www.securityhealth.org	http://www.advocareplans.com/Home/AdvocarePlans/PartDInformation/DrugFormulary/tabid/95/Default.aspx	http://www.advocareplans.com/Home/AdvocarePlans/PartDInformation/ListofNetworkPharmacies/tabid/96/De	(877)-998-0998		(715)-221-9897		(877)-998-0998		(715)-221-9897		(877)-998-0998		(715)-221-9897		(877)-998-0998		(715)-221-9897		(877)-727-2232		(877)-727-2232		(877)-727-2232		(877)-727-2232		(877)-727-2232		(877)-727-2232		(877)-727-2232		(877)-727-2232		2	2	2
H5211	005	0	1	02	01	H5211_005_0	12	1		07/21/2011	2012.02	07/21/2011 03:19:31 PM Central Daylight Time	08/08/2011 11:02:17 AM Central Daylight Time	08/08/2011 10:56:35 AM Central Daylight Time		08/08/2011 11:45:30 AM Central Daylight Time	SECURITY HEALTH PLAN OF WISCONSIN, INC	Advocare	www.securityhealth.org	Advocare Vitality Rx (HMO-POS)	01	02		1			H5211	005	0	2012	Central, Northern and Western Wisconsin		2	3958	2			2						www.securityhealth.org	http://www.advocareplans.com/Home/AdvocarePlans/PartDInformation/DrugFormulary/tabid/95/Default.aspx	http://www.advocareplans.com/Home/AdvocarePlans/PartDInformation/ListofNetworkPharmacies/tabid/96/De	(877)-998-0998		(715)-221-9897		(877)-998-0998		(715)-221-9897		(877)-998-0998		(715)-221-9897		(877)-998-0998		(715)-221-9897		(877)-727-2232		(877)-727-2232		(877)-727-2232		(877)-727-2232		(877)-727-2232		(877)-727-2232		(877)-727-2232		(877)-727-2232		2	2	2
H5211	006	0	1	02	01	H5211_006_0	11	1		07/21/2011	2012.02	07/21/2011 03:19:40 PM Central Daylight Time	07/14/2011 04:18:43 PM Central Daylight Time			07/21/2011 03:41:23 PM Central Daylight Time	SECURITY HEALTH PLAN OF WISCONSIN, INC	Advocare	www.securityhealth.org	Advocare Vitality (HMO-POS)	01	02		1			H5211	006	0	2012	Central, Northern and Western Wisconsin		2	2036	2			2						www.securityhealth.org	http://www.advocareplans.com/Home/AdvocarePlans/PartDInformation/DrugFormulary/tabid/95/Default.aspx	http://www.advocareplans.com/Home/AdvocarePlans/PartDInformation/ListofNetworkPharmacies/tabid/96/De	(877)-998-0998		(715)-221-9897		(877)-998-0998		(715)-221-9897										(877)-727-2232		(877)-727-2232		(877)-727-2232		(877)-727-2232										2	2	2
H5212	001	0	1	20	08	H5212_001_0	1	1		05/24/2011	2012.02	05/24/2011 07:46:23 AM Central Daylight Time		05/24/2011 10:40:29 AM Central Daylight Time		05/24/2011 12:24:49 PM Central Daylight Time	COMMUNITY CARE, INC.	Community Care	www.CommunityCareInc.org	Community Care's PACE Program (PACE)	08	20		1			H5212	001	0	2012	Milwaukee County, Waukesha County		2		2			2							www.CommunityCareInc.org	www.CommunityCareInc.org									(866)-992-6600		(414)-385-6600		(866)-992-6600		(414)-385-6600										(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529				
H5212	002	0	1	20	08	H5212_002_0	1	1		05/24/2011	2012.02	05/24/2011 07:46:37 AM Central Daylight Time		05/24/2011 10:40:29 AM Central Daylight Time		05/24/2011 12:24:49 PM Central Daylight Time	COMMUNITY CARE, INC.	Community Care	www.CommunityCareInc.org	Community Care's PACE Program (PACE)	08	20		1			H5212	002	0	2012	Milwaukee County, Waukesha County		2		2			2							www.CommunityCareInc.org	www.CommunityCareInc.org									(866)-992-6600		(414)-385-6600		(866)-992-6600		(414)-385-6600										(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529				
H5213	001	0	1	20	08	H5213_001_0	3	1		08/05/2011	2012.02	08/05/2011 03:34:05 PM Mountain Daylight Time		08/05/2011 03:33:12 PM Mountain Daylight Time		08/05/2011 03:35:53 PM Mountain Daylight Time	TOTAL COMMUNITY CARE, L.L.C.	Total Community Care	www.TotalCommunityCare.org	Total Community Care (PACE)	08	20		1			H5213	001	0	2012	Albuquerque Metro Area		2		1	1		2							www.TotalCommunityCare.org	www.TotalCommunityCare.org									(505)-924-2608		(505)-924-2608		(877)-277-6163		(303)-869-4664										(505)-924-2608		(505)-924-2608		(877)-277-6163		(303)-869-4664				
H5213	002	0	1	20	08	H5213_002_0	3	1		08/05/2011	2012.02	08/05/2011 03:34:21 PM Mountain Daylight Time		08/05/2011 03:33:10 PM Mountain Daylight Time		08/05/2011 03:35:53 PM Mountain Daylight Time	TOTAL COMMUNITY CARE, L.L.C.	Total Community Care	www.TotalCommunityCare.org	Total Community Care (PACE)	08	20		1			H5213	002	0	2012	Albuquerque Metro Area		2		1	1		2							www.TotalCommunityCare.org	www.TotalCommunityCare.org									(505)-924-2608		(505)-924-2608		(505)-924-2608		(303)-869-4664										(505)-924-2608		(505)-924-2608		(505)-924-2608		(505)-924-2608				
H5214	003	0	1	04	01	H5214_003_0	7	1		07/07/2011	2012.02	07/07/2011 12:12:24 PM Eastern Daylight Time	08/05/2011 12:01:46 PM Eastern Daylight Time	08/04/2011 12:32:06 PM Eastern Daylight Time		08/08/2011 04:05:27 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H5214-003 (PPO)	01	04		1			H5214	003	0	2012	Atlanta Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5214	004	0	1	04	01	H5214_004_0	7	1		07/07/2011	2012.02	07/07/2011 03:42:11 PM Eastern Daylight Time	08/05/2011 11:50:42 AM Eastern Daylight Time	08/04/2011 12:32:26 PM Eastern Daylight Time		08/08/2011 04:05:27 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H5214-004 (PPO)	01	04		1			H5214	004	0	2012	Aiken / Augusta Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5214	008	0	1	04	01	H5214_008_0	7	1		07/07/2011	2012.02	07/07/2011 03:42:34 PM Eastern Daylight Time	08/05/2011 11:55:32 AM Eastern Daylight Time	08/04/2011 12:32:44 PM Eastern Daylight Time		08/08/2011 04:05:27 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H5214-008 (PPO)	01	04		1			H5214	008	0	2012	Athens Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5214	009	0	1	04	01	H5214_009_0	5	1		07/12/2011	2012.02	07/12/2011 10:57:26 AM Eastern Daylight Time	08/05/2011 08:55:10 AM Eastern Daylight Time	08/04/2011 12:33:03 PM Eastern Daylight Time		08/08/2011 04:11:22 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H5214-009 (PPO)	01	04		1			H5214	009	0	2012	Columbus Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5214	010	0	1	04	01	H5214_010_0	7	1		07/07/2011	2012.02	07/07/2011 03:43:24 PM Eastern Daylight Time	08/05/2011 08:58:57 AM Eastern Daylight Time	08/04/2011 12:33:40 PM Eastern Daylight Time		08/08/2011 04:11:22 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H5214-010 (PPO)	01	04		1			H5214	010	0	2012	Russell, Harris and Muscogee Counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5214	011	0	1	04	01	H5214_011_0	5	1		07/07/2011	2012.02	07/07/2011 03:43:42 PM Eastern Daylight Time	08/05/2011 11:56:28 AM Eastern Daylight Time	08/04/2011 12:34:00 PM Eastern Daylight Time		08/08/2011 04:11:22 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H5214-011 (PPO)	01	04		1			H5214	011	0	2012	Towns County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5214	012	0	1	04	01	H5214_012_0	7	1		07/07/2011	2012.02	07/07/2011 03:44:09 PM Eastern Daylight Time	08/05/2011 09:14:01 AM Eastern Daylight Time	08/04/2011 12:34:20 PM Eastern Daylight Time		08/08/2011 04:11:22 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H5214-012 (PPO)	01	04		1			H5214	012	0	2012	Chatham and Evans counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5215	001	0	1	04	01	H5215_001_0	9	1		07/15/2011	2012.02	07/15/2011 02:06:36 PM Central Daylight Time	07/22/2011 12:36:07 PM Central Daylight Time			07/22/2011 01:08:37 PM Central Daylight Time	NETWORK HEALTH INSURANCE CORPORATION	Network Platinum Medicare Advantage Plans	www.nppdrugplans.com	Network PlatinumPlus (PPO)	01	04		1			H5215	001	0	2012	East Central Wisconsin		2		2			2						www.nppdrugplans.com	http://www.nppdrugplans.com/cgi-bin/formulary-2009/index.pl	www.nppdrugplans.com	(800)-378-5234		(920)-720-1345		(800)-983-7587		(920)-720-1280										(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529										2	2	2
H5215	002	0	1	04	01	H5215_002_0	11	1		07/15/2011	2012.02	07/15/2011 02:06:52 PM Central Daylight Time	08/07/2011 09:31:30 AM Central Daylight Time	08/07/2011 09:31:58 AM Central Daylight Time		08/07/2011 09:52:57 AM Central Daylight Time	NETWORK HEALTH INSURANCE CORPORATION	Network Platinum Medicare Advantage Plans	www.nppdrugplans.com	Network PlatinumPlus Pharmacy (PPO)	01	04		1			H5215	002	0	2012	East Central Wisconsin		2		2			2						www.nppdrugplans.com	http://www.nppdrugplans.com/cgi-bin/formulary-2009/index.pl	www.nppdrugplans.com	(800)-378-5234		(920)-720-1345		(800)-983-7587		(920)-720-1280		(800)-378-5234		(920)-720-1345		(800)-983-7587		(920)-720-1280		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		2	2	2
H5215	005	0	1	04	01	H5215_005_0	11	1		07/19/2011	2012.02	07/19/2011 02:08:44 PM Central Daylight Time	08/07/2011 09:32:24 AM Central Daylight Time	08/07/2011 09:33:00 AM Central Daylight Time		08/07/2011 09:52:57 AM Central Daylight Time	NETWORK HEALTH INSURANCE CORPORATION	Network Platinum Medicare Advantage Plans	www.nppdrugplans.com	Network PlatinumPremier Pharmacy (PPO)	01	04		1			H5215	005	0	2012	East Central Wisconsin		2		2			2						www.nppdrugplans.com	http://www.nppdrugplans.com/cgi-bin/formulary-2009/index.pl	www.nppdrugplans.com	(800)-378-5234		(920)-720-1345		(800)-983-7587		(920)-720-1280		(800)-378-5234		(920)-720-1345		(800)-983-7587		(920)-720-1280		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		2	2	2
H5215	006	0	1	04	01	H5215_006_0	9	1		07/19/2011	2012.02	07/19/2011 02:09:02 PM Central Daylight Time	07/22/2011 12:37:23 PM Central Daylight Time			07/22/2011 01:08:37 PM Central Daylight Time	NETWORK HEALTH INSURANCE CORPORATION	Network Platinum Medicare Advantage Plans	www.nppdrugplans.com	Network PlatinumPremier (PPO)	01	04		1			H5215	006	0	2012	East Central Wisconsin		2		2			2						www.nppdrugplans.com	http://www.nppdrugplans.com/cgi-bin/formulary-2009/index.pl	www.nppdrugplans.com	(800)-378-5234		(920)-720-1345		(800)-983-7587		(920)-720-1280										(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529										2	2	2
H5215	007	0	1	04	01	H5215_007_0	9	1	2	08/07/2011	2012.02	08/07/2011 09:38:33 AM Central Daylight Time	08/07/2011 09:29:29 AM Central Daylight Time	08/07/2011 09:29:53 AM Central Daylight Time		08/07/2011 09:52:57 AM Central Daylight Time	NETWORK HEALTH INSURANCE CORPORATION	Network Platinum Medicare Advantage Plans	www.nppdrugplans.com	NetworkCares (PPO SNP)	01	04		1			H5215	007	0	2012	East Central Wisconsin		2		2			1	3		1	2		www.nppdrugplans.com	http://www.nppdrugplans.com/cgi-bin/formulary-2009/index.pl	www.nppdrugplans.com	(800)-378-5234		(920)-720-1345		(800)-983-7587		(920)-720-1280		(800)-378-5234		(920)-720-1345		(800)-983-7587		(920)-720-1280		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		2	2	2
H5215	008	0	1	04	01	H5215_008_0	10	1		07/15/2011	2012.02	07/15/2011 02:09:01 PM Central Daylight Time	08/07/2011 09:30:20 AM Central Daylight Time	08/07/2011 09:30:49 AM Central Daylight Time		08/07/2011 09:52:57 AM Central Daylight Time	NETWORK HEALTH INSURANCE CORPORATION	Network Platinum Medicare Advantage Plans	www.nppdrugplans.com	Network PlatinumSelect (PPO)	01	04		1			H5215	008	0	2012	East Central Wisconsin		2		2			2						www.nppdrugplans.com	http://www.nppdrugplans.com/cgi-bin/formulary-2009/index.pl	www.nppdrugplans.com	(800)-378-5234		(920)-720-1345		(800)-983-7587		(920)-720-1280		(800)-378-5234		(920)-720-1345		(800)-983-7587		(920)-720-1280		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		2	2	2
H5215	806	0	1	04	01	H5215_806_0	3	1		07/15/2011	2012.02	07/15/2011 11:11:57 AM Central Daylight Time	06/06/2011 05:43:35 PM Central Daylight Time			07/15/2011 03:00:06 PM Central Daylight Time	NETWORK HEALTH INSURANCE CORPORATION	Network Platinum Medicare Advantage Plans	www.nppdrugplans.com	Network PlatinumPlus Pharmacy EGP (PPO)	01	04		1			H5215	806	0	2012	East Central WI		1		2			2						www.nppdrugplans.com	http://www.nppdrugplans.com/cgi-bin/formulary-2009/index.pl	www.nppdrugplans.com	(800)-378-5234		(920)-720-1345		(800)-983-7587		(920)-720-1280		(800)-378-5234		(920)-720-1345		(800)-983-7587		(920)-720-1280		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		2	2	2
H5215	807	0	1	04	01	H5215_807_0	3	1		07/15/2011	2012.02	07/15/2011 10:40:16 AM Central Daylight Time	06/06/2011 05:44:00 PM Central Daylight Time			07/15/2011 03:00:06 PM Central Daylight Time	NETWORK HEALTH INSURANCE CORPORATION	Network Platinum Medicare Advantage Plans	www.nppdrugplans.com	Network PlatinumPremier EGP (PPO)	01	04		1			H5215	807	0	2012	East Central WI		1		2			2						www.nppdrugplans.com	http://www.nppdrugplans.com/cgi-bin/formulary-2009/index.pl	www.nppdrugplans.com	(800)-378-5234		(920)-720-1345		(800)-983-7587		(920)-720-1280										(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529										2	2	2
H5215	808	0	1	04	01	H5215_808_0	3	1		07/15/2011	2012.02	07/15/2011 10:40:42 AM Central Daylight Time	06/06/2011 05:44:25 PM Central Daylight Time			07/15/2011 03:00:06 PM Central Daylight Time	NETWORK HEALTH INSURANCE CORPORATION	Network Platinum Medicare Advantage Plans	www.nppdrugplans.com	Network PlatinumPremier Pharmacy EGP (PPO)	01	04		1			H5215	808	0	2012	East Central WI		1		2			2						www.nppdrugplans.com	http://www.nppdrugplans.com/cgi-bin/formulary-2009/index.pl	www.nppdrugplans.com	(800)-378-5234		(920)-720-1345		(800)-983-7587		(920)-720-1280		(800)-378-5234		(920)-720-1345		(800)-983-7587		(920)-720-1280		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		2	2	2
H5216	001	0	1	04	01	H5216_001_0	5	1		07/06/2011	2012.02	07/06/2011 01:23:56 PM Eastern Daylight Time	08/04/2011 02:40:07 PM Eastern Daylight Time	08/04/2011 12:34:38 PM Eastern Daylight Time		08/08/2011 03:13:30 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H5216-001 (PPO)	01	04		1			H5216	001	0	2012	Select Counties in Wisconsin		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5216	003	0	1	04	01	H5216_003_0	4	1		07/06/2011	2012.02	07/06/2011 01:24:22 PM Eastern Daylight Time	08/04/2011 01:58:02 PM Eastern Daylight Time	08/04/2011 12:34:58 PM Eastern Daylight Time		08/08/2011 03:13:30 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H5216-003 (PPO)	01	04		1			H5216	003	0	2012	Select Counties in Wisconsin		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5216	006	0	1	04	01	H5216_006_0	4	1		07/06/2011	2012.02	07/06/2011 01:24:46 PM Eastern Daylight Time	08/04/2011 02:14:35 PM Eastern Daylight Time	08/04/2011 12:35:18 PM Eastern Daylight Time		08/08/2011 03:19:18 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H5216-006 (PPO)	01	04		1			H5216	006	0	2012	Select Counties in Wisconsin		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5216	007	0	1	04	01	H5216_007_0	4	1		07/06/2011	2012.02	07/06/2011 01:25:14 PM Eastern Daylight Time	08/04/2011 02:15:28 PM Eastern Daylight Time	08/04/2011 12:35:37 PM Eastern Daylight Time		08/08/2011 03:19:18 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H5216-007 (PPO)	01	04		1			H5216	007	0	2012	Select Counties in Wisconsin		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5253	004	0	1	02	01	H5253_004_0	4	1		08/04/2011	2012.02	08/04/2011 07:49:05 PM Central Daylight Time	08/05/2011 12:27:03 PM Central Daylight Time	08/05/2011 01:41:30 PM Central Daylight Time		08/09/2011 12:48:01 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H5253	004	0	2012	Metro Milwaukee		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5253	007	0	1	02	01	H5253_007_0	4	1		08/19/2011	2012.02	08/19/2011 03:38:49 PM Central Daylight Time	08/19/2011 11:58:33 AM Central Daylight Time	08/05/2011 01:41:46 PM Central Daylight Time		08/19/2011 04:19:30 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC	UnitedHealthcare	www.EvercareHealthPlans.com	UnitedHealthcare Nursing Home Plan (HMO-POS SNP)	01	02		1			H5253	007	0	2012	Appleton,GreenBay,LaCrosse,Milwaukee,Madison areas		2		2			1	1	1	1			www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5253	011	0	1	02	01	H5253_011_0	4	1		08/04/2011	2012.02	08/04/2011 07:55:36 PM Central Daylight Time	08/05/2011 12:28:15 PM Central Daylight Time	08/05/2011 01:42:01 PM Central Daylight Time		08/09/2011 12:48:01 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H5253	011	0	2012	Green Bay/Fox Valley /Sheboygan/Dodge Counties		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5253	021	0	1	02	01	H5253_021_0	3	1		07/20/2011	2012.02	07/20/2011 12:41:13 PM Central Daylight Time	07/22/2011 01:58:16 PM Central Daylight Time			07/25/2011 01:45:29 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus Essential (HMO-POS)	01	02		1			H5253	021	0	2012	Metro Milwaukee		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514										(711)		(711)		(711)		(711)										2	2	2
H5253	024	0	1	01	01	H5253_024_0	5	1	2	08/05/2011	2012.02	08/05/2011 04:43:10 PM Central Daylight Time	08/05/2011 12:28:52 PM Central Daylight Time	08/05/2011 01:13:48 PM Central Daylight Time		08/09/2011 01:10:13 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC	SecureHorizons by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Dual Complete LP (HMO SNP)	01	01		1			H5253	024	0	2012	Appleton,GreenBay,LaCrosse,Milwaukee,Madison areas		2		2			1	3		1	2		www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5253	028	0	1	02	01	H5253_028_0	4	1		08/04/2011	2012.02	08/04/2011 07:58:31 PM Central Daylight Time	08/05/2011 12:29:28 PM Central Daylight Time	08/05/2011 01:42:18 PM Central Daylight Time		08/09/2011 01:10:13 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H5253	028	0	2012	La Crosse Area Counties		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5253	030	0	1	02	01	H5253_030_0	4	1		08/04/2011	2012.02	08/04/2011 07:59:40 PM Central Daylight Time	08/05/2011 12:30:03 PM Central Daylight Time	08/05/2011 01:42:33 PM Central Daylight Time		08/09/2011 01:10:13 PM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H5253	030	0	2012	Rock County		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5253	801	0	1	01	01	H5253_801_0	2	1		07/06/2011	2012.02	07/06/2011 04:49:43 PM Central Daylight Time	06/03/2011 03:36:38 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H5253	801	0	2012	Milwaukee and Green Bay Area Counties		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5253	802	0	1	01	01	H5253_802_0	2	1		07/06/2011	2012.02	07/06/2011 04:49:48 PM Central Daylight Time	06/03/2011 03:37:47 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H5253	802	0	2012	Milwaukee and Green Bay Area Counties		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548										(711)		(711)		(711)		(711)										2	2	2
H5253	805	0	1	01	01	H5253_805_0	2	1		07/06/2011	2012.02	07/06/2011 04:49:51 PM Central Daylight Time	06/03/2011 03:38:59 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H5253	805	0	2012	Select Counties in WI		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5253	807	0	1	02	01	H5253_807_0	2	1		07/06/2011	2012.02	07/06/2011 04:50:05 PM Central Daylight Time	06/03/2011 03:40:10 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF WISCONSIN, INC	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO-POS)	01	02		1			H5253	807	0	2012	Select counties in WI		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5256	001	0	1	18	06	H5256_001_0	4	2		08/04/2011	2012.02	08/04/2011 11:18:29 AM Central Daylight Time				08/04/2011 11:49:07 AM Central Daylight Time	MEDICAL ASSOCIATES CLINIC HEALTH PLAN	Medical Associates Clinic Health Plan of Wisconsin	www.mahealthcare.com	Medical Associates SmartPlan (Cost)	06	18		1			H5256	001	0	2012	Grant, Crawford, Iowa, Lafayette Counties		2	2400	2			2									(866)-821-1365		(563)-584-4885		(800)-747-8900		(563)-556-8070										(800)-735-2943		(800)-735-2943		(800)-735-2943		(800)-735-2943										2	2	2
H5256	002	0	1	18	06	H5256_002_0	4	2		08/04/2011	2012.02	08/04/2011 11:18:35 AM Central Daylight Time				08/04/2011 11:49:07 AM Central Daylight Time	MEDICAL ASSOCIATES CLINIC HEALTH PLAN	Medical Associates Clinic Health Plan of Wisconsin	www.mahealthcare.com	Medical Associates Community Plan (Cost)	06	18		1			H5256	002	0	2012	Grant, Crawford, Iowa, Lafayette Counties		2	280	2			2									(866)-821-1365		(563)-584-4885		(800)-747-8900		(563)-556-8070										(800)-735-2943		(800)-735-2943		(800)-735-2943		(800)-735-2943										2	2	2
H5256	004	0	1	18	06	H5256_004_0	4	2		08/04/2011	2012.02	08/04/2011 11:18:40 AM Central Daylight Time				08/04/2011 11:49:07 AM Central Daylight Time	MEDICAL ASSOCIATES CLINIC HEALTH PLAN	Medical Associates Clinic Health Plan of Wisconsin	www.mahealthcare.com	Medical Associates Freedom Plan (Cost)	06	18		1			H5256	004	0	2012	Grant, Crawford, Iowa, Lafayette Counties		2	175	2			2									(866)-821-1365		(563)-584-4885		(800)-747-8900		(563)-556-8070										(800)-735-2943		(800)-735-2943		(800)-735-2943		(800)-735-2943										2	2	2
H5262	001	0	1	01	01	H5262_001_0	7	1		07/19/2011	2012.02	07/19/2011 08:15:52 AM Central Daylight Time	06/27/2011 09:18:43 AM Central Daylight Time	07/05/2011 08:18:02 AM Central Daylight Time		07/19/2011 10:11:32 AM Central Daylight Time	GUNDERSEN LUTHERAN HEALTH PLAN	Gundersen Lutheran Health Plan, Inc.	www.seniorpreferred.org	Gundersen Lutheran Senior Pref. Elite (w/RX) (HMO)	01	01		1			H5262	001	0	2012	La Crosse and SW Wisconsin and NE Iowa		2	94999	2			2						http://apps.glhealthplan.org:81/ProvDB/dirSPMainFrame.jsp?screenSize=large	http://www.glhealthplan.org/spformulary	www.pti-nps.com	(800)-394-5566		(608)-775-8077		(800)-394-5566		(608)-775-8077		(800)-394-5566		(608)-775-8077		(800)-394-5566		(608)-775-8077		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		2	2	2
H5262	003	0	1	01	01	H5262_003_0	7	1		07/19/2011	2012.02	07/19/2011 08:16:09 AM Central Daylight Time	06/27/2011 09:20:01 AM Central Daylight Time	07/05/2011 08:18:02 AM Central Daylight Time		07/19/2011 10:11:32 AM Central Daylight Time	GUNDERSEN LUTHERAN HEALTH PLAN	Gundersen Lutheran Health Plan, Inc.	www.seniorpreferred.org	Gundersen Lutheran Senior Pref. Value (w/RX) (HMO)	01	01		1			H5262	003	0	2012	La Crosse and SW Wisconsin and NE Iowa		2	94999	2			2						http://apps.glhealthplan.org:81/ProvDB/dirSPMainFrame.jsp?screenSize=large	http://www.glhealthplan.org/spformulary	www.pti-nps.com	(800)-394-5566		(608)-775-8077		(800)-394-5566		(608)-775-8077		(800)-394-5566		(608)-775-8077		(800)-394-5566		(608)-775-8077		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		2	2	2
H5262	004	0	1	01	01	H5262_004_0	6	1		07/19/2011	2012.02	07/19/2011 08:16:10 AM Central Daylight Time	06/27/2011 09:27:33 AM Central Daylight Time			07/19/2011 10:11:32 AM Central Daylight Time	GUNDERSEN LUTHERAN HEALTH PLAN	Gundersen Lutheran Health Plan, Inc.	www.seniorpreferred.org	Gundersen Lutheran Sr. Pref. Value (no RX) (HMO)	01	01		1			H5262	004	0	2012	La Crosse and SW Wisconsin and NE Iowa		2	94999	2			2						http://apps.glhealthplan.org:81/ProvDB/dirSPMainFrame.jsp?screenSize=large	http://www.glhealthplan.org/spformulary	www.pti-nps.com	(800)-394-5566		(608)-775-8077		(800)-394-5566		(608)-775-8077										(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529										2	2	2
H5262	005	0	1	01	01	H5262_005_0	6	1		07/19/2011	2012.02	07/19/2011 08:22:57 AM Central Daylight Time	06/27/2011 09:29:20 AM Central Daylight Time			07/19/2011 10:11:32 AM Central Daylight Time	GUNDERSEN LUTHERAN HEALTH PLAN	Gundersen Lutheran Health Plan, Inc.	www.seniorpreferred.org	Gundersen Lutheran Sr. Pref. Elite (no RX) (HMO)	01	01		1			H5262	005	0	2012	La Crosse and SW Wisconsin and NE Iowa		2	94999	2			2						http://apps.glhealthplan.org:81/ProvDB/dirSPMainFrame.jsp?screenSize=large	http://www.glhealthplan.org/spformulary	www.pti-nps.com	(800)-394-5566		(608)-775-8077		(800)-394-5566		(608)-775-8077										(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529										2	2	2
H5264	002	0	1	18	06	H5264_002_0	4	2		07/21/2011	2012.02	07/21/2011 11:40:51 AM Central Daylight Time				07/21/2011 11:42:15 AM Central Daylight Time	DEAN HEALTH PLAN, INC.	Dean Health Plan, Inc.	www.deancare.com	DeanCare Gold Enhanced (Cost)	06	18		1			H5264	002	0	2012	DeanCare Gold		2	17500	2			2									(888)-422-3326		(608)-827-4372		(888)-422-3326		(608)-827-4372										(877)-733-6456		(608)-827-4086		(877)-733-6456		(608)-827-4086										2	2	2
H5264	003	0	1	18	06	H5264_003_0	2	2		07/06/2011	2012.02	07/06/2011 11:43:06 AM Central Daylight Time				07/06/2011 01:13:46 PM Central Daylight Time	DEAN HEALTH PLAN, INC.	Dean Health Plan, Inc.	www.deancare.com	DeanCare Gold Basic (Cost)	06	18		1			H5264	003	0	2012	DeanCare Gold		2	400	2			2									(888)-422-3326		(608)-827-4372		(888)-422-3326		(608)-827-4372										(877)-733-6456		(608)-827-4086		(877)-733-6456		(608)-827-4086										2	2	2
H5264	005	0	1	18	06	H5264_005_0	3	2		07/21/2011	2012.02	07/21/2011 09:31:16 AM Central Daylight Time				07/21/2011 10:10:38 AM Central Daylight Time	DEAN HEALTH PLAN, INC.	Dean Health Plan, Inc.	www.deancare.com	DeanCare Gold Shared Value (Cost)	06	18		1			H5264	005	0	2012	DeanCare Gold		2	400	2			2									(888)-422-3326		(608)-827-4372		(888)-422-3326		(608)-827-4372										(877)-733-6456		(608)-827-4086		(877)-733-6456		(608)-827-4086										2	2	2
H5291	001	0	1	01	01	H5291_001_0	4	1		08/08/2011	2012.02	08/08/2011 11:52:40 AM Eastern Daylight Time	08/05/2011 05:38:02 PM Eastern Daylight Time	08/04/2011 12:35:56 PM Eastern Daylight Time		08/08/2011 04:32:56 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H5291-001 (HMO)	01	01		1			H5291	001	0	2012	Colorado's I-25 Corridor area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5291	002	0	1	01	01	H5291_002_0	5	1		08/08/2011	2012.02	08/08/2011 11:52:50 AM Eastern Daylight Time	08/05/2011 05:39:05 PM Eastern Daylight Time	08/04/2011 12:36:16 PM Eastern Daylight Time		08/08/2011 04:32:56 PM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H5291-002 (HMO)	01	01		1			H5291	002	0	2012	Colorado's I-25 Corridor area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5291	801	0	1	01	01	H5291_801_0	7	1		07/06/2011	2012.02	07/06/2011 10:57:14 AM Eastern Daylight Time	06/28/2011 01:07:37 PM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H5291	801	0	2012	Select counties in Colorado		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H5291	802	0	1	01	01	H5291_802_0	7	1		07/06/2011	2012.02	07/06/2011 10:57:20 AM Eastern Daylight Time	06/28/2011 01:08:41 PM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H5291	802	0	2012	Select counties in Colorado		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
H5291	803	0	1	01	01	H5291_803_0	7	1		07/06/2011	2012.02	07/06/2011 10:57:24 AM Eastern Daylight Time	06/28/2011 01:09:37 PM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	Humana Employer Sponsored Non-CY (HMO)	01	01		1			H5291	803	0	2012	Select counties in Colorado		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H5294	001	0	1	01	01	H5294_001_0	5	1	2	07/29/2011	2012.02	07/29/2011 12:45:29 PM Pacific Daylight Time	08/04/2011 12:36:56 PM Pacific Daylight Time	08/04/2011 12:21:58 PM Pacific Daylight Time		08/05/2011 02:37:22 PM Pacific Daylight Time	SUPERIOR HEALTH PLAN, INC.	Advantage by Superior HealthPlan	http://advantage.superiorhealthplan.com	Advantage by Superior HealthPlan (HMO SNP)	01	01		1			H5294	001	0	2012	Bexar and Nueces Counties		2	2585	2			1	3		1	3		http://medicare.superiorhealthplan.com/	www.superiorhealthplan.com	www.superiorhealthplan.com	(866)-516-4501		(866)-516-4501		(866)-516-4501		(866)-516-4501		(866)-516-4501		(866)-516-4501		(866)-516-4501		(866)-516-4501		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		(800)-735-2989		2	1	2
H5302	003	0	1	02	01	H5302_003_0	8	1		08/09/2011	2012.02	08/09/2011 10:19:57 AM Eastern Daylight Time	08/08/2011 01:20:14 PM Eastern Daylight Time	08/04/2011 12:02:53 PM Eastern Daylight Time		08/09/2011 01:38:33 PM Eastern Daylight Time	COVENTRY HEALTH CARE OF GEORGIA, INC.	Coventry Health Care, INC.	www.ga.chcadvantra.com	Advantra Silver (HMO-POS)	01	02		1			H5302	003	0	2012	Savannah, Columbus, Augusta and Metro Atlanta Area		2	4044	2			2						www.ga.chcadvantra.com	http://coventry-medicare.coventryhealthcare.com/advantra-georgia/prescription-drug-benefits/formular	http://coventry-medicare.coventryhealthcare.com/advantra-georgia/prescription-drug-benefits	(866)-613-4977		(866)-613-4977		(877)-886-4939		(877)-886-4939		(800)-690-3412		(800)-690-3412		(877)-886-4939		(877)-886-4939		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5302	006	0	1	02	01	H5302_006_0	5	1		08/09/2011	2012.02	08/09/2011 01:35:40 PM Eastern Daylight Time	08/08/2011 01:48:33 PM Eastern Daylight Time	08/04/2011 12:08:23 PM Eastern Daylight Time		08/09/2011 01:38:33 PM Eastern Daylight Time	COVENTRY HEALTH CARE OF GEORGIA, INC.	Coventry Health Care, INC.	www.ga.chcadvantra.com	Advantra Silver Plus (HMO-POS)	01	02		1			H5302	006	0	2012	Atlanta Metro Area		2		2			2						www.ga.chcadvantra.com	http://coventry-medicare.coventryhealthcare.com/advantra-georgia/prescription-drug-benefits/formular	http://coventry-medicare.coventryhealthcare.com/advantra-georgia/prescription-drug-benefits	(866)-613-4977		(866)-613-4977		(877)-886-4939		(877)-886-4939		(800)-690-3412		(800)-690-3412		(877)-886-4939		(877)-886-4939		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5302	007	0	1	01	01	H5302_007_0	7	1		08/09/2011	2012.02	08/09/2011 01:19:00 PM Eastern Daylight Time	08/08/2011 02:05:19 PM Eastern Daylight Time	08/04/2011 12:14:51 PM Eastern Daylight Time		08/09/2011 01:38:33 PM Eastern Daylight Time	COVENTRY HEALTH CARE OF GEORGIA, INC.	Coventry Health Care, INC.	www.ga.chcadvantra.com	Silver Advantage (HMO)	01	01		1			H5302	007	0	2012	Atlanta Metro and Savannah Areas		2	100	2			2						www.ga.chcadvantra.com	http://coventry-medicare.coventryhealthcare.com/advantra-georgia/prescription-drug-benefits/formular	http://coventry-medicare.coventryhealthcare.com/advantra-georgia/prescription-drug-benefits	(866)-613-4977		(866)-613-4977		(877)-886-4939		(877)-886-4939		(800)-690-3412		(800)-690-3412		(877)-886-4939		(877)-886-4939		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5302	008	0	1	01	01	H5302_008_0	6	1		08/09/2011	2012.02	08/09/2011 10:20:31 AM Eastern Daylight Time	08/08/2011 02:20:03 PM Eastern Daylight Time	08/04/2011 12:20:25 PM Eastern Daylight Time		08/09/2011 01:38:33 PM Eastern Daylight Time	COVENTRY HEALTH CARE OF GEORGIA, INC.	Coventry Health Care, INC.	www.ga.chcadvantra.com	Advantra Elite (HMO)	01	01		1			H5302	008	0	2012	Augusta and Atlanta Metro Area		2	100	2			2						www.ga.chcadvantra.com	http://coventry-medicare.coventryhealthcare.com/advantra-georgia/prescription-drug-benefits/formular	http://coventry-medicare.coventryhealthcare.com/advantra-georgia/prescription-drug-benefits	(866)-613-4977		(866)-613-4977		(877)-886-4939		(877)-886-4939		(800)-690-3412		(800)-690-3412		(877)-886-4939		(877)-886-4939		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5302	009	0	1	01	01	H5302_009_0	7	1		08/09/2011	2012.02	08/09/2011 10:20:43 AM Eastern Daylight Time	08/08/2011 02:38:26 PM Eastern Daylight Time	08/04/2011 12:39:22 PM Eastern Daylight Time		08/09/2011 01:38:33 PM Eastern Daylight Time	COVENTRY HEALTH CARE OF GEORGIA, INC.	Coventry Health Care, INC.	www.ga.chcadvantra.com	Advantra Elite (HMO)	01	01		1			H5302	009	0	2012	Savannah Area		2	100	2			2						www.ga.chcadvantra.com	http://coventry-medicare.coventryhealthcare.com/advantra-georgia/prescription-drug-benefits/formular	http://coventry-medicare.coventryhealthcare.com/advantra-georgia/prescription-drug-benefits	(866)-613-4977		(866)-613-4977		(877)-886-4939		(877)-886-4939		(800)-690-3412		(800)-690-3412		(877)-886-4939		(877)-886-4939		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5302	809	0	1	02	01	H5302_809_0	4	1		05/25/2011	2012.02	05/25/2011 08:09:09 AM Eastern Daylight Time	07/28/2011 02:33:38 PM Eastern Daylight Time			07/28/2011 03:16:51 PM Eastern Daylight Time	COVENTRY HEALTH CARE OF GEORGIA, INC.	Coventry Health Care, INC.	www.ga.chcadvantra.com	Advantra (HMO-POS)	01	02		1			H5302	809	0	2012	Georgia		1	1000	2			2						www.ga.chcadvantra.com	http://coventry-medicare.coventryhealthcare.com/advantra-georgia/prescription-drug-benefits/formular	http://coventry-medicare.coventryhealthcare.com/advantra-georgia/prescription-drug-benefits	(866)-613-4977		(866)-613-4977		(877)-886-4939		(877)-886-4939										(711)		(711)		(711)		(711)										2	1	1
H5302	810	0	1	02	01	H5302_810_0	4	1		05/26/2011	2012.02	05/26/2011 09:18:59 AM Eastern Daylight Time	07/28/2011 02:33:51 PM Eastern Daylight Time			07/28/2011 03:16:51 PM Eastern Daylight Time	COVENTRY HEALTH CARE OF GEORGIA, INC.	Coventry Health Care, INC.	www.ga.chcadvantra.com	Advantra (HMO-POS)	01	02		1			H5302	810	0	2012	Georgia		1	1000	2			2						www.ga.chcadvantra.com	http://coventry-medicare.coventryhealthcare.com/advantra-georgia/prescription-drug-benefits/formular	http://coventry-medicare.coventryhealthcare.com/advantra-georgia/prescription-drug-benefits	(866)-613-4977		(866)-613-4977		(877)-886-4939		(877)-886-4939		(800)-690-3412		(800)-690-3412		(877)-886-4939		(877)-886-4939		(711)		(711)		(711)		(711)		(800)-716-3231		(800)-716-3231		(711)		(711)		2	1	1
H5302	811	0	1	02	01	H5302_811_0	4	1		05/27/2011	2012.02	05/27/2011 11:06:23 AM Eastern Daylight Time	07/28/2011 02:34:05 PM Eastern Daylight Time			07/28/2011 03:16:51 PM Eastern Daylight Time	COVENTRY HEALTH CARE OF GEORGIA, INC.	Coventry Health Care, INC.	www.ga.chcadvantra.com	Advantra (HMO-POS)	01	02		1			H5302	811	0	2012	Georgia		1	1000	2			2						www.ga.chcadvantra.com	http://coventry-medicare.coventryhealthcare.com/advantra-georgia/prescription-drug-benefits/formular	http://coventry-medicare.coventryhealthcare.com/advantra-georgia/prescription-drug-benefits	(866)-613-4977		(866)-613-4977		(877)-886-4939		(877)-886-4939		(800)-690-3412		(800)-690-3412		(877)-886-4939		(877)-886-4939		(711)		(711)		(711)		(711)		(800)-716-3231		(800)-716-3231		(711)		(711)		2	1	1
H5378	010	0	1	04	01	H5378_010_0	4	1		08/04/2011	2012.02	08/04/2011 04:30:21 PM Central Daylight Time	08/05/2011 03:05:15 PM Central Daylight Time	08/04/2011 12:21:44 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptionsPPO.com	Today's Options Advantage Plus 250A (PPO)	01	04		1			H5378	010	0	2012	Select counties in Midwest, Southeast, Southwest		2	578	2			2						www.TodaysOptionsPPO.com	www.TodaysOptionsPPO.com	www.TodaysOptionsPPO.com	(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		2	2	2
H5378	016	0	1	04	01	H5378_016_0	8	1		07/07/2011	2012.02	07/07/2011 04:11:04 PM Central Daylight Time	08/05/2011 03:06:28 PM Central Daylight Time	08/04/2011 01:05:56 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptionsPPO.com	Today's Options Advantage Plus  450H (PPO)	01	04		1			H5378	016	0	2012	Select counties in Midwest, Southeast, Southwest		2	1396	2			2						www.TodaysOptionsPPO.com	www.TodaysOptionsPPO.com	www.TodaysOptionsPPO.com	(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		2	2	2
H5378	182	0	1	04	01	H5378_182_0	8	1		07/07/2011	2012.02	07/07/2011 04:12:06 PM Central Daylight Time	08/05/2011 03:07:19 PM Central Daylight Time	08/04/2011 12:23:00 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptionsPPO.com	Today's Options Advantage Plus 250A (PPO)	01	04		1			H5378	182	0	2012	Select counties in Midwest, Southeast, Southwest		2	262	2			2						www.TodaysOptionsPPO.com	www.TodaysOptionsPPO.com	www.TodaysOptionsPPO.com	(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		2	2	2
H5378	183	0	1	04	01	H5378_183_0	6	1		07/07/2011	2012.02	07/07/2011 03:41:00 PM Central Daylight Time	08/05/2011 03:08:09 PM Central Daylight Time	08/04/2011 12:40:42 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptionsPPO.com	Today's Options Advantage Plus 450B (PPO)	01	04		1			H5378	183	0	2012	Select counties in Midwest, Southeast, Southwest		2	1002	2			2						www.TodaysOptionsPPO.com	www.TodaysOptionsPPO.com	www.TodaysOptionsPPO.com	(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		2	2	2
H5378	184	0	1	04	01	H5378_184_0	8	1		07/07/2011	2012.02	07/07/2011 04:11:43 PM Central Daylight Time	08/05/2011 03:08:54 PM Central Daylight Time	08/04/2011 12:57:16 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptionsPPO.com	Today's Options Advantage Plus 450F (PPO)	01	04		1			H5378	184	0	2012	Select counties in Midwest, Southeast, Southwest		2	3688	2			2						www.TodaysOptionsPPO.com	www.TodaysOptionsPPO.com	www.TodaysOptionsPPO.com	(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		2	2	2
H5378	188	0	1	04	01	H5378_188_0	4	1		07/07/2011	2012.02	07/07/2011 04:12:18 PM Central Daylight Time	08/05/2011 03:10:08 PM Central Daylight Time	08/04/2011 09:32:34 AM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptionsPPO.com	Today's Options Advantage Plus 250A (PPO)	01	04		1			H5378	188	0	2012	Select counties in Midwest, Southeast, Southwest		2	169	2			2						www.TodaysOptionsPPO.com	www.TodaysOptionsPPO.com	www.TodaysOptionsPPO.com	(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		2	2	2
H5378	190	0	1	04	01	H5378_190_0	6	1		08/05/2011	2012.02	08/05/2011 11:34:28 AM Central Daylight Time	08/05/2011 03:10:53 PM Central Daylight Time	08/04/2011 12:34:46 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptionsPPO.com	Today's Options Advantage Plus 650B (PPO)	01	04		1			H5378	190	0	2012	Select counties in Midwest, Southeast, Southwest		2	2878	2			2						www.TodaysOptionsPPO.com	www.TodaysOptionsPPO.com	www.TodaysOptionsPPO.com	(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		2	2	2
H5378	194	0	1	04	01	H5378_194_0	8	1		07/07/2011	2012.02	07/07/2011 03:42:19 PM Central Daylight Time	08/05/2011 03:33:52 PM Central Daylight Time	08/04/2011 12:58:14 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptionsPPO.com	Today's Options Advantage Plus 450F (PPO)	01	04		1			H5378	194	0	2012	Select counties in Midwest, Southeast, Southwest		2	56	2			2						www.TodaysOptionsPPO.com	www.TodaysOptionsPPO.com	www.TodaysOptionsPPO.com	(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		2	2	2
H5378	199	0	1	04	01	H5378_199_0	4	1		07/07/2011	2012.02	07/07/2011 04:12:31 PM Central Daylight Time	08/05/2011 03:34:41 PM Central Daylight Time	08/04/2011 12:09:24 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptionsPPO.com	Today's Options Advantage Plus 250A (PPO)	01	04		1			H5378	199	0	2012	Select counties in Midwest, Southeast, Southwest		2	198	2			2						www.TodaysOptionsPPO.com	www.TodaysOptionsPPO.com	www.TodaysOptionsPPO.com	(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		2	2	2
H5378	200	0	1	04	01	H5378_200_0	3	1		07/07/2011	2012.02	07/07/2011 04:12:43 PM Central Daylight Time	08/05/2011 03:35:24 PM Central Daylight Time	08/04/2011 12:11:30 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptionsPPO.com	Today's Options Advantage Plus 250A (PPO)	01	04		1			H5378	200	0	2012	Select counties in Midwest, Southeast, Southwest		2	298	2			2						www.TodaysOptionsPPO.com	www.TodaysOptionsPPO.com	www.TodaysOptionsPPO.com	(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		(877)-907-2985		(877)-907-2985		(800)-975-8089		(800)-975-8089		2	2	2
H5378	801	0	1	04	01	H5378_801_0	4	1		06/02/2011	2012.02	06/02/2011 11:26:42 AM Central Daylight Time	06/06/2011 12:19:38 AM Central Daylight Time			06/06/2011 05:10:25 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptionsPPO.com	Today's Options PPO - MA Group Plan (PPO)	01	04		1			H5378	801	0	2012	National		1	100	2			2						www.TodaysOptionsPPO.com	http://www.todaysoptionsppo.com	http://www.todaysoptionsppo.com	(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967										(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089										1	1	1
H5378	802	0	1	04	01	H5378_802_0	4	1		06/02/2011	2012.02	06/02/2011 11:28:04 AM Central Daylight Time	06/06/2011 12:29:17 AM Central Daylight Time			06/06/2011 05:10:25 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptionsPPO.com	Today's Options PPO - MAPD Group Plan (PPO)	01	04		1			H5378	802	0	2012	National		1	100	2			2						www.TodaysOptionsPPO.com	http://www.todaysoptionsppo.com	http://www.todaysoptionsppo.com	(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		1	1	1
H5378	803	0	1	04	01	H5378_803_0	4	1		06/02/2011	2012.02	06/02/2011 11:28:32 AM Central Daylight Time	06/06/2011 12:35:30 AM Central Daylight Time			06/06/2011 05:10:25 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptionsPPO.com	Today's Options PPO - MAPD Group Plan - NCY (PPO)	01	04		1			H5378	803	0	2012	National		1	100	2			2						www.TodaysOptionsPPO.com	http://www.todaysoptionsppo.com	http://www.todaysoptionsppo.com	(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(866)-422-5009		(866)-422-5009		(866)-422-1967		(866)-422-1967		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		1	1	1
H5403	001	0	1	20	08	H5403_001_0	1	1		05/31/2011	2012.02	05/31/2011 10:36:16 AM Pacific Daylight Time		05/20/2011 01:50:03 PM Pacific Daylight Time		05/31/2011 10:39:35 AM Pacific Daylight Time	ON LOK SENIOR HEALTH SERVICES	On Lok Lifeways	www.onlok.org/seniorhealth	On Lok Lifeways (Dual Eligibles) (PACE)	08	20		1			H5403	001	0	2012	San Francisco, Alameda and Santa Clara counties		2		2			2							N/A	www.onlok.org									(888)-996-6565		(415)-292-8895		(888)-886-6565		(415)-292-8784										(888)-996-6565		(415)-292-8898		(888)-886-6565		(415)-292-8898				
H5403	002	0	1	20	08	H5403_002_0	1	1		05/31/2011	2012.02	05/31/2011 10:36:45 AM Pacific Daylight Time		05/20/2011 01:50:03 PM Pacific Daylight Time		05/31/2011 10:39:35 AM Pacific Daylight Time	ON LOK SENIOR HEALTH SERVICES	On Lok Lifeways	www.onlok.org/seniorhealth	On Lok Lifeways (Medicare Only) (PACE)	08	20		1			H5403	002	0	2012	San Francisco, Alameda and Santa Clara counties		2		2			2							N/A	www.onlok.org									(888)-996-6565		(415)-292-8895		(888)-886-6565		(415)-292-8784										(888)-996-6565		(415)-292-8898		(888)-886-6565		(415)-292-8898				
H5404	001	0	1	01	01	H5404_001_0	6	1		08/09/2011	2012.02	08/09/2011 10:33:07 AM Eastern Daylight Time	08/09/2011 11:01:38 AM Eastern Daylight Time	08/09/2011 11:04:15 AM Eastern Daylight Time		08/09/2011 11:08:17 AM Eastern Daylight Time	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	Medicare Masterpiece (HMO)	01	01		1			H5404	001	0	2012	Florida		2		2			2						http://www.univhc.com	www.univhc.com/medicare/members/medicare-formulary.php	http://www.univhc.com	(866)-690-4842		(866)-690-4842		(800)-965-7034		(800)-965-7034		(877)-204-8149		(877)-204-8149		(800)-965-7034		(800)-965-7034		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-759-1089		(800)-759-1089		(800)-617-0177		(800)-617-0177		2	2	2
H5404	034	0	1	01	01	H5404_034_0	5	1		08/09/2011	2012.02	08/09/2011 10:33:26 AM Eastern Daylight Time	08/09/2011 11:02:13 AM Eastern Daylight Time	08/09/2011 11:04:50 AM Eastern Daylight Time		08/09/2011 11:08:17 AM Eastern Daylight Time	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	Medicare Masterpiece (HMO)	01	01		1			H5404	034	0	2012	South Florida		2		2			2						http://www.univhc.com	www.univhc.com/medicare/members/medicare-formulary.php	http://www.univhc.com	(866)-690-4842		(866)-690-4842		(800)-965-7034		(800)-965-7034		(877)-204-8149		(877)-204-8149		(800)-965-7034		(800)-965-7034		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-759-1089		(800)-759-1089		(800)-617-0177		(800)-617-0177		2	2	2
H5404	086	0	1	02	01	H5404_086_0	11	1		08/09/2011	2012.02	08/09/2011 10:33:40 AM Eastern Daylight Time	08/09/2011 01:20:53 PM Eastern Daylight Time	08/09/2011 01:28:52 PM Eastern Daylight Time		08/09/2011 06:43:35 PM Eastern Daylight Time	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	Medicare Masterpiece Plus (HMO-POS)	01	02		1			H5404	086	0	2012	Florida		2		2			2						http://www.univhc.com	www.univhc.com/medicare/members/medicare-formulary.php	http://www.univhc.com	(866)-690-4842		(866)-690-4842		(800)-965-7034		(800)-965-7034		(877)-204-8149		(877)-204-8149		(800)-965-7034		(800)-965-7034		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-759-1089		(800)-759-1089		(800)-617-0177		(800)-617-0177		2	2	2
H5404	111	0	1	01	01	H5404_111_0	5	1	2	08/09/2011	2012.02	08/09/2011 04:28:53 PM Eastern Daylight Time	08/09/2011 04:19:58 PM Eastern Daylight Time	08/09/2011 04:26:34 PM Eastern Daylight Time		08/09/2011 06:43:35 PM Eastern Daylight Time	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	Medicare Masterpiece Premier SNP - Dual (HMO SNP)	01	01		1			H5404	111	0	2012	Florida Dual SNP		2		2			1	3		1	2		http://www.univhc.com	www.univhc.com/medicare/members/medicare-formulary.php	http://www.univhc.com	(866)-690-4842		(866)-690-4842		(800)-965-7034		(800)-965-7034		(877)-204-8149		(877)-204-8149		(800)-965-7034		(800)-965-7034		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-759-1089		(800)-759-1089		(800)-617-0177		(800)-617-0177		2	2	2
H5404	116	0	1	01	01	H5404_116_0	3	1		06/04/2011	2012.02	06/04/2011 01:09:11 PM Eastern Daylight Time	07/22/2011 04:21:46 PM Eastern Daylight Time			07/22/2011 04:38:56 PM Eastern Daylight Time	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	Medicare Masterpiece MA Only (HMO)	01	01		1			H5404	116	0	2012	Florida		2		2			2						http://www.univhc.com	www.univhc.com/medicare/members/medicare-formulary.php	http://www.univhc.com	(866)-690-4842		(866)-690-4842		(800)-965-7034		(800)-965-7034										(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-617-0177										2	2	2
H5404	135	0	1	01	01	H5404_135_0	7	1		08/09/2011	2012.02	08/09/2011 10:33:58 AM Eastern Daylight Time	08/09/2011 01:21:29 PM Eastern Daylight Time	08/09/2011 02:12:55 PM Eastern Daylight Time		08/09/2011 06:43:35 PM Eastern Daylight Time	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	Medicare Masterpiece Premier - Diabetes, CHF, CVD (HMO SNP)	01	01		1			H5404	135	0	2012	Florida Diabetes SNP		2		2			1	4		1		00000000000000000010	http://www.univhc.com	www.univhc.com/medicare/members/medicare-formulary.php	http://www.univhc.com	(866)-690-4842		(866)-690-4842		(800)-965-7034		(800)-965-7034		(877)-204-8149		(877)-204-8149		(800)-965-7034		(800)-965-7034		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-759-1089		(800)-759-1089		(800)-617-0177		(800)-617-0177		2	2	2
H5404	136	0	1	01	01	H5404_136_0	8	1		08/09/2011	2012.02	08/09/2011 10:34:12 AM Eastern Daylight Time	08/09/2011 01:22:03 PM Eastern Daylight Time	08/09/2011 02:13:21 PM Eastern Daylight Time		08/09/2011 06:43:35 PM Eastern Daylight Time	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	Medicare Masterpiece Premier - Dementia (HMO SNP)	01	01		1			H5404	136	0	2012	Florida Dementia SNP		2		2			1	4		1		00000100000000000000	http://www.univhc.com	www.univhc.com/medicare/members/medicare-formulary.php	http://www.univhc.com	(866)-690-4842		(866)-690-4842		(800)-965-7034		(800)-965-7034		(877)-204-8149		(877)-204-8149		(800)-965-7034		(800)-965-7034		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-759-1089		(800)-759-1089		(800)-617-0177		(800)-617-0177		2	2	2
H5404	137	0	1	01	01	H5404_137_0	11	1		08/09/2011	2012.02	08/09/2011 10:34:25 AM Eastern Daylight Time	08/09/2011 01:22:34 PM Eastern Daylight Time	08/09/2011 02:13:45 PM Eastern Daylight Time		08/09/2011 06:43:35 PM Eastern Daylight Time	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	Medicare Masterpiece Premier - COPD (HMO SNP)	01	01		1			H5404	137	0	2012	Florida COPD SNP		2		2			1	4		1		00000000000100000000	http://www.univhc.com	www.univhc.com/medicare/members/medicare-formulary.php	http://www.univhc.com	(866)-690-4842		(866)-690-4842		(800)-965-7034		(800)-965-7034		(877)-204-8149		(877)-204-8149		(800)-965-7034		(800)-965-7034		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-759-1089		(800)-759-1089		(800)-617-0177		(800)-617-0177		2	2	2
H5404	138	0	1	01	01	H5404_138_0	9	1		08/09/2011	2012.02	08/09/2011 10:34:42 AM Eastern Daylight Time	08/09/2011 11:03:20 AM Eastern Daylight Time	08/09/2011 11:05:37 AM Eastern Daylight Time		08/09/2011 11:08:17 AM Eastern Daylight Time	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	Medicare Masterpiece Premier (HMO)	01	01		1			H5404	138	0	2012	Florida Premier		2		2			2						http://www.univhc.com	www.univhc.com/medicare/members/medicare-formulary.php	http://www.univhc.com	(866)-690-4842		(866)-690-4842		(800)-965-7034		(800)-965-7034		(877)-204-8149		(877)-204-8149		(800)-965-7034		(800)-965-7034		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-759-1089		(800)-759-1089		(800)-617-0177		(800)-617-0177		2	2	2
H5404	143	0	1	01	01	H5404_143_0	5	1		08/09/2011	2012.02	08/09/2011 10:34:54 AM Eastern Daylight Time	08/09/2011 01:23:20 PM Eastern Daylight Time	08/09/2011 02:14:11 PM Eastern Daylight Time		08/09/2011 06:43:35 PM Eastern Daylight Time	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	Medicare Masterpiece (HMO)	01	01		1			H5404	143	0	2012	Miami-Dade County		2		2			2						http://www.univhc.com	www.univhc.com/medicare/members/medicare-formulary.php	http://www.univhc.com	(866)-690-4842		(866)-690-4842		(800)-965-7034		(800)-965-7034		(877)-204-8149		(877)-204-8149		(800)-965-7034		(800)-965-7034		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-759-1089		(800)-759-1089		(800)-617-0177		(800)-617-0177		2	2	2
H5404	801	0	1	01	01	H5404_801_0	2	1		06/04/2011	2012.02	06/04/2011 01:39:06 PM Eastern Daylight Time	07/22/2011 04:26:11 PM Eastern Daylight Time			07/22/2011 04:38:56 PM Eastern Daylight Time	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	Medicare Masterpiece EGWP (HMO)	01	01		1			H5404	801	0	2012	Florida		1		2			2						http://www.univhc.com	www.univhc.com/medicare/members/medicare-formulary.php	http://www.univhc.com	(866)-690-4842		(866)-690-4842		(800)-965-7034		(800)-965-7034		(877)-204-8149		(877)-204-8149		(800)-965-7034		(800)-965-7034		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-759-1089		(800)-759-1089		(800)-617-0177		(800)-617-0177		2	2	2
H5405	001	0	1	20	08	H5405_001_0	1	1		05/20/2011	2012.01	05/20/2011 03:49:47 PM Pacific Daylight Time		05/20/2011 12:42:26 PM Pacific Daylight Time		05/20/2011 03:55:09 PM Pacific Daylight Time	CENTER FOR ELDERS INDEPENDENCE	Center For Elders' Independence	www.cei.elders.org	Center for Elders Independence - Part D (PACE)	08	20		1			H5405	001	0	2012	Alameda and Contra Costa Counties		2		2			2							www.cei.elders.org	www.cei.elders.org									(510)-433-1150		(510)-433-1150		(510)-433-1150		(510)-433-1150										(510)-433-1165		(510)-433-1165		(510)-433-1165		(510)-433-1165				
H5405	002	0	1	20	08	H5405_002_0	1	1		05/20/2011	2012.01	05/20/2011 03:50:14 PM Pacific Daylight Time		05/20/2011 12:42:26 PM Pacific Daylight Time		05/20/2011 03:55:09 PM Pacific Daylight Time	CENTER FOR ELDERS INDEPENDENCE	Center For Elders' Independence	www.cei.elders.org	Center for Elders-Part D/MediCare, only (PACE)	08	20		1			H5405	002	0	2012	Alameda and Contra Costa Counties		2		2			2							www.cei.elders.org	www.cei.elders.org									(510)-433-1150		(510)-433-1150		(510)-433-1150		(510)-433-1150										(510)-433-1165		(510)-433-1165		(510)-433-1165		(510)-433-1165				
H5406	001	0	1	20	08	H5406_001_0	1	1		05/24/2011	2012.01	05/24/2011 01:38:48 PM Pacific Daylight Time		05/24/2011 07:06:34 AM Pacific Daylight Time		05/24/2011 01:49:18 PM Pacific Daylight Time	SUTTER HEALTH SACRAMENTO SIERRA REGION	Sutter SeniorCare PACE	www.sutterseniorcare.org	Sutter SeniorCare (PACE)	08	20		1			H5406	001	0	2012	San Francisco, California		2		2			2							sutterseniorcare.org	sutterseniorcare.org									(916)-424-8412	13404	(916)-424-8412	13404	(916)-424-8412		(916)-424-8412	13422									(916)-424-8412		(916)-424-8412		(916)-424-8412		(916)-424-8412				
H5406	002	0	1	20	08	H5406_002_0	1	1		05/24/2011	2012.01	05/24/2011 01:41:38 PM Pacific Daylight Time		05/24/2011 07:06:34 AM Pacific Daylight Time		05/24/2011 01:49:18 PM Pacific Daylight Time	SUTTER HEALTH SACRAMENTO SIERRA REGION	Sutter SeniorCare PACE	www.sutterseniorcare.org	Sutter SeniorCare (PACE)	08	20		1			H5406	002	0	2012	San Francisco, California		2		2			2							sutterseniorcare.org	sutterseniorcare.org									(916)-424-8412	13404	(916)-424-8412	13404	(916)-424-8412		(916)-424-8412	13422									(916)-424-8412		(916)-424-8412		(916)-424-8412		(916)-424-8412				
H5407	001	0	1	01	01	H5407_001_0	4	1		08/04/2011	2012.02	08/04/2011 08:14:19 PM Central Daylight Time	08/05/2011 11:07:28 AM Central Daylight Time	08/05/2011 01:42:49 PM Central Daylight Time		08/09/2011 11:07:45 AM Central Daylight Time	CITRUS HEALTH CARE, INC.	Citrus Health Care, Inc.	www.citrushc.com	Citrus Total (HMO)	01	01		1			H5407	001	0	2012	Central Florida and South Florida Region		2		2			2						www.citrushc.com	http://citrushc.com/our_services/citruscare/formularies.php	http://WWW.citrushc.com/	(877)-624-8787		(877)-624-8787		(877)-886-7312		(877)-886-7312		(877)-624-8787		(877)-624-8787		(877)-886-7312		(877)-886-7312		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5407	004	0	1	01	01	H5407_004_0	4	1		08/04/2011	2012.02	08/04/2011 08:15:00 PM Central Daylight Time	08/05/2011 11:09:11 AM Central Daylight Time	08/05/2011 01:43:04 PM Central Daylight Time		08/09/2011 11:07:45 AM Central Daylight Time	CITRUS HEALTH CARE, INC.	Citrus Health Care, Inc.	www.citrushc.com	Citrus Total (HMO)	01	01		1			H5407	004	0	2012	Gulf Coast Florida Region		2		2			2						www.citrushc.com	http://citrushc.com/our_services/citruscare/formularies.php	http://WWW.citrushc.com/	(877)-624-8787		(877)-624-8787		(877)-886-7312		(877)-886-7312		(877)-624-8787		(877)-624-8787		(877)-886-7312		(877)-886-7312		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5407	011	0	1	01	01	H5407_011_0	3	1	2	07/20/2011	2012.02	07/20/2011 02:45:29 PM Central Daylight Time	08/05/2011 11:10:30 AM Central Daylight Time	08/05/2011 01:43:21 PM Central Daylight Time		08/09/2011 11:07:45 AM Central Daylight Time	CITRUS HEALTH CARE, INC.	Citrus Health Care, Inc.	www.citrushc.com	Citrus Plus (HMO SNP)	01	01		1			H5407	011	0	2012	Central, South, and Gulf Florida Region		2		2			1	3		1	2		www.citrushc.com	http://citrushc.com/our_services/citruscare/formularies.php	http://WWW.citrushc.com/	(877)-624-8787		(877)-624-8787		(877)-886-7312		(877)-886-7312		(877)-624-8787		(877)-624-8787		(877)-886-7312		(877)-886-7312		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5410	001	0	1	01	01	H5410_001_0	6	1		08/08/2011	2012.02	08/08/2011 11:27:12 AM Eastern Daylight Time	08/05/2011 02:43:44 PM Central Daylight Time	08/04/2011 05:47:14 PM Central Daylight Time		08/08/2011 06:14:25 PM Central Daylight Time	HEALTHSPRING OF FLORIDA, INC.	HealthSpring of Florida, Inc.	www.lmchealthplans.com	Leon Medical Centers Health Plans - Leon Cares (HMO)	01	01		1			H5410	001	0	2012	Miami-Dade county		2	0	2			2							www.healthspring.com	www.healthspring.com	(866)-393-5366		(305)-559-5366		(866)-393-5366		(305)-559-5366		(866)-393-5366		(305)-559-5366		(866)-393-5366		(305)-559-5366		(866)-478-9317		(305)-220-5752		(866)-478-9317		(305)-220-5752		(866)-478-9317		(305)-220-5752		(866)-478-9317		(305)-220-5752		2	2	2
H5410	004	0	1	01	01	H5410_004_0	4	1		07/28/2011	2012.02	07/28/2011 03:23:10 PM Central Daylight Time	05/27/2011 06:49:41 PM Central Daylight Time			07/28/2011 06:06:50 PM Central Daylight Time	HEALTHSPRING OF FLORIDA, INC.	HealthSpring of Florida, Inc.	healthspring.com	HealthyAdvantage (HMO)	01	01		1			H5410	004	0	2012	Pensacola		2		2			2							www.healthspring.com	www.healthspring.com	(866)-382-0511		(866)-382-0511		(888)-767-1879		(888)-767-1879										(877)-262-9090		(877)-262-9090		(877)-262-9090		(877)-262-9090										2	2	2
H5410	005	0	1	01	01	H5410_005_0	8	1		08/05/2011	2012.02	08/05/2011 03:40:49 PM Central Daylight Time	08/05/2011 02:26:09 PM Central Daylight Time	08/04/2011 05:47:58 PM Central Daylight Time		08/09/2011 04:56:32 PM Central Daylight Time	HEALTHSPRING OF FLORIDA, INC.	HealthSpring of Florida, Inc.	healthspring.com	HealthyAdvantage Preferred (HMO)	01	01		1			H5410	005	0	2012	Pensacola		2		2			2							www.healthspring.com	www.healthspring.com	(866)-382-0511		(866)-382-0511		(888)-767-1879		(888)-767-1879		(800)-331-6293		(800)-331-6293		(888)-767-1879		(888)-767-1879		(877)-262-9090		(877)-262-9090		(877)-262-9090		(877)-262-9090		(877)-262-9090		(877)-262-9090		(866)-845-7230		(866)-845-7230		2	2	2
H5410	012	0	1	02	01	H5410_012_0	7	1		08/05/2011	2012.02	08/05/2011 03:42:53 PM Central Daylight Time	08/05/2011 02:28:52 PM Central Daylight Time	08/04/2011 05:48:40 PM Central Daylight Time		08/09/2011 04:56:32 PM Central Daylight Time	HEALTHSPRING OF FLORIDA, INC.	HealthSpring of Florida, Inc.	www.healthspring.com	HealthyAdvantage Premier (HMO-POS)	01	02		1			H5410	012	0	2012	Pensacola		2		2			2							www.healthspring.com	www.healthspring.com	(866)-382-0511		(866)-382-0511		(888)-767-1879		(888)-767-1879		(800)-331-6293		(800)-331-6293		(888)-767-1879		(888)-767-1879		(877)-262-9090		(877)-262-9090		(877)-262-9090		(877)-262-9090		(877)-262-9090		(877)-262-9090		(866)-845-7230		(866)-845-7230		2	2	2
H5410	013	0	1	01	01	H5410_013_0	6	1	2	08/08/2011	2012.02	08/08/2011 04:01:39 PM Central Daylight Time	08/05/2011 02:30:03 PM Central Daylight Time	08/04/2011 05:49:22 PM Central Daylight Time		08/09/2011 04:56:32 PM Central Daylight Time	HEALTHSPRING OF FLORIDA, INC.	HealthSpring of Florida, Inc.	HealthSpring.com	TotalCare (HMO SNP)	01	01		1			H5410	013	0	2012	Pensacola		2		2			1	3		1	2			www.healthspring.com	www.healthspring.com	(866)-382-0511		(866)-382-0511		(888)-767-1879		(888)-767-1879		(800)-331-6293		(800)-331-6293		(888)-767-1879		(888)-767-1879		(877)-262-9090		(877)-262-9090		(877)-262-9090		(877)-262-9090		(877)-262-9090		(877)-262-9090		(866)-845-7230		(866)-845-7230		2	2	2
H5414	009	0	1	01	01	H5414_009_0	5	1		07/12/2011	2012.02	07/12/2011 03:14:05 PM Central Daylight Time	08/04/2011 12:38:19 PM Central Daylight Time	08/04/2011 10:01:28 AM Central Daylight Time		08/08/2011 08:57:36 AM Central Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (HMO)	01	01		1			H5414	009	0	2012	Tampa and Sarasota		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H5414	019	0	1	01	01	H5414_019_0	5	1		07/12/2011	2012.02	07/12/2011 03:14:51 PM Central Daylight Time	08/04/2011 12:43:37 PM Central Daylight Time	08/04/2011 10:01:52 AM Central Daylight Time		08/08/2011 08:57:36 AM Central Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (HMO)	01	01		1			H5414	019	0	2012	Jacksonville and South Florida		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H5414	801	0	1	01	01	H5414_801_0	1	1		04/22/2011	2012.02	04/22/2011 10:05:56 AM Eastern Daylight Time	06/02/2011 01:11:45 PM Eastern Daylight Time			06/03/2011 10:51:30 AM Eastern Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan (HMO)	01	01		1			H5414	801	0	2012	Florida		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748										1	1	1
H5414	803	0	1	01	01	H5414_803_0	1	1		04/22/2011	2012.02	04/22/2011 10:06:17 AM Eastern Daylight Time	06/02/2011 01:22:54 PM Eastern Daylight Time			06/03/2011 10:51:30 AM Eastern Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan w/Rx CY (HMO)	01	01		1			H5414	803	0	2012	Florida		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		1	1	1
H5415	039	0	1	04	01	H5415_039_0	7	1		07/06/2011	2012.02	07/06/2011 11:27:31 AM Eastern Daylight Time	08/04/2011 09:54:52 AM Eastern Daylight Time	08/04/2011 12:36:48 PM Eastern Daylight Time		08/09/2011 07:37:09 AM Eastern Daylight Time	HUMANA HEALTH INSURANCE COMPANY OF FL, INC.	Humana Health Insurance Company of FL, Inc.	www.humana-medicare.com	HumanaChoice H5415-039 (PPO)	01	04		1			H5415	039	0	2012	Flagler and Volusia counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5415	056	0	1	04	01	H5415_056_0	9	1		07/13/2011	2012.02	07/13/2011 10:42:00 AM Eastern Daylight Time	08/04/2011 09:44:51 AM Eastern Daylight Time	08/04/2011 12:37:07 PM Eastern Daylight Time		08/08/2011 04:03:20 PM Eastern Daylight Time	HUMANA HEALTH INSURANCE COMPANY OF FL, INC.	Humana Health Insurance Company of FL, Inc.	www.humana-medicare.com	HumanaChoice H5415-056 (PPO)	01	04		1			H5415	056	0	2012	Broward, Miami-Dade and Palm Beach counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5415	066	0	1	04	01	H5415_066_0	9	1		07/06/2011	2012.02	07/06/2011 11:27:59 AM Eastern Daylight Time	08/04/2011 09:52:42 AM Eastern Daylight Time	08/04/2011 12:37:25 PM Eastern Daylight Time		08/09/2011 07:37:09 AM Eastern Daylight Time	HUMANA HEALTH INSURANCE COMPANY OF FL, INC.	Humana Health Insurance Company of FL, Inc.	www.humana-medicare.com	HumanaChoice H5415-066 (PPO)	01	04		1			H5415	066	0	2012	Flagler and Volusia counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5415	067	0	1	04	01	H5415_067_0	7	1		07/12/2011	2012.02	07/12/2011 11:33:30 AM Eastern Daylight Time	08/04/2011 09:54:24 AM Eastern Daylight Time	08/04/2011 12:37:45 PM Eastern Daylight Time		08/08/2011 04:03:20 PM Eastern Daylight Time	HUMANA HEALTH INSURANCE COMPANY OF FL, INC.	Humana Health Insurance Company of FL, Inc.	www.humana-medicare.com	HumanaChoice H5415-067 (PPO)	01	04		1			H5415	067	0	2012	Palm Beach County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5415	068	0	1	04	01	H5415_068_0	8	1		07/12/2011	2012.02	07/12/2011 10:14:07 AM Eastern Daylight Time	08/04/2011 09:53:54 AM Eastern Daylight Time	08/04/2011 12:38:04 PM Eastern Daylight Time		08/08/2011 04:03:20 PM Eastern Daylight Time	HUMANA HEALTH INSURANCE COMPANY OF FL, INC.	Humana Health Insurance Company of FL, Inc.	www.humana-medicare.com	HumanaChoice H5415-068 (PPO)	01	04		1			H5415	068	0	2012	Broward County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5415	801	0	1	04	01	H5415_801_0	3	1		06/21/2011	2012.02	06/21/2011 08:55:56 AM Eastern Daylight Time	05/31/2011 08:43:31 AM Eastern Daylight Time			06/21/2011 10:54:13 AM Eastern Daylight Time	HUMANA HEALTH INSURANCE COMPANY OF FL, INC.	Humana Health Insurance Company of FL, Inc.	www.humana-medicare.com	Humana Employer Sponsored (PPO)	01	04		1			H5415	801	0	2012	Select Counties in Florida		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H5415	803	0	1	04	01	H5415_803_0	3	1		06/21/2011	2012.02	06/21/2011 08:56:21 AM Eastern Daylight Time	05/31/2011 09:23:10 AM Eastern Daylight Time			06/21/2011 10:54:13 AM Eastern Daylight Time	HUMANA HEALTH INSURANCE COMPANY OF FL, INC.	Humana Health Insurance Company of FL, Inc.	www.humana-medicare.com	Humana Employer Sponsored (PPO)	01	04		1			H5415	803	0	2012	Select Counties in Florida		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
H5415	804	0	1	04	01	H5415_804_0	3	1		06/21/2011	2012.02	06/21/2011 08:56:43 AM Eastern Daylight Time	05/31/2011 09:24:04 AM Eastern Daylight Time			06/21/2011 10:54:13 AM Eastern Daylight Time	HUMANA HEALTH INSURANCE COMPANY OF FL, INC.	Humana Health Insurance Company of FL, Inc.	www.humana-medicare.com	Humana Employer Sponsored Non-CY (PPO)	01	04		1			H5415	804	0	2012	Select Counties in Florida		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H5415	806	0	2	04	01	H5415_806_0	3	1		06/21/2011	2012.02	06/21/2011 09:12:57 AM Eastern Daylight Time	05/31/2011 10:20:27 AM Eastern Daylight Time			06/21/2011 10:54:13 AM Eastern Daylight Time	HUMANA HEALTH INSURANCE COMPANY OF FL, INC.	Humana Health Insurance Company of FL, Inc.	www.humana-medicare.com	Humana Employer Sponsored (PPO)	01	04		2	2		H5415	806	0	2012	Select Counties in Florida		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H5415	807	0	2	04	01	H5415_807_0	3	1		06/21/2011	2012.02	06/21/2011 09:13:22 AM Eastern Daylight Time	05/31/2011 10:21:24 AM Eastern Daylight Time			06/21/2011 10:54:13 AM Eastern Daylight Time	HUMANA HEALTH INSURANCE COMPANY OF FL, INC.	Humana Health Insurance Company of FL, Inc.	www.humana-medicare.com	Humana Employer Sponsored (PPO)	01	04		2	2		H5415	807	0	2012	Select Counties in Florida		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
H5415	808	0	2	04	01	H5415_808_0	3	1		06/21/2011	2012.02	06/21/2011 09:13:44 AM Eastern Daylight Time	05/31/2011 10:22:21 AM Eastern Daylight Time			06/21/2011 10:54:13 AM Eastern Daylight Time	HUMANA HEALTH INSURANCE COMPANY OF FL, INC.	Humana Health Insurance Company of FL, Inc.	www.humana-medicare.com	Humana Employer Sponsored Non-CY (PPO)	01	04		2	2		H5415	808	0	2012	Select Counties in Florida		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H5415	809	0	1	04	01	H5415_809_0	4	1		06/21/2011	2012.02	06/21/2011 08:57:05 AM Eastern Daylight Time	07/19/2011 10:04:06 AM Eastern Daylight Time			07/22/2011 06:28:25 PM Eastern Daylight Time	HUMANA HEALTH INSURANCE COMPANY OF FL, INC.	Humana Health Insurance Company of FL, Inc.	www.humana-medicare.com	Humana Employer Sponsored (PPO)	01	04		1			H5415	809	0	2012	Select Couties in Florida		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H5415	810	0	1	04	01	H5415_810_0	4	1		06/21/2011	2012.02	06/21/2011 08:57:30 AM Eastern Daylight Time	07/19/2011 10:05:32 AM Eastern Daylight Time			07/22/2011 06:28:25 PM Eastern Daylight Time	HUMANA HEALTH INSURANCE COMPANY OF FL, INC.	Humana Health Insurance Company of FL, Inc.	www.humana-medicare.com	Humana Employer Sponsored (PPO)	01	04		1			H5415	810	0	2012	Select Counties in Florida		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
H5415	811	0	1	04	01	H5415_811_0	4	1		06/21/2011	2012.02	06/21/2011 08:57:52 AM Eastern Daylight Time	07/19/2011 10:07:00 AM Eastern Daylight Time			07/22/2011 06:28:25 PM Eastern Daylight Time	HUMANA HEALTH INSURANCE COMPANY OF FL, INC.	Humana Health Insurance Company of FL, Inc.	www.humana-medicare.com	Humana Employer Sponsored Non-CY (PPO)	01	04		1			H5415	811	0	2012	Select Counties in Florida		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H5415	812	0	2	04	01	H5415_812_0	4	1		06/21/2011	2012.02	06/21/2011 09:14:07 AM Eastern Daylight Time	07/19/2011 10:08:07 AM Eastern Daylight Time			07/22/2011 06:28:25 PM Eastern Daylight Time	HUMANA HEALTH INSURANCE COMPANY OF FL, INC.	Humana Health Insurance Company of FL, Inc.	www.humana-medicare.com	Humana Employer Sponsored (PPO)	01	04		2	2		H5415	812	0	2012	Select Counites in Florida		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H5415	813	0	2	04	01	H5415_813_0	4	1		06/21/2011	2012.02	06/21/2011 09:14:33 AM Eastern Daylight Time	07/19/2011 10:09:15 AM Eastern Daylight Time			07/22/2011 06:28:25 PM Eastern Daylight Time	HUMANA HEALTH INSURANCE COMPANY OF FL, INC.	Humana Health Insurance Company of FL, Inc.	www.humana-medicare.com	Humana Employer Sponsored (PPO)	01	04		2	2		H5415	813	0	2012	Select Counties in Florida		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
H5415	814	0	2	04	01	H5415_814_0	4	1		06/21/2011	2012.02	06/21/2011 09:14:55 AM Eastern Daylight Time	07/19/2011 10:10:52 AM Eastern Daylight Time			07/22/2011 06:28:25 PM Eastern Daylight Time	HUMANA HEALTH INSURANCE COMPANY OF FL, INC.	Humana Health Insurance Company of FL, Inc.	www.humana-medicare.com	Humana Employer Sponsored Non-CY (PPO)	01	04		2	2		H5415	814	0	2012	Select Counties In Florida		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H5415	815	0	1	04	01	H5415_815_0	4	1		06/21/2011	2012.02	06/21/2011 08:58:13 AM Eastern Daylight Time	07/19/2011 12:48:33 PM Eastern Daylight Time			07/22/2011 06:28:25 PM Eastern Daylight Time	HUMANA HEALTH INSURANCE COMPANY OF FL, INC.	Humana Health Insurance Company of FL, Inc.	www.humana-medicare.com	Humana Employer Sponsored - Walmart (PPO)	01	04		1			H5415	815	0	2012	Select counties in Florida		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H5415	816	0	1	04	01	H5415_816_0	4	1		06/21/2011	2012.02	06/21/2011 08:58:35 AM Eastern Daylight Time	07/19/2011 12:49:48 PM Eastern Daylight Time			07/22/2011 06:28:25 PM Eastern Daylight Time	HUMANA HEALTH INSURANCE COMPANY OF FL, INC.	Humana Health Insurance Company of FL, Inc.	www.humana-medicare.com	Humana Employer Sponsored - Walmart (PPO)	01	04		1			H5415	816	0	2012	Select counties in Florida		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H5416	002	0	1	01	01	H5416_002_0	8	1		08/08/2011	2012.02	08/08/2011 10:57:16 AM Central Daylight Time	08/07/2011 12:50:58 PM Central Daylight Time	08/04/2011 01:14:09 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARCADIAN HEALTH PLAN, INC.	Spokane Community Care	www.spokanecommunitycare.com	Spokane Community Care - Plus (HMO)	01	01		1			H5416	002	0	2012	Spokane County		2		2			2						www.arcadianhealth.com	www.spokanecommunitycare.com	www.spokanecommunitycare.com	(800)-573-8597		(800)-573-8597		(800)-573-8609		(509)-325-8004		(800)-573-8597		(800)-573-8597		(800)-573-8609		(509)-325-8004		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H5416	004	0	1	01	01	H5416_004_0	8	1		08/08/2011	2012.02	08/08/2011 10:09:57 AM Central Daylight Time	08/07/2011 12:52:24 PM Central Daylight Time	08/04/2011 01:26:17 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARCADIAN HEALTH PLAN, INC.	Spokane Community Care	www.columbiacommuntiycare.com	Columbia Community Care - Plus (HMO)	01	01		1			H5416	004	0	2012	Benton/ Franklin		2		2			2						www.arcadianhealth.com	www.spokanecommunitycare.com	www.spokanecommunitycare.com	(800)-573-8597		(800)-573-8597		(800)-573-8609		(509)-325-8004		(800)-573-8597		(800)-573-8597		(800)-573-8609		(509)-325-8004		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H5416	009	0	1	01	01	H5416_009_0	9	1		08/08/2011	2012.02	08/08/2011 10:10:25 AM Central Daylight Time	08/07/2011 12:53:47 PM Central Daylight Time	08/04/2011 01:29:26 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARCADIAN HEALTH PLAN, INC.	Spokane Community Care	www.columbiacommuntiycare.com	Columbia Community Care - Plus (HMO)	01	01		1			H5416	009	0	2012	Yakima		2		2			2						www.arcadianhealth.com	www.spokanecommunitycare.com	www.spokanecommunitycare.com	(800)-573-8597		(800)-573-8597		(800)-573-8609		(509)-325-8004		(800)-573-8597		(800)-573-8597		(800)-573-8609		(509)-325-8004		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H5416	013	0	1	01	01	H5416_013_0	8	1		08/08/2011	2012.02	08/08/2011 10:12:37 AM Central Daylight Time	08/07/2011 12:55:13 PM Central Daylight Time	08/04/2011 01:31:59 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARCADIAN HEALTH PLAN, INC.	Spokane Community Care	www.SoutheastCommunityCare.com	Southeast Community Care - Plus (HMO)	01	01		1			H5416	013	0	2012	Roanoke		2		2			2						www.arcadianhealth.com	www.spokanecommunitycare.com	www.spokanecommunitycare.com	(800)-573-8597		(800)-573-8597		(800)-653-2924		(757)-461-6344		(800)-573-8597		(800)-573-8597		(800)-653-2924		(757)-461-6344		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H5416	014	0	1	01	01	H5416_014_0	7	1	2	07/07/2011	2012.02	07/07/2011 11:01:06 AM Central Daylight Time	07/17/2011 05:54:04 PM Central Daylight Time	07/19/2011 07:48:16 PM Central Daylight Time		07/20/2011 04:17:07 PM Central Daylight Time	ARCADIAN HEALTH PLAN, INC.	Spokane Community Care	www.arcadianhealth.com	Spokane Community Care - Dual Plus (HMO SNP)	01	01		1			H5416	014	0	2012	Washington		2		2			1	3		1	5		www.arcadianhealth.com	www.spokanecommunitycare.com	www.spokanecommunitycare.com	(800)-573-8597		(800)-573-8597		(800)-573-8609		(509)-325-8004		(800)-573-8597		(800)-573-8597		(800)-573-8609		(509)-325-8004		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H5416	016	0	1	01	01	H5416_016_0	8	1		08/08/2011	2012.02	08/08/2011 10:13:01 AM Central Daylight Time	08/07/2011 12:56:35 PM Central Daylight Time	08/04/2011 01:33:43 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARCADIAN HEALTH PLAN, INC.	Spokane Community Care	www.NortheastCommunityCare.com	Northeast Community Care - Plus (HMO)	01	01		1			H5416	016	0	2012	New Hampshire		2		2			2						www.arcadianhealth.com	www.spokanecommunitycare.com	www.spokanecommunitycare.com	(800)-573-8597		(800)-573-8597		(800)-998-3056		(800)-998-3056		(800)-573-8597		(800)-573-8597		(800)-998-3056		(800)-998-3056		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H5416	017	0	1	01	01	H5416_017_0	8	1		08/08/2011	2012.02	08/08/2011 10:13:28 AM Central Daylight Time	08/07/2011 12:57:59 PM Central Daylight Time	08/04/2011 01:41:36 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARCADIAN HEALTH PLAN, INC.	Spokane Community Care	www.arcadianhealth.com	Ozark Health Plan - Plus (HMO)	01	01		1			H5416	017	0	2012	Joplin		2		2			2						www.arcadianhealth.com	www.spokanecommunitycare.com	www.spokanecommunitycare.com	(800)-573-8597		(800)-573-8597		(800)-658-3518		(800)-658-3518		(800)-573-8597		(800)-573-8597		(800)-658-3518		(800)-658-3518		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H5416	018	0	1	01	01	H5416_018_0	9	1		08/08/2011	2012.02	08/08/2011 10:14:04 AM Central Daylight Time	08/07/2011 12:59:24 PM Central Daylight Time	08/04/2011 01:44:39 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARCADIAN HEALTH PLAN, INC.	Spokane Community Care	www.arcadianhealth.com	Ozark Health Plan - Plus (HMO)	01	01		1			H5416	018	0	2012	Springfield		2		2			2						www.arcadianhealth.com	www.spokanecommunitycare.com	www.spokanecommunitycare.com	(800)-573-8597		(800)-573-8597		(800)-658-3518		(800)-658-3518		(800)-573-8597		(800)-573-8597		(800)-658-3518		(800)-658-3518		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H5416	019	0	1	01	01	H5416_019_0	7	1	2	07/07/2011	2012.02	07/07/2011 11:02:22 AM Central Daylight Time	07/17/2011 06:00:42 PM Central Daylight Time	07/19/2011 07:51:28 PM Central Daylight Time		07/20/2011 04:17:07 PM Central Daylight Time	ARCADIAN HEALTH PLAN, INC.	Spokane Community Care	www.arcadianhealth.com	Ozark Health Plan - Dual Plus (HMO SNP)	01	01		1			H5416	019	0	2012	Missouri		2		2			1	3		1	5		www.arcadianhealth.com	www.spokanecommunitycare.com	www.spokanecommunitycare.com	(800)-573-8597		(800)-573-8597		(800)-658-3518		(800)-658-3518		(800)-573-8597		(800)-573-8597		(800)-658-3518		(800)-658-3518		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H5416	020	0	1	01	01	H5416_020_0	8	1		08/08/2011	2012.02	08/08/2011 10:14:32 AM Central Daylight Time	08/07/2011 01:00:50 PM Central Daylight Time	08/04/2011 01:56:15 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARCADIAN HEALTH PLAN, INC.	Spokane Community Care	www.arcadianhealth.com	Arcadian Community Care - Plus (HMO)	01	01		1			H5416	020	0	2012	Tulare		2		2			2						www.arcadianhealth.com	www.spokanecommunitycare.com	www.spokanecommunitycare.com	(800)-573-8597		(800)-573-8597		(800)-699-5125		(805)-481-7169		(800)-573-8597		(800)-573-8597		(800)-699-5125		(805)-481-7169		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H5416	021	0	1	01	01	H5416_021_0	8	1		08/08/2011	2012.02	08/08/2011 10:14:55 AM Central Daylight Time	08/07/2011 01:02:12 PM Central Daylight Time	08/04/2011 01:57:10 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARCADIAN HEALTH PLAN, INC.	Spokane Community Care	www.arcadianhealth.com	Arcadian Community Care - Plus (HMO)	01	01		1			H5416	021	0	2012	Shasta		2		2			2						www.arcadianhealth.com	www.spokanecommunitycare.com	www.spokanecommunitycare.com	(800)-573-8597		(800)-573-8597		(800)-699-5125		(805)-481-7169		(800)-573-8597		(800)-573-8597		(800)-699-5125		(805)-481-7169		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H5416	023	0	1	01	01	H5416_023_0	8	1		08/08/2011	2012.02	08/08/2011 10:15:17 AM Central Daylight Time	08/07/2011 01:03:36 PM Central Daylight Time	08/04/2011 01:59:34 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARCADIAN HEALTH PLAN, INC.	Spokane Community Care	www.arcadianhealth.com	Southeast Community Care - Plus (HMO)	01	01		1			H5416	023	0	2012	Virginia Beach		2		2			2						www.arcadianhealth.com	www.spokanecommunitycare.com	www.spokanecommunitycare.com	(800)-573-8597		(800)-573-8597		(800)-653-2924		(757)-461-6344		(800)-573-8597		(800)-573-8597		(800)-653-2924		(757)-461-6344		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H5417	001	0	1	04	01	H5417_001_0	4	1		07/22/2011	2012.02	07/22/2011 12:14:01 PM Central Daylight Time	08/29/2011 10:40:43 AM Central Daylight Time	08/05/2011 01:43:37 PM Central Daylight Time		08/29/2011 04:50:42 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.EvercareHealthPlans.com	UnitedHealthcare Nursing Home Plan (PPO SNP)	01	04		1			H5417	001	0	2012	Panhandle, Jax, Tampa, Orlando,  Southern FL areas		2		2			1	1	1	1			www.EvercareHealthPlans.com	EvercareHealthPlans.com/prescription_drug_coverage.jsp	www.PrescriptionSolutions.com	(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(800)-393-0993		(800)-393-0993		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5420	001	0	1	05	01	H5420_001_0	6	1		08/04/2011	2012.02	08/04/2011 12:01:15 PM Eastern Daylight Time	08/05/2011 06:19:16 PM Eastern Daylight Time	08/04/2011 04:03:14 PM Eastern Daylight Time		08/05/2011 07:03:04 PM Eastern Daylight Time	MEDICA HEALTHCARE PLANS, INC.	Medica HealthCare Plans, Inc.	www.medicaplans.com	Medica HealthCare Plans MedicareMax (PSO)	01	05		1			H5420	001	0	2012	Miami-Dade County		2	23986	2			2						www.medicaplans.com	www.medicaplans.com	www.medicaplans.com	(800)-407-9069		(305)-421-1244		(800)-507-0544		(305)-267-5267		(800)-407-9069		(305)-421-1244		(800)-507-0544		(305)-267-5267		(800)-517-6923		(305)-421-1251		(800)-865-4057		(305)-448-3407		(800)-517-6923		(305)-421-1251		(800)-865-4057		(305)-448-3407		2	2	2
H5420	003	0	1	05	01	H5420_003_0	4	1		08/04/2011	2012.02	08/04/2011 04:52:09 PM Eastern Daylight Time	08/05/2011 06:23:41 PM Eastern Daylight Time	08/04/2011 04:04:48 PM Eastern Daylight Time		08/05/2011 07:03:04 PM Eastern Daylight Time	MEDICA HEALTHCARE PLANS, INC.	Medica HealthCare Plans, Inc.	www.medicaplans.com	Medica HealthCare Plans MedicareMax (PSO)	01	05		1			H5420	003	0	2012	Broward County		2	6430	2			2						www.medicaplans.com	www.medicaplans.com	www.medicaplans.com	(800)-407-9069		(305)-421-1244		(800)-719-4570		(800)-719-4570		(800)-407-9069		(305)-421-1244		(800)-719-4570		(800)-719-4570		(800)-517-6923		(305)-421-1251		(800)-865-4057		(800)-865-4057		(800)-517-6923		(305)-421-1251		(800)-865-4057		(800)-865-4057		2	2	2
H5420	006	0	1	05	01	H5420_006_0	4	1	2	07/21/2011	2012.02	07/21/2011 10:14:32 AM Eastern Daylight Time	08/05/2011 06:28:38 PM Eastern Daylight Time	08/04/2011 04:05:22 PM Eastern Daylight Time		08/05/2011 07:03:04 PM Eastern Daylight Time	MEDICA HEALTHCARE PLANS, INC.	Medica HealthCare Plans, Inc.	www.medicaplans.com	Medica HealthCare Plans MedicareMax Plus (PSO SNP)	01	05		1			H5420	006	0	2012	Miami-Dade and Broward County		2	4511	2			1	3		1	3		www.medicaplans.com	www.medicaplans.com	www.medicaplans.com	(800)-407-9069		(305)-421-1244		(800)-507-0544		(800)-507-0544		(800)-407-9069		(800)-407-9069		(800)-507-0544		(800)-507-0544		(800)-517-6923		(305)-421-1251		(800)-865-4057		(800)-865-4057		(800)-517-6923		(800)-517-6923		(800)-865-4057		(800)-865-4057		2	2	2
H5420	007	0	1	05	01	H5420_007_0	3	1		07/21/2011	2012.02	07/21/2011 10:14:26 AM Eastern Daylight Time	07/18/2011 02:36:22 PM Eastern Daylight Time			07/21/2011 11:16:44 AM Eastern Daylight Time	MEDICA HEALTHCARE PLANS, INC.	Medica HealthCare Plans, Inc.	www.medicaplans.com	Medica HealthCare Plans MedicareMax Value (PSO)	01	05		1			H5420	007	0	2012	Miami-Dade County		2	209	2			2						www.medicaplans.com	www.medicaplans.com	www.medicaplans.com	(800)-407-9069		(305)-421-1244		(800)-507-0544		(305)-267-5267										(800)-517-6923		(305)-421-1251		(800)-865-4057		(305)-448-3407										2	2	2
H5420	008	0	1	05	01	H5420_008_0	3	1		07/21/2011	2012.02	07/21/2011 10:14:19 AM Eastern Daylight Time	07/19/2011 12:05:32 PM Eastern Daylight Time			07/21/2011 11:16:44 AM Eastern Daylight Time	MEDICA HEALTHCARE PLANS, INC.	Medica HealthCare Plans, Inc.	www.medicaplans.com	Medica HealthCare Plans MedicareMax Value (PSO)	01	05		1			H5420	008	0	2012	Broward County		2	713	2			2						www.medicaplans.com	www.medicaplans.com	www.medicaplans.com	(800)-407-9069		(305)-421-1244		(800)-719-4570		(800)-719-4570										(800)-517-6923		(305)-421-1251		(800)-865-4057		(800)-865-4057										2	2	2
H5420	009	0	1	05	01	H5420_009_0	5	1		08/04/2011	2012.02	08/04/2011 12:03:10 PM Eastern Daylight Time	08/05/2011 12:43:20 PM Eastern Daylight Time	08/11/2011 12:01:52 PM Eastern Daylight Time		08/11/2011 03:40:23 PM Eastern Daylight Time	MEDICA HEALTHCARE PLANS, INC.	Medica HealthCare Plans, Inc.	www.medicaplans.com	Medica HealthCare Plans MedicareMax Value RX (PSO)	01	05		1			H5420	009	0	2012	Miami-Dade and Broward County		2	6784	2			2						www.medicaplans.com	www.medicaplans.com	www.medicaplans.com	(800)-407-9069		(305)-421-1244		(800)-507-0544		(800)-507-0544		(800)-407-9069		(800)-407-9069		(800)-507-0544		(800)-507-0544		(800)-517-6923		(305)-421-1251		(800)-865-4057		(800)-865-4057		(800)-517-6923		(800)-517-6923		(800)-865-4057		(800)-865-4057		2	2	2
H5420	010	0	1	05	01	H5420_010_0	5	1		08/04/2011	2012.02	08/04/2011 05:30:13 PM Eastern Daylight Time	08/05/2011 01:00:46 PM Eastern Daylight Time	08/04/2011 04:05:55 PM Eastern Daylight Time		08/05/2011 07:03:04 PM Eastern Daylight Time	MEDICA HEALTHCARE PLANS, INC.	Medica HealthCare Plans, Inc.	www.medicaplans.com	Medica HealthCare Plans MedicareMax Chronic Care (PSO SNP)	01	05		1			H5420	010	0	2012	Miami-Dade and Broward County		2	115	2			1	4		1		00000000000000001000	www.medicaplans.com	www.medicaplans.com	www.medicaplans.com	(800)-407-9069		(305)-421-1244		(800)-507-0544		(800)-507-0544		(800)-407-9069		(305)-421-1244		(800)-507-0544		(800)-507-0544		(800)-517-6923		(305)-421-1251		(800)-865-4057		(800)-865-4057		(800)-517-6923		(305)-421-1251		(800)-865-4057		(800)-865-4057		2	2	2
H5421	046	0	1	09	04	H5421_046_0	4	1		07/06/2011	2012.02	07/06/2011 05:27:27 PM Central Daylight Time	07/15/2011 02:41:49 PM Central Daylight Time			07/18/2011 11:20:32 AM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier 400 (PFFS)	04	09	2	1			H5421	046	0	2012	Select counties in Midwest, Southeast, Southwest		2	3417	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										2		2
H5421	047	0	1	09	04	H5421_047_0	4	1		07/06/2011	2012.02	07/06/2011 05:27:34 PM Central Daylight Time	07/15/2011 02:42:47 PM Central Daylight Time			07/18/2011 11:20:32 AM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier 400 (PFFS)	04	09	2	1			H5421	047	0	2012	Select counties in Midwest, Southeast, Southwest		2	3843	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										2		2
H5421	048	0	1	09	04	H5421_048_0	4	1		07/06/2011	2012.02	07/06/2011 05:27:44 PM Central Daylight Time	07/15/2011 02:43:41 PM Central Daylight Time			07/18/2011 11:20:32 AM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier 400 (PFFS)	04	09	2	1			H5421	048	0	2012	Select counties in Midwest, Southeast, Southwest		2	599	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										2		2
H5421	049	0	1	09	04	H5421_049_0	4	1		07/06/2011	2012.02	07/06/2011 05:27:59 PM Central Daylight Time	07/15/2011 02:44:20 PM Central Daylight Time			07/18/2011 11:20:32 AM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier 400 (PFFS)	04	09	2	1			H5421	049	0	2012	Select counties in Midwest, Southeast, Southwest		2	4265	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										2		2
H5421	056	0	1	09	04	H5421_056_0	4	1		07/06/2011	2012.02	07/06/2011 05:28:10 PM Central Daylight Time	07/15/2011 02:45:03 PM Central Daylight Time			07/18/2011 11:20:32 AM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier 400 (PFFS)	04	09	2	1			H5421	056	0	2012	Select counties in Midwest, Southeast, Southwest		2	1257	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										2		2
H5421	057	0	1	09	04	H5421_057_0	4	1		07/06/2011	2012.02	07/06/2011 05:28:22 PM Central Daylight Time	07/15/2011 02:45:43 PM Central Daylight Time			07/18/2011 11:20:32 AM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier 400 (PFFS)	04	09	2	1			H5421	057	0	2012	Select counties in Midwest, Southeast, Southwest		2	734	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										2		2
H5421	065	0	1	09	04	H5421_065_0	6	1		07/06/2011	2012.02	07/06/2011 05:28:32 PM Central Daylight Time	08/05/2011 09:37:08 AM Central Daylight Time	08/04/2011 12:31:06 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier Plus 450B (PFFS)	04	09	2	1			H5421	065	0	2012	Select counties in Midwest, Southeast, Southwest		2	2871	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867		(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		2		2
H5421	067	0	1	09	04	H5421_067_0	4	1		07/06/2011	2012.02	07/06/2011 04:19:45 PM Central Daylight Time	08/05/2011 09:46:26 AM Central Daylight Time	08/04/2011 12:20:34 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier Plus 250A (PFFS)	04	09	2	1			H5421	067	0	2012	Select counties in Midwest, Southeast, Southwest		2	1652	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867		(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		2		2
H5421	068	0	1	09	04	H5421_068_0	4	1		07/06/2011	2012.02	07/06/2011 04:19:59 PM Central Daylight Time	08/05/2011 09:56:36 AM Central Daylight Time	08/04/2011 12:19:26 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier Plus 250A (PFFS)	04	09	2	1			H5421	068	0	2012	Select counties in Midwest, Southeast, Southwest		2	507	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867		(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		2		2
H5421	070	0	1	09	04	H5421_070_0	6	1		07/06/2011	2012.02	07/06/2011 05:28:43 PM Central Daylight Time	08/05/2011 10:05:00 AM Central Daylight Time	08/04/2011 12:38:46 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier Plus 450B (PFFS)	04	09	2	1			H5421	070	0	2012	Select counties in Midwest, Southeast, Southwest		2	1581	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867		(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		2		2
H5421	072	0	1	09	04	H5421_072_0	8	1		07/06/2011	2012.02	07/06/2011 05:28:59 PM Central Daylight Time	08/05/2011 10:26:54 AM Central Daylight Time	08/04/2011 12:48:26 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier Plus 450C (PFFS)	04	09	2	1			H5421	072	0	2012	Select counties in Midwest, Southeast, Southwest		2	668	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867		(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		2		2
H5421	073	0	1	09	04	H5421_073_0	8	1		07/06/2011	2012.02	07/06/2011 05:29:18 PM Central Daylight Time	08/05/2011 10:37:38 AM Central Daylight Time	08/04/2011 12:52:22 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier Plus 450D (PFFS)	04	09	2	1			H5421	073	0	2012	Select counties in Midwest, Southeast, Southwest		2	2945	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867		(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		2		2
H5421	074	0	1	09	04	H5421_074_0	8	1		07/06/2011	2012.02	07/06/2011 05:29:34 PM Central Daylight Time	08/05/2011 10:46:37 AM Central Daylight Time	08/04/2011 01:42:48 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier Plus 450E (PFFS)	04	09	2	1			H5421	074	0	2012	Select counties in Midwest, Southeast, Southwest		2	918	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867		(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		2		2
H5421	075	0	1	09	04	H5421_075_0	8	1		07/06/2011	2012.02	07/06/2011 05:29:41 PM Central Daylight Time	08/05/2011 10:55:36 AM Central Daylight Time	08/04/2011 12:47:28 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier Plus 450C (PFFS)	04	09	2	1			H5421	075	0	2012	Select counties in Midwest, Southeast, Southwest		2	1095	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867		(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		2		2
H5421	206	0	1	09	04	H5421_206_0	2	1		07/06/2011	2012.02	07/06/2011 04:21:24 PM Central Daylight Time	06/05/2011 11:05:54 PM Central Daylight Time			07/08/2011 04:40:04 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier 200 (PFFS)	04	09	2	1			H5421	206	0	2012	Select counties in Midwest, Southeast, Southwest		2	283	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										2		2
H5421	207	0	1	09	04	H5421_207_0	2	1		07/06/2011	2012.02	07/06/2011 04:21:38 PM Central Daylight Time	06/05/2011 11:06:12 PM Central Daylight Time			07/08/2011 04:40:04 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier 200 (PFFS)	04	09	2	1			H5421	207	0	2012	Select counties in Midwest, Southeast, Southwest		2	283	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										2		2
H5421	208	0	1	09	04	H5421_208_0	2	1		07/06/2011	2012.02	07/06/2011 04:21:52 PM Central Daylight Time	06/05/2011 11:06:31 PM Central Daylight Time			07/08/2011 04:40:04 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier 200 (PFFS)	04	09	2	1			H5421	208	0	2012	Select counties in Midwest, Southeast, Southwest		2	283	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										2		2
H5421	209	0	1	09	04	H5421_209_0	2	1		07/06/2011	2012.02	07/06/2011 04:22:08 PM Central Daylight Time	06/05/2011 11:06:44 PM Central Daylight Time			07/08/2011 04:40:04 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier 200 (PFFS)	04	09	2	1			H5421	209	0	2012	Select counties in Midwest, Southeast, Southwest		2	283	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										2		2
H5421	210	0	1	09	04	H5421_210_0	2	1		07/06/2011	2012.02	07/06/2011 04:22:23 PM Central Daylight Time	06/05/2011 11:06:59 PM Central Daylight Time			07/08/2011 04:40:04 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier 200 (PFFS)	04	09	2	1			H5421	210	0	2012	Select counties in Midwest, Southeast, Southwest		2	283	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										2		2
H5421	211	0	1	09	04	H5421_211_0	2	1		07/06/2011	2012.02	07/06/2011 04:22:42 PM Central Daylight Time	06/05/2011 11:07:15 PM Central Daylight Time			07/08/2011 04:40:04 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier 200 (PFFS)	04	09	2	1			H5421	211	0	2012	Select counties in Midwest, Southeast, Southwest		2	283	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										2		2
H5421	212	0	1	09	04	H5421_212_0	4	1		07/06/2011	2012.02	07/06/2011 04:22:56 PM Central Daylight Time	08/05/2011 08:57:45 AM Central Daylight Time	08/04/2011 12:07:54 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier Plus 250A (PFFS)	04	09	2	1			H5421	212	0	2012	Select counties in Midwest, Southeast, Southwest		2	245	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867		(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		2		2
H5421	213	0	1	09	04	H5421_213_0	4	1		07/06/2011	2012.02	07/06/2011 04:23:16 PM Central Daylight Time	08/05/2011 09:07:25 AM Central Daylight Time	08/04/2011 12:10:24 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier Plus 250A (PFFS)	04	09	2	1			H5421	213	0	2012	Select counties in Midwest, Southeast, Southwest		2	245	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867		(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		2		2
H5421	214	0	1	09	04	H5421_214_0	3	1		07/06/2011	2012.02	07/06/2011 04:23:31 PM Central Daylight Time	08/05/2011 09:16:17 AM Central Daylight Time	08/04/2011 12:12:34 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier Plus 250A (PFFS)	04	09	2	1			H5421	214	0	2012	Select counties in Midwest, Southeast, Southwest		2	245	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867		(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		2		2
H5421	215	0	1	09	04	H5421_215_0	3	1		07/06/2011	2012.02	07/06/2011 04:23:44 PM Central Daylight Time	08/05/2011 09:26:20 AM Central Daylight Time	08/04/2011 12:14:38 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier Plus 250A (PFFS)	04	09	2	1			H5421	215	0	2012	Select counties in Midwest, Southeast, Southwest		2	245	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867		(866)-568-8921		(866)-568-8921		(800)-996-8867		(800)-996-8867		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		2		2
H5422	002	0	1	01	01	H5422_002_0	9	1		08/04/2011	2012.02	08/04/2011 10:12:08 AM Pacific Daylight Time	08/08/2011 03:07:46 PM Pacific Daylight Time	08/04/2011 12:42:34 PM Pacific Daylight Time		08/08/2011 11:55:40 PM Pacific Daylight Time	BLUE CROSS BLUE SHIELD OF GEORGIA	Blue Cross Blue Shield Healthcare Plan of Georgia	www.bcbsga.com/medicare	BlueValue Secure (HMO)	01	01		1			H5422	002	0	2012	Select Counties in Georgia		2	2850	2			2						www.bcbsga.com/medicare	www.bcbsga.com	www.bcbsga.com	(866)-438-9968		(866)-438-9968		(800)-797-1769		(800)-797-1769		(866)-438-9968		(866)-438-9968		(800)-797-1769		(800)-797-1769		(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894		(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894		2	2	2
H5422	006	0	1	01	01	H5422_006_0	9	1		08/04/2011	2012.02	08/04/2011 10:12:13 AM Pacific Daylight Time	08/08/2011 03:07:47 PM Pacific Daylight Time	08/04/2011 12:42:34 PM Pacific Daylight Time		08/08/2011 11:55:40 PM Pacific Daylight Time	BLUE CROSS BLUE SHIELD OF GEORGIA	Blue Cross Blue Shield Healthcare Plan of Georgia	www.bcbsga.com/medicare	BlueValue Basic (HMO)	01	01		1			H5422	006	0	2012	Select Counties in Georgia		2	1196	2			2						www.bcbsga.com/medicare	www.bcbsga.com	www.bcbsga.com	(866)-438-9968		(866)-438-9968		(800)-797-1769		(800)-797-1769		(866)-438-9968		(866)-438-9968		(800)-797-1769		(800)-797-1769		(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894		(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894		2	2	2
H5422	803	0	1	01	01	H5422_803_0	4	1		07/06/2011	2012.02	07/06/2011 05:10:51 PM Pacific Daylight Time	06/06/2011 09:02:53 PM Pacific Daylight Time			07/07/2011 12:53:14 PM Pacific Daylight Time	BLUE CROSS BLUE SHIELD OF GEORGIA	Blue Cross Blue Shield Healthcare Plan of Georgia	www.bcbsga.com/medicare	BlueValue (HMO)	01	01		1			H5422	803	0	2012	Georgia Select Counties		1	50	2			2							www.bcbsga.com	www.bcbsga.com	(866)-207-8869		(866)-207-8869		(866)-207-8869		(866)-207-8869										(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657										2	2	2
H5422	804	0	1	01	01	H5422_804_0	4	1		07/06/2011	2012.02	07/06/2011 05:11:01 PM Pacific Daylight Time	06/06/2011 09:02:53 PM Pacific Daylight Time			07/07/2011 12:53:14 PM Pacific Daylight Time	BLUE CROSS BLUE SHIELD OF GEORGIA	Blue Cross Blue Shield Healthcare Plan of Georgia	www.bcbsga.com/medicare	BlueValue (HMO)	01	01		1			H5422	804	0	2012	Georgia - Select Counties		1	50	2			2							www.bcbsga.com	www.bcbsga.com	(866)-207-8869		(866)-207-8869		(866)-207-8869		(866)-207-8869		(866)-207-8869		(866)-207-8869		(866)-207-8869		(866)-207-8869		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		2	2	2
H5422	805	0	1	01	01	H5422_805_0	4	1		07/06/2011	2012.02	07/06/2011 05:11:11 PM Pacific Daylight Time	06/06/2011 09:02:53 PM Pacific Daylight Time			07/07/2011 12:53:14 PM Pacific Daylight Time	BLUE CROSS BLUE SHIELD OF GEORGIA	Blue Cross Blue Shield Healthcare Plan of Georgia	www.bcbsga.com/medicare	BlueValue (HMO)	01	01		1			H5422	805	0	2012	Georgia - Select Counties		1	50	2			2							www.bcbsga.com	www.bcbsga.com	(866)-207-8869		(866)-207-8869		(866)-207-8869		(866)-207-8869		(866)-207-8869		(866)-207-8869		(866)-207-8869		(866)-207-8869		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		2	2	2
H5424	001	0	1	04	01	H5424_001_0	3	1		08/08/2011	2012.02	08/08/2011 12:10:20 PM Central Daylight Time	08/04/2011 04:13:30 PM Central Daylight Time	08/05/2011 01:43:53 PM Central Daylight Time		08/09/2011 02:44:43 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice (PPO)	01	04		1			H5424	001	0	2012	Honolulu County		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5424	003	0	1	04	01	H5424_003_0	2	1		07/21/2011	2012.02	07/21/2011 11:38:52 AM Central Daylight Time	07/22/2011 03:37:10 PM Central Daylight Time			07/25/2011 01:23:05 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice Essential (PPO)	01	04		1			H5424	003	0	2012	Honolulu County		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514										(711)		(711)		(711)		(711)										2	2	2
H5424	005	0	1	04	01	H5424_005_0	4	1	2	08/09/2011	2012.02	08/09/2011 01:02:13 PM Central Daylight Time	08/08/2011 02:43:22 PM Central Daylight Time	08/05/2011 01:14:09 PM Central Daylight Time		08/09/2011 01:10:13 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Dual Complete (PPO SNP)	01	04		1			H5424	005	0	2012	Honolulu County		2		2			1	3		1	2		www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(866)-622-8054		(866)-622-8054		(888)-834-3721		(888)-834-3721		(866)-622-8054		(866)-622-8054		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5425	001	0	1	01	01	H5425_001_0	9	1		08/08/2011	2012.02	08/08/2011 10:11:49 AM Pacific Daylight Time	08/06/2011 12:47:59 PM Pacific Daylight Time	08/03/2011 03:00:00 PM Pacific Daylight Time		08/09/2011 10:16:12 AM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Classic (HMO)	01	01		1			H5425	001	0	2012	Ventura County		2		2			2						www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5425	003	0	1	01	01	H5425_003_0	12	1		08/08/2011	2012.02	08/08/2011 10:15:42 AM Pacific Daylight Time	08/06/2011 01:02:47 PM Pacific Daylight Time	08/03/2011 03:01:00 PM Pacific Daylight Time		08/09/2011 10:16:12 AM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Classic (HMO)	01	01		1			H5425	003	0	2012	Kern County		2		2			2						www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5425	004	0	1	01	01	H5425_004_0	9	1		08/08/2011	2012.02	08/08/2011 10:15:03 AM Pacific Daylight Time	08/06/2011 01:16:14 PM Pacific Daylight Time	08/03/2011 03:02:00 PM Pacific Daylight Time		08/09/2011 10:16:12 AM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Signature (HMO)	01	01		1			H5425	004	0	2012	San Diego County		2		2			2						www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5425	005	0	1	01	01	H5425_005_0	9	1		08/08/2011	2012.02	08/08/2011 10:15:04 AM Pacific Daylight Time	08/06/2011 01:32:46 PM Pacific Daylight Time	08/03/2011 03:03:00 PM Pacific Daylight Time		08/09/2011 10:16:12 AM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Classic (HMO)	01	01		1			H5425	005	0	2012	San Diego County		2		2			2						www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5425	006	0	1	01	01	H5425_006_0	7	1		08/08/2011	2012.02	08/08/2011 10:15:04 AM Pacific Daylight Time	08/06/2011 03:14:52 PM Pacific Daylight Time	08/03/2011 03:04:00 PM Pacific Daylight Time		08/09/2011 10:16:12 AM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Classic (HMO)	01	01		1			H5425	006	0	2012	Los Angeles County		2	20600	2			2						www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5425	007	0	1	01	01	H5425_007_0	9	1		08/08/2011	2012.02	08/08/2011 10:15:05 AM Pacific Daylight Time	08/06/2011 03:29:52 PM Pacific Daylight Time	08/03/2011 03:04:00 PM Pacific Daylight Time		08/09/2011 10:16:12 AM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Classic (HMO)	01	01		1			H5425	007	0	2012	Orange County		2		2			2						www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5425	008	0	1	01	01	H5425_008_0	9	1		08/08/2011	2012.02	08/08/2011 10:15:06 AM Pacific Daylight Time	08/06/2011 03:42:01 PM Pacific Daylight Time	08/03/2011 03:05:00 PM Pacific Daylight Time		08/09/2011 10:16:12 AM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Classic (HMO)	01	01		1			H5425	008	0	2012	Riverside County		2		2			2						www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5425	009	0	1	01	01	H5425_009_0	9	1		08/08/2011	2012.02	08/08/2011 10:15:06 AM Pacific Daylight Time	08/06/2011 03:52:50 PM Pacific Daylight Time	08/03/2011 03:06:00 PM Pacific Daylight Time		08/09/2011 10:16:12 AM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Classic (HMO)	01	01		1			H5425	009	0	2012	San Bernardino County		2		2			2						www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5425	010	0	1	01	01	H5425_010_0	7	1	2	07/15/2011	2012.02	07/15/2011 11:22:31 AM Pacific Daylight Time	08/06/2011 06:01:26 PM Pacific Daylight Time	08/03/2011 03:11:00 PM Pacific Daylight Time		08/09/2011 03:46:53 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Connections (HMO SNP)	01	01		1			H5425	010	0	2012	Los Angeles County		2		2			1	3		1	5		www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(866)-722-6725		(866)-722-6725		(800)-915-7226		(800)-915-7226		(866)-722-6725		(866)-722-6725		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5425	011	0	1	01	01	H5425_011_0	7	1	2	07/12/2011	2012.02	07/12/2011 03:58:08 PM Pacific Daylight Time	08/06/2011 06:18:26 PM Pacific Daylight Time	08/03/2011 03:11:00 PM Pacific Daylight Time		08/09/2011 03:46:53 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Connections (HMO SNP)	01	01		1			H5425	011	0	2012	Riverside County		2		2			1	3		1	5		www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(866)-722-6725		(866)-722-6725		(800)-915-7226		(800)-915-7226		(866)-722-6725		(866)-722-6725		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5425	012	0	1	01	01	H5425_012_0	7	1	2	07/12/2011	2012.02	07/12/2011 03:41:33 PM Pacific Daylight Time	08/07/2011 05:10:40 PM Pacific Daylight Time	08/03/2011 03:12:00 PM Pacific Daylight Time		08/09/2011 03:46:53 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Connections (HMO SNP)	01	01		1			H5425	012	0	2012	San Bernardino County		2		2			1	3		1	5		www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(866)-722-6725		(866)-722-6725		(800)-915-7226		(800)-915-7226		(866)-722-6725		(866)-722-6725		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5425	014	0	1	01	01	H5425_014_0	7	1		08/08/2011	2012.02	08/08/2011 10:23:17 AM Pacific Daylight Time	08/06/2011 04:03:01 PM Pacific Daylight Time	08/03/2011 03:12:00 PM Pacific Daylight Time		08/09/2011 10:38:04 AM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Options (HMO)	01	01		1			H5425	014	0	2012	Orange County		2		2			2						www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5425	015	0	1	01	01	H5425_015_0	6	1		08/08/2011	2012.02	08/08/2011 10:23:18 AM Pacific Daylight Time	08/06/2011 04:12:59 PM Pacific Daylight Time	08/03/2011 03:13:00 PM Pacific Daylight Time		08/09/2011 10:38:04 AM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Options (HMO)	01	01		1			H5425	015	0	2012	Riverside County		2		2			2						www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5425	016	0	1	01	01	H5425_016_0	6	1		08/08/2011	2012.02	08/08/2011 10:23:19 AM Pacific Daylight Time	08/06/2011 04:24:53 PM Pacific Daylight Time	08/03/2011 03:14:00 PM Pacific Daylight Time		08/09/2011 10:38:04 AM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Options (HMO)	01	01		1			H5425	016	0	2012	San Bernardino County		2		2			2						www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5425	018	0	1	01	01	H5425_018_0	6	1		08/08/2011	2012.02	08/08/2011 10:23:19 AM Pacific Daylight Time	08/08/2011 06:08:25 PM Pacific Daylight Time	08/03/2011 03:14:00 PM Pacific Daylight Time		08/09/2011 10:38:04 AM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Classic (HMO)	01	01		1			H5425	018	0	2012	Contra Costa County		2		2			2						www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5425	019	0	1	01	01	H5425_019_0	8	1		08/08/2011	2012.02	08/08/2011 10:23:20 AM Pacific Daylight Time	08/08/2011 06:14:43 PM Pacific Daylight Time	08/03/2011 03:15:00 PM Pacific Daylight Time		08/09/2011 10:38:04 AM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Classic (HMO)	01	01		1			H5425	019	0	2012	San Francisco County		2		2			2						www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5425	020	0	1	01	01	H5425_020_0	8	1		08/08/2011	2012.02	08/08/2011 10:23:21 AM Pacific Daylight Time	08/08/2011 06:24:56 PM Pacific Daylight Time	08/03/2011 03:16:00 PM Pacific Daylight Time		08/09/2011 10:38:04 AM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Classic (HMO)	01	01		1			H5425	020	0	2012	Santa Clara County		2		2			2						www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5425	022	0	1	01	01	H5425_022_0	8	1		08/08/2011	2012.02	08/08/2011 10:23:22 AM Pacific Daylight Time	08/08/2011 06:39:04 PM Pacific Daylight Time	08/03/2011 03:16:00 PM Pacific Daylight Time		08/09/2011 10:38:04 AM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Options (HMO)	01	01		1			H5425	022	0	2012	Contra Costa County		2		2			2						www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5425	023	0	1	01	01	H5425_023_0	8	1		08/08/2011	2012.02	08/08/2011 10:23:22 AM Pacific Daylight Time	08/08/2011 06:46:48 PM Pacific Daylight Time	08/03/2011 03:18:00 PM Pacific Daylight Time		08/09/2011 10:38:04 AM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Options (HMO)	01	01		1			H5425	023	0	2012	San Francisco County		2		2			2						www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5425	024	0	1	01	01	H5425_024_0	8	1		08/08/2011	2012.02	08/08/2011 10:23:23 AM Pacific Daylight Time	08/08/2011 07:22:47 PM Pacific Daylight Time	08/03/2011 03:19:00 PM Pacific Daylight Time		08/09/2011 10:38:04 AM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Options (HMO)	01	01		1			H5425	024	0	2012	Santa Clara County		2		2			2						www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5425	025	0	1	02	01	H5425_025_0	7	1		09/12/2011	2012.02	09/12/2011 12:16:28 PM Pacific Daylight Time	08/08/2011 04:39:43 PM Pacific Daylight Time	08/03/2011 03:19:00 PM Pacific Daylight Time		09/16/2011 10:40:44 AM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	My Choice (HMO-POS)	01	02		1			H5425	025	0	2012	Los Angeles County		2		2			2						www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(877)-231-7226		(877)-231-7226		(800)-915-7226		(800)-915-7226		(877)-231-7226		(877)-231-7226		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5425	026	0	1	02	01	H5425_026_0	7	1		09/12/2011	2012.02	09/12/2011 12:18:15 PM Pacific Daylight Time	08/08/2011 04:43:13 PM Pacific Daylight Time	08/03/2011 03:20:00 PM Pacific Daylight Time		09/16/2011 10:40:44 AM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	My Choice (HMO-POS)	01	02		1			H5425	026	0	2012	Orange County		2		2			2						www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(877)-231-7226		(877)-231-7226		(800)-915-7226		(800)-915-7226		(877)-231-7226		(877)-231-7226		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5425	027	0	1	02	01	H5425_027_0	7	1		09/16/2011	2012.02	09/16/2011 09:52:21 AM Pacific Daylight Time	08/08/2011 04:46:04 PM Pacific Daylight Time	08/03/2011 03:20:00 PM Pacific Daylight Time		09/16/2011 10:40:44 AM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	My Choice (HMO-POS)	01	02		1			H5425	027	0	2012	Riverside and  San Bernardino County		2		2			2						www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(877)-231-7226		(877)-231-7226		(800)-915-7226		(800)-915-7226		(877)-231-7226		(877)-231-7226		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5425	028	0	1	01	01	H5425_028_0	7	1		08/08/2011	2012.02	08/08/2011 10:23:28 AM Pacific Daylight Time	08/08/2011 04:49:59 PM Pacific Daylight Time	08/03/2011 03:21:00 PM Pacific Daylight Time		08/09/2011 11:19:50 AM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	Heart First (HMO SNP)	01	01		1			H5425	028	0	2012	Los Angeles County		2		2			1	4		1		00001000000000000000	www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5425	029	0	1	01	01	H5425_029_0	7	1	2	07/12/2011	2012.02	07/12/2011 04:00:44 PM Pacific Daylight Time	08/07/2011 05:23:34 PM Pacific Daylight Time	08/03/2011 03:21:00 PM Pacific Daylight Time		08/09/2011 03:46:53 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Connections at Home (HMO SNP)	01	01		1			H5425	029	0	2012	Los Angeles County		2		2			1	3		1	5		www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(866)-722-6725		(866)-722-6725		(800)-915-7226		(800)-915-7226		(866)-722-6725		(866)-722-6725		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5425	030	0	1	01	01	H5425_030_0	6	1	2	07/12/2011	2012.02	07/12/2011 03:45:25 PM Pacific Daylight Time	08/08/2011 08:37:21 AM Pacific Daylight Time	08/03/2011 03:22:00 PM Pacific Daylight Time		08/09/2011 03:46:53 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Connections at Home (HMO SNP)	01	01		1			H5425	030	0	2012	Riverside County		2		2			1	3		1	5		www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(866)-722-6725		(866)-722-6725		(800)-915-7226		(800)-915-7226		(866)-722-6725		(866)-722-6725		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5425	031	0	1	01	01	H5425_031_0	7	1	2	07/12/2011	2012.02	07/12/2011 03:45:31 PM Pacific Daylight Time	08/08/2011 08:48:48 AM Pacific Daylight Time	08/03/2011 03:23:00 PM Pacific Daylight Time		08/09/2011 03:46:53 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Connections at Home (HMO SNP)	01	01		1			H5425	031	0	2012	San Bernardino County		2		2			1	3		1	5		www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(866)-722-6725		(866)-722-6725		(800)-915-7226		(800)-915-7226		(866)-722-6725		(866)-722-6725		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5425	801	0	1	01	01	H5425_801_0	6	1		07/18/2011	2012.02	07/18/2011 01:39:38 PM Pacific Daylight Time	07/21/2011 11:19:46 AM Pacific Daylight Time			07/21/2011 01:06:51 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Employer Group (HMO)	01	01		1			H5425	801	0	2012	SCAN Employer Group		1		2			2						www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226										(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929										2	2	2
H5425	803	0	1	01	01	H5425_803_0	6	1		07/18/2011	2012.02	07/18/2011 01:39:49 PM Pacific Daylight Time	07/21/2011 11:40:13 AM Pacific Daylight Time			07/21/2011 01:06:51 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Employer Group (HMO)	01	01		1			H5425	803	0	2012	SCAN Employer Group		1		2			2						www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5425	804	0	1	01	01	H5425_804_0	6	1		07/18/2011	2012.02	07/18/2011 01:40:01 PM Pacific Daylight Time	07/21/2011 11:57:48 AM Pacific Daylight Time			07/21/2011 01:06:51 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Employer Group (HMO)	01	01		1			H5425	804	0	2012	SCAN Employer Group		1		2			2						www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5426	001	0	1	01	01	H5426_001_0	6	1		07/06/2011	2012.02	07/06/2011 01:18:04 PM Eastern Daylight Time	08/04/2011 09:37:38 AM Eastern Daylight Time	08/04/2011 12:38:40 PM Eastern Daylight Time		08/08/2011 04:34:39 PM Eastern Daylight Time	HUMANA ADVANTAGECARE PLAN, INC.	Humana AdvantageCare Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H5426-001 (HMO)	01	01		1			H5426	001	0	2012	Treasure Coast Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5426	002	0	1	01	01	H5426_002_0	7	1		07/06/2011	2012.02	07/06/2011 01:17:19 PM Eastern Daylight Time	08/04/2011 09:38:49 AM Eastern Daylight Time	08/04/2011 12:39:00 PM Eastern Daylight Time		08/08/2011 04:34:39 PM Eastern Daylight Time	HUMANA ADVANTAGECARE PLAN, INC.	Humana AdvantageCare Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H5426-002 (HMO)	01	01		1			H5426	002	0	2012	Gulf  Coast and Central Areas		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5426	008	0	1	01	01	H5426_008_0	5	1		07/21/2011	2012.02	07/21/2011 05:13:42 PM Eastern Daylight Time	08/04/2011 09:39:15 AM Eastern Daylight Time	08/04/2011 12:39:25 PM Eastern Daylight Time		08/08/2011 04:34:39 PM Eastern Daylight Time	HUMANA ADVANTAGECARE PLAN, INC.	Humana AdvantageCare Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H5426-008 (HMO)	01	01		1			H5426	008	0	2012	Gulf Coast and Central Areas		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5426	013	0	1	01	01	H5426_013_0	4	1	2	07/20/2011	2012.02	07/20/2011 09:18:15 AM Eastern Daylight Time	08/04/2011 09:38:01 AM Eastern Daylight Time	08/04/2011 12:39:44 PM Eastern Daylight Time		08/08/2011 03:20:12 PM Eastern Daylight Time	HUMANA ADVANTAGECARE PLAN, INC.	Humana AdvantageCare Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H5426-013 (HMO SNP)	01	01		1			H5426	013	0	2012	Treasure Coast Area		2		2			1	3		1	2		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5426	019	0	1	01	01	H5426_019_0	5	1		07/06/2011	2012.02	07/06/2011 12:14:52 PM Eastern Daylight Time	08/04/2011 09:42:01 AM Eastern Daylight Time	08/04/2011 12:40:03 PM Eastern Daylight Time		08/08/2011 03:20:12 PM Eastern Daylight Time	HUMANA ADVANTAGECARE PLAN, INC.	Humana AdvantageCare Plan, Inc.	www.humana-medicare.com	Humana Gold Plus H5426-019 (HMO)	01	01		1			H5426	019	0	2012	Lake, Marion, Sumter counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5426	025	0	1	01	01	H5426_025_0	4	1	2	07/20/2011	2012.02	07/20/2011 10:22:21 AM Eastern Daylight Time	08/04/2011 09:51:41 AM Eastern Daylight Time	08/04/2011 12:40:24 PM Eastern Daylight Time		08/08/2011 03:20:12 PM Eastern Daylight Time	HUMANA ADVANTAGECARE PLAN, INC.	Humana AdvantageCare Plan, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H5426-025 (HMO SNP)	01	01		1			H5426	025	0	2012	Glades, Martin, Okeechobee and St Lucie counties		2		2			1	3		1	5		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5426	801	0	1	01	01	H5426_801_0	4	1		07/06/2011	2012.02	07/06/2011 10:57:28 AM Eastern Daylight Time	06/02/2011 04:17:44 PM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA ADVANTAGECARE PLAN, INC.	Humana AdvantageCare Plan, Inc.	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H5426	801	0	2012	Select counties in Gulf Coast and Central areas		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H5426	802	0	1	01	01	H5426_802_0	4	1		07/06/2011	2012.02	07/06/2011 10:57:34 AM Eastern Daylight Time	06/02/2011 04:18:58 PM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA ADVANTAGECARE PLAN, INC.	Humana AdvantageCare Plan, Inc.	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H5426	802	0	2012	Select counties in Gulf Coast and Central areas		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
H5426	803	0	1	01	01	H5426_803_0	4	1		07/06/2011	2012.02	07/06/2011 10:57:38 AM Eastern Daylight Time	06/02/2011 04:20:04 PM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA ADVANTAGECARE PLAN, INC.	Humana AdvantageCare Plan, Inc.	www.humana-medicare.com	Humana Employer Sponsored Non-CY (HMO)	01	01		1			H5426	803	0	2012	Select counties in Gulf Coast and Central areas		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H5427	052	0	1	01	01	H5427_052_0	7	1		07/01/2011	2012.02	07/01/2011 09:35:49 AM Eastern Daylight Time	06/06/2011 03:30:40 PM Eastern Daylight Time			07/11/2011 11:03:12 AM Eastern Daylight Time	FREEDOM HEALTH PLAN, INC.	Freedom Health, Inc.	www.FreedomHealth.com	Freedom Savings Plan (HMO)	01	01		1			H5427	052	0	2012	Select Counties in Florida		2	1871	2			2						http://www.FreedomHealth.com	www.freedomhealth.com	www.freedomhealth.com	(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740										(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771										2	2	2
H5427	053	0	1	01	01	H5427_053_0	7	1		08/03/2011	2012.02	08/03/2011 11:01:31 AM Eastern Daylight Time	08/04/2011 09:24:54 PM Eastern Daylight Time	08/04/2011 01:29:04 PM Eastern Daylight Time		08/08/2011 10:04:58 AM Eastern Daylight Time	FREEDOM HEALTH PLAN, INC.	Freedom Health, Inc.	www.FreedomHealth.com	Freedom Savings Plan Rx (HMO)	01	01		1			H5427	053	0	2012	Select Counties in Florida		2	5585	2			2						http://www.FreedomHealth.com	www.freedomhealth.com	www.freedomhealth.com	(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5427	054	0	1	01	01	H5427_054_0	8	1		07/01/2011	2012.02	07/01/2011 09:36:02 AM Eastern Daylight Time	08/04/2011 09:28:50 PM Eastern Daylight Time	08/04/2011 01:28:26 PM Eastern Daylight Time		08/08/2011 10:04:58 AM Eastern Daylight Time	FREEDOM HEALTH PLAN, INC.	Freedom Health, Inc.	www.FreedomHealth.com	Freedom Savings Plan Rx (HMO)	01	01		1			H5427	054	0	2012	Select Counties in Florida		2	6865	2			2						http://www.FreedomHealth.com	www.freedomhealth.com	www.freedomhealth.com	(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5427	059	0	1	01	01	H5427_059_0	9	1		07/01/2011	2012.02	07/01/2011 09:36:09 AM Eastern Daylight Time	08/04/2011 09:21:02 PM Eastern Daylight Time	08/04/2011 01:29:28 PM Eastern Daylight Time		08/08/2011 10:04:58 AM Eastern Daylight Time	FREEDOM HEALTH PLAN, INC.	Freedom Health, Inc.	www.FreedomHealth.com	Freedom Medicare Plan Rx (HMO)	01	01		1			H5427	059	0	2012	Select Counties in Florida		2	1384	2			2						http://www.FreedomHealth.com	www.freedomhealth.com	www.freedomhealth.com	(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5427	060	0	1	01	01	H5427_060_0	8	1		08/03/2011	2012.02	08/03/2011 11:03:27 AM Eastern Daylight Time	08/04/2011 09:32:54 PM Eastern Daylight Time	08/04/2011 01:25:50 PM Eastern Daylight Time		08/08/2011 10:04:58 AM Eastern Daylight Time	FREEDOM HEALTH PLAN, INC.	Freedom Health, Inc.	www.FreedomHealth.com	Freedom Medicare Plan Rx (HMO)	01	01		1			H5427	060	0	2012	Select Counties in Florida		2	2244	2			2						http://www.FreedomHealth.com	www.freedomhealth.com	www.freedomhealth.com	(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5427	070	0	1	01	01	H5427_070_0	7	1		07/01/2011	2012.02	07/01/2011 09:36:23 AM Eastern Daylight Time	08/04/2011 09:36:30 PM Eastern Daylight Time	08/04/2011 01:31:14 PM Eastern Daylight Time		08/08/2011 10:04:58 AM Eastern Daylight Time	FREEDOM HEALTH PLAN, INC.	Freedom Health, Inc.	www.FreedomHealth.com	Freedom VIP Care (HMO SNP)	01	01		1			H5427	070	0	2012	Select Counties in Florida		2	3372	2			1	4		1		00000000000000000010	http://www.FreedomHealth.com	www.freedomhealth.com	www.freedomhealth.com	(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5427	072	0	1	01	01	H5427_072_0	7	1		07/01/2011	2012.02	07/01/2011 09:36:30 AM Eastern Daylight Time	08/04/2011 09:40:28 PM Eastern Daylight Time	08/04/2011 01:30:48 PM Eastern Daylight Time		08/08/2011 10:04:58 AM Eastern Daylight Time	FREEDOM HEALTH PLAN, INC.	Freedom Health, Inc.	www.FreedomHealth.com	Freedom VIP Savings (HMO SNP)	01	01		1			H5427	072	0	2012	Select Counties in Florida		2	14414	2			1	4		1		00000000000000000010	http://www.FreedomHealth.com	www.freedomhealth.com	www.freedomhealth.com	(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5427	076	0	1	01	01	H5427_076_0	7	1		07/01/2011	2012.02	07/01/2011 09:36:36 AM Eastern Daylight Time	08/04/2011 09:43:52 PM Eastern Daylight Time	08/04/2011 01:30:18 PM Eastern Daylight Time		08/08/2011 10:04:58 AM Eastern Daylight Time	FREEDOM HEALTH PLAN, INC.	Freedom Health, Inc.	www.FreedomHealth.com	Freedom VIP Care COPD (HMO SNP)	01	01		1			H5427	076	0	2012	Select Counties in Florida		2	1426	2			1	4		1		00000000000100000000	http://www.FreedomHealth.com	www.freedomhealth.com	www.freedomhealth.com	(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5427	077	0	1	01	01	H5427_077_0	7	1		07/01/2011	2012.02	07/01/2011 09:36:44 AM Eastern Daylight Time	08/04/2011 09:47:38 PM Eastern Daylight Time	08/04/2011 01:31:36 PM Eastern Daylight Time		08/08/2011 10:04:58 AM Eastern Daylight Time	FREEDOM HEALTH PLAN, INC.	Freedom Health, Inc.	www.FreedomHealth.com	Freedom VIP Savings COPD (HMO SNP)	01	01		1			H5427	077	0	2012	Select Counties in Florida		2	4654	2			1	4		1		00000000000100000000	http://www.FreedomHealth.com	www.freedomhealth.com	www.freedomhealth.com	(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5427	078	0	1	01	01	H5427_078_0	7	1	2	08/22/2011	2012.02	08/22/2011 02:31:30 PM Eastern Daylight Time	08/04/2011 09:51:40 PM Eastern Daylight Time	08/04/2011 01:34:38 PM Eastern Daylight Time		08/22/2011 02:42:21 PM Eastern Daylight Time	FREEDOM HEALTH PLAN, INC.	Freedom Health, Inc.	www.FreedomHealth.com	Freedom Medi-Medi Partial (HMO SNP)	01	01		1			H5427	078	0	2012	Select Counties in Florida		2	1070	2			1	3		1	4		http://www.FreedomHealth.com	www.freedomhealth.com	www.freedomhealth.com	(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5427	082	0	1	01	01	H5427_082_0	8	1		07/01/2011	2012.02	07/01/2011 09:36:58 AM Eastern Daylight Time	08/04/2011 09:55:30 PM Eastern Daylight Time	08/04/2011 01:34:10 PM Eastern Daylight Time		08/08/2011 10:04:58 AM Eastern Daylight Time	FREEDOM HEALTH PLAN, INC.	Freedom Health, Inc.	www.FreedomHealth.com	Freedom VIP Savings (HMO SNP)	01	01		1			H5427	082	0	2012	Select Counties in Florida		2	1937	2			1	4		1		00000000000000000010	http://www.FreedomHealth.com	www.freedomhealth.com	www.freedomhealth.com	(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5427	083	0	1	01	01	H5427_083_0	7	1		07/01/2011	2012.02	07/01/2011 09:37:04 AM Eastern Daylight Time	08/04/2011 09:58:48 PM Eastern Daylight Time	08/04/2011 01:33:12 PM Eastern Daylight Time		08/08/2011 10:04:58 AM Eastern Daylight Time	FREEDOM HEALTH PLAN, INC.	Freedom Health, Inc.	www.FreedomHealth.com	Freedom VIP Savings COPD (HMO SNP)	01	01		1			H5427	083	0	2012	Select Counties in Florida		2	554	2			1	4		1		00000000000100000000	http://www.FreedomHealth.com	www.freedomhealth.com	www.freedomhealth.com	(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5427	084	0	1	01	01	H5427_084_0	8	1		07/01/2011	2012.02	07/01/2011 09:37:11 AM Eastern Daylight Time	08/04/2011 10:04:36 PM Eastern Daylight Time	08/04/2011 01:32:48 PM Eastern Daylight Time		08/08/2011 10:04:58 AM Eastern Daylight Time	FREEDOM HEALTH PLAN, INC.	Freedom Health, Inc.	www.FreedomHealth.com	Freedom Savings Rx (HMO)	01	01		1			H5427	084	0	2012	Clay and Duval Counties		2	157	2			2						http://www.FreedomHealth.com	www.freedomhealth.com	www.freedomhealth.com	(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5427	087	0	1	01	01	H5427_087_0	5	1	2	08/22/2011	2012.02	08/22/2011 02:32:52 PM Eastern Daylight Time	08/09/2011 11:46:08 AM Eastern Daylight Time	08/04/2011 01:35:14 PM Eastern Daylight Time		08/22/2011 02:42:21 PM Eastern Daylight Time	FREEDOM HEALTH PLAN, INC.	Freedom Health, Inc.	www.FreedomHealth.com	Freedom Medi-Medi Full (HMO SNP)	01	01		1			H5427	087	0	2012	Select Counties in Florida		2	1985	2			1	3		1	5		http://www.FreedomHealth.com	www.freedomhealth.com	www.freedomhealth.com	(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-401-2740		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5428	001	0	1	01	01	H5428_001_0	6	1	2	08/09/2011	2012.02	08/09/2011 08:37:34 AM Pacific Daylight Time	08/08/2011 02:00:24 PM Pacific Daylight Time	08/08/2011 01:59:47 PM Pacific Daylight Time		08/09/2011 11:44:07 AM Pacific Daylight Time	SAN MATEO HEALTH COMMISSION	Health Plan of San Mateo	http://www.hpsm.org/members/	HPSM CareAdvantage (HMO SNP)	01	01		1			H5428	001	0	2012	San Mateo County		2	8300	2			1	3		1	5		www.hpsm.org	http://www.hpsm.org/Members.aspx/139.htm	http://www.hpsm.org/Members.aspx/139.htm	(866)-880-0606		(650)-616-2174		(888)-252-3153		(650)-616-1500		(866)-880-0606		(650)-616-2174		(888)-252-3153		(650)-616-1500		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5429	001	0	1	04	01	H5429_001_0	8	1		08/09/2011	2012.02	08/09/2011 10:35:25 AM Eastern Daylight Time	08/09/2011 01:23:55 PM Eastern Daylight Time	08/09/2011 02:14:38 PM Eastern Daylight Time		08/09/2011 06:43:35 PM Eastern Daylight Time	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	Medicare Masterpiece (PPO)	01	04		1			H5429	001	0	2012	Florida		2		2			2						www.univhc.com	www.univhc.com/medicare/members/medicare-formulary.php	http://www.univhc.com	(866)-690-4842		(866)-690-4842		(800)-965-7034		(800)-965-7034		(877)-204-8149		(877)-204-8149		(800)-965-7034		(800)-965-7034		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-759-1089		(800)-759-1089		(800)-617-0177		(800)-617-0177		2	2	2
H5430	001	0	1	01	01	H5430_001_0	7	1	2	08/08/2011	2012.02	08/08/2011 01:32:13 PM US Mountain Standard Time	08/08/2011 01:30:45 PM US Mountain Standard Time	08/08/2011 01:30:45 PM US Mountain Standard Time		08/08/2011 01:34:47 PM US Mountain Standard Time	CARE1ST HEALTH PLAN OF ARIZONA	ONECare by Care1st Health Plan Arizona, Inc.	www.care1st.com/az	ONECare by Care1st Health Plan Arizona, Inc. (HMO SNP)	01	01		1			H5430	001	0	2012	County: Maricopa		2	1650	2			1	3		1	4		http://www.care1st.com/az/healthplans/onecare_medicare_directory.asp	https://www.care1st.com/az/index.asp	https://www.care1st.com/az/index.asp	(877)-778-1855		(602)-778-8345		(877)-778-1855		(602)-778-8340		(877)-778-1855		(602)-778-8345		(877)-778-1855		(602)-778-8340		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		2	2	2
H5431	001	0	1	01	01	H5431_001_0	6	1		08/09/2011	2012.02	08/09/2011 09:51:45 AM Eastern Daylight Time	08/09/2011 10:24:54 AM Eastern Daylight Time	08/04/2011 05:16:09 PM Eastern Daylight Time		08/09/2011 12:40:44 PM Eastern Daylight Time	HEALTHSUN HEALTH PLANS, INC.	HealthSun Health Plans, Inc.	www.healthsun.com	SunPlus Advantage Plan (HMO)	01	01		1			H5431	001	0	2012	Miami-Dade		2	2945	2			2							www.healthsun.com	www.healthsun.com	(877)-207-4900		(305)-234-9292		(877)-207-4900		(305)-234-9292		(877)-207-4900		(305)-234-9292		(877)-207-4900		(305)-234-9292		(877)-206-0500		(877)-206-0500		(877)-206-0500		(877)-206-0500		(877)-206-0500		(877)-206-0500		(877)-206-0500		(877)-206-0500		2	2	2
H5431	002	0	1	01	01	H5431_002_0	6	1		08/09/2011	2012.02	08/09/2011 09:52:13 AM Eastern Daylight Time	08/09/2011 10:23:42 AM Eastern Daylight Time	08/04/2011 05:45:07 PM Eastern Daylight Time		08/09/2011 12:40:44 PM Eastern Daylight Time	HEALTHSUN HEALTH PLANS, INC.	HealthSun Health Plans, Inc.	www.healthsun.com	SunPlus Advantage Plan (HMO)	01	01		1			H5431	002	0	2012	Broward		2	279	2			2							www.healthsun.com	www.healthsun.com	(877)-207-4900		(305)-234-9292		(877)-207-4900		(305)-234-9292		(877)-207-4900		(305)-234-9292		(877)-207-4900		(305)-234-9292		(877)-206-0500		(877)-206-0500		(877)-206-0500		(877)-206-0500		(877)-206-0500		(877)-206-0500		(877)-206-0500		(877)-206-0500		2	2	2
H5431	005	0	1	01	01	H5431_005_0	6	1		08/09/2011	2012.02	08/09/2011 09:52:39 AM Eastern Daylight Time	08/09/2011 10:20:48 AM Eastern Daylight Time	08/04/2011 05:44:33 PM Eastern Daylight Time		08/09/2011 12:40:44 PM Eastern Daylight Time	HEALTHSUN HEALTH PLANS, INC.	HealthSun Health Plans, Inc.	www.healthsun.com	Healthy Advantage Plan (HMO)	01	01		1			H5431	005	0	2012	Miami-Dade		2	250	2			2							www.healthsun.com	www.healthsun.com	(877)-207-4900		(305)-234-9292		(877)-207-4900		(305)-234-9292		(877)-207-4900		(305)-234-9292		(877)-207-4900		(305)-234-9292		(877)-206-0500		(877)-206-0500		(877)-206-0500		(877)-206-0500		(877)-206-0500		(877)-206-0500		(877)-206-0500		(877)-206-0500		2	2	2
H5431	006	0	1	01	01	H5431_006_0	6	1		08/09/2011	2012.02	08/09/2011 09:53:59 AM Eastern Daylight Time	08/09/2011 10:16:14 AM Eastern Daylight Time	08/04/2011 05:45:48 PM Eastern Daylight Time		08/09/2011 12:40:44 PM Eastern Daylight Time	HEALTHSUN HEALTH PLANS, INC.	HealthSun Health Plans, Inc.	www.healthsun.com	MediMax (HMO)	01	01		1			H5431	006	0	2012	Broward and Miami-Dade		2	2945	2			2							www.healthsun.com	www.healthsun.com	(877)-207-4900		(305)-234-9292		(877)-207-4900		(305)-234-9292		(877)-207-4900		(305)-234-9292		(877)-207-4900		(305)-234-9292		(877)-206-0500		(877)-206-0500		(877)-206-0500		(877)-206-0500		(877)-206-0500		(877)-206-0500		(877)-206-0500		(877)-206-0500		2	2	2
H5433	001	0	1	01	01	H5433_001_0	5	1	2	08/12/2011	2012.02	08/12/2011 07:36:26 AM Pacific Daylight Time	08/08/2011 04:06:00 PM Pacific Daylight Time	08/08/2011 04:03:00 PM Pacific Daylight Time		08/12/2011 08:07:18 AM Pacific Daylight Time	ORANGE COUNTY HEALTH AUTHORITY	OneCare	www.caloptima.org\onecare	OneCare (HMO SNP)	01	01		1			H5433	001	0	2012	Orange County		2	13258	2			1	3		1	5		www.caloptima.org	http://www.caloptima.org/en/Members/OneCare/MedicarePartD.aspx	http://www.caloptima.org/en/Members/OneCare/YourDoctorHealthNetworkAndPharmacy.aspx	(877)-412-2734		(877)-412-2734		(877)-412-2734		(877)-412-2734		(877)-412-2734		(877)-412-2734		(877)-412-2734		(877)-412-2734		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5434	002	0	1	04	01	H5434_002_0	6	1		08/08/2011	2012.02	08/08/2011 10:08:14 AM Eastern Daylight Time	08/04/2011 12:21:48 PM Eastern Daylight Time	08/04/2011 09:51:31 AM Eastern Daylight Time		08/09/2011 03:53:54 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Blue Cross and Blue Shield of Florida, Inc.	www.BlueMedicareFL.com	BlueMedicare PPO (PPO)	01	04		1			H5434	002	0	2012	Select counties in S.FL/ W.FL/C.FL,N.C. FL/N.W FL		2		2			2						www.BlueMedicareFL.com	www.myprime.com	www.myprime.com	(800)-926-6565		(800)-926-6565		(800)-876-2227		(800)-876-2227		(800)-926-6565		(800)-926-6565		(800)-876-2227		(800)-876-2227		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5434	801	0	1	04	01	H5434_801_0	4	1		07/20/2011	2012.02	07/20/2011 04:48:42 PM Eastern Daylight Time	06/28/2011 08:36:51 AM Eastern Daylight Time			07/22/2011 01:05:18 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Blue Cross and Blue Shield of Florida, Inc.	www.BlueMedicareFL.com	BlueMedicare Group PPO (PPO)	01	04		1			H5434	801	0	2012	State of Florida with National Coverage		1		2			2						www.BlueMedicareFL.com	www.myprime.com	www.myprime.com	(800)-926-6565		(800)-926-6565		(800)-876-2227		(800)-876-2227		(800)-926-6565		(800)-926-6565		(800)-876-2227		(800)-876-2227		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		1	2	2
H5434	802	0	1	04	01	H5434_802_0	4	1		07/20/2011	2012.02	07/20/2011 04:49:00 PM Eastern Daylight Time	06/28/2011 08:40:22 AM Eastern Daylight Time			07/22/2011 01:05:18 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Blue Cross and Blue Shield of Florida, Inc.	www.BlueMedicareFL.com	BlueMedicare Group PPO (PPO)	01	04		1			H5434	802	0	2012	State of Florida with National Coverage		1		2			2						www.BlueMedicareFL.com	www.myprime.com	www.myprime.com	(800)-926-6565		(800)-926-6565		(800)-876-2227		(800)-876-2227		(800)-926-6565		(800)-926-6565		(800)-876-2227		(800)-876-2227		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		1	2	2
H5435	001	0	1	09	04	H5435_001_0	3	1		07/20/2011	2012.02	07/20/2011 01:32:31 PM Central Daylight Time	07/22/2011 12:14:53 PM Central Daylight Time			07/25/2011 02:06:59 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	UnitedHealthcare MedicareDirect Essential (PFFS)	04	09	2	1			H5435	001	0	2012	Select counties nationwide		2		2			2							www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(866)-579-8774		(866)-579-8774		(800)-555-5757		(800)-555-5757										(711)		(711)		(711)		(711)										2		2
H5435	014	0	1	09	04	H5435_014_0	5	1		08/07/2011	2012.02	08/07/2011 07:15:20 AM Central Daylight Time	08/04/2011 09:01:01 PM Central Daylight Time	08/05/2011 01:44:08 PM Central Daylight Time		08/09/2011 03:57:48 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	UnitedHealthcare MedicareDirect Rx (PFFS)	04	09	2	1			H5435	014	0	2012	Select counties nationwide		2		2			2							www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(866)-579-8774		(866)-579-8774		(800)-555-5757		(800)-555-5757		(866)-579-8774		(866)-579-8774		(800)-555-5757		(800)-555-5757		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2		2
H5435	024	0	1	09	04	H5435_024_0	5	1		08/07/2011	2012.02	08/07/2011 07:15:54 AM Central Daylight Time	08/04/2011 09:01:38 PM Central Daylight Time	08/05/2011 01:44:24 PM Central Daylight Time		08/09/2011 03:57:48 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	UnitedHealthcare MedicareDirect Rx (PFFS)	04	09	2	1			H5435	024	0	2012	Select counties nationwide		2		2			2							www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(866)-579-8774		(866)-579-8774		(800)-555-5757		(800)-555-5757		(866)-579-8774		(866)-579-8774		(800)-555-5757		(800)-555-5757		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2		2
H5439	001	0	1	04	01	H5439_001_0	6	1		07/21/2011	2012.02	07/21/2011 04:35:40 PM Pacific Daylight Time	08/05/2011 02:47:28 PM Pacific Daylight Time	08/04/2011 02:47:36 PM Pacific Daylight Time		08/05/2011 02:43:29 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net Life Insurance Company	www.healthnet.com	Health Net Violet (PPO)	01	04		1			H5439	001	0	2012	San Diego County		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-960-4638		(800)-960-4638		(800)-935-6565		(800)-935-6565		(800)-960-4638		(800)-960-4638		(800)-935-6565		(800)-935-6565		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	2	2
H5439	002	0	1	04	01	H5439_002_0	6	1		07/21/2011	2012.02	07/21/2011 04:36:10 PM Pacific Daylight Time	08/05/2011 02:48:24 PM Pacific Daylight Time	08/04/2011 02:44:16 PM Pacific Daylight Time		08/05/2011 02:43:29 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net Life Insurance Company	www.healthnet.com	Health Net Violet (PPO)	01	04		1			H5439	002	0	2012	Sacramento County		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-960-4638		(800)-960-4638		(800)-935-6565		(800)-935-6565		(800)-960-4638		(800)-960-4638		(800)-935-6565		(800)-935-6565		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	2	2
H5439	003	0	1	04	01	H5439_003_0	6	1		07/21/2011	2012.02	07/21/2011 04:36:43 PM Pacific Daylight Time	08/05/2011 09:54:52 AM Pacific Daylight Time	08/04/2011 02:47:56 PM Pacific Daylight Time		08/05/2011 02:43:29 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net Life Insurance Company	www.healthnet.com	Health Net Violet (PPO)	01	04		1			H5439	003	0	2012	Contra Costa County		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-960-4638		(800)-960-4638		(800)-935-6565		(800)-935-6565		(800)-960-4638		(800)-960-4638		(800)-935-6565		(800)-935-6565		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	2	2
H5439	801	0	1	04	01	H5439_801_0	2	1		05/31/2011	2012.02	05/31/2011 03:30:56 PM Central Daylight Time	06/05/2011 12:54:04 AM Pacific Daylight Time			06/05/2011 12:25:53 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net Life Insurance Company	www.healthnet.com	Health Net Medicare Advantage Employer (PPO)	01	04		1			H5439	801	0	2012	Contra Costa, Sacramento and San Diego Counties		1		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-960-4638		(800)-960-4638		(800)-935-6565		(800)-935-6565		(800)-960-4638		(800)-960-4638		(800)-935-6565		(800)-935-6565		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	1	1
H5439	802	0	1	04	01	H5439_802_0	2	1		05/31/2011	2012.02	05/31/2011 03:31:20 PM Central Daylight Time	06/05/2011 12:54:18 AM Pacific Daylight Time			06/05/2011 12:25:53 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net Life Insurance Company	www.healthnet.com	Health Net Medicare Advantage Employer (PPO)	01	04		1			H5439	802	0	2012	Contra Costa, Sacramento and San Diego Counties		1		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-960-4638		(800)-960-4638		(800)-935-6565		(800)-935-6565										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955										2	1	1
H5439	803	0	1	04	01	H5439_803_0	2	1		05/31/2011	2012.02	05/31/2011 03:31:43 PM Central Daylight Time	06/05/2011 12:54:34 AM Pacific Daylight Time			06/05/2011 12:25:53 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net Life Insurance Company	www.healthnet.com	Health Net Medicare Advantage Employer (PPO)	01	04		1			H5439	803	0	2012	Contra Costa, Sacramento and San Diego Counties		1		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(800)-960-4638		(800)-960-4638		(800)-935-6565		(800)-935-6565		(800)-960-4638		(800)-960-4638		(800)-935-6565		(800)-935-6565		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	1	1
H5440	001	0	1	01	01	H5440_001_0	4	1	2	08/08/2011	2012.02	08/08/2011 08:18:38 PM Central Daylight Time	08/09/2011 09:30:19 AM Central Daylight Time	08/05/2011 01:14:30 PM Central Daylight Time		08/09/2011 01:10:13 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	Evercare by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Dual Complete EV (HMO SNP)	01	01		1			H5440	001	0	2012	Tampa Area		2		2			1	3		1	2		www.EvercareHealthPlans.com	EvercareHealthPlans.com/prescription_drug_coverage.jsp	www.PrescriptionSolutions.com	(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5470	002	0	1	04	01	H5470_002_0	4	1		07/11/2011	2012.02	07/11/2011 02:55:12 PM Eastern Daylight Time	08/04/2011 01:59:12 PM Eastern Daylight Time	08/04/2011 12:40:46 PM Eastern Daylight Time		08/08/2011 03:23:44 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H5470-002 (PPO)	01	04		1			H5470	002	0	2012	Select Counties in Michigan		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5470	005	0	1	04	01	H5470_005_0	4	1		07/11/2011	2012.02	07/11/2011 02:55:35 PM Eastern Daylight Time	08/04/2011 02:16:15 PM Eastern Daylight Time	08/04/2011 12:41:05 PM Eastern Daylight Time		08/08/2011 03:23:44 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H5470-005 (PPO)	01	04		1			H5470	005	0	2012	Select Counties in Michigan		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5470	007	0	1	04	01	H5470_007_0	4	1		07/11/2011	2012.02	07/11/2011 02:56:04 PM Eastern Daylight Time	08/04/2011 02:17:15 PM Eastern Daylight Time	08/04/2011 12:41:27 PM Eastern Daylight Time		08/08/2011 03:28:09 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H5470-007 (PPO)	01	04		1			H5470	007	0	2012	Select Counties in Michigan		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5471	001	0	1	01	01	H5471_001_0	10	1	2	08/09/2011	2012.02	08/09/2011 02:55:25 PM Eastern Daylight Time	08/09/2011 03:06:18 PM Eastern Daylight Time	08/05/2011 12:06:56 AM Eastern Daylight Time		08/09/2011 03:53:58 PM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Heathcare Plans, Inc.	www.mysimplymedicare.com	Simply Complete (HMO SNP)	01	01		1			H5471	001	0	2012	Miami-Dade County		2	17539	2			1	3		1	2		www.mysimplymedicare.com	http://www.simplyhealthcareplans.com/medicare/pharmacy/formulary/index.html	http://www.simplyhealthcareplans.com/medicare/pharmacy/pharmacy-locator/index.html	(800)-887-6888		(305)-408-5823		(877)-577-0212		(877)-577-0212		(800)-887-6888		(305)-408-5823		(877)-577-0212		(877)-577-0212		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5471	002	0	1	01	01	H5471_002_0	8	1		08/04/2011	2012.02	08/04/2011 05:36:45 PM Eastern Daylight Time	08/05/2011 01:15:06 PM Eastern Daylight Time	08/04/2011 06:45:45 PM Eastern Daylight Time		08/05/2011 06:47:05 PM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Heathcare Plans, Inc.	www.mysimplymedicare.com	Simply More (HMO)	01	01		1			H5471	002	0	2012	Miami-Dade County		2	10854	2			2						www.mysimplymedicare.com	http://www.simplyhealthcareplans.com/medicare/pharmacy/formulary/index.html	http://www.simplyhealthcareplans.com/medicare/pharmacy/pharmacy-locator/index.html	(800)-887-6888		(305)-408-5823		(877)-577-0212		(877)-577-0212		(800)-887-6888		(305)-408-5823		(877)-577-0212		(877)-577-0212		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5471	003	0	1	02	01	H5471_003_0	8	1		08/04/2011	2012.02	08/04/2011 05:37:09 PM Eastern Daylight Time	08/05/2011 01:24:31 PM Eastern Daylight Time	08/04/2011 06:45:22 PM Eastern Daylight Time		08/05/2011 06:47:05 PM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Heathcare Plans, Inc.	www.mysimplymedicare.com	Simply Options (HMO-POS)	01	02		1			H5471	003	0	2012	Miami-Dade County		2	4629	2			2						www.mysimplymedicare.com	http://www.simplyhealthcareplans.com/medicare/pharmacy/formulary/index.html	http://www.simplyhealthcareplans.com/medicare/pharmacy/pharmacy-locator/index.html	(800)-887-6888		(305)-408-5823		(877)-577-0212		(877)-577-0212		(800)-887-6888		(305)-408-5823		(877)-577-0212		(877)-577-0212		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5471	004	0	1	01	01	H5471_004_0	10	1		08/04/2011	2012.02	08/04/2011 05:37:29 PM Eastern Daylight Time	08/08/2011 11:24:52 AM Eastern Daylight Time	08/08/2011 10:24:48 AM Eastern Daylight Time		08/08/2011 11:33:34 AM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Heathcare Plans, Inc.	www.mysimplymedicare.com	Simply Extra (HMO)	01	01		1			H5471	004	0	2012	Miami-Dade County		2	1538	2			2						www.mysimplymedicare.com	http://www.simplyhealthcareplans.com/medicare/pharmacy/formulary/index.html	http://www.simplyhealthcareplans.com/medicare/pharmacy/pharmacy-locator/index.html	(800)-887-6888		(305)-408-5823		(877)-577-0212		(877)-577-0212		(800)-887-6888		(305)-408-5823		(877)-577-0212		(877)-577-0212		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5471	005	0	1	01	01	H5471_005_0	8	1		08/04/2011	2012.02	08/04/2011 05:37:49 PM Eastern Daylight Time	08/05/2011 01:53:51 PM Eastern Daylight Time	08/04/2011 06:41:35 PM Eastern Daylight Time		08/05/2011 06:47:05 PM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Heathcare Plans, Inc.	www.mysimplymedicare.com	Simply More (HMO)	01	01		1			H5471	005	0	2012	Hillsborough County		2	3408	2			2						www.mysimplymedicare.com	http://www.simplyhealthcareplans.com/medicare/pharmacy/formulary/index.html	http://www.simplyhealthcareplans.com/medicare/pharmacy/pharmacy-locator/index.html	(800)-887-6888		(305)-408-5823		(877)-577-0212		(877)-577-0212		(800)-887-6888		(305)-408-5823		(877)-577-0212		(877)-577-0212		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5471	006	0	1	01	01	H5471_006_0	8	1		08/04/2011	2012.02	08/04/2011 05:49:50 PM Eastern Daylight Time	08/05/2011 02:01:00 PM Eastern Daylight Time	08/04/2011 06:41:20 PM Eastern Daylight Time		08/05/2011 06:47:05 PM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Heathcare Plans, Inc.	www.mysimplymedicare.com	Simply Extra (HMO)	01	01		1			H5471	006	0	2012	Hillsborough County		2	848	2			2						www.mysimplymedicare.com	http://www.simplyhealthcareplans.com/medicare/pharmacy/formulary/index.html	http://www.simplyhealthcareplans.com/medicare/pharmacy/pharmacy-locator/index.html	(800)-887-6888		(305)-408-5823		(877)-577-0212		(877)-577-0212		(800)-887-6888		(305)-408-5823		(877)-577-0212		(877)-577-0212		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5471	007	0	1	01	01	H5471_007_0	10	1	2	08/09/2011	2012.02	08/09/2011 02:55:46 PM Eastern Daylight Time	08/09/2011 03:10:34 PM Eastern Daylight Time	08/05/2011 09:19:58 AM Eastern Daylight Time		08/09/2011 04:00:48 PM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Heathcare Plans, Inc.	www.mysimplymedicare.com	Simply Complete (HMO SNP)	01	01		1			H5471	007	0	2012	Hillsborough County		2	4385	2			1	3		1	2		www.mysimplymedicare.com	http://www.simplyhealthcareplans.com/medicare/pharmacy/formulary/index.html	http://www.simplyhealthcareplans.com/medicare/pharmacy/pharmacy-locator/index.html	(800)-887-6888		(305)-408-5823		(877)-577-0212		(877)-577-0212		(800)-887-6888		(305)-408-5823		(877)-577-0212		(877)-577-0212		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5471	008	0	1	01	01	H5471_008_0	7	1		08/04/2011	2012.02	08/04/2011 05:39:45 PM Eastern Daylight Time	08/08/2011 09:30:40 AM Eastern Daylight Time	08/08/2011 09:30:40 AM Eastern Daylight Time		08/08/2011 09:31:00 AM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Heathcare Plans, Inc.	www.mysimplymedicare.com	Simply Care (HMO SNP)	01	01		1			H5471	008	0	2012	Miami-Dade County		2	3936	2			1	1	1	1			www.mysimplymedicare.com	http://www.simplyhealthcareplans.com/medicare/pharmacy/formulary/index.html	http://www.simplyhealthcareplans.com/medicare/pharmacy/pharmacy-locator/index.html	(800)-887-6888		(305)-408-5823		(877)-577-0212		(877)-577-0212		(800)-887-6888		(305)-408-5823		(877)-577-0212		(877)-577-0212		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5471	009	0	1	01	01	H5471_009_0	7	1		08/04/2011	2012.02	08/04/2011 05:40:00 PM Eastern Daylight Time	08/08/2011 09:30:40 AM Eastern Daylight Time	08/08/2011 09:30:40 AM Eastern Daylight Time		08/08/2011 09:31:00 AM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Heathcare Plans, Inc.	www.mysimplymedicare.com	Simply Comfort (HMO SNP)	01	01		1			H5471	009	0	2012	Miami-Dade County		2	1488	2			1	1	2	1			www.mysimplymedicare.com	http://www.simplyhealthcareplans.com/medicare/pharmacy/formulary/index.html	http://www.simplyhealthcareplans.com/medicare/pharmacy/pharmacy-locator/index.html	(800)-887-6888		(305)-408-5823		(877)-577-0212		(877)-577-0212		(800)-887-6888		(305)-408-5823		(877)-577-0212		(877)-577-0212		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5471	010	0	1	01	01	H5471_010_0	7	1		08/04/2011	2012.02	08/04/2011 05:40:20 PM Eastern Daylight Time	08/05/2011 06:10:14 PM Eastern Daylight Time	08/05/2011 06:10:12 PM Eastern Daylight Time		08/05/2011 06:47:05 PM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Heathcare Plans, Inc.	www.mysimplymedicare.com	Simply Care (HMO SNP)	01	01		1			H5471	010	0	2012	Hillsborough County		2	984	2			1	1	1	1			www.mysimplymedicare.com	http://www.simplyhealthcareplans.com/medicare/pharmacy/formulary/index.html	http://www.simplyhealthcareplans.com/medicare/pharmacy/pharmacy-locator/index.html	(800)-887-6888		(305)-408-5823		(877)-577-0212		(877)-577-0212		(800)-887-6888		(305)-408-5823		(877)-577-0212		(877)-577-0212		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5471	011	0	1	01	01	H5471_011_0	7	1		08/04/2011	2012.02	08/04/2011 05:40:32 PM Eastern Daylight Time	08/05/2011 06:10:13 PM Eastern Daylight Time	08/05/2011 06:10:12 PM Eastern Daylight Time		08/05/2011 06:47:05 PM Eastern Daylight Time	SIMPLY HEALTHCARE PLANS, INC.	Simply Heathcare Plans, Inc.	www.mysimplymedicare.com	Simply Comfort (HMO SNP)	01	01		1			H5471	011	0	2012	Hillsborough County		2	372	2			1	1	2	1			www.mysimplymedicare.com	http://www.simplyhealthcareplans.com/medicare/pharmacy/formulary/index.html	http://www.simplyhealthcareplans.com/medicare/pharmacy/pharmacy-locator/index.html	(800)-887-6888		(305)-408-5823		(877)-577-0212		(877)-577-0212		(800)-887-6888		(305)-408-5823		(877)-577-0212		(877)-577-0212		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5475	001	0	1	01	01	H5475_001_0	4	1	2	08/08/2011	2012.02	08/08/2011 09:25:11 AM Eastern Daylight Time	08/09/2011 04:50:50 PM Eastern Daylight Time	08/09/2011 04:50:46 PM Eastern Daylight Time		08/09/2011 04:53:45 PM Eastern Daylight Time	HEALTH PLAN OF MICHIGAN, INC.	Health Plan of Michigan Gold Plan	www.hpmich.com/medicaregold	Health Plan of Michigan Gold Plan (HMO SNP)	01	01		1			H5475	001	0	2012	Macomb, Oakland and Wayne counties		2	224	2			1	3		1	5		http://www.hpmich.com/medicaregold/	http://www.hpmich.com/medicaregold	http://www.hpmich.com/medicaregold	(877)-902-6784		(877)-902-6784		(877)-902-6784		(877)-902-6784		(877)-902-6784		(877)-902-6784		(877)-902-6784		(877)-902-6784		(800)-649-3777		(800)-649-3777		(800)-649-3777		(800)-649-3777		(800)-649-3777		(800)-649-3777		(800)-649-3777		(800)-649-3777		2	2	2
H5507	001	0	1	04	01	H5507_001_0	4	1		08/04/2011	2012.02	08/04/2011 08:03:16 PM Central Daylight Time	08/08/2011 10:31:02 AM Central Daylight Time	08/05/2011 01:44:40 PM Central Daylight Time		08/09/2011 01:10:13 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice (PPO)	01	04		1			H5507	001	0	2012	Select counties in Illinois and Missouri		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5508	001	0	1	04	01	H5508_001_0	6	1		08/08/2011	2012.02	08/08/2011 02:02:12 PM Eastern Daylight Time	08/09/2011 12:07:53 PM Eastern Daylight Time	08/09/2011 12:07:34 PM Eastern Daylight Time		08/09/2011 02:00:06 PM Eastern Daylight Time	ADVANTAGE HEALTH SOLUTIONS, INC.	ADVANTAGE Health Solutions, Inc.	www.advantageplan.com	ADVANTAGE Enhanced (PPO)	01	04		1			H5508	001	0	2012	Central Indiana, Allen, Delaware, Howard, StJoseph		2	2580	2			2						www.advantageplan.com	http://www.advantageplan.com/	http://www.advantageplan.com/	(800)-523-7533		(317)-573-7950		(800)-201-8342		(800)-201-8342		(877)-684-0014		(877)-684-0014		(800)-201-8342		(800)-201-8342		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(866)-763-9630		(866)-763-9630		(800)-743-3333		(800)-743-3333		2	2	2
H5508	002	0	1	04	01	H5508_002_0	4	1		07/07/2011	2012.02	07/07/2011 11:08:32 AM Eastern Daylight Time	07/20/2011 02:07:40 PM Eastern Daylight Time			07/20/2011 02:10:59 PM Eastern Daylight Time	ADVANTAGE HEALTH SOLUTIONS, INC.	ADVANTAGE Health Solutions, Inc.	www.advantageplan.com	ADVANTAGE Preferred (PPO)	01	04		1			H5508	002	0	2012	Central Indiana, Allen, Delaware, Howard, StJoseph		2	420	2			2						www.advantageplan.com	http://www.advantageplan.com/	http://www.advantageplan.com/	(800)-523-7533		(317)-573-7950		(800)-201-8342		(800)-201-8342										(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333										2	2	2
H5508	005	0	1	04	01	H5508_005_0	7	1		08/08/2011	2012.02	08/08/2011 02:03:22 PM Eastern Daylight Time	08/09/2011 12:07:54 PM Eastern Daylight Time	08/11/2011 10:33:11 AM Eastern Daylight Time		08/11/2011 10:36:39 AM Eastern Daylight Time	ADVANTAGE HEALTH SOLUTIONS, INC.	ADVANTAGE Health Solutions, Inc.	www.advantageplan.com	ADVANTAGE Select (PPO)	01	04		1			H5508	005	0	2012	Central Indiana, Allen, Delaware, Howard, StJoseph		2	1550	2			2						www.advantageplan.com	http://www.advantageplan.com/	http://www.advantageplan.com/	(800)-523-7533		(317)-573-7950		(800)-201-8342		(800)-201-8342		(877)-684-0014		(877)-684-0014		(800)-201-8342		(800)-201-8342		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(866)-763-9630		(866)-763-9630		(800)-743-3333		(800)-743-3333		2	2	2
H5508	006	0	1	04	01	H5508_006_0	6	1		08/08/2011	2012.02	08/08/2011 02:03:32 PM Eastern Daylight Time	08/09/2011 12:07:55 PM Eastern Daylight Time	08/09/2011 12:07:35 PM Eastern Daylight Time		08/09/2011 02:00:06 PM Eastern Daylight Time	ADVANTAGE HEALTH SOLUTIONS, INC.	ADVANTAGE Health Solutions, Inc.	www.advantageplan.com	ADVANTAGE Choice (PPO)	01	04		1			H5508	006	0	2012	Central Indiana, Allen, Delaware, Howard, StJoseph		2	950	2			2						www.advantageplan.com	http://www.advantageplan.com/	http://www.advantageplan.com/	(800)-523-7533		(317)-573-7950		(800)-201-8342		(800)-201-8342		(877)-684-0014		(877)-684-0014		(800)-201-8342		(800)-201-8342		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(866)-763-9630		(866)-763-9630		(800)-743-3333		(800)-743-3333		2	2	2
H5508	007	0	1	04	01	H5508_007_0	6	1		08/08/2011	2012.02	08/08/2011 02:13:37 PM Eastern Daylight Time	08/09/2011 12:07:56 PM Eastern Daylight Time	08/09/2011 12:07:36 PM Eastern Daylight Time		08/09/2011 02:00:06 PM Eastern Daylight Time	ADVANTAGE HEALTH SOLUTIONS, INC.	ADVANTAGE Health Solutions, Inc.	www.advantageplan.com	ADVANTAGE Elite (PPO)	01	04		1			H5508	007	0	2012	Central Indiana, Allen Delaware, Howard, StJoseph		2	525	2			2						www.advantageplan.com	http://www.advantageplan.com/	http://www.advantageplan.com/	(800)-523-7533		(317)-573-7950		(800)-201-8342		(800)-201-8342		(877)-684-0014		(877)-684-0014		(800)-201-8342		(800)-201-8342		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(866)-763-9630		(866)-763-9630		(800)-743-3333		(800)-743-3333		2	2	2
H5508	801	0	1	04	01	H5508_801_0	2	1		06/03/2011	2012.02	06/03/2011 08:29:55 AM Eastern Daylight Time	05/27/2011 02:44:37 PM Eastern Daylight Time			06/03/2011 09:13:21 AM Eastern Daylight Time	ADVANTAGE HEALTH SOLUTIONS, INC.	ADVANTAGE Health Solutions, Inc.	www.advantageplan.com	ADVANTAGE Select Plus Group (PPO)	01	04		1			H5508	801	0	2012	Indiana		1	250	2			2						www.advantageplan.com	http://www.advantageplan.com/	http://www.advantageplan.com/	(800)-523-7533		(317)-573-7950		(800)-201-8342		(800)-201-8342		(877)-684-0014		(877)-684-0014		(800)-201-8342		(800)-201-8342		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(866)-763-9630		(866)-763-9630		(800)-743-3333		(800)-743-3333		1	1	1
H5508	802	0	1	04	01	H5508_802_0	2	1		06/03/2011	2012.02	06/03/2011 08:30:12 AM Eastern Daylight Time	05/27/2011 02:44:38 PM Eastern Daylight Time			06/03/2011 09:13:21 AM Eastern Daylight Time	ADVANTAGE HEALTH SOLUTIONS, INC.	ADVANTAGE Health Solutions, Inc.	www.advantageplan.com	ADVANTAGE Preferred Group (PPO)	01	04		1			H5508	802	0	2012	Indiana		1	760	2			2						www.advantageplan.com	http://www.advantageplan.com/	http://www.advantageplan.com/	(800)-523-7533		(317)-573-7950		(800)-201-8342		(800)-201-8342										(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333										1	1	1
H5508	803	0	1	04	01	H5508_803_0	2	1		06/03/2011	2012.02	06/03/2011 08:30:27 AM Eastern Daylight Time	05/27/2011 02:44:39 PM Eastern Daylight Time			06/03/2011 09:13:21 AM Eastern Daylight Time	ADVANTAGE HEALTH SOLUTIONS, INC.	ADVANTAGE Health Solutions, Inc.	www.advantageplan.com	ADVANTAGE Select Group (PPO)	01	04		1			H5508	803	0	2012	Indiana		1	250	2			2						www.advantageplan.com	http://www.advantageplan.com/	http://www.advantageplan.com/	(800)-523-7533		(317)-573-7950		(800)-201-8342		(800)-201-8342										(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333										1	1	1
H5508	804	0	1	04	01	H5508_804_0	3	1		06/03/2011	2012.02	06/03/2011 08:30:41 AM Eastern Daylight Time	07/21/2011 03:41:08 PM Eastern Daylight Time			07/21/2011 03:49:08 PM Eastern Daylight Time	ADVANTAGE HEALTH SOLUTIONS, INC.	ADVANTAGE Health Solutions, Inc.	www.advantageplan.com	ADVANTAGE Preferred Plus Group (PPO)	01	04		1			H5508	804	0	2012	Indiana		1	1	2			2						www.advantageplan.com	http://www.advantageplan.com/	http://www.advantageplan.com/	(800)-523-7533		(317)-573-7950		(800)-201-8342		(800)-201-8342		(877)-684-0014		(877)-684-0014		(800)-201-8342		(800)-201-8342		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(866)-763-9630		(866)-763-9630		(800)-743-3333		(800)-743-3333		1	1	1
H5509	001	0	1	04	01	H5509_001_0	11	1		08/09/2011	2012.02	08/09/2011 01:20:44 PM Central Daylight Time	08/08/2011 10:03:26 AM Central Daylight Time	08/04/2011 11:53:08 AM Central Daylight Time		08/09/2011 01:39:51 PM Central Daylight Time	COVENTRY HEALTH AND LIFE INS. COMPANY	COVENTRY HEALTH CARE	www.kc.chcadvantra.com	Advantra Freedom (PPO)	01	04		1			H5509	001	0	2012	Kansas City Metro Area		2		2			2						www.ProviderDirectory.coventry-medicare.com	www.KSFormulary.coventry-medicare.com	www.kc.chcadvantra.com	(800)-727-9712		(800)-727-9712		(877)-886-7566		(877)-886-7566		(866)-294-9803		(866)-294-9803		(877)-886-7566		(877)-886-7566		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5509	003	0	1	04	01	H5509_003_0	9	1		08/09/2011	2012.02	08/09/2011 01:20:51 PM Central Daylight Time	08/08/2011 03:29:52 PM Central Daylight Time	08/04/2011 11:58:52 AM Central Daylight Time		08/09/2011 01:39:51 PM Central Daylight Time	COVENTRY HEALTH AND LIFE INS. COMPANY	COVENTRY HEALTH CARE	www.kc.chcadvantra.com	Advantra Freedom (PPO)	01	04		1			H5509	003	0	2012	Butler, Harvey, and Sedgwick Counties		2		2			2						www.ProviderDirectory.coventry-medicare.com	www.KSFormulary.coventry-medicare.com	www.kc.chcadvantra.com	(800)-727-9712		(800)-727-9712		(877)-886-7566		(877)-886-7566		(866)-294-9803		(866)-294-9803		(877)-886-7566		(877)-886-7566		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5509	010	0	1	04	01	H5509_010_0	7	1		08/09/2011	2012.02	08/09/2011 01:21:01 PM Central Daylight Time	08/08/2011 10:44:34 AM Central Daylight Time	08/04/2011 12:06:54 PM Central Daylight Time		08/09/2011 01:39:51 PM Central Daylight Time	COVENTRY HEALTH AND LIFE INS. COMPANY	COVENTRY HEALTH CARE	www.kc.chcadvantra.com	Advantra Freedom (PPO)	01	04		1			H5509	010	0	2012	Southeast Kansas/Southwest Missouri		2		2			2						www.ProviderDirectory.coventry-medicare.com	www.KSFormulary.coventry-medicare.com	www.kc.chcadvantra.com	(800)-727-9712		(800)-727-9712		(877)-886-7566		(877)-886-7566		(866)-294-9803		(866)-294-9803		(877)-886-7566		(877)-886-7566		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5509	011	0	1	04	01	H5509_011_0	8	1		08/09/2011	2012.02	08/09/2011 01:21:11 PM Central Daylight Time	08/08/2011 10:59:42 AM Central Daylight Time	08/04/2011 12:13:26 PM Central Daylight Time		08/09/2011 01:39:51 PM Central Daylight Time	COVENTRY HEALTH AND LIFE INS. COMPANY	COVENTRY HEALTH CARE	www.kc.chcadvantra.com	Advantra Freedom (PPO)	01	04		1			H5509	011	0	2012	Springfield Metro Area		2		2			2						www.ProviderDirectory.coventry-medicare.com	www.KSFormulary.coventry-medicare.com	www.kc.chcadvantra.com	(800)-727-9712		(800)-727-9712		(877)-886-7566		(877)-886-7566		(866)-294-9803		(866)-294-9803		(877)-886-7566		(877)-886-7566		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5509	012	0	1	04	01	H5509_012_0	7	1		08/09/2011	2012.02	08/09/2011 01:21:20 PM Central Daylight Time	08/08/2011 11:15:40 AM Central Daylight Time	08/04/2011 12:18:52 PM Central Daylight Time		08/09/2011 01:39:51 PM Central Daylight Time	COVENTRY HEALTH AND LIFE INS. COMPANY	COVENTRY HEALTH CARE	www.kc.chcadvantra.com	Advantra Freedom (PPO)	01	04		1			H5509	012	0	2012	Jefferson and Shawnee Counties		2		2			2						www.ProviderDirectory.coventry-medicare.com	www.KSFormulary.coventry-medicare.com	www.kc.chcadvantra.com	(800)-727-9712		(800)-727-9712		(877)-886-7566		(877)-886-7566		(866)-294-9803		(866)-294-9803		(877)-886-7566		(877)-886-7566		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5509	014	0	1	04	01	H5509_014_0	8	1		08/09/2011	2012.02	08/09/2011 01:21:50 PM Central Daylight Time	08/08/2011 11:30:12 AM Central Daylight Time	08/04/2011 12:24:34 PM Central Daylight Time		08/09/2011 01:39:51 PM Central Daylight Time	COVENTRY HEALTH AND LIFE INS. COMPANY	COVENTRY HEALTH CARE	www.kc.chcadvantra.com	Advantra Freedom (PPO)	01	04		1			H5509	014	0	2012	Geary and Riley Counties		2		2			2						www.ProviderDirectory.coventry-medicare.com	www.KSFormulary.coventry-medicare.com	www.kc.chcadvantra.com	(800)-727-9712		(800)-727-9712		(877)-886-7566		(877)-886-7566		(866)-294-9803		(866)-294-9803		(877)-886-7566		(877)-886-7566		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5509	015	0	1	04	01	H5509_015_0	6	1		08/09/2011	2012.02	08/09/2011 01:21:58 PM Central Daylight Time	08/08/2011 11:46:10 AM Central Daylight Time	08/04/2011 12:29:34 PM Central Daylight Time		08/09/2011 01:39:51 PM Central Daylight Time	COVENTRY HEALTH AND LIFE INS. COMPANY	COVENTRY HEALTH CARE	www.kc.chcadvantra.com	Advantra Freedom (PPO)	01	04		1			H5509	015	0	2012	Ozark, Stone, and Taney Counties		2		2			2						www.ProviderDirectory.coventry-medicare.com	www.KSFormulary.coventry-medicare.com	www.kc.chcadvantra.com	(800)-727-9712		(800)-727-9712		(877)-886-7566		(877)-886-7566		(866)-294-9803		(866)-294-9803		(877)-886-7566		(877)-886-7566		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5509	016	0	1	04	01	H5509_016_0	8	1		08/09/2011	2012.02	08/09/2011 01:22:09 PM Central Daylight Time	08/08/2011 11:58:56 AM Central Daylight Time	08/04/2011 12:55:10 PM Central Daylight Time		08/09/2011 01:39:51 PM Central Daylight Time	COVENTRY HEALTH AND LIFE INS. COMPANY	COVENTRY HEALTH CARE	www.kc.chcadvantra.com	Advantra Freedom (PPO)	01	04		1			H5509	016	0	2012	Benton, Madison, and Washington Counties		2		2			2						www.ProviderDirectory.coventry-medicare.com	www.KSFormulary.coventry-medicare.com	www.kc.chcadvantra.com	(800)-727-9712		(800)-727-9712		(877)-886-7566		(877)-886-7566		(866)-294-9803		(866)-294-9803		(877)-886-7566		(877)-886-7566		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5509	801	0	1	04	01	H5509_801_0	2	1		05/26/2011	2012.02	05/26/2011 08:01:00 AM Central Daylight Time	07/22/2011 01:22:16 PM Central Daylight Time			07/27/2011 02:35:56 PM Central Daylight Time	COVENTRY HEALTH AND LIFE INS. COMPANY	COVENTRY HEALTH CARE	www.kc.chcadvantra.com	Advantra Freedom Employer Group (PPO)	01	04		1			H5509	801	0	2012	Arkansas, Kansas, and Missouri		1		2			2						www.ProviderDirectory.coventry-medicare.com	www.KSFormulary.coventry-medicare.com	www.kc.chcadvantra.com	(800)-727-9712		(800)-727-9712		(877)-886-7566		(877)-886-7566		(866)-294-9803		(866)-294-9803		(877)-886-7566		(877)-886-7566		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H5509	802	0	1	04	01	H5509_802_0	2	1		05/26/2011	2012.02	05/26/2011 08:01:26 AM Central Daylight Time	07/22/2011 01:25:06 PM Central Daylight Time			07/27/2011 02:35:56 PM Central Daylight Time	COVENTRY HEALTH AND LIFE INS. COMPANY	COVENTRY HEALTH CARE	www.kc.chcadvantra.com	Advantra Freedom Employer Group (PPO)	01	04		1			H5509	802	0	2012	Arkansas, Kansas, and Missouri		1		2			2						www.ProviderDirectory.coventry-medicare.com	www.KSFormulary.coventry-medicare.com	www.kc.chcadvantra.com	(800)-727-9712		(800)-727-9712		(877)-886-7566		(877)-886-7566										(711)		(711)		(711)		(711)										1	1	1
H5509	803	0	1	04	01	H5509_803_0	3	1		05/26/2011	2012.02	05/26/2011 08:01:46 AM Central Daylight Time	07/22/2011 01:27:32 PM Central Daylight Time			07/27/2011 02:35:56 PM Central Daylight Time	COVENTRY HEALTH AND LIFE INS. COMPANY	COVENTRY HEALTH CARE	www.kc.chcadvantra.com	Advantra Freedom Employer Group (PPO)	01	04		1			H5509	803	0	2012	Arkansas, Kansas, and Missouri		1		2			2						www.ProviderDirectory.coventry-medicare.com	www.KSFormulary.coventry-medicare.com	www.kc.chcadvantra.com	(800)-727-9712		(800)-727-9712		(877)-886-7566		(877)-886-7566		(866)-294-9803		(866)-294-9803		(877)-886-7566		(877)-886-7566		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H5516	001	0	1	04	01	H5516_001_0	6	1		09/13/2011	2012.02	09/13/2011 01:40:09 PM Central Daylight Time	08/04/2011 10:17:26 PM Central Daylight Time	08/05/2011 01:44:55 PM Central Daylight Time		09/13/2011 01:48:30 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareComplete.com	AARP MedicareComplete Choice (PPO)	01	04		1			H5516	001	0	2012	Select Counties in North Carolina		2		2			2							www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5520	001	0	1	04	01	H5520_001_0	3	1		07/12/2011	2012.02	07/12/2011 03:29:29 PM Pacific Daylight Time	07/13/2011 11:47:00 AM Pacific Daylight Time			07/14/2011 03:09:00 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net Medicare Advantage	www.healthnet.com	Health Net Aqua (PPO)	01	04		1			H5520	001	0	2012	Portland, Salem, MidVly, OR and Clark WA		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(888)-445-8913		(888)-445-8913		(800)-949-6165		(800)-949-6165										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955										2	2	2
H5520	002	0	1	04	01	H5520_002_0	6	1		07/12/2011	2012.02	07/12/2011 03:29:51 PM Pacific Daylight Time	08/05/2011 10:00:22 AM Pacific Daylight Time	08/04/2011 02:44:38 PM Pacific Daylight Time		08/05/2011 02:45:32 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net Medicare Advantage	www.healthnet.com	Health Net Violet Option 1 (PPO)	01	04		1			H5520	002	0	2012	Portland, Salem, MidVly, OR and Clark WA		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(888)-445-8913		(888)-445-8913		(800)-949-6165		(800)-949-6165		(888)-445-8913		(888)-445-8913		(877)-863-2260		(877)-863-2260		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	2	2
H5520	003	0	1	04	01	H5520_003_0	3	1		07/12/2011	2012.02	07/12/2011 03:32:32 PM Pacific Daylight Time	07/13/2011 11:47:32 AM Pacific Daylight Time			07/14/2011 03:09:00 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net Medicare Advantage	www.healthnet.com	Health Net Aqua (PPO)	01	04		1			H5520	003	0	2012	Douglas, Jackson and Josephine Counties, OR		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(888)-445-8913		(888)-445-8913		(800)-949-6165		(800)-949-6165										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955										2	2	2
H5520	004	0	1	04	01	H5520_004_0	6	1		07/12/2011	2012.02	07/12/2011 03:58:47 PM Pacific Daylight Time	08/05/2011 10:00:50 AM Pacific Daylight Time	08/04/2011 02:45:08 PM Pacific Daylight Time		08/05/2011 02:45:32 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net Medicare Advantage	www.healthnet.com	Health Net Violet Option 1 (PPO)	01	04		1			H5520	004	0	2012	Douglas, Jackson and Josephine Counties, OR		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(888)-445-8913		(888)-445-8913		(800)-949-6165		(800)-949-6165		(888)-445-8913		(888)-445-8913		(877)-863-2260		(877)-863-2260		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	2	2
H5520	005	0	1	04	01	H5520_005_0	6	1		07/12/2011	2012.02	07/12/2011 04:00:08 PM Pacific Daylight Time	08/05/2011 10:01:04 AM Pacific Daylight Time	08/04/2011 02:45:30 PM Pacific Daylight Time		08/05/2011 02:45:32 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net Medicare Advantage	www.healthnet.com	Health Net Violet Option 2 (PPO)	01	04		1			H5520	005	0	2012	Portland, Salem, MidVly, OR and Clark WA		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(888)-445-8913		(888)-445-8913		(800)-949-6165		(800)-949-6165		(888)-445-8913		(888)-445-8913		(877)-863-2260		(877)-863-2260		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	2	2
H5520	006	0	1	04	01	H5520_006_0	5	1		07/12/2011	2012.02	07/12/2011 04:01:19 PM Pacific Daylight Time	08/05/2011 10:01:18 AM Pacific Daylight Time	08/04/2011 02:45:42 PM Pacific Daylight Time		08/05/2011 02:45:32 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net Medicare Advantage	www.healthnet.com	Health Net Violet Option 2 (PPO)	01	04		1			H5520	006	0	2012	Douglas, Jackson and Josephine Counties, OR		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(888)-445-8913		(888)-445-8913		(800)-949-6165		(800)-949-6165		(888)-445-8913		(888)-445-8913		(877)-863-2260		(877)-863-2260		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	2	2
H5520	009	0	1	04	01	H5520_009_0	5	1		07/12/2011	2012.02	07/12/2011 04:19:00 PM Pacific Daylight Time	08/05/2011 10:01:32 AM Pacific Daylight Time	08/04/2011 02:46:20 PM Pacific Daylight Time		08/05/2011 02:45:32 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net Medicare Advantage	www.healthnet.com	Health Net Healthy Heart (PPO)	01	04		1			H5520	009	0	2012	Portland, Salem, MidVly, OR and Clark WA		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(888)-445-8913		(888)-445-8913		(800)-949-6165		(800)-949-6165		(888)-445-8913		(888)-445-8913		(877)-863-2260		(877)-863-2260		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	2	2
H5520	010	0	1	04	01	H5520_010_0	5	1		07/12/2011	2012.02	07/12/2011 04:20:08 PM Pacific Daylight Time	08/05/2011 10:01:46 AM Pacific Daylight Time	08/04/2011 02:47:02 PM Pacific Daylight Time		08/05/2011 02:45:32 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net Medicare Advantage	www.healthnet.com	Health Net Healthy Heart (PPO)	01	04		1			H5520	010	0	2012	Douglas, Jackson and Josephine Counties, OR		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(888)-445-8913		(888)-445-8913		(800)-949-6165		(800)-949-6165		(888)-445-8913		(888)-445-8913		(877)-863-2260		(877)-863-2260		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	2	2
H5520	807	0	1	04	01	H5520_807_0	3	1		07/11/2011	2012.02	07/11/2011 05:45:08 PM Pacific Daylight Time	06/05/2011 01:14:48 AM Pacific Daylight Time			07/14/2011 03:09:00 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net Medicare Advantage	www.healthnet.com	Health Net Aqua Employer (PPO)	01	04		1			H5520	807	0	2012	Ptld, Salem, MdVly, Doug, Jkson, Josephine, Clark		1		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(888)-445-8913		(888)-445-8913		(800)-949-6165		(800)-949-6165										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955										2	2	1
H5520	808	0	1	04	01	H5520_808_0	3	1		07/11/2011	2012.02	07/11/2011 05:37:15 PM Pacific Daylight Time	06/05/2011 01:15:04 AM Pacific Daylight Time			07/14/2011 03:09:00 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net Medicare Advantage	www.healthnet.com	Health Net Violet Employer (PPO)	01	04		1			H5520	808	0	2012	Ptld, Salem, MdVly, Doug, Jkson, Josephine, Clark		1		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(888)-445-8913		(888)-445-8913		(800)-949-6165		(800)-949-6165		(888)-445-8913		(888)-445-8913		(877)-863-2260		(877)-863-2260		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	2	1
H5520	809	0	1	04	01	H5520_809_0	3	1		07/11/2011	2012.02	07/11/2011 05:44:46 PM Pacific Daylight Time	06/05/2011 01:15:18 AM Pacific Daylight Time			07/14/2011 03:09:00 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net Medicare Advantage	www.healthnet.com	Health Net Violet Employer (PPO)	01	04		1			H5520	809	0	2012	Ptld, Salem, MdVly, Doug, Jkson, Josephine, Clark		1		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(888)-445-8913		(888)-445-8913		(800)-949-6165		(800)-949-6165		(888)-445-8913		(888)-445-8913		(877)-863-2260		(877)-863-2260		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	2	1
H5521	012	0	1	04	01	H5521_012_0	5	1		07/12/2011	2012.02	07/12/2011 03:16:01 PM Central Daylight Time	08/04/2011 12:56:12 PM Central Daylight Time	08/04/2011 10:02:18 AM Central Daylight Time		08/08/2011 09:51:11 AM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (PPO)	01	04		1			H5521	012	0	2012	Central and NE PA		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H5521	013	0	1	04	01	H5521_013_0	4	1		07/08/2011	2012.02	07/08/2011 11:07:49 AM Central Daylight Time	08/04/2011 01:48:15 PM Central Daylight Time	08/04/2011 10:02:48 AM Central Daylight Time		08/08/2011 09:51:11 AM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Standard Plan (PPO)	01	04		1			H5521	013	0	2012	Connecticut		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H5521	015	0	1	04	01	H5521_015_0	5	1		07/12/2011	2012.02	07/12/2011 03:17:36 PM Central Daylight Time	08/04/2011 02:02:12 PM Central Daylight Time	08/04/2011 10:03:14 AM Central Daylight Time		08/08/2011 08:57:36 AM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (PPO)	01	04		1			H5521	015	0	2012	District of Columbia		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H5521	016	0	1	04	01	H5521_016_0	4	1		07/08/2011	2012.02	07/08/2011 11:24:51 AM Central Daylight Time	08/04/2011 12:25:39 PM Central Daylight Time	08/04/2011 10:03:39 AM Central Daylight Time		08/08/2011 08:23:16 AM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Standard Plan (PPO)	01	04		1			H5521	016	0	2012	Cook County		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H5521	020	0	1	04	01	H5521_020_0	4	1		07/08/2011	2012.02	07/08/2011 11:25:11 AM Central Daylight Time	08/04/2011 01:08:42 PM Central Daylight Time	08/04/2011 10:04:03 AM Central Daylight Time		08/08/2011 08:23:16 AM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Standard Plan (PPO)	01	04		1			H5521	020	0	2012	Ohio		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H5521	022	0	1	04	01	H5521_022_0	5	1		09/09/2011	2012.02	09/09/2011 01:44:16 PM Central Daylight Time	08/04/2011 02:25:36 PM Central Daylight Time	08/04/2011 10:28:22 AM Central Daylight Time		09/09/2011 01:45:31 PM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Select Plan (PPO)	01	04		1			H5521	022	0	2012	Clark County		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H5521	027	0	1	04	01	H5521_027_0	5	1		07/12/2011	2012.02	07/12/2011 03:18:45 PM Central Daylight Time	08/04/2011 02:13:51 PM Central Daylight Time	08/04/2011 10:05:09 AM Central Daylight Time		08/08/2011 08:57:36 AM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Standard Plan (PPO)	01	04		1			H5521	027	0	2012	Fairfax County and Surrounding Area		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H5521	028	0	1	04	01	H5521_028_0	4	1		07/08/2011	2012.02	07/08/2011 11:16:53 AM Central Daylight Time	08/04/2011 02:23:29 PM Central Daylight Time	08/04/2011 10:05:38 AM Central Daylight Time		08/08/2011 07:54:55 AM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Select Plan (PPO)	01	04		1			H5521	028	0	2012	Denver and Surrounding Counties		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H5521	033	0	1	04	01	H5521_033_0	4	1		07/08/2011	2012.02	07/08/2011 11:20:48 AM Central Daylight Time	08/04/2011 12:51:25 PM Central Daylight Time	08/04/2011 10:06:02 AM Central Daylight Time		08/08/2011 08:57:36 AM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (PPO)	01	04		1			H5521	033	0	2012	Florida		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H5521	036	0	1	04	01	H5521_036_0	5	1		07/12/2011	2012.02	07/12/2011 03:19:48 PM Central Daylight Time	08/04/2011 01:36:01 PM Central Daylight Time	08/04/2011 10:07:27 AM Central Daylight Time		08/08/2011 08:57:36 AM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Standard Plan (PPO)	01	04		1			H5521	036	0	2012	Baltimore and Surrounding Counties		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H5521	037	0	1	04	01	H5521_037_0	4	1		07/08/2011	2012.02	07/08/2011 11:08:25 AM Central Daylight Time	08/04/2011 01:43:18 PM Central Daylight Time	08/04/2011 10:07:49 AM Central Daylight Time		08/08/2011 09:51:11 AM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Standard Plan (PPO)	01	04		1			H5521	037	0	2012	Northern New Jersey		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H5521	038	0	1	04	01	H5521_038_0	5	1		07/12/2011	2012.02	07/12/2011 03:21:23 PM Central Daylight Time	08/04/2011 01:46:39 PM Central Daylight Time	08/04/2011 10:08:43 AM Central Daylight Time		08/08/2011 09:51:11 AM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (PPO)	01	04		1			H5521	038	0	2012	Northern New Jersey		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H5521	040	0	1	04	01	H5521_040_0	5	1		07/12/2011	2012.02	07/12/2011 03:22:51 PM Central Daylight Time	08/05/2011 09:43:56 AM Central Daylight Time	08/04/2011 10:09:09 AM Central Daylight Time		08/08/2011 09:51:11 AM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Standard Plan (PPO)	01	04		1			H5521	040	0	2012	New York		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H5521	801	0	1	04	01	H5521_801_0	1	1		06/02/2011	2012.02	06/02/2011 04:53:55 PM Eastern Daylight Time	06/02/2011 02:29:37 PM Eastern Daylight Time			06/03/2011 10:51:30 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan (PPO)	01	04		1			H5521	801	0	2012	National		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748										1	1	1
H5521	802	0	1	04	01	H5521_802_0	1	1		05/09/2011	2012.02	05/09/2011 07:38:22 AM Central Daylight Time	06/02/2011 02:53:38 PM Eastern Daylight Time			06/03/2011 10:51:30 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan w/Rx CY (PPO)	01	04		1			H5521	802	0	2012	National		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		1	1	1
H5521	805	0	2	04	01	H5521_805_0	1	1		04/22/2011	2012.02	04/22/2011 10:07:55 AM Eastern Daylight Time	06/02/2011 02:21:21 PM Eastern Daylight Time			06/03/2011 10:51:30 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Part B Only Plan (PPO)	01	04		2	2		H5521	805	0	2012	National		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748										1	1	1
H5521	806	0	2	04	01	H5521_806_0	1	1		04/22/2011	2012.02	04/22/2011 10:08:15 AM Eastern Daylight Time	06/02/2011 02:09:46 PM Eastern Daylight Time			06/03/2011 10:51:30 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Part B Only Plan w/Rx CY (PPO)	01	04		2	2		H5521	806	0	2012	National		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		1	1	1
H5522	001	0	1	04	01	H5522_001_0	9	1		08/09/2011	2012.02	08/09/2011 11:16:55 AM Eastern Daylight Time	08/08/2011 02:58:03 PM Eastern Daylight Time	08/04/2011 02:00:26 PM Eastern Daylight Time		08/09/2011 01:09:51 PM Eastern Daylight Time	HEALTHASSURANCE PENNSYLVANIA, INC.	HealthAmerica	http://coventry-medicare.com	Advantra Gold (PPO)	01	04		1			H5522	001	0	2012	Allegheny County		2		2			2						http://providerdirectory.coventry-medicare.com	http://PAFormulary.coventry-medicare.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator	(800)-290-0190		(800)-290-0190		(877)-887-5787		(877)-887-5787		(866)-291-5221		(866)-291-5221		(877)-887-5787		(877)-887-5787		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5522	002	0	1	04	01	H5522_002_0	10	1		08/09/2011	2012.02	08/09/2011 10:57:54 AM Eastern Daylight Time	08/08/2011 03:01:41 PM Eastern Daylight Time	08/04/2011 02:05:36 PM Eastern Daylight Time		08/09/2011 01:09:51 PM Eastern Daylight Time	HEALTHASSURANCE PENNSYLVANIA, INC.	HealthAmerica	http://coventry-medicare.com	Advantra Gold (PPO)	01	04		1			H5522	002	0	2012	Central Pennsylvania		2		2			2						http://providerdirectory.coventry-medicare.com	http://PAFormulary.coventry-medicare.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator	(800)-290-0190		(800)-290-0190		(877)-886-2944		(877)-886-2944		(866)-291-5221		(866)-291-5221		(877)-886-2944		(877)-886-2944		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5522	004	0	1	04	01	H5522_004_0	11	1		08/09/2011	2012.02	08/09/2011 10:58:35 AM Eastern Daylight Time	08/08/2011 04:18:19 PM Eastern Daylight Time	08/04/2011 02:11:43 PM Eastern Daylight Time		08/09/2011 01:09:51 PM Eastern Daylight Time	HEALTHASSURANCE PENNSYLVANIA, INC.	HealthAmerica	http://coventry-medicare.com	Advantra Silver (PPO)	01	04		1			H5522	004	0	2012	Central Pennsylvania		2		2			2						http://providerdirectory.coventry-medicare.com	http://PAFormulary.coventry-medicare.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator	(800)-290-0190		(800)-290-0190		(877)-886-2944		(877)-886-2944		(866)-291-5221		(866)-291-5221		(877)-886-2944		(877)-886-2944		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5522	005	0	1	04	01	H5522_005_0	10	1		08/09/2011	2012.02	08/09/2011 10:58:46 AM Eastern Daylight Time	08/08/2011 04:20:41 PM Eastern Daylight Time	08/04/2011 02:16:57 PM Eastern Daylight Time		08/09/2011 01:09:51 PM Eastern Daylight Time	HEALTHASSURANCE PENNSYLVANIA, INC.	HealthAmerica	http://coventry-medicare.com	Advantra Silver (PPO)	01	04		1			H5522	005	0	2012	Western Pennsylvania		2		2			2						http://providerdirectory.coventry-medicare.com	http://PAFormulary.coventry-medicare.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator	(800)-290-0190		(800)-290-0190		(877)-887-5787		(877)-887-5787		(866)-291-5221		(866)-291-5221		(877)-887-5787		(877)-887-5787		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5522	008	0	1	04	01	H5522_008_0	10	1		08/09/2011	2012.02	08/09/2011 10:58:54 AM Eastern Daylight Time	08/08/2011 03:06:58 PM Eastern Daylight Time	08/04/2011 02:22:21 PM Eastern Daylight Time		08/09/2011 01:09:51 PM Eastern Daylight Time	HEALTHASSURANCE PENNSYLVANIA, INC.	HealthAmerica	http://coventry-medicare.com	Advantra Elite (PPO)	01	04		1			H5522	008	0	2012	Central Pennsylvania		2		2			2						http://providerdirectory.coventry-medicare.com	http://PAFormulary.coventry-medicare.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator	(800)-290-0190		(800)-290-0190		(877)-886-2944		(877)-886-2944		(866)-291-5221		(866)-291-5221		(877)-886-2944		(877)-886-2944		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5522	009	0	1	04	01	H5522_009_0	10	1		08/09/2011	2012.02	08/09/2011 10:59:07 AM Eastern Daylight Time	08/08/2011 03:14:47 PM Eastern Daylight Time	08/04/2011 02:27:28 PM Eastern Daylight Time		08/09/2011 01:09:51 PM Eastern Daylight Time	HEALTHASSURANCE PENNSYLVANIA, INC.	HealthAmerica	http://coventry-medicare.com	Advantra Elite (PPO)	01	04		1			H5522	009	0	2012	Western Pennsylvania		2		2			2						http://providerdirectory.coventry-medicare.com	http://PAFormulary.coventry-medicare.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator	(800)-290-0190		(800)-290-0190		(877)-887-5787		(877)-887-5787		(866)-291-5221		(866)-291-5221		(877)-887-5787		(877)-887-5787		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5522	013	0	1	04	01	H5522_013_0	10	1		08/09/2011	2012.02	08/09/2011 10:59:16 AM Eastern Daylight Time	08/08/2011 03:17:26 PM Eastern Daylight Time	08/04/2011 02:32:41 PM Eastern Daylight Time		08/09/2011 01:09:51 PM Eastern Daylight Time	HEALTHASSURANCE PENNSYLVANIA, INC.	HealthAmerica	http://coventry-medicare.com	Advantra Silver Plus (PPO)	01	04		1			H5522	013	0	2012	Central Pennsylvania		2		2			2						http://providerdirectory.coventry-medicare.com	http://PAFormulary.coventry-medicare.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator	(800)-290-0190		(800)-290-0190		(877)-886-2944		(877)-886-2944		(866)-291-5221		(866)-291-5221		(877)-886-2944		(877)-886-2944		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5522	014	0	1	04	01	H5522_014_0	10	1		08/09/2011	2012.02	08/09/2011 10:59:25 AM Eastern Daylight Time	08/08/2011 03:19:00 PM Eastern Daylight Time	08/04/2011 02:38:32 PM Eastern Daylight Time		08/09/2011 01:09:51 PM Eastern Daylight Time	HEALTHASSURANCE PENNSYLVANIA, INC.	HealthAmerica	http://coventry-medicare.com	Advantra Gold (PPO)	01	04		1			H5522	014	0	2012	Philadelphia and Delaware Counties		2		2			2						http://providerdirectory.coventry-medicare.com	http://PAFormulary.coventry-medicare.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator	(800)-290-0190		(800)-290-0190		(877)-886-2944		(877)-886-2944		(866)-291-5221		(866)-291-5221		(877)-886-2944		(877)-886-2944		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5522	802	0	1	04	01	H5522_802_0	4	1		05/25/2011	2012.02	05/25/2011 01:22:34 PM Eastern Daylight Time	07/25/2011 01:33:16 PM Eastern Daylight Time			07/27/2011 02:54:48 PM Eastern Daylight Time	HEALTHASSURANCE PENNSYLVANIA, INC.	HealthAmerica	http://coventry-medicare.com	Advantra MA Only (PPO)	01	04		1			H5522	802	0	2012	Pennsylvania		1		2			2						http://providerdirectory.coventry-medicare.com	http://PAFormulary.coventry-medicare.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator	(800)-290-0190		(800)-290-0190		(800)-470-4272		(800)-470-4272										(711)		(711)		(711)		(711)										1	1	1
H5522	803	0	1	04	01	H5522_803_0	4	1		05/25/2011	2012.02	05/25/2011 12:01:53 PM Eastern Daylight Time	07/25/2011 01:37:45 PM Eastern Daylight Time			07/27/2011 02:54:48 PM Eastern Daylight Time	HEALTHASSURANCE PENNSYLVANIA, INC.	HealthAmerica	http://coventry-medicare.com	Advantra Gold (PPO)	01	04		1			H5522	803	0	2012	Pennsylvania		1		2			2						http://providerdirectory.coventry-medicare.com	http://PAFormulary.coventry-medicare.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator	(800)-290-0190		(800)-290-0190		(800)-470-4272		(800)-470-4272		(866)-291-5221		(866)-291-5221		(800)-470-4272		(800)-470-4272		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H5522	805	0	1	04	01	H5522_805_0	4	1		05/25/2011	2012.02	05/25/2011 12:01:10 PM Eastern Daylight Time	07/25/2011 01:42:42 PM Eastern Daylight Time			07/27/2011 02:54:48 PM Eastern Daylight Time	HEALTHASSURANCE PENNSYLVANIA, INC.	HealthAmerica	http://coventry-medicare.com	Advantra Gold (PPO)	01	04		1			H5522	805	0	2012	Pennsylvania		1		2			2						http://providerdirectory.coventry-medicare.com	http://PAFormulary.coventry-medicare.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator	(800)-290-0190		(800)-290-0190		(800)-470-4272		(800)-470-4272		(866)-291-5221		(866)-291-5221		(800)-470-4272		(800)-470-4272		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H5525	004	0	1	04	01	H5525_004_0	5	1		07/06/2011	2012.02	07/06/2011 01:27:03 PM Eastern Daylight Time	08/04/2011 02:18:13 PM Eastern Daylight Time	08/04/2011 12:41:46 PM Eastern Daylight Time		08/08/2011 03:28:09 PM Eastern Daylight Time	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Humana Benefit Plan of Illinois, Inc.	www.humana-medicare.com	HumanaChoice H5525-004 (PPO)	01	04		1			H5525	004	0	2012	Select Counties in Illinois		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5526	002	0	1	04	01	H5526_002_0	6	1		07/22/2011	2012.02	07/22/2011 02:05:45 PM Eastern Daylight Time	07/22/2011 02:27:45 PM Eastern Daylight Time			07/22/2011 02:45:28 PM Eastern Daylight Time	HEALTHNOW NEW YORK INC.	BlueCross BlueShield of WNY and BlueShield of NENY	www.bcbswny.com	BlueCross BlueShield Forever Blue Medicare PPO 701 (PPO)	01	04		1			H5526	002	0	2012	Western New York		2	454	2			2						www.bcbswny.com (Western New York) or www.bsneny.com (Northeastern New York)	http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	www.bcbswny.com,    www.bsneny.com	(800)-329-2792		(800)-329-2792		(888)-587-2583		(888)-587-2583										(877)-834-6918		(877)-834-6918		(877)-286-5710		(877)-286-5710										2	2	2
H5526	003	0	1	04	01	H5526_003_0	8	1		07/22/2011	2012.02	07/22/2011 02:06:13 PM Eastern Daylight Time	08/09/2011 02:29:28 PM Eastern Daylight Time	08/09/2011 02:29:35 PM Eastern Daylight Time		08/09/2011 02:40:07 PM Eastern Daylight Time	HEALTHNOW NEW YORK INC.	BlueCross BlueShield of WNY and BlueShield of NENY	www.bsneny.com	BlueShield Forever Blue Medicare PPO 751 (PPO)	01	04		1			H5526	003	0	2012	Northeastern New York		2	946	2			2						www.bcbswny.com (Western New York) or www.bsneny.com (Northeastern New York)	http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	www.bcbswny.com,    www.bsneny.com	(800)-329-2792		(800)-329-2792		(877)-258-7453		(877)-258-7453		(800)-329-2792		(800)-329-2792		(877)-258-7453		(877)-258-7453		(877)-834-6918		(877)-834-6918		(877)-513-1470		(877)-513-1470		(877)-834-6918		(877)-834-6918		(877)-513-1470		(877)-513-1470		2	2	2
H5526	004	0	1	04	01	H5526_004_0	9	1		07/22/2011	2012.02	07/22/2011 02:06:49 PM Eastern Daylight Time	08/09/2011 02:29:42 PM Eastern Daylight Time	08/09/2011 02:29:49 PM Eastern Daylight Time		08/09/2011 02:40:07 PM Eastern Daylight Time	HEALTHNOW NEW YORK INC.	BlueCross BlueShield of WNY and BlueShield of NENY	www.bcbswny.com	BlueCross BlueShield Forever Blue Medicare PPO 751 (PPO)	01	04		1			H5526	004	0	2012	Western New York		2	3500	2			2						www.bcbswny.com (Western New York) or www.bsneny.com (Northeastern New York)	http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	www.bcbswny.com,    www.bsneny.com	(800)-329-2792		(800)-329-2792		(888)-587-2583		(888)-587-2583		(800)-329-2792		(800)-329-2792		(888)-587-2583		(888)-587-2583		(877)-834-6918		(877)-834-6918		(877)-286-5710		(877)-286-5710		(877)-834-6918		(877)-834-6918		(877)-286-5710		(877)-286-5710		2	2	2
H5526	806	0	1	04	01	H5526_806_0	4	1		05/31/2011	2012.02	05/31/2011 09:48:23 AM Eastern Daylight Time	07/11/2011 11:08:18 AM Eastern Daylight Time			07/11/2011 11:52:58 AM Eastern Daylight Time	HEALTHNOW NEW YORK INC.	BlueCross BlueShield of WNY and BlueShield of NENY	www.bcbswny.com (WNY) or www.bsneny.com (NENY)	Forever Blue Medicare PPO Group (MA Only) CY (PPO)	01	04		1			H5526	806	0	2012	Western and Northeastern New York		1	2327	2			2						www.bcbswny.com (Western New York) or www.bsneny.com (Northeastern New York)	http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	www.bcbswny.com,    www.bsneny.com	(800)-329-2792		(800)-329-2792		(888)-587-2583		(888)-587-2583										(877)-834-6918		(877)-834-6918		(877)-286-5710		(877)-286-5710										1	1	1
H5526	808	0	1	04	01	H5526_808_0	4	1		05/16/2011	2012.02	05/16/2011 01:48:59 PM Eastern Daylight Time	07/11/2011 11:08:18 AM Eastern Daylight Time			07/11/2011 11:52:58 AM Eastern Daylight Time	HEALTHNOW NEW YORK INC.	BlueCross BlueShield of WNY and BlueShield of NENY	www.bcbswny.com (WNY) or www.bsneny.com (NENY)	Forever Blue Medicare PPO Group (MA-PD) CY (PPO)	01	04		1			H5526	808	0	2012	Western and Northeastern New York		1	8400	2			2						www.bcbswny.com (Western New York) or www.bsneny.com (Northeastern New York)	http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	www.bcbswny.com,    www.bsneny.com	(800)-329-2792		(800)-329-2792		(888)-587-2583		(888)-587-2583		(800)-329-2792		(800)-329-2792		(888)-587-2583		(888)-587-2583		(877)-834-6918		(877)-834-6918		(877)-286-5710		(877)-286-5710		(877)-834-6918		(877)-834-6918		(877)-286-5710		(877)-286-5710		1	1	1
H5526	810	0	1	04	01	H5526_810_0	3	1		05/16/2011	2012.02	05/16/2011 01:49:29 PM Eastern Daylight Time	07/11/2011 11:08:18 AM Eastern Daylight Time			07/11/2011 11:26:42 AM Eastern Daylight Time	HEALTHNOW NEW YORK INC.	BlueCross BlueShield of WNY and BlueShield of NENY	www.bcbswny.com (WNY) or www.bsneny.com (NENY)	Forever Blue Medicare PPO Group (MA-PD) NCY (PPO)	01	04		1			H5526	810	0	2012	Western and Northeastern New York		1	500	2			2						www.bcbswny.com (Western New York) or www.bsneny.com (Northeastern New York)	http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	www.bcbswny.com,    www.bsneny.com	(800)-329-2792		(800)-329-2792		(888)-587-2583		(888)-587-2583		(800)-329-2792		(800)-329-2792		(888)-587-2583		(888)-587-2583		(877)-834-6918		(877)-834-6918		(877)-286-5710		(877)-286-5710		(877)-834-6918		(877)-834-6918		(877)-286-5710		(877)-286-5710		1	1	1
H5528	001	0	1	04	01	H5528_001_0	9	1		08/12/2011	2012.02	08/12/2011 11:11:03 AM Eastern Daylight Time	07/21/2011 08:46:17 AM Eastern Daylight Time			08/12/2011 11:55:06 AM Eastern Daylight Time	GROUP HEALTH INCORPORATED	EmblemHealth Medicare PPO	www.emblemhealth.com	PPO I (PPO)	01	04		1			H5528	001	0	2012	Counties of New York City		2		2			2							www.emblemhealth.com	www.emblemhealth.com	(866)-557-7300		(866)-557-7300		(800)-611-8454		(800)-611-8454										(866)-248-0640		(866)-248-0640		(877)-444-2786		(877)-444-2786										2	2	2
H5528	002	0	1	04	01	H5528_002_0	10	1		09/20/2011	2012.02	09/20/2011 12:36:30 PM Eastern Daylight Time	08/05/2011 12:31:56 PM Eastern Daylight Time	08/05/2011 12:32:02 PM Eastern Daylight Time		09/20/2011 01:29:56 PM Eastern Daylight Time	GROUP HEALTH INCORPORATED	EmblemHealth Medicare PPO	www.emblemhealth.com	PPO II (PPO)	01	04		1			H5528	002	0	2012	Counties of New York City		2		2			2							www.emblemhealth.com	www.emblemhealth.com	(866)-557-7300		(866)-557-7300		(800)-611-8454		(800)-611-8454		(877)-444-7097		(877)-444-7097		(800)-611-8454		(800)-611-8454		(866)-248-0640		(866)-248-0640		(877)-444-2786		(877)-444-2786		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		2	2	2
H5528	003	0	1	04	01	H5528_003_0	12	1		09/20/2011	2012.02	09/20/2011 04:46:30 PM Eastern Daylight Time	08/05/2011 12:32:08 PM Eastern Daylight Time	08/05/2011 12:32:13 PM Eastern Daylight Time		09/20/2011 05:07:13 PM Eastern Daylight Time	GROUP HEALTH INCORPORATED	EmblemHealth Medicare PPO	www.emblemhealth.com	PPO III (PPO)	01	04		1			H5528	003	0	2012	Counties of New York City		2		2			2							www.emblemhealth.com	www.emblemhealth.com	(866)-557-7300		(866)-557-7300		(800)-611-8454		(800)-611-8454		(877)-444-7097		(877)-444-7097		(800)-611-8454		(800)-611-8454		(866)-248-0640		(866)-248-0640		(877)-444-2786		(877)-444-2786		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		2	2	2
H5528	004	0	1	04	01	H5528_004_0	8	1		07/11/2011	2012.02	07/11/2011 03:22:11 PM Eastern Daylight Time	07/21/2011 08:46:45 AM Eastern Daylight Time			07/21/2011 09:54:25 AM Eastern Daylight Time	GROUP HEALTH INCORPORATED	EmblemHealth Medicare PPO	www.emblemhealth.com	PPO I (PPO)	01	04		1			H5528	004	0	2012	Nassau, Westchester and Rockland Counties		2		2			2							www.emblemhealth.com	www.emblemhealth.com	(866)-557-7300		(866)-557-7300		(800)-611-8454		(800)-611-8454										(866)-248-0640		(866)-248-0640		(877)-444-2786		(877)-444-2786										2	2	2
H5528	005	0	1	04	01	H5528_005_0	10	1		09/20/2011	2012.02	09/20/2011 12:37:04 PM Eastern Daylight Time	08/05/2011 12:32:19 PM Eastern Daylight Time	08/05/2011 12:32:23 PM Eastern Daylight Time		09/20/2011 01:29:56 PM Eastern Daylight Time	GROUP HEALTH INCORPORATED	EmblemHealth Medicare PPO	www.emblemhealth.com	PPO II (PPO)	01	04		1			H5528	005	0	2012	Nassau, Westchester and Rockland Counties		2		2			2							www.emblemhealth.com	www.emblemhealth.com	(866)-557-7300		(866)-557-7300		(800)-611-8454		(800)-611-8454		(877)-444-7097		(877)-444-7097		(800)-611-8454		(800)-611-8454		(866)-248-0640		(866)-248-0640		(877)-444-2786		(877)-444-2786		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		2	2	2
H5528	008	0	1	04	01	H5528_008_0	12	1		09/20/2011	2012.02	09/20/2011 04:44:11 PM Eastern Daylight Time	08/05/2011 12:32:29 PM Eastern Daylight Time	08/05/2011 12:32:34 PM Eastern Daylight Time		09/20/2011 05:07:13 PM Eastern Daylight Time	GROUP HEALTH INCORPORATED	EmblemHealth Medicare PPO	www.emblemhealth.com	PPO III (PPO)	01	04		1			H5528	008	0	2012	Nassau, Westchester and Rockland Counties		2		2			2							www.emblemhealth.com	www.emblemhealth.com	(866)-557-7300		(866)-557-7300		(800)-611-8454		(800)-611-8454		(877)-444-7097		(877)-444-7097		(800)-611-8454		(800)-611-8454		(866)-248-0640		(866)-248-0640		(877)-444-2786		(877)-444-2786		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		2	2	2
H5528	009	0	1	04	01	H5528_009_0	8	1		07/01/2011	2012.02	07/01/2011 10:36:27 AM Eastern Daylight Time	07/21/2011 08:51:44 AM Eastern Daylight Time			07/21/2011 09:54:25 AM Eastern Daylight Time	GROUP HEALTH INCORPORATED	EmblemHealth Medicare PPO	www.emblemhealth.com	PPO I (PPO)	01	04		1			H5528	009	0	2012	Suffolk County		2		2			2							www.emblemhealth.com	www.emblemhealth.com	(866)-557-7300		(866)-557-7300		(800)-611-8454		(800)-611-8454										(866)-248-0640		(866)-248-0640		(877)-444-2786		(877)-444-2786										2	2	2
H5528	010	0	1	04	01	H5528_010_0	10	1		09/20/2011	2012.02	09/20/2011 12:37:21 PM Eastern Daylight Time	08/05/2011 12:32:39 PM Eastern Daylight Time	08/05/2011 12:32:44 PM Eastern Daylight Time		09/20/2011 01:29:56 PM Eastern Daylight Time	GROUP HEALTH INCORPORATED	EmblemHealth Medicare PPO	www.emblemhealth.com	PPO II (PPO)	01	04		1			H5528	010	0	2012	Suffolk County		2		2			2							www.emblemhealth.com	www.emblemhealth.com	(866)-557-7300		(866)-557-7300		(800)-611-8454		(800)-611-8454		(877)-444-7097		(877)-444-7097		(800)-611-8454		(800)-611-8454		(866)-248-0640		(866)-248-0640		(877)-444-2786		(877)-444-2786		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		2	2	2
H5528	011	0	1	04	01	H5528_011_0	13	1		09/20/2011	2012.02	09/20/2011 04:44:21 PM Eastern Daylight Time	08/05/2011 12:32:51 PM Eastern Daylight Time	08/05/2011 12:32:57 PM Eastern Daylight Time		09/20/2011 05:07:13 PM Eastern Daylight Time	GROUP HEALTH INCORPORATED	EmblemHealth Medicare PPO	www.emblemhealth.com	PPO III (PPO)	01	04		1			H5528	011	0	2012	Suffolk County		2		2			2							www.emblemhealth.com	www.emblemhealth.com	(866)-557-7300		(866)-557-7300		(800)-611-8454		(800)-611-8454		(877)-444-7097		(877)-444-7097		(800)-611-8454		(800)-611-8454		(866)-248-0640		(866)-248-0640		(877)-444-2786		(877)-444-2786		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		2	2	2
H5528	018	0	1	04	01	H5528_018_0	12	1	2	09/20/2011	2012.02	09/20/2011 12:39:48 PM Eastern Daylight Time	08/12/2011 11:52:55 AM Eastern Daylight Time	08/12/2011 11:53:00 AM Eastern Daylight Time		09/20/2011 01:29:56 PM Eastern Daylight Time	GROUP HEALTH INCORPORATED	EmblemHealth Medicare PPO	www.emblemhealth.com	Dual Eligible (PPO SNP)	01	04		1			H5528	018	0	2012	Counties of NYC, Westchester, Rockland		2		2			1	3		1	4			www.emblemhealth.com	www.emblemhealth.com	(866)-557-7300		(866)-557-7300		(800)-611-8454		(800)-611-8454		(877)-444-7097		(877)-444-7097		(800)-611-8454		(800)-611-8454		(866)-248-0640		(866)-248-0640		(877)-444-2786		(877)-444-2786		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		2	2	2
H5528	019	0	1	04	01	H5528_019_0	10	1		09/20/2011	2012.02	09/20/2011 04:44:30 PM Eastern Daylight Time	08/05/2011 12:33:21 PM Eastern Daylight Time	08/05/2011 12:33:25 PM Eastern Daylight Time		09/20/2011 05:07:13 PM Eastern Daylight Time	GROUP HEALTH INCORPORATED	EmblemHealth Medicare PPO	www.emblemhealth.com	PPO High Option (PPO)	01	04		1			H5528	019	0	2012	Counties of NYC		2		2			2							www.emblemhealth.com	www.emblemhealth.com	(866)-557-7300		(866)-557-7300		(800)-611-8454		(800)-611-8454		(877)-444-7097		(877)-444-7097		(800)-611-8454		(800)-611-8454		(866)-248-0640		(866)-248-0640		(877)-444-2786		(877)-444-2786		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		2	2	2
H5528	020	0	1	04	01	H5528_020_0	10	1		09/20/2011	2012.02	09/20/2011 04:44:37 PM Eastern Daylight Time	08/05/2011 12:33:30 PM Eastern Daylight Time	08/05/2011 12:33:35 PM Eastern Daylight Time		09/20/2011 05:07:13 PM Eastern Daylight Time	GROUP HEALTH INCORPORATED	EmblemHealth Medicare PPO	www.emblemhealth.com	PPO High Option (PPO)	01	04		1			H5528	020	0	2012	Nassau, Westchester and Rockland Counties		2		2			2							www.emblemhealth.com	www.emblemhealth.com	(866)-557-7300		(866)-557-7300		(800)-611-8454		(800)-611-8454		(877)-444-7097		(877)-444-7097		(800)-611-8454		(800)-611-8454		(866)-248-0640		(866)-248-0640		(877)-444-2786		(877)-444-2786		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		2	2	2
H5528	021	0	1	04	01	H5528_021_0	10	1		09/20/2011	2012.02	09/20/2011 04:44:47 PM Eastern Daylight Time	08/05/2011 12:33:40 PM Eastern Daylight Time	08/05/2011 12:33:45 PM Eastern Daylight Time		09/20/2011 05:07:13 PM Eastern Daylight Time	GROUP HEALTH INCORPORATED	EmblemHealth Medicare PPO	www.emblemhealth.com	PPO High Option (PPO)	01	04		1			H5528	021	0	2012	Suffolk County		2		2			2							www.emblemhealth.com	www.emblemhealth.com	(866)-557-7300		(866)-557-7300		(800)-611-8454		(800)-611-8454		(877)-444-7097		(877)-444-7097		(800)-611-8454		(800)-611-8454		(866)-248-0640		(866)-248-0640		(877)-444-2786		(877)-444-2786		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		2	2	2
H5528	804	0	1	04	01	H5528_804_0	6	1		07/01/2011	2012.02	07/01/2011 12:38:55 PM Eastern Daylight Time	07/21/2011 08:53:39 AM Eastern Daylight Time			07/21/2011 09:54:25 AM Eastern Daylight Time	GROUP HEALTH INCORPORATED	EmblemHealth Medicare PPO	www.emblemhealth.com	Group Access (PPO)	01	04		1			H5528	804	0	2012	United States		1		2			2							www.emblemhealth.com	www.emblemhealth.com	(866)-557-7300		(866)-557-7300		(800)-611-8454		(800)-611-8454										(866)-248-0640		(866)-248-0640		(877)-444-2786		(877)-444-2786										2	2	2
H5528	807	0	1	04	01	H5528_807_0	6	1		06/02/2011	2012.02	06/02/2011 04:49:14 PM Eastern Daylight Time	07/21/2011 08:53:44 AM Eastern Daylight Time			07/21/2011 09:54:25 AM Eastern Daylight Time	GROUP HEALTH INCORPORATED	EmblemHealth Medicare PPO	www.emblemhealth.com	Group Access Rx (PPO)	01	04		1			H5528	807	0	2012	United States		1		2			2							www.emblemhealth.com	www.emblemhealth.com	(866)-557-7300		(866)-557-7300		(800)-611-8454		(800)-611-8454		(877)-444-7097		(877)-444-7097		(800)-611-8454		(800)-611-8454		(866)-248-0640		(866)-248-0640		(877)-444-2786		(877)-444-2786		(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786		2	2	2
H5529	001	0	1	04	01	H5529_001_0	9	1		08/04/2011	2012.02	08/04/2011 02:01:54 PM Eastern Daylight Time	08/08/2011 07:08:23 PM Eastern Daylight Time	08/08/2011 07:10:36 PM Eastern Daylight Time		08/08/2011 07:18:07 PM Eastern Daylight Time	COMMUNITY INSURANCE COMPANY	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred Standard (PPO)	01	04		1			H5529	001	0	2012	Select Counties in Ohio		2	9462	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(800)-467-1199		(800)-467-1199		(800)-797-1765		(800)-797-1765		(800)-467-1199		(800)-467-1199		(800)-797-1765		(800)-797-1765		(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894		(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894		2	2	2
H5529	004	0	1	04	01	H5529_004_0	9	1		08/04/2011	2012.02	08/04/2011 02:02:02 PM Eastern Daylight Time	08/08/2011 07:08:30 PM Eastern Daylight Time	08/08/2011 07:10:43 PM Eastern Daylight Time		08/08/2011 07:18:07 PM Eastern Daylight Time	COMMUNITY INSURANCE COMPANY	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred Select (PPO)	01	04		1			H5529	004	0	2012	Select Counties in Ohio		2	11913	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(800)-467-1199		(800)-467-1199		(800)-797-1765		(800)-797-1765		(800)-467-1199		(800)-467-1199		(800)-797-1765		(800)-797-1765		(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894		(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894		2	2	2
H5529	804	0	1	04	01	H5529_804_0	6	1		07/01/2011	2012.02	07/01/2011 10:23:43 AM Eastern Daylight Time	07/22/2011 11:51:58 AM Eastern Daylight Time			07/22/2011 01:46:35 PM Eastern Daylight Time	COMMUNITY INSURANCE COMPANY	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred (PPO)	01	04		1			H5529	804	0	2012	Ohio		1	14084	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608		(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		2	2	2
H5529	805	0	1	04	01	H5529_805_0	6	1		07/07/2011	2012.02	07/07/2011 03:46:29 PM Eastern Daylight Time	07/22/2011 11:51:59 AM Eastern Daylight Time			07/22/2011 01:46:35 PM Eastern Daylight Time	COMMUNITY INSURANCE COMPANY	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred (PPO)	01	04		1			H5529	805	0	2012	Ohio		1	50	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608										(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754										2	2	2
H5529	806	0	1	04	01	H5529_806_0	6	1		07/07/2011	2012.02	07/07/2011 03:46:42 PM Eastern Daylight Time	07/22/2011 11:52:00 AM Eastern Daylight Time			07/22/2011 01:46:35 PM Eastern Daylight Time	COMMUNITY INSURANCE COMPANY	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred (PPO)	01	04		1			H5529	806	0	2012	Ohio		1	50	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608		(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		2	2	2
H5529	807	0	1	04	01	H5529_807_0	6	1		07/07/2011	2012.02	07/07/2011 03:46:59 PM Eastern Daylight Time	07/22/2011 11:52:01 AM Eastern Daylight Time			07/22/2011 01:46:35 PM Eastern Daylight Time	COMMUNITY INSURANCE COMPANY	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred (PPO)	01	04		1			H5529	807	0	2012	Ohio		1	50	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608										(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754										2	2	2
H5530	001	0	1	04	01	H5530_001_0	9	1		08/04/2011	2012.02	08/04/2011 02:03:03 PM Eastern Daylight Time	08/08/2011 07:08:38 PM Eastern Daylight Time	08/08/2011 07:10:49 PM Eastern Daylight Time		08/08/2011 07:18:07 PM Eastern Daylight Time	ANTHEM HEALTH PLANS OF KENTUCKY, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred Standard (PPO)	01	04		1			H5530	001	0	2012	Select Counties in Kentucky		2	2613	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(800)-467-1199		(800)-467-1199		(800)-797-1759		(800)-797-1759		(800)-467-1199		(800)-467-1199		(800)-797-1759		(800)-797-1759		(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894		(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894		2	2	2
H5530	004	0	1	04	01	H5530_004_0	9	1		08/04/2011	2012.02	08/04/2011 02:03:20 PM Eastern Daylight Time	08/08/2011 07:08:45 PM Eastern Daylight Time	08/08/2011 07:10:58 PM Eastern Daylight Time		08/08/2011 07:18:07 PM Eastern Daylight Time	ANTHEM HEALTH PLANS OF KENTUCKY, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred Select (PPO)	01	04		1			H5530	004	0	2012	Select Counties in Kentucky		2	1728	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(800)-467-1199		(800)-467-1199		(800)-797-1759		(800)-797-1759		(800)-467-1199		(800)-467-1199		(800)-797-1759		(800)-797-1759		(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894		(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894		2	2	2
H5530	804	0	1	04	01	H5530_804_0	7	1		07/07/2011	2012.02	07/07/2011 12:44:03 PM Eastern Daylight Time	07/22/2011 11:52:01 AM Eastern Daylight Time			07/22/2011 01:36:47 PM Eastern Daylight Time	ANTHEM HEALTH PLANS OF KENTUCKY, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred (PPO)	01	04		1			H5530	804	0	2012	Kentucky		1	233	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608		(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		2	2	2
H5530	805	0	1	04	01	H5530_805_0	5	1		07/07/2011	2012.02	07/07/2011 12:44:12 PM Eastern Daylight Time	07/22/2011 11:52:02 AM Eastern Daylight Time			07/22/2011 01:36:47 PM Eastern Daylight Time	ANTHEM HEALTH PLANS OF KENTUCKY, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred (PPO)	01	04		1			H5530	805	0	2012	Kentucky		1	50	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608										(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754										2	2	2
H5530	806	0	1	04	01	H5530_806_0	5	1		07/07/2011	2012.02	07/07/2011 12:44:28 PM Eastern Daylight Time	07/22/2011 11:52:02 AM Eastern Daylight Time			07/22/2011 01:36:47 PM Eastern Daylight Time	ANTHEM HEALTH PLANS OF KENTUCKY, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred (PPO)	01	04		1			H5530	806	0	2012	Kentucky		1	50	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608		(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		2	2	2
H5530	807	0	1	04	01	H5530_807_0	5	1		07/07/2011	2012.02	07/07/2011 02:05:28 PM Eastern Daylight Time	07/22/2011 11:52:03 AM Eastern Daylight Time			07/22/2011 01:36:47 PM Eastern Daylight Time	ANTHEM HEALTH PLANS OF KENTUCKY, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem Medicare Preferred (PPO)	01	04		1			H5530	807	0	2012	Kentucky		1	50	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608										(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754										2	2	2
H5532	001	0	1	04	01	H5532_001_0	5	1		08/04/2011	2012.02	08/04/2011 08:17:46 PM Central Daylight Time	08/05/2011 11:13:38 AM Central Daylight Time	08/05/2011 01:45:12 PM Central Daylight Time		08/09/2011 11:07:45 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice (PPO)	01	04		1			H5532	001	0	2012	Charlotte,Hernando,Hillsborough,Lee,Pasco,Pinellas		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5533	003	0	1	04	01	H5533_003_0	5	1		08/09/2011	2012.02	08/09/2011 09:35:34 AM Eastern Daylight Time	08/09/2011 09:45:43 AM Eastern Daylight Time	08/09/2011 07:02:05 AM Eastern Daylight Time		08/09/2011 11:07:02 AM Eastern Daylight Time	UPMC HEALTH NETWORK	UPMC Health Plan	http://www.upmchealthplan.com/medicare/	UPMC for Life PPO High Deductible with Rx (PPO)	01	04		1			H5533	003	0	2012	Western Pennsylvania		2	5000	2			2						www.upmchealthplan.com/medicare/	http://www.upmchealthplan.com/medicare/partd.html	http://www.upmchealthplan.com/medicare/partd.html	(877)-539-3080		(877)-539-3080		(877)-381-3765		(877)-381-3765		(877)-539-3080		(877)-539-3080		(877)-381-3765		(877)-381-3765		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		2	2	2
H5533	004	0	1	04	01	H5533_004_0	8	1		06/07/2011	2012.02	06/07/2011 06:58:20 AM Eastern Daylight Time	08/11/2011 02:46:49 PM Eastern Daylight Time	08/11/2011 02:47:31 PM Eastern Daylight Time		08/12/2011 08:40:15 AM Eastern Daylight Time	UPMC HEALTH NETWORK	UPMC Health Plan	http://www.upmchealthplan.com/medicare/	UPMC for Life PPO Rx (PPO)	01	04		1			H5533	004	0	2012	Western Pennsylvania		2	2500	2			2						www.upmchealthplan.com/medicare/	http://www.upmchealthplan.com/medicare/partd.html	http://www.upmchealthplan.com/medicare/partd.html	(877)-539-3080		(877)-539-3080		(877)-381-3765		(877)-381-3765		(877)-539-3080		(877)-539-3080		(877)-381-3765		(877)-381-3765		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		2	2	2
H5533	801	0	1	04	01	H5533_801_0	2	1		05/25/2011	2012.02	05/25/2011 10:59:32 AM Eastern Daylight Time	07/12/2011 11:55:48 AM Eastern Daylight Time			07/18/2011 02:09:42 PM Eastern Daylight Time	UPMC HEALTH NETWORK	UPMC Health Plan	http://www.upmchealthplan.com/medicare/	UPMC Employer Group (PPO)	01	04		1			H5533	801	0	2012	Western Pennsylvania		1	100	2			2						www.upmchealthplan.com/medicare/	http://www.upmchealthplan.com/medicare/partd.html	http://www.upmchealthplan.com/medicare/partd.html	(877)-539-3080		(877)-539-3080		(877)-381-3765		(877)-381-3765										(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629										2	2	2
H5533	802	0	1	04	01	H5533_802_0	2	1		05/25/2011	2012.02	05/25/2011 10:58:35 AM Eastern Daylight Time	07/12/2011 11:35:50 AM Eastern Daylight Time			07/18/2011 02:09:42 PM Eastern Daylight Time	UPMC HEALTH NETWORK	UPMC Health Plan	http://www.upmchealthplan.com/medicare/	UPMC Employer Group Rx (PPO)	01	04		1			H5533	802	0	2012	Western Pennsylvania		1	1500	2			2						www.upmchealthplan.com/medicare/	http://www.upmchealthplan.com/medicare/partd.html	http://www.upmchealthplan.com/medicare/partd.html	(877)-539-3080		(877)-539-3080		(877)-381-3765		(877)-381-3765		(877)-539-3080		(877)-539-3080		(877)-381-3765		(877)-381-3765		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		2	2	2
H5533	803	0	1	04	01	H5533_803_0	2	1		05/25/2011	2012.02	05/25/2011 10:58:56 AM Eastern Daylight Time	07/12/2011 11:37:30 AM Eastern Daylight Time			07/18/2011 02:09:42 PM Eastern Daylight Time	UPMC HEALTH NETWORK	UPMC Health Plan	http://www.upmchealthplan.com/medicare/	UPMC Employer Group Rx (PPO)	01	04		1			H5533	803	0	2012	Western Pennsylvania		1	100	2			2						www.upmchealthplan.com/medicare/	http://www.upmchealthplan.com/medicare/partd.html	http://www.upmchealthplan.com/medicare/partd.html	(877)-539-3080		(877)-539-3080		(877)-381-3765		(877)-381-3765		(877)-539-3080		(877)-539-3080		(877)-381-3765		(877)-381-3765		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		2	2	2
H5549	002	0	1	01	01	H5549_002_0	4	1	2	06/13/2011	2012.02	06/13/2011 10:57:09 AM Atlantic Standard Time	07/28/2011 06:04:50 PM Atlantic Standard Time	07/28/2011 04:48:50 PM Atlantic Standard Time		07/29/2011 02:52:26 PM Atlantic Standard Time	VNS CHOICE	VNSNY CHOICE Medicare	www.vnsnychoice.org	VNSNY CHOICE Medicare Preferred (HMO SNP)	01	01		1			H5549	002	0	2012	Bronx, Kings, New York, Queens, Richmond Counties		2	6676	2			1	3		1	2			http://www.vnsnychoice.org/	http://www.vnsnychoice.org/	(866)-783-1444		(866)-783-1444		(866)-867-0047		(866)-867-0047		(866)-783-1444		(866)-783-1444		(866)-867-0047		(866)-867-0047		(888)-844-5530		(888)-844-5530		(888)-292-8472		(888)-292-8472		(888)-844-5530		(888)-844-5530		(888)-292-8472		(888)-292-8472		2	2	2
H5549	003	0	1	01	01	H5549_003_0	6	1	2	06/13/2011	2012.02	06/13/2011 10:57:17 AM Atlantic Standard Time	07/28/2011 06:06:02 PM Atlantic Standard Time	07/28/2011 04:50:12 PM Atlantic Standard Time		07/29/2011 02:52:26 PM Atlantic Standard Time	VNS CHOICE	VNSNY CHOICE Medicare	www.vnsnychoice.org	VNSNY CHOICE Total (HMO SNP)	01	01		1			H5549	003	0	2012	Bronx, Kings, New York, Queens, Richmond Counties		2	91	2			1	3		1	5			http://www.vnsnychoice.org/	http://www.vnsnychoice.org/	(866)-597-6674		(866)-597-6674		(866)-867-0047		(866)-867-0047		(866)-597-6674		(866)-597-6674		(866)-867-0047		(866)-867-0047		(888)-844-5530		(888)-844-5530		(888)-292-8472		(888)-292-8472		(888)-844-5530		(888)-844-5530		(888)-292-8472		(888)-292-8472		2	2	2
H5549	004	0	1	01	01	H5549_004_0	7	1		06/13/2011	2012.02	06/13/2011 10:57:25 AM Atlantic Standard Time	08/04/2011 05:42:12 PM Atlantic Standard Time	08/04/2011 05:42:12 PM Atlantic Standard Time		08/04/2011 05:53:31 PM Atlantic Standard Time	VNS CHOICE	VNSNY CHOICE Medicare	www.vnsnychoice.org	VNSNY CHOICE Medicare Enhanced (HMO)	01	01		1			H5549	004	0	2012	Bronx, Kings, New York, Queens, Richmond Counties		2	3172	2			2							http://www.vnsnychoice.org/	http://www.vnsnychoice.org/	(866)-783-1444		(866)-783-1444		(866)-867-0047		(866)-867-0047		(866)-783-1444		(866)-783-1444		(866)-867-0047		(866)-867-0047		(888)-844-5530		(888)-844-5530		(888)-292-8472		(888)-292-8472		(888)-844-5530		(888)-844-5530		(888)-292-8472		(888)-292-8472		2	2	2
H5549	006	0	1	01	01	H5549_006_0	9	1	2	07/20/2011	2012.02	07/20/2011 11:52:22 AM Atlantic Standard Time	07/28/2011 06:08:22 PM Atlantic Standard Time	07/28/2011 04:47:22 PM Atlantic Standard Time		07/29/2011 02:52:26 PM Atlantic Standard Time	VNS CHOICE	VNSNY CHOICE Medicare	www.vnsnychoice.org	VNSNY CHOICE Medicare Maximum (HMO SNP)	01	01		1			H5549	006	0	2012	Bronx, Kings, New York, Queens, Richmond Counties		2	339	2			1	3		1	5			http://www.vnsnychoice.org/	http://www.vnsnychoice.org/	(866)-783-1444		(866)-783-1444		(866)-867-0047		(866)-867-0047		(866)-783-1444		(866)-783-1444		(866)-867-0047		(866)-867-0047		(888)-844-5530		(888)-844-5530		(888)-292-8472		(888)-292-8472		(888)-844-5530		(888)-844-5530		(888)-292-8472		(888)-292-8472		2	2	2
H5575	005	0	1	01	01	H5575_005_0	7	1		08/12/2011	2012.02	08/12/2011 03:18:30 PM Central Daylight Time	08/12/2011 03:11:23 PM Central Daylight Time	08/12/2011 03:11:18 PM Central Daylight Time		08/12/2011 04:27:26 PM Central Daylight Time	FIDELIS SECURECARE OF NORTH CAROLINA	Fidelis SecureCare of North Carolina	www.fidelissc.com	Fidelis Secure Comfort (HMO SNP)	01	01		1			H5575	005	0	2012	North Carolina		2		2			1	1	1	1			http://www.fidelissc.com/pdfs/NC-ProviderDirectory.pdf	http://www.fidelissc.com/pharmacy/index.asp	http://www.fidelissc.com/pharmacy/index.asp	(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		2	2	2
H5575	006	0	1	01	01	H5575_006_0	7	1		06/07/2011	2012.02	06/07/2011 02:15:19 PM Central Daylight Time	06/06/2011 10:09:33 PM Central Daylight Time	07/22/2011 12:51:00 PM Central Daylight Time		07/23/2011 12:38:50 PM Central Daylight Time	FIDELIS SECURECARE OF NORTH CAROLINA	Fidelis SecureCare of North Carolina	www.fidelissc.com	Fidelis Secure Comfort Plus (HMO SNP)	01	01		1			H5575	006	0	2012	North Carolina		2		2			1	1	1	1			http://www.fidelissc.com/pdfs/NC-ProviderDirectory.pdf	http://www.fidelissc.com/pharmacy/index.asp	http://www.fidelissc.com/pharmacy/index.asp	(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		2	2	2
H5575	007	0	1	01	01	H5575_007_0	10	1		07/19/2011	2012.02	07/19/2011 11:54:55 AM Central Daylight Time	08/09/2011 11:03:50 AM Central Daylight Time	08/09/2011 11:03:48 AM Central Daylight Time		08/09/2011 11:27:59 AM Central Daylight Time	FIDELIS SECURECARE OF NORTH CAROLINA	Fidelis SecureCare of North Carolina	www.fidelissc.com	Fidelis Secure Independence (HMO SNP)	01	01		1			H5575	007	0	2012	North Carolina		2		2			1	1	2	1			http://www.fidelissc.com/pdfs/NC-ProviderDirectory.pdf	http://www.fidelissc.com/pharmacy/index.asp	http://www.fidelissc.com/pharmacy/index.asp	(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		2	2	2
H5575	011	0	1	01	01	H5575_011_0	8	1		08/12/2011	2012.02	08/12/2011 03:51:50 PM Central Daylight Time	08/12/2011 03:11:22 PM Central Daylight Time	08/12/2011 03:11:26 PM Central Daylight Time		08/12/2011 04:27:26 PM Central Daylight Time	FIDELIS SECURECARE OF NORTH CAROLINA	Fidelis SecureCare of North Carolina	www.fidelissc.com	Fidelis Secure Freedom (HMO SNP)	01	01		1			H5575	011	0	2012	North Carolina		2		2			1	1	2	1			http://www.fidelissc.com/pdfs/NC-ProviderDirectory.pdf	http://www.fidelissc.com/pharmacy/index.asp	http://www.fidelissc.com/pharmacy/index.asp	(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		2	2	2
H5576	006	0	1	02	01	H5576_006_0	10	1		07/25/2011	2012.02	07/25/2011 09:11:00 AM Central Daylight Time	08/08/2011 04:57:49 PM Central Daylight Time	08/08/2011 05:01:37 PM Central Daylight Time		08/08/2011 05:15:03 PM Central Daylight Time	VANTAGE  HEALTH PLAN, INC.	Vantage Health Plan, Inc.	www.vhp-medicare.com	AAA3 Vantage PREMIUM (HMO-POS)	01	02		1			H5576	006	0	2012	North Louisiana, Central Louisiana		2		2			2						www.vhp-medicare.com	www.vhp-medicare.com	www.catalystrx.com	(888)-823-1910	1	(318)-361-0900	1	(888)-823-1910	1	(318)-361-0900	1	(888)-823-1910	1	(318)-361-0900	1	(888)-823-1910	1	(318)-361-0900	1	(866)-524-5144		(318)-361-2131		(866)-524-5144		(318)-361-2131		(866)-524-5144		(318)-361-2131		(866)-524-5144		(318)-361-2131		2	2	2
H5576	007	0	1	02	01	H5576_007_0	8	1		07/25/2011	2012.02	07/25/2011 09:11:10 AM Central Daylight Time	08/08/2011 05:02:06 PM Central Daylight Time	08/08/2011 05:02:31 PM Central Daylight Time		08/08/2011 05:15:03 PM Central Daylight Time	VANTAGE  HEALTH PLAN, INC.	Vantage Health Plan, Inc.	www.vhp-medicare.com	AAA0 Vantage ZERO (HMO-POS)	01	02		1			H5576	007	0	2012	North Louisiana, Central Louisiana		2		2			2						www.vhp-medicare.com	www.vhp-medicare.com	www.catalystrx.com	(888)-823-1910	1	(318)-361-0900	1	(888)-823-1910	1	(318)-361-0900	1	(888)-823-1910	1	(318)-361-0900	1	(888)-823-1910	1	(318)-361-0900	1	(866)-524-5144		(318)-361-2131		(866)-524-5144		(318)-361-2131		(866)-524-5144		(318)-361-2131		(866)-524-5144		(318)-361-2131		2	2	2
H5576	008	0	1	01	01	H5576_008_0	6	1		08/08/2011	2012.02	08/08/2011 02:34:11 PM Central Daylight Time	08/08/2011 05:03:18 PM Central Daylight Time	08/08/2011 05:03:43 PM Central Daylight Time		08/08/2011 05:15:03 PM Central Daylight Time	VANTAGE  HEALTH PLAN, INC.	Vantage Health Plan, Inc.	www.vhp-medicare.com	AAA4 Vantage TRADITIONAL PLUS (HMO)	01	01		1			H5576	008	0	2012	North Louisiana, Central Louisiana and Baton Rouge		2		2			2						www.vhp-medicare.com	www.vhp-medicare.com	www.catalystrx.com	(888)-823-1910	1	(318)-361-0900	1	(888)-823-1910	1	(318)-361-0900	1	(888)-823-1910	1	(318)-361-0900	1	(888)-823-1910	1	(318)-361-0900	1	(866)-524-5144		(318)-361-2131		(866)-524-5144		(318)-361-2131		(866)-524-5144		(318)-361-2131		(866)-524-5144		(318)-361-2131		2	2	2
H5576	009	0	1	02	01	H5576_009_0	8	1		07/25/2011	2012.02	07/25/2011 09:11:19 AM Central Daylight Time	08/08/2011 05:04:09 PM Central Daylight Time	08/08/2011 05:04:36 PM Central Daylight Time		08/08/2011 05:15:03 PM Central Daylight Time	VANTAGE  HEALTH PLAN, INC.	Vantage Health Plan, Inc.	www.vhp-medicare.com	AAA1 Vantage VALUE (HMO-POS)	01	02		1			H5576	009	0	2012	North Louisiana, Central Louisiana		2		2			2						www.vhp-medicare.com	www.vhp-medicare.com	www.catalystrx.com	(888)-823-1910	1	(318)-361-0900	1	(888)-823-1910	1	(318)-361-0900	1	(888)-823-1910	1	(318)-361-0900	1	(888)-823-1910	1	(318)-361-0900	1	(866)-524-5144		(318)-361-2131		(866)-524-5144		(318)-361-2131		(866)-524-5144		(318)-361-2131		(866)-524-5144		(318)-361-2131		2	2	2
H5576	012	0	1	02	01	H5576_012_0	6	1		07/25/2011	2012.02	07/25/2011 09:17:46 AM Central Daylight Time	08/08/2011 05:05:14 PM Central Daylight Time	08/08/2011 05:05:40 PM Central Daylight Time		08/08/2011 05:15:03 PM Central Daylight Time	VANTAGE  HEALTH PLAN, INC.	Vantage Health Plan, Inc.	www.vhp-medicare.com	AAA6 Vantage CAPITOL (HMO-POS)	01	02		1			H5576	012	0	2012	Iberville, East and West Baton Rouge Parishes		2		2			2						www.vhp-medicare.com	www.vhp-medicare.com	www.catalystrx.com	(888)-823-1910	1	(318)-361-0900	1	(888)-823-1910	1	(318)-361-0900	1	(888)-823-1910	1	(318)-361-0900	1	(888)-823-1910	1	(318)-361-0900	1	(866)-524-5144		(318)-361-2131		(866)-524-5144		(318)-361-2131		(866)-524-5144		(318)-361-2131		(866)-524-5144		(318)-361-2131		2	2	2
H5576	801	0	1	02	01	H5576_801_0	2	1		05/04/2011	2012.02	05/04/2011 10:09:45 AM Central Daylight Time	06/05/2011 09:21:38 PM Central Daylight Time			06/05/2011 09:50:21 PM Central Daylight Time	VANTAGE  HEALTH PLAN, INC.	Vantage Health Plan, Inc.	www.vhp-medicare.com	Vantage - MAPD Employer Calendar (HMO-POS)	01	02		1			H5576	801	0	2012	Louisiana		1		2			2						www.vhp-medicare.com	www.vhp-medicare.com	www.catalystrx.com	(888)-823-1910	1	(318)-361-0900	1	(888)-823-1910	1	(318)-361-0900	1	(888)-823-1910	1	(318)-361-0900	1	(888)-823-1910	1	(318)-361-0900	1	(866)-524-5144		(318)-361-2131		(866)-524-5144		(318)-361-2131		(866)-524-5144		(318)-361-2131		(866)-524-5144		(318)-361-2131		1	1	1
H5576	802	0	1	02	01	H5576_802_0	3	1		05/04/2011	2012.02	05/04/2011 10:11:36 AM Central Daylight Time	07/28/2011 07:54:15 AM Central Daylight Time			07/28/2011 07:57:09 AM Central Daylight Time	VANTAGE  HEALTH PLAN, INC.	Vantage Health Plan, Inc.	www.vhp-medicare.com	Vantage - MAPD Emp Non-Calendar (HMO-POS)	01	02		1			H5576	802	0	2012	Louisiana		1		2			2						www.vhp-medicare.com	www.vhp-medicare.com	www.catalystrx.com	(888)-823-1910	1	(318)-361-0900	1	(888)-823-1910	1	(318)-361-0900	1	(888)-823-1910	1	(318)-361-0900	1	(888)-823-1910	1	(318)-361-0900	1	(866)-524-5144		(318)-361-2131		(866)-524-5144		(318)-361-2131		(866)-524-5144		(318)-361-2131		(866)-524-5144		(318)-361-2131		1	1	1
H5576	803	0	1	02	01	H5576_803_0	2	1		05/04/2011	2012.02	05/04/2011 10:11:48 AM Central Daylight Time	06/05/2011 09:19:22 PM Central Daylight Time			06/05/2011 09:50:21 PM Central Daylight Time	VANTAGE  HEALTH PLAN, INC.	Vantage Health Plan, Inc.	www.vhp-medicare.com	Vantage - MA Employer Calendar (HMO-POS)	01	02		1			H5576	803	0	2012	Louisiana		1		2			2						www.vhp-medicare.com	www.vhp-medicare.com	www.catalystrx.com	(888)-823-1910	1	(318)-361-0900	1	(888)-823-1910	1	(318)-361-0900	1									(866)-524-5144		(318)-361-2131		(866)-524-5144		(318)-361-2131										1	1	1
H5577	002	0	1	01	01	H5577_002_0	6	1	1	07/19/2011	2012.02	07/19/2011 03:05:31 PM SA Western Standard Time	08/05/2011 04:55:44 PM SA Western Standard Time	08/08/2011 09:27:28 AM SA Western Standard Time		08/09/2011 09:55:49 AM SA Western Standard Time	MCS ADVANTAGE INC.	MCS Classicare	www.mcsclassicare.com	MCS Classicare Ideal (HMO SNP)	01	01		1			H5577	002	0	2012	Puerto Rico		2	58349	2		1	1	3		1	3		www.mcsclassicare.com	www.mcsclassicare.com	www.mcsclassicare.com	(866)-627-8183		(787)-620-2530		(866)-627-8181		(787)-620-2528		(866)-627-8183		(787)-620-2530		(866)-627-8181		(787)-620-2528		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		2	2	2
H5577	005	0	1	01	01	H5577_005_0	7	1		07/19/2011	2012.02	07/19/2011 03:05:42 PM SA Western Standard Time	08/05/2011 04:56:34 PM SA Western Standard Time	08/08/2011 09:28:34 AM SA Western Standard Time		08/09/2011 09:55:49 AM SA Western Standard Time	MCS ADVANTAGE INC.	MCS Classicare	www.mcsclassicare.com	MCS Classicare InteliCare (HMO)	01	01		1			H5577	005	0	2012	Puerto Rico		2	750	2			2						www.mcsclassicare.com	www.mcsclassicare.com	www.mcsclassicare.com	(866)-627-8183		(787)-620-2530		(866)-627-8181		(787)-620-2528		(866)-627-8183		(787)-620-2530		(866)-627-8181		(787)-620-2528		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182		2	2	2
H5578	002	0	1	01	01	H5578_002_0	8	1		08/08/2011	2012.02	08/08/2011 10:15:52 AM Central Daylight Time	08/07/2011 08:59:45 PM Central Daylight Time	08/04/2011 02:00:19 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARCADIAN HEALTH PLAN OF GEORGIA, INC.	Southeast Community Care	www.southeastcommunitycare.com	Southeast Community Care - Plus (HMO)	01	01		1			H5578	002	0	2012	Savannah		2		2			2							www.southeastcommunitycare.com	www.southeastcommunitycare.com	(800)-573-8597		(800)-573-8597		(888)-701-2678		(478)-474-2678		(800)-573-8597		(800)-573-8597		(888)-701-2678		(478)-474-2678		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H5578	006	0	1	01	01	H5578_006_0	7	1		08/08/2011	2012.02	08/08/2011 10:16:15 AM Central Daylight Time	08/07/2011 01:06:24 PM Central Daylight Time	08/04/2011 02:01:03 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARCADIAN HEALTH PLAN OF GEORGIA, INC.	Southeast Community Care	www.southeastcommunitycare.com	Southeast Community Care - Plus (HMO)	01	01		1			H5578	006	0	2012	Athens, Macon		2		2			2							www.southeastcommunitycare.com	www.southeastcommunitycare.com	(800)-573-8597		(800)-573-8597		(888)-701-2678		(478)-474-2678		(800)-573-8597		(800)-573-8597		(888)-701-2678		(478)-474-2678		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H5578	007	0	1	01	01	H5578_007_0	7	1	2	07/07/2011	2012.02	07/07/2011 11:03:51 AM Central Daylight Time	07/17/2011 06:10:31 PM Central Daylight Time	07/19/2011 07:57:15 PM Central Daylight Time		07/20/2011 04:17:07 PM Central Daylight Time	ARCADIAN HEALTH PLAN OF GEORGIA, INC.	Southeast Community Care	www.southeastcommunitycare.com	Southeast Community Care - Dual Plus (HMO SNP)	01	01		1			H5578	007	0	2012	Athens, Columbus, Macon		2		2			1	3		1	1			www.southeastcommunitycare.com	www.southeastcommunitycare.com	(800)-573-8597		(800)-573-8597		(888)-701-2678		(478)-474-2678		(800)-573-8597		(800)-573-8597		(888)-701-2678		(478)-474-2678		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H5578	009	0	1	01	01	H5578_009_0	7	1		08/08/2011	2012.02	08/08/2011 10:16:42 AM Central Daylight Time	08/07/2011 01:07:50 PM Central Daylight Time	08/04/2011 02:03:28 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARCADIAN HEALTH PLAN OF GEORGIA, INC.	Southeast Community Care	www.southeastcommunitycare.com	Southeast Community Care - Plus (HMO)	01	01		1			H5578	009	0	2012	Augusta		2		2			2							www.southeastcommunitycare.com	www.southeastcommunitycare.com	(800)-573-8597		(800)-573-8597		(888)-701-2678		(478)-474-2678		(800)-573-8597		(800)-573-8597		(888)-701-2678		(478)-474-2678		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H5578	013	0	1	01	01	H5578_013_0	9	1		08/08/2011	2012.02	08/08/2011 10:17:07 AM Central Daylight Time	08/07/2011 01:09:36 PM Central Daylight Time	08/04/2011 02:04:02 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARCADIAN HEALTH PLAN OF GEORGIA, INC.	Southeast Community Care	www.southeastcommunitycare.com	Southeast Community Care - Plus (HMO)	01	01		1			H5578	013	0	2012	Columbus		2		2			2							www.southeastcommunitycare.com	www.southeastcommunitycare.com	(800)-573-8597		(800)-573-8597		(888)-701-2678		(478)-474-2678		(800)-573-8597		(800)-573-8597		(888)-701-2678		(478)-474-2678		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H5580	001	0	1	01	01	H5580_001_0	3	1	2	06/04/2011	2012.02	06/04/2011 08:50:44 AM Central Daylight Time	07/01/2011 04:08:25 PM Central Daylight Time	07/01/2011 03:59:49 PM Central Daylight Time		07/12/2011 09:44:51 AM Central Daylight Time	SOUTHWEST CATHOLIC HEALTH NETWORK CORPORATION	Mercy Care Advantage	www.mercycareadvantage.com	Mercy Care Advantage (HMO SNP)	01	01		1			H5580	001	0	2012	Maricopa, Pima, and Santa Cruz Counties		2		2			1	3		1	3		http://www.mercycareadvantage.com	http://www.mercycareplan.com/mca/members/downloads/RCompFormulary2011BWEnglishR2_5_19_11.pdf	http://www.mercycareplan.com/mca/members/downloads/MCA_provider_directory_R1.pdf	(800)-624-3879		(602)-263-3000		(866)-571-5781		(602)-414-7630		(800)-624-3879		(602)-263-3000		(866)-571-5781		(602)-414-7630		(866)-602-1982		(602)-248-9273		(866)-602-1982		(602)-248-9273		(866)-602-1982		(602)-248-9273		(866)-602-1982		(602)-248-9273		2	2	2
H5587	001	0	1	01	01	H5587_001_0	3	1	2	07/01/2011	2012.02	07/01/2011 07:00:49 AM US Mountain Standard Time	08/11/2011 03:43:08 PM US Mountain Standard Time	08/11/2011 03:46:16 PM US Mountain Standard Time		08/11/2011 01:52:55 PM US Mountain Standard Time	HEALTH CHOICE ARIZONA, INC.	Health Choice Generations HMO SNP	www.hcgenerations.com	Health Choice Generations (HMO SNP)	01	01		1			H5587	001	0	2012	Counties: APA, CCN, MAR, NAV, PIM, PIN		2	2800	2			1	3		1	3		www.HCGenerations.com	http://www.hcgenerations.com/index.asp?page=formulary.aspf=partd	http://www.express-scripts.com	(800)-656-8991		(800)-656-8991		(800)-656-8991		(800)-656-8991		(800)-656-8991		(800)-656-8991		(800)-656-8991		(800)-656-8991		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		2	2	2
H5587	002	0	1	01	01	H5587_002_0	3	1	2	07/01/2011	2012.02	07/01/2011 07:00:57 AM US Mountain Standard Time	08/11/2011 03:42:42 PM US Mountain Standard Time	08/11/2011 03:46:26 PM US Mountain Standard Time		08/11/2011 01:52:55 PM US Mountain Standard Time	HEALTH CHOICE ARIZONA, INC.	Health Choice Generations HMO SNP	www.hcgenerations.com	Health Choice Generations (HMO SNP)	01	01		1			H5587	002	0	2012	Counties: APA, CCN, NAV, MAR, MOH, YUM, PIM, SAN		2	1550	2			1	3		1	4		www.HCGenerations.com	http://www.hcgenerations.com/index.asp?page=formulary.aspf=partd	http://www.express-scripts.com	(800)-656-8991		(800)-656-8991		(800)-656-8991		(800)-656-8991		(800)-656-8991		(800)-656-8991		(800)-656-8991		(800)-656-8991		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		2	2	2
H5590	002	0	1	01	01	H5590_002_0	7	1	2	07/29/2011	2012.02	07/29/2011 12:45:35 PM Pacific Daylight Time	08/04/2011 12:39:29 PM Pacific Daylight Time	08/04/2011 12:22:51 PM Pacific Daylight Time		08/05/2011 02:37:22 PM Pacific Daylight Time	BRIDGEWAY HEALTH SOLUTIONS	Advantage by Bridgeway Health Solutions	http://advantage.bridgewayhs.com	Advantage by Bridgeway Health Solutions (HMO SNP)	01	01		1			H5590	002	0	2012	Maricopa, Pima and Santa Cruz Counties		2	1993	2			1	3		1	5		http://medicare.bridgewayhs.com/	http://medicare.bridgewayhs.com/home/prescription-drug-part-d-benefit-information/formulary/	http://medicare.bridgewayhs.com/home/prescription-drug-part-d-benefit-information/	(866)-475-3129		(866)-475-3129		(866)-475-3129		(866)-475-3129		(866)-475-3129		(866)-475-3129		(866)-475-3129		(866)-475-3129		(877)-613-2076		(877)-613-2076		(877)-613-2076		(877)-613-2076		(877)-613-2076		(877)-613-2076		(877)-613-2076		(877)-613-2076		2	1	2
H5591	001	0	1	02	01	H5591_001_0	7	1		08/08/2011	2012.02	08/08/2011 10:56:52 AM Eastern Daylight Time	08/07/2011 01:05:46 PM Eastern Daylight Time	08/07/2011 01:05:46 PM Eastern Daylight Time		08/08/2011 11:25:55 AM Eastern Daylight Time	MARTIN'S POINT GENERATIONS, LLC	Martin's Point Generations Advantage	www.martinspoint.org/medicare	Martin's Point Generations Advantage Prime (HMO-POS)	01	02		1			H5591	001	0	2012	State of Maine		2		2			2						www.martinspoint.org/medicare	www.martinspoint.org/medicare	www.martinspoint.org/medicare	(866)-544-7504		(866)-544-7504		(888)-640-4423		(888)-640-4423		(866)-544-7504		(866)-544-7504		(888)-640-4423		(888)-640-4423		(866)-544-7503		(866)-544-7503		(866)-544-7502		(866)-544-7502		(866)-544-7503		(866)-544-7503		(866)-544-7502		(866)-544-7502		2	2	2
H5591	003	0	1	01	01	H5591_003_0	5	1		07/20/2011	2012.02	07/20/2011 02:46:06 PM Eastern Daylight Time	06/06/2011 03:40:29 PM Eastern Daylight Time			07/20/2011 04:30:52 PM Eastern Daylight Time	MARTIN'S POINT GENERATIONS, LLC	Martin's Point Generations Advantage	www.martinspoint.org/medicare	Martin's Point Generations Advantage Value (HMO)	01	01		1			H5591	003	0	2012	State of Maine		2		2			2						www.martinspoint.org/medicare	www.martinspoint.org/medicare	www.martinspoint.org/medicare	(866)-544-7504		(866)-544-7504		(888)-640-4423		(888)-640-4423										(866)-544-7503		(866)-544-7503		(866)-544-7502		(866)-544-7502										2	2	2
H5594	001	0	1	02	01	H5594_001_0	5	1		07/01/2011	2012.02	07/01/2011 09:37:29 AM Eastern Daylight Time	08/04/2011 10:51:14 AM Eastern Daylight Time	08/04/2011 09:01:26 AM Eastern Daylight Time		08/08/2011 10:04:58 AM Eastern Daylight Time	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthcare.com	Optimum Gold Rewards Plan (HMO-POS)	01	02		1			H5594	001	0	2012	Select Counties in Florida		2	8780	2			2						www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	(866)-245-5360		(866)-245-5360		(866)-245-5360		(352)-688-9131		(866)-245-5360		(352)-688-9131		(866)-245-5360		(352)-688-9131		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5594	002	0	1	02	01	H5594_002_0	4	1		07/01/2011	2012.02	07/01/2011 09:37:34 AM Eastern Daylight Time	08/04/2011 10:55:44 AM Eastern Daylight Time	08/04/2011 09:12:10 AM Eastern Daylight Time		08/08/2011 10:04:58 AM Eastern Daylight Time	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthcare.com	Optimum Platinum Plan (HMO-POS)	01	02		1			H5594	002	0	2012	Select Counties in Florida		2	2227	2			2						www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	(866)-245-5360		(866)-245-5360		(866)-245-5360		(352)-688-9131		(866)-245-5360		(352)-688-9131		(866)-245-5360		(352)-688-9131		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5594	006	0	1	02	01	H5594_006_0	6	1		07/01/2011	2012.02	07/01/2011 09:37:40 AM Eastern Daylight Time	08/04/2011 12:40:44 PM Eastern Daylight Time	08/04/2011 09:58:26 AM Eastern Daylight Time		08/08/2011 10:04:58 AM Eastern Daylight Time	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthcare.com	Optimum Platinum Plan (HMO-POS)	01	02		1			H5594	006	0	2012	Select Counties in Florida		2	82	2			2						www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	(866)-245-5360		(866)-245-5360		(866)-245-5360		(352)-688-9131		(866)-245-5360		(352)-688-9131		(866)-245-5360		(352)-688-9131		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5594	016	0	1	01	01	H5594_016_0	6	1	2	08/22/2011	2012.02	08/22/2011 02:29:42 PM Eastern Daylight Time	08/04/2011 01:43:38 PM Eastern Daylight Time	08/04/2011 01:34:18 PM Eastern Daylight Time		08/22/2011 02:42:21 PM Eastern Daylight Time	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthcare.com	Optimum Emerald Partial (HMO SNP)	01	01		1			H5594	016	0	2012	Select Counties in Florida		2	239	2			1	3		1	4		www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	(866)-245-5360		(866)-245-5360		(866)-245-5360		(352)-688-9131		(866)-245-5360		(352)-688-9131		(866)-245-5360		(352)-688-9131		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5594	017	0	1	01	01	H5594_017_0	5	1	2	08/22/2011	2012.02	08/22/2011 02:28:45 PM Eastern Daylight Time	08/04/2011 01:59:30 PM Eastern Daylight Time	08/04/2011 01:55:28 PM Eastern Daylight Time		08/22/2011 02:42:21 PM Eastern Daylight Time	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthcare.com	Optimum Emerald Full (HMO SNP)	01	01		1			H5594	017	0	2012	Select Counties in Florida		2	599	2			1	3		1	5		www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	(866)-245-5360		(866)-245-5360		(866)-245-5360		(352)-688-9131		(866)-245-5360		(352)-688-9131		(866)-245-5360		(352)-688-9131		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5594	018	0	1	02	01	H5594_018_0	6	1		07/01/2011	2012.02	07/01/2011 09:37:57 AM Eastern Daylight Time	08/04/2011 12:45:42 PM Eastern Daylight Time	08/04/2011 09:22:08 AM Eastern Daylight Time		08/08/2011 10:04:58 AM Eastern Daylight Time	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthcare.com	Optimum Gold Rewards Plan (HMO-POS)	01	02		1			H5594	018	0	2012	Select Counties in Florida		2	738	2			2						www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	(866)-245-5360		(866)-245-5360		(866)-245-5360		(352)-688-9131		(866)-245-5360		(352)-688-9131		(866)-245-5360		(352)-688-9131		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5594	019	0	1	02	01	H5594_019_0	5	1		07/01/2011	2012.02	07/01/2011 09:38:17 AM Eastern Daylight Time	08/04/2011 12:56:28 PM Eastern Daylight Time	08/04/2011 09:23:52 AM Eastern Daylight Time		08/08/2011 10:04:58 AM Eastern Daylight Time	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthcare.com	Optimum Platinum Plan (HMO-POS)	01	02		1			H5594	019	0	2012	Select Counties in Florida		2	244	2			2						www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	(866)-245-5360		(866)-245-5360		(866)-245-5360		(352)-688-9131		(866)-245-5360		(352)-688-9131		(866)-245-5360		(352)-688-9131		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5594	022	0	1	02	01	H5594_022_0	5	1		07/01/2011	2012.02	07/01/2011 09:38:22 AM Eastern Daylight Time	08/04/2011 01:00:56 PM Eastern Daylight Time	08/04/2011 09:25:42 AM Eastern Daylight Time		08/08/2011 10:04:58 AM Eastern Daylight Time	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthcare.com	Optimum Gold Rewards Plan (HMO-POS)	01	02		1			H5594	022	0	2012	Select Counties in Florida		2	365	2			2						www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	(866)-245-5360		(866)-245-5360		(866)-245-5360		(352)-688-9131		(866)-245-5360		(352)-688-9131		(866)-245-5360		(352)-688-9131		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5594	023	0	1	02	01	H5594_023_0	5	1		07/01/2011	2012.02	07/01/2011 09:38:29 AM Eastern Daylight Time	08/04/2011 01:05:34 PM Eastern Daylight Time	08/04/2011 09:27:32 AM Eastern Daylight Time		08/08/2011 10:04:58 AM Eastern Daylight Time	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthcare.com	Optimum Platinum Plan (HMO-POS)	01	02		1			H5594	023	0	2012	Select Counties in Florida		2	121	2			2						www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	(866)-245-5360		(866)-245-5360		(866)-245-5360		(352)-688-9131		(866)-245-5360		(352)-688-9131		(866)-245-5360		(352)-688-9131		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5594	026	0	1	02	01	H5594_026_0	5	1		07/01/2011	2012.02	07/01/2011 09:38:54 AM Eastern Daylight Time	08/04/2011 01:09:20 PM Eastern Daylight Time	08/04/2011 09:28:58 AM Eastern Daylight Time		08/08/2011 10:04:58 AM Eastern Daylight Time	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthcare.com	Optimum Gold Rewards Plan (HMO-POS)	01	02		1			H5594	026	0	2012	Select Counties in Florida		2	483	2			2						www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	(866)-245-5360		(866)-245-5360		(866)-245-5360		(352)-688-9131		(866)-245-5360		(352)-688-9131		(866)-245-5360		(352)-688-9131		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5594	027	0	1	02	01	H5594_027_0	4	1		07/01/2011	2012.02	07/01/2011 09:39:01 AM Eastern Daylight Time	08/04/2011 01:16:00 PM Eastern Daylight Time	08/04/2011 09:30:20 AM Eastern Daylight Time		08/08/2011 10:04:58 AM Eastern Daylight Time	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthcare.com	Optimum Platinum Plan (HMO-POS)	01	02		1			H5594	027	0	2012	Select Counties in Florida		2	121	2			2						www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	(866)-245-5360		(866)-245-5360		(866)-245-5360		(352)-688-9131		(866)-245-5360		(352)-688-9131		(866)-245-5360		(352)-688-9131		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5594	028	0	1	02	01	H5594_028_0	4	1		07/01/2011	2012.02	07/01/2011 09:39:08 AM Eastern Daylight Time	08/04/2011 10:37:52 AM Eastern Daylight Time	08/04/2011 09:42:20 AM Eastern Daylight Time		08/08/2011 10:04:58 AM Eastern Daylight Time	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthcare.com	Optimum Diamond Rewards (HMO-POS SNP)	01	02		1			H5594	028	0	2012	Select Counties in Florida		2	1099	2			1	4		1		00000000000000000010	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	(866)-245-5360		(866)-245-5360		(866)-245-5360		(352)-688-9131		(866)-245-5360		(352)-688-9131		(866)-245-5360		(352)-688-9131		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5594	029	0	1	02	01	H5594_029_0	4	1		07/01/2011	2012.02	07/01/2011 09:39:15 AM Eastern Daylight Time	08/04/2011 01:22:48 PM Eastern Daylight Time	08/04/2011 09:43:50 AM Eastern Daylight Time		08/08/2011 10:04:58 AM Eastern Daylight Time	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthcare.com	Optimum Diamond Rewards COPD (HMO-POS SNP)	01	02		1			H5594	029	0	2012	Select Counties in Florida		2	550	2			1	4		1		00000000000100000000	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	(866)-245-5360		(866)-245-5360		(866)-245-5360		(352)-688-9131		(866)-245-5360		(352)-688-9131		(866)-245-5360		(352)-688-9131		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5594	030	0	1	02	01	H5594_030_0	4	1		07/01/2011	2012.02	07/01/2011 09:39:22 AM Eastern Daylight Time	08/04/2011 01:26:24 PM Eastern Daylight Time	08/04/2011 09:45:18 AM Eastern Daylight Time		08/08/2011 10:04:58 AM Eastern Daylight Time	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthcare.com	Optimum Diamond Rewards (HMO-POS SNP)	01	02		1			H5594	030	0	2012	Select Counties in Florida		2	211	2			1	4		1		00000000000000000010	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	(866)-245-5360		(866)-245-5360		(866)-245-5360		(352)-688-9131		(866)-245-5360		(352)-688-9131		(866)-245-5360		(352)-688-9131		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5594	031	0	1	02	01	H5594_031_0	4	1		07/01/2011	2012.02	07/01/2011 09:39:30 AM Eastern Daylight Time	08/04/2011 01:30:02 PM Eastern Daylight Time	08/04/2011 09:47:16 AM Eastern Daylight Time		08/08/2011 10:04:58 AM Eastern Daylight Time	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthcare.com	Optimum Diamond Rewards COPD (HMO-POS SNP)	01	02		1			H5594	031	0	2012	Select Counties in Florida		2	106	2			1	4		1		00000000000100000000	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	www.youroptimumhealthcare.com	(866)-245-5360		(866)-245-5360		(866)-245-5360		(352)-688-9131		(866)-245-5360		(352)-688-9131		(866)-245-5360		(352)-688-9131		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5608	001	0	1	01	01	H5608_001_0	3	1	2	08/08/2011	2012.02	08/08/2011 04:19:03 PM Mountain Daylight Time	08/08/2011 11:37:42 AM Mountain Daylight Time	08/08/2011 02:16:14 PM Mountain Daylight Time		08/09/2011 12:19:41 PM Mountain Daylight Time	DENVER HEALTH MEDICAL PLAN, INC.	Denver Health Medical Plan	http://denverhealthmedicalplan.com	Denver Health Medicare Choice (HMO SNP)	01	01		1			H5608	001	0	2012	Denver County		2	1260	2			1	3		1	2		http://denverhealthmedicalplan.com	http://denverhealthmedicalplan.com	http://denverhealthmedicalplan.com	(877)-956-2111		(303)-602-2111		(877)-956-2111		(303)-602-2111		(877)-956-2111		(303)-602-2111		(877)-956-2111		(303)-602-2111		(866)-538-5288		(303)-602-2129		(866)-538-5288		(303)-602-2129		(866)-538-5288		(303)-602-2129		(866)-538-5288		(303)-602-2129		2	2	2
H5608	002	0	1	01	01	H5608_002_0	3	1		08/08/2011	2012.02	08/08/2011 04:19:42 PM Mountain Daylight Time	08/08/2011 11:41:47 AM Mountain Daylight Time	08/08/2011 02:16:52 PM Mountain Daylight Time		08/09/2011 12:19:41 PM Mountain Daylight Time	DENVER HEALTH MEDICAL PLAN, INC.	Denver Health Medical Plan	http://denverhealthmedicalplan.com	Denver Health Medicare Select (HMO)	01	01		1			H5608	002	0	2012	Denver County		2	2160	2			2						http://denverhealthmedicalplan.com	http://denverhealthmedicalplan.com	http://denverhealthmedicalplan.com	(877)-956-2111		(303)-602-2111		(877)-956-2111		(303)-602-2111		(877)-956-2111		(303)-602-2111		(877)-956-2111		(303)-602-2111		(866)-538-5288		(303)-602-2129		(866)-538-5288		(303)-602-2129		(866)-538-5288		(303)-602-2129		(866)-538-5288		(303)-602-2129		2	2	2
H5609	001	0	1	01	01	H5609_001_0	8	1		06/06/2011	2012.02	06/06/2011 08:01:45 PM Eastern Daylight Time	08/09/2011 05:13:45 PM Eastern Daylight Time	08/09/2011 05:19:37 PM Eastern Daylight Time		08/09/2011 05:27:48 PM Eastern Daylight Time	GEMCARE HEALTH PLAN INC.	GEMCARE Health Plan	www.gemcarehealthplan.com	GEMCare Medicare Plus (HMO)	01	01		1			H5609	001	0	2012	Kern County		2	5500	2			2						www.gemcarehealthplan.com	www.gemcarehealthplan.com	www.gemcarehealthplan.com	(877)-697-2464		(661)-716-8800		(877)-697-2464		(661)-716-8800		(877)-697-2464		(661)-716-8800		(877)-697-2464		(661)-716-8800		(888)-833-9312		(888)-833-9312		(888)-833-9312		(888)-833-9312		(888)-833-9312		(888)-833-9312		(888)-833-9312		(888)-833-9312		2	2	2
H5609	004	0	1	01	01	H5609_004_0	7	1		06/06/2011	2012.02	06/06/2011 08:34:04 PM Eastern Daylight Time	08/09/2011 05:13:45 PM Eastern Daylight Time	08/09/2011 05:19:37 PM Eastern Daylight Time		08/09/2011 05:27:48 PM Eastern Daylight Time	GEMCARE HEALTH PLAN INC.	GEMCARE Health Plan	www.gemcarehealthplan.com	Physicians Choice Medicare Plus (HMO)	01	01		1			H5609	004	0	2012	SLO / SB - Partial County Areas		2		2			2						www.gemcarehealthplan.com	www.gemcarehealthplan.com	www.gemcarehealthplan.com	(877)-697-2464		(877)-697-2464		(877)-697-2464		(877)-697-2464		(877)-697-2464		(877)-697-2464		(877)-697-2464		(877)-697-2464		(888)-833-9312		(888)-833-9312		(888)-833-9312		(888)-833-9312		(888)-833-9312		(888)-833-9312		(888)-833-9312		(888)-833-9312		2	2	2
H5609	005	0	1	01	01	H5609_005_0	7	1		06/06/2011	2012.02	06/06/2011 08:34:23 PM Eastern Daylight Time	08/09/2011 05:13:45 PM Eastern Daylight Time	08/09/2011 05:19:37 PM Eastern Daylight Time		08/09/2011 05:27:48 PM Eastern Daylight Time	GEMCARE HEALTH PLAN INC.	GEMCARE Health Plan	www.gemcarehealthplan.com	Physicians Choice Medicare Plus (HMO)	01	01		1			H5609	005	0	2012	Ventura County (Partial)		2		2			2						www.gemcarehealthplan.com	www.gemcarehealthplan.com	www.gemcarehealthplan.com	(877)-697-2464		(877)-697-2464		(877)-697-2464		(877)-697-2464		(877)-697-2464		(877)-697-2464		(877)-697-2464		(877)-697-2464		(888)-833-9312		(888)-833-9312		(888)-833-9312		(888)-833-9312		(888)-833-9312		(888)-833-9312		(888)-833-9312		(888)-833-9312		2	2	2
H5609	801	0	1	01	01	H5609_801_0	4	1		06/01/2011	2012.02	06/01/2011 03:34:25 PM Eastern Daylight Time	06/06/2011 11:53:52 PM Eastern Daylight Time			06/06/2011 11:54:05 PM Eastern Daylight Time	GEMCARE HEALTH PLAN INC.	GEMCARE Health Plan	www.gemcarehealthplan.com	GEMCARE Medicare Plus ES Plan (HMO)	01	01		1			H5609	801	0	2012	Kern (Full), SB, SLO, and Ventura (Partial)		1	170	2			2						www.gemcarehealthplan.com	www.gemcarehealthplan.com	www.gemcarehealthplan.com	(877)-697-2464		(661)-716-8800		(877)-697-2464		(661)-716-8800		(877)-697-2464		(661)-716-8800		(877)-697-2464		(661)-716-8800		(888)-833-9312		(888)-833-9312		(888)-833-9312		(888)-833-9312		(888)-833-9312		(888)-833-9312		(888)-833-9312		(888)-833-9312		1	1	1
H5610	001	0	1	20	08	H5610_001_0	1	1		05/23/2011	2012.01	05/23/2011 10:57:57 AM Eastern Daylight Time		05/20/2011 06:07:38 PM Eastern Daylight Time		05/23/2011 11:00:33 AM Eastern Daylight Time	CARE RESOURCES, INC.	Care Resources	www.care-resources.org	Care Resources (PACE)	08	20		1			H5610	001	0	2012	Kent County		2		1	1		2							www.care-resources.org	www.care-resources.org									(800)-610-6299		(616)-913-2006		(800)-610-6299		(616)-913-2006										(800)-649-3777		(616)-913-2006		(800)-649-3777		(616)-913-2006				
H5610	003	0	1	20	08	H5610_003_0	1	1		05/23/2011	2012.01	05/23/2011 10:58:14 AM Eastern Daylight Time		05/20/2011 06:07:38 PM Eastern Daylight Time		05/23/2011 11:00:33 AM Eastern Daylight Time	CARE RESOURCES, INC.	Care Resources	www.care-resources.org	Care Resources (PACE)	08	20		1			H5610	003	0	2012	Kent County		2		1	1		2							www.care-resources.org	www.care-resources.org									(800)-610-6299		(616)-913-2006		(800)-610-6299		(616)-913-2006										(800)-649-3777		(616)-913-2006		(800)-649-3777		(616)-913-2006				
H5619	001	0	1	01	01	H5619_001_0	9	1		08/08/2011	2012.02	08/08/2011 10:17:35 AM Central Daylight Time	08/07/2011 09:28:59 PM Central Daylight Time	08/04/2011 02:04:58 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARCADIAN HEALTH PLAN, INC.	Northeast Community Care	www.northeastcommunitycare.com	Northeast Community Care - Plus (HMO)	01	01		1			H5619	001	0	2012	Southern Maine		2		2			2							www.northeastcommunitycare.com	www.northeastcommunitycare.com	(800)-573-8597		(800)-573-8597		(800)-998-3056		(207)-773-3920		(800)-573-8597		(800)-573-8597		(800)-998-3056		(207)-773-3920		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H5619	003	0	1	01	01	H5619_003_0	7	1	2	07/07/2011	2012.02	07/07/2011 11:07:25 AM Central Daylight Time	07/17/2011 06:17:04 PM Central Daylight Time	07/19/2011 07:59:31 PM Central Daylight Time		07/20/2011 04:17:07 PM Central Daylight Time	ARCADIAN HEALTH PLAN, INC.	Northeast Community Care	www.northeastcommunitycare.com	Northeast Community Care - Dual Plus (HMO SNP)	01	01		1			H5619	003	0	2012	Cumberland, York, Lewiston, Bangor		2		2			1	3		1	1			www.northeastcommunitycare.com	www.northeastcommunitycare.com	(800)-573-8597		(800)-573-8597		(800)-998-3056		(207)-773-3920		(800)-573-8597		(800)-573-8597		(800)-998-3056		(207)-773-3920		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H5619	004	0	1	01	01	H5619_004_0	9	1		08/08/2011	2012.02	08/08/2011 10:18:04 AM Central Daylight Time	08/07/2011 01:12:49 PM Central Daylight Time	08/04/2011 02:07:38 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARCADIAN HEALTH PLAN, INC.	Northeast Community Care	www.northeastcommunitycare.com	Northeast Community Care - Plus (HMO)	01	01		1			H5619	004	0	2012	Northern Maine		2		2			2							www.northeastcommunitycare.com	www.northeastcommunitycare.com	(800)-573-8597		(800)-573-8597		(800)-998-3056		(207)-773-3920		(800)-573-8597		(800)-573-8597		(800)-998-3056		(207)-773-3920		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H5619	007	0	1	01	01	H5619_007_0	9	1		08/08/2011	2012.02	08/08/2011 10:18:27 AM Central Daylight Time	08/07/2011 01:14:18 PM Central Daylight Time	08/04/2011 02:08:25 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARCADIAN HEALTH PLAN, INC.	Northeast Community Care	www.northeastcommunitycare.com	Northeast Community Care - Plus (HMO)	01	01		1			H5619	007	0	2012	Mid- Maine		2		2			2							www.northeastcommunitycare.com	www.northeastcommunitycare.com	(800)-573-8597		(800)-573-8597		(800)-998-3056		(207)-773-3920		(800)-573-8597		(800)-573-8597		(800)-998-3056		(207)-773-3920		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H5619	009	0	1	01	01	H5619_009_0	7	1	2	07/07/2011	2012.02	07/07/2011 11:08:04 AM Central Daylight Time	07/17/2011 06:22:07 PM Central Daylight Time	07/19/2011 08:01:15 PM Central Daylight Time		07/20/2011 04:17:07 PM Central Daylight Time	ARCADIAN HEALTH PLAN, INC.	Northeast Community Care	www.northeastcommunitycare.com	Northeast Community Care - Dual Plus (HMO SNP)	01	01		1			H5619	009	0	2012	Maine		2		2			1	3		1	5			www.northeastcommunitycare.com	www.northeastcommunitycare.com	(800)-573-8597		(800)-573-8597		(800)-998-3056		(207)-773-3920		(800)-573-8597		(800)-573-8597		(800)-998-3056		(207)-773-3920		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H5628	001	0	1	01	01	H5628_001_0	2	1	2	08/04/2011	2012.02	08/04/2011 11:48:49 AM Pacific Daylight Time	08/04/2011 07:15:00 PM Pacific Daylight Time	08/04/2011 03:51:00 PM Pacific Daylight Time		08/05/2011 02:51:40 PM Pacific Daylight Time	MOLINA HEALTHCARE OF UTAH, INC.	Molina Healthcare of Utah	www.molinamedicare.com	Molina Medicare Options Plus (HMO SNP)	01	01		1			H5628	001	0	2012	Northern/Central/Southern Utah		2		2			1	3		1	1		www.molinamedicare.com	www.molinamedicare.com	www.molinamedicare.com	(888)-665-1328		(888)-665-1328		(866)-403-8293		(866)-403-8293		(888)-665-1328		(888)-665-1328		(866)-403-8293		(866)-403-8293		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		2	2	2
H5628	002	0	1	01	01	H5628_002_0	4	1		07/28/2011	2012.02	07/28/2011 11:28:06 AM Pacific Daylight Time	08/04/2011 07:15:00 PM Pacific Daylight Time	08/04/2011 02:05:00 PM Pacific Daylight Time		08/05/2011 02:51:40 PM Pacific Daylight Time	MOLINA HEALTHCARE OF UTAH, INC.	Molina Healthcare of Utah	www.molinamedicare.com	Molina Medicare Options (HMO)	01	01		1			H5628	002	0	2012	Northern/Central/Southern Utah		2		2			2						www.molinamedicare.com	www.molinamedicare.com	www.molinamedicare.com	(888)-665-1328		(888)-665-1328		(866)-403-8293		(866)-403-8293		(888)-665-1328		(888)-665-1328		(866)-403-8293		(866)-403-8293		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		2	2	2
H5628	006	0	1	01	01	H5628_006_0	3	1	2	08/04/2011	2012.02	08/04/2011 11:49:10 AM Pacific Daylight Time	08/04/2011 07:15:00 PM Pacific Daylight Time	08/04/2011 02:05:00 PM Pacific Daylight Time		08/05/2011 02:51:40 PM Pacific Daylight Time	MOLINA HEALTHCARE OF UTAH, INC.	Molina Healthcare of Utah	www.molinamedicare.com	Healthy Advantage (HMO SNP)	01	01		1			H5628	006	0	2012	Northern/Central Utah		2		2			1	3		1	5		www.molinamedicare.com	www.molinamedicare.com	www.molinamedicare.com	(866)-472-9479		(866)-472-9479		(866)-472-9479		(866)-472-9479		(866)-472-9479		(877)-644-0344		(866)-472-9479		(866)-472-9479		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		2	2	2
H5629	001	0	1	20	08	H5629_001_0	1	1		05/20/2011	2012.01	05/20/2011 02:02:49 PM Pacific Daylight Time		05/20/2011 12:26:41 PM Pacific Daylight Time		05/20/2011 02:05:21 PM Pacific Daylight Time	COMMUNITY ELDERCARE OF  SAN DIEGO	St. Paul's PACE	http://www.stpaulspace.org/	St. Paul's PACE (PACE)	08	20		1			H5629	001	0	2012	San Diego Metro Area		2		2			2							stpaulspace.org	stpaulspace.org									(619)-239-6900		(619)-239-6900		(619)-239-6900		(619)-239-6900										(800)-735-2922		(800)-735-2922		(800)-735-2922		(800)-735-2922				
H5629	002	0	1	20	08	H5629_002_0	1	1		05/20/2011	2012.01	05/20/2011 02:03:15 PM Pacific Daylight Time		05/20/2011 12:26:41 PM Pacific Daylight Time		05/20/2011 02:05:21 PM Pacific Daylight Time	COMMUNITY ELDERCARE OF  SAN DIEGO	St. Paul's PACE	http://www.stpaulspace.org/	St. Paul's PACE (PACE)	08	20		1			H5629	002	0	2012	San Diego Metro Area		2		2			2							stpaulspace.org	stpaulspace.org									(619)-239-6900		(619)-239-6900		(619)-239-6900		(619)-239-6900										(800)-735-2922		(800)-735-2922		(800)-735-2922		(800)-735-2922				
H5640	001	0	1	01	01	H5640_001_0	4	1	2	08/09/2011	2012.02	08/09/2011 12:03:26 PM Pacific Daylight Time	08/09/2011 10:55:16 AM Pacific Daylight Time	08/09/2011 10:55:17 AM Pacific Daylight Time		08/09/2011 12:04:11 PM Pacific Daylight Time	IEHP HEALTH ACCESS	IEHP Medicare DualChoice	www.iehp.org	IEHP Medicare DualChoice (HMO SNP)	01	01		1			H5640	001	0	2012	Riverside and San Bernardino Counties		2	5980	2			1	3		1	5		www.iehp.org	www.iehp.org	www.iehp.org	(877)-273-4347		(909)-890-2000		(877)-273-4347		(909)-890-2000		(877)-273-4347		(909)-890-2000		(877)-273-4347		(909)-890-2000		(800)-718-4347		(800)-718-4347		(800)-718-4347		(800)-718-4347		(800)-718-4347		(800)-718-4347		(800)-718-4347		(800)-718-4347		2	2	2
H5649	001	0	1	01	01	H5649_001_0	5	1		08/04/2011	2012.02	08/04/2011 02:12:28 PM Pacific Daylight Time	08/05/2011 08:59:47 AM Pacific Daylight Time	08/04/2011 10:27:59 AM Pacific Daylight Time		08/05/2011 12:05:42 PM Pacific Daylight Time	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Central Health Medicare Plan	http://www.centralhealthplan.com	Central Health Medicare Plan (HMO)	01	01		1			H5649	001	0	2012	Counties:  LA, partial OC, partial SB		2	10000	2			2						http://www.centralhealthplan.com/ProviderDirectory.html	http://www.centralhealthplan.com/Benefits/Formulary.aspx	http://www.centralhealthplan.com/Benefits/PharmacyList.aspx	(866)-314-2427		(626)-388-2390		(866)-314-2427		(626)-388-2390		(866)-314-2427		(626)-388-2390		(866)-314-2427		(626)-388-2390		(888)-205-7671		(626)-388-2391		(888)-205-7671		(626)-388-2391		(888)-205-7671		(626)-388-2391		(888)-205-7671		(626)-388-2391		2	2	2
H5649	002	0	1	01	01	H5649_002_0	4	1	2	08/04/2011	2012.02	08/04/2011 02:12:59 PM Pacific Daylight Time	08/05/2011 09:01:30 AM Pacific Daylight Time	08/04/2011 10:28:42 AM Pacific Daylight Time		08/05/2011 12:05:42 PM Pacific Daylight Time	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Central Health Medicare Plan	http://www.centralhealthplan.com	Central Health Medi-Medi Plan (HMO SNP)	01	01		1			H5649	002	0	2012	Los Angeles and Partial San Bernardino County		2	3100	2			1	3		1	2		http://www.centralhealthplan.com/ProviderDirectory.html	http://www.centralhealthplan.com/Benefits/Formulary.aspx	http://www.centralhealthplan.com/Benefits/PharmacyList.aspx	(866)-314-2427		(626)-388-2390		(866)-314-2427		(626)-388-2390		(866)-314-2427		(626)-388-2390		(866)-314-2427		(626)-388-2390		(888)-205-7671		(626)-388-2391		(888)-205-7671		(626)-388-2391		(888)-205-7671		(626)-388-2391		(888)-205-7671		(626)-388-2391		2	2	2
H5652	001	0	1	02	01	H5652_001_0	4	1		07/21/2011	2012.02	07/21/2011 12:37:17 PM Central Daylight Time	08/29/2011 09:53:54 AM Central Daylight Time	08/05/2011 01:14:51 PM Central Daylight Time		09/01/2011 10:37:35 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.EricksonAdvantage.com	Erickson Advantage Signature with Drugs (HMO-POS)	01	02		1			H5652	001	0	2012	Erickson Campuses - CO,KS,MD,MA,MI,NJ,PA,TX,VA		2		2			2						www.EricksonAdvantage.com	www.EricksonAdvantage.com/formulary.asp	www.PrescriptionSolutions.com	(866)-314-8188		(866)-314-8188		(800)-989-1389		(800)-989-1389		(866)-314-8188		(866)-314-8188		(800)-989-1389		(800)-989-1389		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5652	002	0	1	02	01	H5652_002_0	3	1		07/21/2011	2012.02	07/21/2011 12:37:33 PM Central Daylight Time	08/29/2011 11:40:14 AM Central Daylight Time			09/01/2011 10:37:35 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.EricksonAdvantage.com	Erickson Advantage Signature without Drugs (HMO-POS)	01	02		1			H5652	002	0	2012	Erickson Campuses - CO,KS,MD,MA,MI,NJ,PA,TX,VA		2		2			2						www.EricksonAdvantage.com	www.EricksonAdvantage.com/formulary.asp	www.PrescriptionSolutions.com	(866)-314-8188		(866)-314-8188		(800)-989-1389		(800)-989-1389										(711)		(711)		(711)		(711)										2	2	2
H5652	003	0	1	02	01	H5652_003_0	4	1		07/21/2011	2012.02	07/21/2011 12:33:47 PM Central Daylight Time	08/29/2011 09:59:27 AM Central Daylight Time	08/05/2011 01:15:11 PM Central Daylight Time		09/01/2011 10:37:35 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.EricksonAdvantage.com	Erickson Advantage Guardian (HMO-POS SNP)	01	02		1			H5652	003	0	2012	Erickson Campuses - MD, MA, MI, NJ, PA, and VA		2		2			1	1	1	1			www.EricksonAdvantage.com	www.EricksonAdvantage.com/formulary.asp	www.PrescriptionSolutions.com	(866)-314-8188		(866)-314-8188		(800)-989-1389		(800)-989-1389		(866)-314-8188		(866)-314-8188		(800)-989-1389		(800)-989-1389		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5652	004	0	1	02	01	H5652_004_0	4	1		07/21/2011	2012.02	07/21/2011 12:34:34 PM Central Daylight Time	08/29/2011 10:00:44 AM Central Daylight Time	08/05/2011 01:15:32 PM Central Daylight Time		09/01/2011 10:37:35 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.EricksonAdvantage.com	Erickson Advantage Champion (HMO-POS SNP)	01	02		1			H5652	004	0	2012	Erickson Campuses - CO,KS,MD,MA,MI,NJ,PA,TX,VA		2		2			1	4		1		00011010000000000000	www.EricksonAdvantage.com	www.EricksonAdvantage.com/formulary.asp	www.PrescriptionSolutions.com	(866)-314-8188		(866)-314-8188		(800)-989-1389		(800)-989-1389		(866)-314-8188		(866)-314-8188		(800)-989-1389		(800)-989-1389		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5656	001	0	1	01	01	H5656_001_0	7	1		08/05/2011	2012.02	08/05/2011 11:22:47 AM Central Daylight Time	08/04/2011 04:54:00 PM Central Daylight Time	08/04/2011 08:46:50 AM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	SELECTCARE HEALTH PLANS, INC.	Universal American	www.Universal-American-Medicare.com	TexanPlus Classic (HMO)	01	01		1			H5656	001	0	2012	North Texas		2	100	2			2						www.Universal-American-Medicare.com	www.Universal-American-Medicare.com	www.Universal-American-Medicare.com	(800)-958-2707		(800)-958-2707		(866)-245-4143		(866)-245-4143		(800)-958-2707		(800)-958-2707		(866)-245-4143		(866)-245-4143		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		2	2	2
H5656	003	0	1	01	01	H5656_003_0	6	1		07/08/2011	2012.02	07/08/2011 10:28:25 AM Central Daylight Time	07/02/2011 01:35:00 AM Central Daylight Time			07/08/2011 04:40:04 PM Central Daylight Time	SELECTCARE HEALTH PLANS, INC.	Universal American	www.Universal-American-Medicare.com	TexanPlus Value (HMO)	01	01		1			H5656	003	0	2012	North Texas		2	100	2			2						www.Universal-American-Medicare.com	www.Universal-American-Medicare.com	www.Universal-American-Medicare.com	(800)-958-2707		(800)-958-2707		(866)-245-4143		(866)-245-4143										(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089										2	2	2
H5656	014	0	1	01	01	H5656_014_0	5	1		07/08/2011	2012.02	07/08/2011 03:30:51 PM Central Daylight Time	08/05/2011 01:43:58 PM Central Daylight Time	08/04/2011 12:02:18 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	SELECTCARE HEALTH PLANS, INC.	Universal American	www.Universal-American-Medicare.com	Today's Options Classic (HMO)	01	01		1			H5656	014	0	2012	Indiana Counties Hamilton, Johnson, and Marion		2	100	2			2						www.Universal-American-Medicare.com	www.Universal-American-Medicare.com	www.Universal-American-Medicare.com	(866)-802-8571		(866)-802-8571		(866)-355-2138		(866)-355-2138		(866)-802-8571		(866)-802-8571		(866)-355-2138		(866)-355-2138		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		2	2	2
H5656	015	0	1	01	01	H5656_015_0	5	1		07/08/2011	2012.02	07/08/2011 03:31:08 PM Central Daylight Time	08/05/2011 02:13:28 PM Central Daylight Time	08/04/2011 12:03:08 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	SELECTCARE HEALTH PLANS, INC.	Universal American	www.Universal-American-Medicare.com	Today's Options Premier (HMO)	01	01		1			H5656	015	0	2012	Indiana Counties Hamilton, Johnson, and Marion		2	100	2			2						www.Universal-American-Medicare.com	www.Universal-American-Medicare.com	www.Universal-American-Medicare.com	(866)-802-8571		(866)-802-8571		(866)-355-2138		(866)-355-2138		(866)-802-8571		(866)-802-8571		(866)-355-2138		(866)-355-2138		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		2	2	2
H5656	801	0	1	01	01	H5656_801_0	6	1		06/02/2011	2012.02	06/02/2011 02:18:35 PM Central Daylight Time	06/06/2011 12:21:21 PM Central Daylight Time			06/06/2011 12:43:56 PM Central Daylight Time	SELECTCARE HEALTH PLANS, INC.	Universal American	www.Universal-American-Medicare.com	Retiree - MA-PD CY (HMO)	01	01		1			H5656	801	0	2012	Employer Group--North Texas (MAPD--CY)		1	100	2			2						www.Universal-American-Medicare.com	www.Universal-American-Medicare.com	www.Universal-American-Medicare.com	(800)-958-2707		(800)-958-2707		(866)-245-4143		(866)-245-4143		(800)-958-2707		(800)-958-2707		(866)-245-4143		(866)-245-4143		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		1	1	1
H5656	802	0	1	01	01	H5656_802_0	6	1		06/02/2011	2012.02	06/02/2011 02:19:48 PM Central Daylight Time	06/06/2011 12:21:21 PM Central Daylight Time			06/06/2011 12:43:56 PM Central Daylight Time	SELECTCARE HEALTH PLANS, INC.	Universal American	www.Universal-American-Medicare.com	Retiree - MA-PD non-CY (HMO)	01	01		1			H5656	802	0	2012	Employer Group--North Texas (MAPD--non-CY)		1	100	2			2						www.Universal-American-Medicare.com	www.Universal-American-Medicare.com	www.Universal-American-Medicare.com	(800)-958-2707		(800)-958-2707		(866)-245-4143		(866)-245-4143		(800)-958-2707		(800)-958-2707		(866)-245-4143		(866)-245-4143		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089		1	1	1
H5656	803	0	1	01	01	H5656_803_0	6	1		06/02/2011	2012.02	06/02/2011 02:20:34 PM Central Daylight Time	06/06/2011 12:21:21 PM Central Daylight Time			06/06/2011 12:43:56 PM Central Daylight Time	SELECTCARE HEALTH PLANS, INC.	Universal American	www.Universal-American-Medicare.com	Retiree - MA (HMO)	01	01		1			H5656	803	0	2012	Employer Group--North Texas (MA--CY)		1	100	2			2						www.Universal-American-Medicare.com	www.Universal-American-Medicare.com	www.Universal-American-Medicare.com	(800)-958-2707		(800)-958-2707		(866)-245-4143		(866)-245-4143										(800)-958-2692		(800)-958-2692		(800)-975-8089		(800)-975-8089										1	1	1
H5665	002	0	1	01	01	H5665_002_0	6	1		08/09/2011	2012.02	08/09/2011 09:03:15 AM Eastern Daylight Time	08/06/2011 04:37:00 PM Eastern Daylight Time	08/09/2011 10:05:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS  OF MARYLAND, INC.	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Gold Rx (HMO SNP)	01	01		1			H5665	002	0	2012	Maryland		2	2000	2			1	4		1		00000000000000000100	www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://careimprovementplus.com/members/maryland/medicarePartD/partDOverview.aspx	(800)-204-1002		(800)-204-1002		(800)-711-1656		(800)-711-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5679	001	0	1	01	01	H5679_001_0	9	1		08/04/2011	2012.02	08/04/2011 10:12:22 AM Pacific Daylight Time	08/08/2011 03:07:49 PM Pacific Daylight Time	08/04/2011 12:42:35 PM Pacific Daylight Time		08/08/2011 11:55:40 PM Pacific Daylight Time	HMO COLORADO, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	SureValue Basic (HMO)	01	01		1			H5679	001	0	2012	Denver Metro Area in Colorado		2	2160	2			2						www.anthem.com/medicare	www.anthem.com	www.anthem.com	(866)-408-7086		(866)-408-7086		(800)-797-1746		(800)-797-1746		(866)-408-7086		(866)-408-7086		(800)-797-1746		(800)-797-1746		(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894		(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894		2	2	2
H5679	801	0	1	01	01	H5679_801_0	6	1		07/06/2011	2012.02	07/06/2011 05:10:05 PM Pacific Daylight Time	06/06/2011 09:02:54 PM Pacific Daylight Time			07/07/2011 12:53:14 PM Pacific Daylight Time	HMO COLORADO, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	SureValue (HMO)	01	01		1			H5679	801	0	2012	Denver Metro Area		1	50	2			2						www.anthem.com/medicare	www.anthem.com	www.anthem.com	(866)-362-4250		(866)-362-4250		(866)-362-4250		(866)-362-4250		(866)-362-4250		(866)-362-4250		(866)-362-4250		(866)-362-4250		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		2	2	2
H5679	802	0	1	01	01	H5679_802_0	5	1		07/06/2011	2012.02	07/06/2011 05:10:28 PM Pacific Daylight Time	06/06/2011 09:02:54 PM Pacific Daylight Time			07/07/2011 12:53:14 PM Pacific Daylight Time	HMO COLORADO, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	SureValue (HMO)	01	01		1			H5679	802	0	2012	Denver Metro Area		1	50	2			2						www.anthem.com/medicare	www.anthem.com	www.anthem.com	(866)-362-4250		(866)-362-4250		(866)-362-4250		(866)-362-4250										(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657										2	2	2
H5679	803	0	1	01	01	H5679_803_0	5	1		07/06/2011	2012.02	07/06/2011 05:10:40 PM Pacific Daylight Time	06/06/2011 09:02:54 PM Pacific Daylight Time			07/07/2011 12:53:14 PM Pacific Daylight Time	HMO COLORADO, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	SureValue (HMO)	01	01		1			H5679	803	0	2012	Denver Metro Area		1	50	2			2						www.anthem.com/medicare	www.anthem.com	www.anthem.com	(866)-362-4250		(866)-362-4250		(866)-362-4250		(866)-362-4250		(866)-362-4250		(866)-362-4250		(866)-362-4250		(866)-362-4250		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		2	2	2
H5685	001	0	1	01	01	H5685_001_0	5	1	2	08/09/2011	2012.02	08/09/2011 09:50:00 AM Eastern Daylight Time	08/09/2011 08:54:00 AM Eastern Daylight Time	08/09/2011 08:56:00 AM Eastern Daylight Time		08/09/2011 02:39:19 PM Eastern Daylight Time	MIDWEST HEALTH PLAN, INC.	Midwest Advantage	Midwestadvantage.org	Midwest  Advantage (HMO SNP)	01	01		1			H5685	001	0	2012	Midwest Advantage of Wayne and Oakland Counties		2	535	2			1	3		1	3		www.midwestadvantage.org	www.midwestadvantage.org	www.midwestadvantage.org	(888)-654-0706		(313)-581-3700		(888)-654-0706		(313)-581-3700		(888)-654-0706		(313)-581-3700		(888)-654-0706		(313)-581-3700		(800)-649-3777		(800)-649-3777		(800)-649-3777		(800)-649-3777		(800)-649-3777		(800)-649-3777		(800)-649-3777		(800)-649-3777		2	1	1
H5696	001	0	1	01	01	H5696_001_0	5	1		07/09/2011	2012.02	07/09/2011 11:14:49 PM Eastern Daylight Time	08/04/2011 04:17:36 PM Eastern Daylight Time	08/04/2011 08:54:52 AM Eastern Daylight Time		08/08/2011 12:25:33 PM Eastern Daylight Time	PHYSICIANS UNITED PLAN, INC.	PUP	www.UaskPUP.com	PUP EASY (HMO)	01	01		1			H5696	001	0	2012	Polk County		2	1161	2			2						www.UaskPUP.com	www.UaskPUP.com	www.UaskPUP.com	(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5696	002	0	1	01	01	H5696_002_0	4	1		07/09/2011	2012.02	07/09/2011 10:14:06 PM Eastern Daylight Time	08/04/2011 03:52:20 PM Eastern Daylight Time	08/04/2011 08:56:08 AM Eastern Daylight Time		08/08/2011 12:25:33 PM Eastern Daylight Time	PHYSICIANS UNITED PLAN, INC.	PUP	www.UaskPUP.com	PUP REWARDS (HMO)	01	01		1			H5696	002	0	2012	Polk County		2	1904	2			2						www.UaskPUP.com	www.UaskPUP.com	www.UaskPUP.com	(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5696	003	0	1	01	01	H5696_003_0	5	1		07/09/2011	2012.02	07/09/2011 10:14:15 PM Eastern Daylight Time	08/11/2011 02:45:34 PM Eastern Daylight Time	08/04/2011 09:00:02 AM Eastern Daylight Time		08/11/2011 03:04:40 PM Eastern Daylight Time	PHYSICIANS UNITED PLAN, INC.	PUP	www.UaskPUP.com	PUP EASY (HMO)	01	01		1			H5696	003	0	2012	Central Florida		2	1984	2			2						www.UaskPUP.com	www.UaskPUP.com	www.UaskPUP.com	(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5696	004	0	1	01	01	H5696_004_0	4	1		07/09/2011	2012.02	07/09/2011 10:14:25 PM Eastern Daylight Time	08/04/2011 11:23:24 AM Eastern Daylight Time	08/04/2011 09:01:14 AM Eastern Daylight Time		08/08/2011 12:25:33 PM Eastern Daylight Time	PHYSICIANS UNITED PLAN, INC.	PUP	www.UaskPUP.com	PUP REWARDS (HMO)	01	01		1			H5696	004	0	2012	Central Florida		2	1542	2			2						www.UaskPUP.com	www.UaskPUP.com	www.UaskPUP.com	(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5696	021	0	1	01	01	H5696_021_0	4	1	2	07/09/2011	2012.02	07/09/2011 10:16:57 PM Eastern Daylight Time	08/04/2011 09:18:10 AM Eastern Daylight Time	08/04/2011 09:13:24 AM Eastern Daylight Time		08/08/2011 12:25:33 PM Eastern Daylight Time	PHYSICIANS UNITED PLAN, INC.	PUP	www.UaskPUP.com	PUP EXTRA (HMO SNP)	01	01		1			H5696	021	0	2012	Orlando Metro Area and Tampa Metro Area		2	3300	2			1	3		1	2		www.UaskPUP.com	www.UaskPUP.com	www.UaskPUP.com	(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5696	023	0	1	01	01	H5696_023_0	4	1		07/09/2011	2012.02	07/09/2011 10:17:16 PM Eastern Daylight Time	08/04/2011 05:08:40 PM Eastern Daylight Time	08/04/2011 04:30:04 PM Eastern Daylight Time		08/08/2011 12:25:33 PM Eastern Daylight Time	PHYSICIANS UNITED PLAN, INC.	PUP	www.UaskPUP.com	PUP EASY (HMO)	01	01		1			H5696	023	0	2012	Marion and Sumter Counties		2	702	2			2						www.UaskPUP.com	www.UaskPUP.com	www.UaskPUP.com	(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5696	024	0	1	01	01	H5696_024_0	5	1		07/09/2011	2012.02	07/09/2011 10:17:27 PM Eastern Daylight Time	08/04/2011 04:44:38 PM Eastern Daylight Time	08/04/2011 04:31:36 PM Eastern Daylight Time		08/08/2011 12:25:33 PM Eastern Daylight Time	PHYSICIANS UNITED PLAN, INC.	PUP	www.UaskPUP.com	PUP REWARDS (HMO)	01	01		1			H5696	024	0	2012	Marion and Sumter Counties		2	719	2			2						www.UaskPUP.com	www.UaskPUP.com	www.UaskPUP.com	(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5696	025	0	1	01	01	H5696_025_0	4	1		07/12/2011	2012.02	07/12/2011 01:05:32 PM Eastern Daylight Time	08/04/2011 05:49:44 PM Eastern Daylight Time	08/04/2011 04:33:46 PM Eastern Daylight Time		08/08/2011 12:25:33 PM Eastern Daylight Time	PHYSICIANS UNITED PLAN, INC.	PUP	www.UaskPUP.com	PUP EASY (HMO)	01	01		1			H5696	025	0	2012	Miami-Dade County		2	1600	2			2						www.UaskPUP.com	www.UaskPUP.com	www.UaskPUP.com	(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5696	027	0	1	01	01	H5696_027_0	4	1		07/09/2011	2012.02	07/09/2011 10:17:45 PM Eastern Daylight Time	08/04/2011 10:03:54 PM Eastern Daylight Time	08/04/2011 04:35:32 PM Eastern Daylight Time		08/08/2011 12:25:33 PM Eastern Daylight Time	PHYSICIANS UNITED PLAN, INC.	PUP	www.UaskPUP.com	PUP EASY (HMO)	01	01		1			H5696	027	0	2012	Palm Beach County		2	1550	2			2						www.UaskPUP.com	www.UaskPUP.com	www.UaskPUP.com	(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5696	028	0	1	01	01	H5696_028_0	4	1		07/09/2011	2012.02	07/09/2011 10:17:55 PM Eastern Daylight Time	08/04/2011 10:32:14 PM Eastern Daylight Time	08/04/2011 04:39:12 PM Eastern Daylight Time		08/08/2011 12:25:33 PM Eastern Daylight Time	PHYSICIANS UNITED PLAN, INC.	PUP	www.UskPUP.com	PUP REWARDS (HMO)	01	01		1			H5696	028	0	2012	Miami-Dade, Broward and Palm Beach Counties		2	300	2			2						www.UaskPUP.com	www.UaskPUP.com	www.UaskPUP.com	(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5696	030	0	1	01	01	H5696_030_0	4	1		07/09/2011	2012.02	07/09/2011 10:18:04 PM Eastern Daylight Time	08/05/2011 04:57:54 PM Eastern Daylight Time	08/05/2011 04:48:10 PM Eastern Daylight Time		08/08/2011 12:25:33 PM Eastern Daylight Time	PHYSICIANS UNITED PLAN, INC.	PUP	www.UaskPUP.com	PUP PLUS (HMO)	01	01		1			H5696	030	0	2012	Polk County		2	2200	2			2						www.UaskPUP.com	www.UaskPUP.com	www.UaskPUP.com	(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5696	033	0	1	01	01	H5696_033_0	4	1		07/09/2011	2012.02	07/09/2011 10:18:43 PM Eastern Daylight Time	08/06/2011 09:04:14 AM Eastern Daylight Time	08/06/2011 08:58:54 AM Eastern Daylight Time		08/08/2011 12:25:33 PM Eastern Daylight Time	PHYSICIANS UNITED PLAN, INC.	PUP	www.UaskPUP.com	PUP SIMPLE (HMO)	01	01		1			H5696	033	0	2012	Central Florida		2	2175	2			2						www.UaskPUP.com	www.UaskPUP.com	www.UaskPUP.com	(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5696	034	0	1	01	01	H5696_034_0	4	1		07/09/2011	2012.02	07/09/2011 10:18:55 PM Eastern Daylight Time	08/06/2011 08:34:04 AM Eastern Daylight Time	08/05/2011 04:45:54 PM Eastern Daylight Time		08/08/2011 12:25:33 PM Eastern Daylight Time	PHYSICIANS UNITED PLAN, INC.	PUP	www.UaskPUP.com	PUP PLUS (HMO)	01	01		1			H5696	034	0	2012	Central Florida		2	1400	2			2						www.UaskPUP.com	www.UaskPUP.com	www.UaskPUP.com	(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5696	035	0	1	01	01	H5696_035_0	3	1		07/09/2011	2012.02	07/09/2011 10:19:45 PM Eastern Daylight Time	08/05/2011 11:15:06 PM Eastern Daylight Time	08/05/2011 11:11:24 PM Eastern Daylight Time		08/08/2011 12:25:33 PM Eastern Daylight Time	PHYSICIANS UNITED PLAN, INC.	PUP	www.UaskPUP.com	PUP SIMPLE (HMO)	01	01		1			H5696	035	0	2012	Marion and Sumter Counties		2	350	2			2						www.UaskPUP.com	www.UaskPUP.com	www.UaskPUP.com	(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5696	037	0	1	01	01	H5696_037_0	3	1		07/09/2011	2012.02	07/09/2011 10:20:01 PM Eastern Daylight Time	08/05/2011 10:48:16 PM Eastern Daylight Time	08/05/2011 10:45:54 PM Eastern Daylight Time		08/08/2011 12:25:33 PM Eastern Daylight Time	PHYSICIANS UNITED PLAN, INC.	PUP	www.UaskPUP.com	PUP SIMPLE (HMO)	01	01		1			H5696	037	0	2012	Pinellas County		2	100	2			2						www.UaskPUP.com	www.UaskPUP.com	www.UaskPUP.com	(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5696	038	0	1	01	01	H5696_038_0	4	1		07/09/2011	2012.02	07/09/2011 10:20:09 PM Eastern Daylight Time	08/05/2011 10:22:28 PM Eastern Daylight Time	08/05/2011 10:19:38 PM Eastern Daylight Time		08/08/2011 12:25:33 PM Eastern Daylight Time	PHYSICIANS UNITED PLAN, INC.	PUP	www.UaskPUP.com	PUP PLUS (HMO)	01	01		1			H5696	038	0	2012	Pinellas County		2	100	2			2						www.UaskPUP.com	www.UaskPUP.com	www.UaskPUP.com	(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5696	039	0	1	01	01	H5696_039_0	4	1		07/09/2011	2012.02	07/09/2011 10:20:18 PM Eastern Daylight Time	08/05/2011 10:00:12 PM Eastern Daylight Time	08/05/2011 09:55:46 PM Eastern Daylight Time		08/08/2011 12:25:33 PM Eastern Daylight Time	PHYSICIANS UNITED PLAN, INC.	PUP	www.UaskPUP.com	PUP SIMPLE (HMO)	01	01		1			H5696	039	0	2012	Hillsborough and Pasco Counties		2	200	2			2						www.UaskPUP.com	www.UaskPUP.com	www.UaskPUP.com	(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5696	040	0	1	01	01	H5696_040_0	4	1		07/09/2011	2012.02	07/09/2011 10:20:26 PM Eastern Daylight Time	08/05/2011 08:08:12 PM Eastern Daylight Time	08/05/2011 08:05:36 PM Eastern Daylight Time		08/08/2011 12:25:33 PM Eastern Daylight Time	PHYSICIANS UNITED PLAN, INC.	PUP	www.UaskPUP.com	PUP PLUS (HMO)	01	01		1			H5696	040	0	2012	Hillsborough and Pasco Counties		2	200	2			2						www.UaskPUP.com	www.UaskPUP.com	www.UaskPUP.com	(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5696	041	0	1	01	01	H5696_041_0	5	1		07/09/2011	2012.02	07/09/2011 10:20:35 PM Eastern Daylight Time	08/05/2011 07:30:50 PM Eastern Daylight Time	08/05/2011 07:24:50 PM Eastern Daylight Time		08/08/2011 12:25:33 PM Eastern Daylight Time	PHYSICIANS UNITED PLAN, INC.	PUP	www.UaskPUP.com	PUP EASY (HMO)	01	01		1			H5696	041	0	2012	Broward County		2	1550	2			2						www.UaskPUP.com	www.UaskPUP.com	www.UaskPUP.com	(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5696	043	0	1	01	01	H5696_043_0	5	1		07/09/2011	2012.02	07/09/2011 11:36:36 PM Eastern Daylight Time	08/05/2011 07:49:36 PM Eastern Daylight Time	08/05/2011 07:46:00 PM Eastern Daylight Time		08/08/2011 12:25:33 PM Eastern Daylight Time	PHYSICIANS UNITED PLAN, INC.	PUP	www.UaskPUP.com	PUP SIMPLE (HMO)	01	01		1			H5696	043	0	2012	Polk County		2	1250	2			2						www.UaskPUP.com	www.UaskPUP.com	www.UaskPUP.com	(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(866)-571-0693		(866)-571-0693		(888)-827-5787		(888)-827-5787		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
H5698	020	0	1	01	01	H5698_020_0	8	1		08/05/2011	2012.02	08/05/2011 09:56:06 AM Central Daylight Time	08/04/2011 03:36:45 PM Central Daylight Time	08/04/2011 10:18:06 AM Central Daylight Time		08/05/2011 12:16:20 PM Central Daylight Time	WINDSOR HEALTH PLAN, INC.	Windsor Medicare Extra	www.windsorextra.com	Windsor Medicare Extra Gold Plan (HMO)	01	01		1			H5698	020	0	2012	Arkansas		2	2994	2			2						www.windsorextra.com	www.windsorextra.com	www.windsorextra.com	(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		2	2	2
H5698	028	0	1	01	01	H5698_028_0	7	1		08/05/2011	2012.02	08/05/2011 10:29:55 AM Central Daylight Time	08/04/2011 03:38:08 PM Central Daylight Time	08/04/2011 08:52:13 AM Central Daylight Time		08/05/2011 12:16:20 PM Central Daylight Time	WINDSOR HEALTH PLAN, INC.	Windsor Medicare Extra	www.windsorextra.com	Windsor Medicare Extra Gold Plan (HMO)	01	01		1			H5698	028	0	2012	Mississippi		2	5100	2			2						www.windsorextra.com	www.windsorextra.com	www.windsorextra.com	(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		2	2	2
H5698	035	0	1	01	01	H5698_035_0	5	1		07/19/2011	2012.02	07/19/2011 12:19:00 PM Central Daylight Time	08/01/2011 12:42:49 PM Central Daylight Time			08/02/2011 09:12:46 AM Central Daylight Time	WINDSOR HEALTH PLAN, INC.	Windsor Medicare Extra	www.windsorextra.com	Windsor Medicare Extra Silver Plan (HMO)	01	01		1			H5698	035	0	2012	AL, AR, MS, SC, and TN		2	1065	2			2						www.windsorextra.com	www.windsorextra.com	www.windsorextra.com	(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313										(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617										2	2	2
H5698	036	0	1	01	01	H5698_036_0	7	1		08/05/2011	2012.02	08/05/2011 10:29:55 AM Central Daylight Time	08/04/2011 03:39:29 PM Central Daylight Time	08/04/2011 08:52:34 AM Central Daylight Time		08/05/2011 12:16:20 PM Central Daylight Time	WINDSOR HEALTH PLAN, INC.	Windsor Medicare Extra	www.windsorextra.com	Windsor Medicare Extra Gold Plan (HMO)	01	01		1			H5698	036	0	2012	Tennessee		2	4348	2			2						www.windsorextra.com	www.windsorextra.com	www.windsorextra.com	(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		2	2	2
H5698	061	0	1	01	01	H5698_061_0	7	1		08/05/2011	2012.02	08/05/2011 10:13:18 AM Central Daylight Time	08/04/2011 03:19:34 PM Central Daylight Time	08/04/2011 10:07:20 AM Central Daylight Time		08/05/2011 12:16:20 PM Central Daylight Time	WINDSOR HEALTH PLAN, INC.	Windsor Medicare Extra	www.windsorextra.com	Windsor Medicare Extra Emerald Plan (HMO)	01	01		1			H5698	061	0	2012	Mississippi		2	957	2			2						www.windsorextra.com	www.windsorextra.com	www.windsorextra.com	(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		2	2	2
H5698	062	0	1	01	01	H5698_062_0	9	1		08/05/2011	2012.02	08/05/2011 10:32:15 AM Central Daylight Time	08/04/2011 03:20:55 PM Central Daylight Time	08/11/2011 11:29:48 AM Central Daylight Time		08/11/2011 11:30:17 AM Central Daylight Time	WINDSOR HEALTH PLAN, INC.	Windsor Medicare Extra	www.windsorextra.com	Windsor Medicare Extra Emerald Plan (HMO)	01	01		1			H5698	062	0	2012	Tennessee		2	3424	2			2						www.windsorextra.com	www.windsorextra.com	www.windsorextra.com	(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		2	2	2
H5698	063	0	1	01	01	H5698_063_0	7	1		08/05/2011	2012.02	08/05/2011 10:32:15 AM Central Daylight Time	08/04/2011 03:22:20 PM Central Daylight Time	08/04/2011 10:08:05 AM Central Daylight Time		08/05/2011 12:16:20 PM Central Daylight Time	WINDSOR HEALTH PLAN, INC.	Windsor Medicare Extra	www.windsorextra.com	Windsor Medicare Extra Emerald Plan (HMO)	01	01		1			H5698	063	0	2012	Arkansas		2	2299	2			2						www.windsorextra.com	www.windsorextra.com	www.windsorextra.com	(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		2	2	2
H5698	067	0	1	01	01	H5698_067_0	10	1		08/05/2011	2012.02	08/05/2011 10:12:20 AM Central Daylight Time	08/11/2011 08:16:18 AM Central Daylight Time	08/04/2011 10:10:48 AM Central Daylight Time		08/11/2011 10:48:15 AM Central Daylight Time	WINDSOR HEALTH PLAN, INC.	Windsor Medicare Extra	www.windsorextra.com	Windsor Medicare Extra Diamond Plan (HMO)	01	01		1			H5698	067	0	2012	Mississippi		2	2269	2			2						www.windsorextra.com	www.windsorextra.com	www.windsorextra.com	(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		2	2	2
H5698	068	0	1	01	01	H5698_068_0	8	1		08/05/2011	2012.02	08/05/2011 10:31:13 AM Central Daylight Time	08/04/2011 03:09:08 PM Central Daylight Time	08/04/2011 10:11:10 AM Central Daylight Time		08/05/2011 12:16:20 PM Central Daylight Time	WINDSOR HEALTH PLAN, INC.	Windsor Medicare Extra	www.windsorextra.com	Windsor Medicare Extra Diamond Plan (HMO)	01	01		1			H5698	068	0	2012	Tennessee		2	572	2			2						www.windsorextra.com	www.windsorextra.com	www.windsorextra.com	(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		2	2	2
H5698	069	0	1	01	01	H5698_069_0	8	1		08/05/2011	2012.02	08/05/2011 10:31:13 AM Central Daylight Time	08/04/2011 03:10:31 PM Central Daylight Time	08/04/2011 10:11:32 AM Central Daylight Time		08/05/2011 12:16:20 PM Central Daylight Time	WINDSOR HEALTH PLAN, INC.	Windsor Medicare Extra	www.windsorextra.com	Windsor Medicare Extra Diamond Plan (HMO)	01	01		1			H5698	069	0	2012	Arkansas		2	249	2			2						www.windsorextra.com	www.windsorextra.com	www.windsorextra.com	(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		2	2	2
H5698	122	0	1	01	01	H5698_122_0	7	1	2	08/05/2011	2012.02	08/05/2011 10:15:21 AM Central Daylight Time	08/04/2011 02:29:38 PM Central Daylight Time	08/03/2011 05:00:55 PM Central Daylight Time		08/05/2011 12:16:20 PM Central Daylight Time	WINDSOR HEALTH PLAN, INC.	Windsor Medicare Extra	www.windsorextra.com	Windsor Medicare Extra Comp Plus Plan (HMO SNP)	01	01		1			H5698	122	0	2012	Alabama		2	218	2			1	3		1	4		www.windsorextra.com	www.windsorextra.com	www.windsorextra.com	(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		2	2	2
H5698	128	0	1	01	01	H5698_128_0	6	1	2	07/19/2011	2012.02	07/19/2011 12:30:56 PM Central Daylight Time	08/04/2011 02:30:56 PM Central Daylight Time	08/03/2011 04:54:53 PM Central Daylight Time		08/05/2011 12:16:20 PM Central Daylight Time	WINDSOR HEALTH PLAN, INC.	Windsor Medicare Extra	www.windsorextra.com	Windsor Medicare Extra Comp Plus Plan (HMO SNP)	01	01		1			H5698	128	0	2012	Arkansas		2	2383	2			1	3		1	4		www.windsorextra.com	www.windsorextra.com	www.windsorextra.com	(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		2	1	2
H5698	129	0	1	01	01	H5698_129_0	7	1		08/05/2011	2012.02	08/05/2011 10:11:25 AM Central Daylight Time	08/04/2011 03:30:54 PM Central Daylight Time	08/03/2011 04:59:29 PM Central Daylight Time		08/05/2011 12:16:20 PM Central Daylight Time	WINDSOR HEALTH PLAN, INC.	Windsor Medicare Extra	www.windsorextra.com	Windsor Medicare Extra Fusion Plan (HMO SNP)	01	01		1			H5698	129	0	2012	Arkansas		2	478	2			1	4		1		00000000000010000000	www.windsorextra.com	www.windsorextra.com	www.windsorextra.com	(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		2	2	2
H5698	134	0	1	01	01	H5698_134_0	6	1	2	08/05/2011	2012.02	08/05/2011 10:16:04 AM Central Daylight Time	08/04/2011 02:32:15 PM Central Daylight Time	08/03/2011 05:01:19 PM Central Daylight Time		08/05/2011 12:21:25 PM Central Daylight Time	WINDSOR HEALTH PLAN, INC.	Windsor Medicare Extra	www.windsorextra.com	Windsor Medicare Extra Comp Plus Plan (HMO SNP)	01	01		1			H5698	134	0	2012	Mississippi		2	5152	2			1	3		1	4		www.windsorextra.com	www.windsorextra.com	www.windsorextra.com	(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		2	1	2
H5698	140	0	1	01	01	H5698_140_0	6	1	2	08/05/2011	2012.02	08/05/2011 10:16:45 AM Central Daylight Time	08/04/2011 02:33:33 PM Central Daylight Time	08/03/2011 05:01:42 PM Central Daylight Time		08/05/2011 12:21:25 PM Central Daylight Time	WINDSOR HEALTH PLAN, INC.	Windsor Medicare Extra	www.windsorextra.com	Windsor Medicare Extra Comp Plus Plan (HMO SNP)	01	01		1			H5698	140	0	2012	Tennessee		2	6694	2			1	3		1	4		www.windsorextra.com	www.windsorextra.com	www.windsorextra.com	(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		2	1	2
H5698	141	0	1	01	01	H5698_141_0	7	1		08/12/2011	2012.02	08/12/2011 11:59:19 AM Central Daylight Time	08/04/2011 03:32:15 PM Central Daylight Time	08/03/2011 04:59:51 PM Central Daylight Time		08/12/2011 12:04:32 PM Central Daylight Time	WINDSOR HEALTH PLAN, INC.	Windsor Medicare Extra	www.windsorextra.com	Windsor Medicare Extra Fusion Plan (HMO SNP)	01	01		1			H5698	141	0	2012	Tennessee		2	246	2			1	4		1		00000000000010000000	www.windsorextra.com	www.windsorextra.com	www.windsorextra.com	(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		2	2	2
H5698	150	0	1	01	01	H5698_150_0	7	1		08/05/2011	2012.02	08/05/2011 10:32:15 AM Central Daylight Time	08/04/2011 03:23:46 PM Central Daylight Time	08/04/2011 10:08:27 AM Central Daylight Time		08/05/2011 12:21:25 PM Central Daylight Time	WINDSOR HEALTH PLAN, INC.	Windsor Medicare Extra	www.windsorextra.com	Windsor Medicare Extra Emerald Plan (HMO)	01	01		1			H5698	150	0	2012	Alabama		2	216	2			2						www.windsorextra.com	www.windsorextra.com	www.windsorextra.com	(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		2	2	2
H5698	151	0	1	01	01	H5698_151_0	7	1		08/05/2011	2012.02	08/05/2011 10:29:56 AM Central Daylight Time	08/04/2011 03:59:00 PM Central Daylight Time	08/04/2011 08:52:56 AM Central Daylight Time		08/05/2011 12:21:25 PM Central Daylight Time	WINDSOR HEALTH PLAN, INC.	Windsor Medicare Extra	www.windsorextra.com	Windsor Medicare Extra Gold Plan (HMO)	01	01		1			H5698	151	0	2012	Alabama		2	239	2			2						www.windsorextra.com	www.windsorextra.com	www.windsorextra.com	(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		2	2	2
H5698	152	0	1	01	01	H5698_152_0	9	1		08/05/2011	2012.02	08/05/2011 10:31:13 AM Central Daylight Time	08/04/2011 03:11:51 PM Central Daylight Time	08/04/2011 10:11:54 AM Central Daylight Time		08/05/2011 12:21:25 PM Central Daylight Time	WINDSOR HEALTH PLAN, INC.	Windsor Medicare Extra	www.windsorextra.com	Windsor Medicare Extra Diamond Plan (HMO)	01	01		1			H5698	152	0	2012	Alabama		2	10	2			2						www.windsorextra.com	www.windsorextra.com	www.windsorextra.com	(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		2	2	2
H5698	153	0	1	01	01	H5698_153_0	10	1		08/05/2011	2012.02	08/05/2011 10:14:26 AM Central Daylight Time	08/04/2011 02:40:26 PM Central Daylight Time	08/03/2011 04:56:15 PM Central Daylight Time		08/07/2011 07:37:29 PM Central Daylight Time	WINDSOR HEALTH PLAN, INC.	Windsor Medicare Extra	www.windsorextra.com	Windsor Medicare Extra Diabetes Plan (HMO SNP)	01	01		1			H5698	153	0	2012	Alabama		2	5	2			1	4		1		00000010000000000000	www.windsorextra.com	www.windsorextra.com	www.windsorextra.com	(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		2	2	2
H5698	154	0	1	01	01	H5698_154_0	8	1		08/05/2011	2012.02	08/05/2011 10:32:58 AM Central Daylight Time	08/04/2011 02:41:46 PM Central Daylight Time	08/03/2011 04:56:35 PM Central Daylight Time		08/07/2011 07:37:29 PM Central Daylight Time	WINDSOR HEALTH PLAN, INC.	Windsor Medicare Extra	www.windsorextra.com	Windsor Medicare Extra Diabetes Plan (HMO SNP)	01	01		1			H5698	154	0	2012	Arkansas		2	59	2			1	4		1		00000010000000000000	www.windsorextra.com	www.windsorextra.com	www.windsorextra.com	(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		2	2	2
H5698	155	0	1	01	01	H5698_155_0	8	1		08/05/2011	2012.02	08/05/2011 10:32:58 AM Central Daylight Time	08/04/2011 02:43:05 PM Central Daylight Time	08/03/2011 04:56:57 PM Central Daylight Time		08/07/2011 07:37:29 PM Central Daylight Time	WINDSOR HEALTH PLAN, INC.	Windsor Medicare Extra	www.windsorextra.com	Windsor Medicare Extra Diabetes Plan (HMO SNP)	01	01		1			H5698	155	0	2012	Mississippi		2	187	2			1	4		1		00000010000000000000	www.windsorextra.com	www.windsorextra.com	www.windsorextra.com	(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		2	2	2
H5698	156	0	1	01	01	H5698_156_0	8	1		08/05/2011	2012.02	08/05/2011 10:32:58 AM Central Daylight Time	08/04/2011 02:44:26 PM Central Daylight Time	08/03/2011 04:57:18 PM Central Daylight Time		08/07/2011 07:37:29 PM Central Daylight Time	WINDSOR HEALTH PLAN, INC.	Windsor Medicare Extra	www.windsorextra.com	Windsor Medicare Extra Diabetes Plan (HMO SNP)	01	01		1			H5698	156	0	2012	Tennessee		2	95	2			1	4		1		00000010000000000000	www.windsorextra.com	www.windsorextra.com	www.windsorextra.com	(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		2	2	2
H5698	157	0	1	01	01	H5698_157_0	6	1		08/05/2011	2012.02	08/05/2011 10:29:56 AM Central Daylight Time	08/04/2011 04:00:26 PM Central Daylight Time	08/04/2011 08:53:18 AM Central Daylight Time		08/05/2011 12:21:25 PM Central Daylight Time	WINDSOR HEALTH PLAN, INC.	Windsor Medicare Extra	www.windsorextra.com	Windsor Medicare Extra Gold Plan (HMO)	01	01		1			H5698	157	0	2012	South Carolina		2	1421	2			2						www.windsorextra.com	www.windsorextra.com	www.windsorextra.com	(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		2	2	2
H5698	158	0	1	01	01	H5698_158_0	5	1	2	07/19/2011	2012.02	07/19/2011 12:40:26 PM Central Daylight Time	08/04/2011 02:35:02 PM Central Daylight Time	08/03/2011 04:55:17 PM Central Daylight Time		08/05/2011 12:21:25 PM Central Daylight Time	WINDSOR HEALTH PLAN, INC.	Windsor Medicare Extra	www.windsorextra.com	Windsor Medicare Extra Comp Plus Plan (HMO SNP)	01	01		1			H5698	158	0	2012	South Carolina		2	1024	2			1	3		1	4		www.windsorextra.com	www.windsorextra.com	www.windsorextra.com	(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		2	1	2
H5698	159	0	1	01	01	H5698_159_0	6	1		08/05/2011	2012.02	08/05/2011 10:32:15 AM Central Daylight Time	08/04/2011 03:25:06 PM Central Daylight Time	08/04/2011 10:08:49 AM Central Daylight Time		08/05/2011 12:21:25 PM Central Daylight Time	WINDSOR HEALTH PLAN, INC.	Windsor Medicare Extra	www.windsorextra.com	Windsor Medicare Extra Emerald Plan (HMO)	01	01		1			H5698	159	0	2012	South Carolina		2	956	2			2						www.windsorextra.com	www.windsorextra.com	www.windsorextra.com	(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		2	2	2
H5698	160	0	1	01	01	H5698_160_0	7	1		08/05/2011	2012.02	08/05/2011 10:31:13 AM Central Daylight Time	08/04/2011 03:13:10 PM Central Daylight Time	08/04/2011 10:12:16 AM Central Daylight Time		08/05/2011 12:21:25 PM Central Daylight Time	WINDSOR HEALTH PLAN, INC.	Windsor Medicare Extra	www.windsorextra.com	Windsor Medicare Extra Diamond Plan (HMO)	01	01		1			H5698	160	0	2012	South Carolina		2	22	2			2						www.windsorextra.com	www.windsorextra.com	www.windsorextra.com	(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		2	2	2
H5698	163	0	1	01	01	H5698_163_0	8	1		08/05/2011	2012.02	08/05/2011 10:32:58 AM Central Daylight Time	08/04/2011 02:45:45 PM Central Daylight Time	08/03/2011 04:57:40 PM Central Daylight Time		08/07/2011 07:37:29 PM Central Daylight Time	WINDSOR HEALTH PLAN, INC.	Windsor Medicare Extra	www.windsorextra.com	Windsor Medicare Extra Diabetes Plan (HMO SNP)	01	01		1			H5698	163	0	2012	South Carolina		2	10	2			1	4		1		00000010000000000000	www.windsorextra.com	www.windsorextra.com	www.windsorextra.com	(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		2	2	2
H5698	801	0	1	01	01	H5698_801_0	2	1		06/06/2011	2012.02	06/06/2011 04:01:26 PM Central Daylight Time	07/21/2011 08:43:50 AM Central Daylight Time			07/21/2011 05:48:43 PM Central Daylight Time	WINDSOR HEALTH PLAN, INC.	Windsor Medicare Extra	www.windsorextra.com	Windsor Medicare Extra Employer Plan Part D (CY) (HMO)	01	01		1			H5698	801	0	2012	AL, AR, MS, SC and TN		1	100	2			2						www.windsorextra.com	www.windsorextra.com	www.windsorextra.com	(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		1	1	1
H5698	802	0	1	01	01	H5698_802_0	2	1		06/06/2011	2012.02	06/06/2011 04:01:52 PM Central Daylight Time	07/21/2011 08:35:45 AM Central Daylight Time			07/21/2011 05:48:43 PM Central Daylight Time	WINDSOR HEALTH PLAN, INC.	Windsor Medicare Extra	www.windsorextra.com	Windsor Medicare Extra Employer Plan (CY) (HMO)	01	01		1			H5698	802	0	2012	AL, AR, MS, SC, and TN		1	50	2			2						www.windsorextra.com	www.windsorextra.com	www.windsorextra.com	(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313										(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617										1	1	1
H5698	803	0	1	01	01	H5698_803_0	2	1		06/06/2011	2012.02	06/06/2011 04:02:16 PM Central Daylight Time	07/21/2011 08:42:43 AM Central Daylight Time			07/21/2011 05:48:43 PM Central Daylight Time	WINDSOR HEALTH PLAN, INC.	Windsor Medicare Extra	www.windsorextra.com	Windsor Medicare Extra Employer Plan (NonCY) (HMO)	01	01		1			H5698	803	0	2012	AL, AR, MS, SC and TN		1	50	2			2						www.windsorextra.com	www.windsorextra.com	www.windsorextra.com	(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313										(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617										1	1	1
H5698	804	0	1	01	01	H5698_804_0	2	1		06/06/2011	2012.02	06/06/2011 04:02:46 PM Central Daylight Time	07/21/2011 08:46:15 AM Central Daylight Time			07/21/2011 05:48:43 PM Central Daylight Time	WINDSOR HEALTH PLAN, INC.	Windsor Medicare Extra	www.windsorextra.com	Windsor Medicare Extra Employer Part D (NonCY) (HMO)	01	01		1			H5698	804	0	2012	AL, AR, MS, SC and TN		1	50	2			2						www.windsorextra.com	www.windsorextra.com	www.windsorextra.com	(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(800)-316-2273		(615)-782-7878		(866)-448-8313		(866)-448-8313		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		(866)-460-7617		1	1	1
H5700	002	0	1	01	01	H5700_002_0	9	1		08/08/2011	2012.02	08/08/2011 10:18:53 AM Central Daylight Time	08/07/2011 01:15:52 PM Central Daylight Time	08/04/2011 02:13:35 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARKANSAS COMMUNITY CARE, INC.	Arkansas Community Care	www.arkansascommunitycare.com	Arkansas Community  Care -  Plus (HMO)	01	01		1			H5700	002	0	2012	Northwest Arkansas		2		2			2							www.arkansascommunitycare.com	www.arkansascommunitycare.com	(800)-573-8597		(800)-573-8597		(800)-705-0766		(501)-223-9088		(800)-573-8597		(800)-573-8597		(800)-705-0766		(501)-223-9088		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H5700	005	0	1	01	01	H5700_005_0	8	1		08/08/2011	2012.02	08/08/2011 10:20:19 AM Central Daylight Time	08/07/2011 01:17:22 PM Central Daylight Time	08/04/2011 02:14:15 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARKANSAS COMMUNITY CARE, INC.	Arkansas Community Care	www.arkansascommunitycare.com	Arkansas Community Care - Plus (HMO)	01	01		1			H5700	005	0	2012	Central Arkansas		2		2			2							www.arkansascommunitycare.com	www.arkansascommunitycare.com	(800)-573-8597		(800)-573-8597		(800)-705-0766		(501)-223-9088		(800)-573-8597		(800)-573-8597		(800)-705-0766		(501)-223-9088		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H5700	009	0	1	01	01	H5700_009_0	9	1		08/08/2011	2012.02	08/08/2011 10:21:01 AM Central Daylight Time	08/07/2011 01:18:50 PM Central Daylight Time	08/04/2011 02:15:48 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARKANSAS COMMUNITY CARE, INC.	Arkansas Community Care	www.arkansascommunitycare.com	Arkansas Community Care - Plus (HMO)	01	01		1			H5700	009	0	2012	Fort Smith		2		2			2							www.arkansascommunitycare.com	www.arkansascommunitycare.com	(800)-573-8597		(800)-573-8597		(800)-705-0766		(501)-223-9088		(800)-573-8597		(800)-573-8597		(800)-705-0766		(501)-223-9088		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H5700	018	0	1	01	01	H5700_018_0	7	1	2	07/07/2011	2012.02	07/07/2011 11:08:57 AM Central Daylight Time	07/17/2011 06:28:39 PM Central Daylight Time	07/19/2011 08:03:57 PM Central Daylight Time		07/20/2011 04:17:07 PM Central Daylight Time	ARKANSAS COMMUNITY CARE, INC.	Arkansas Community Care	www.arkansascommunitycare.com	Arkansas Community Care -Dual Plus (HMO SNP)	01	01		1			H5700	018	0	2012	Arkansas		2		2			1	3		1	1			www.arkansascommunitycare.com	www.arkansascommunitycare.com	(800)-573-8597		(800)-573-8597		(800)-705-0766		(501)-223-9088		(800)-573-8597		(800)-573-8597		(800)-705-0766		(501)-223-9088		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H5700	020	0	1	01	01	H5700_020_0	9	1		08/08/2011	2012.02	08/08/2011 10:21:30 AM Central Daylight Time	08/07/2011 01:20:21 PM Central Daylight Time	08/04/2011 02:18:23 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARKANSAS COMMUNITY CARE, INC.	Arkansas Community Care	www.arkansascommunitycare.com	Texarkana Community Care - Plus (HMO)	01	01		1			H5700	020	0	2012	Texarkana		2		2			2							www.arkansascommunitycare.com	www.arkansascommunitycare.com	(800)-573-8597		(800)-573-8597		(800)-705-0766		(501)-223-9088		(800)-573-8597		(800)-573-8597		(800)-705-0766		(501)-223-9088		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H5700	027	0	1	01	01	H5700_027_0	8	1		08/08/2011	2012.02	08/08/2011 10:21:53 AM Central Daylight Time	08/07/2011 01:21:48 PM Central Daylight Time	08/04/2011 02:19:03 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARKANSAS COMMUNITY CARE, INC.	Arkansas Community Care	www.arkansascommunitycare.com	Arkansas Community Care - Plus (HMO)	01	01		1			H5700	027	0	2012	Pulaski / Saline		2		2			2							www.arkansascommunitycare.com	www.arkansascommunitycare.com	(800)-573-8597		(800)-573-8597		(800)-705-0766		(501)-223-9088		(800)-573-8597		(800)-573-8597		(800)-705-0766		(501)-223-9088		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H5700	028	0	1	01	01	H5700_028_0	7	1	2	07/07/2011	2012.02	07/07/2011 11:09:33 AM Central Daylight Time	07/17/2011 09:06:00 PM Central Daylight Time	07/19/2011 08:05:38 PM Central Daylight Time		07/20/2011 04:17:07 PM Central Daylight Time	ARKANSAS COMMUNITY CARE, INC.	Arkansas Community Care	www.arkansascommunitycare.com	Arkansas Community Care - Dual Plus (HMO SNP)	01	01		1			H5700	028	0	2012	Arkansas		2		2			1	3		1	5			www.arkansascommunitycare.com	www.arkansascommunitycare.com	(800)-573-8597		(800)-573-8597		(800)-705-0766		(501)-223-9088		(800)-573-8597		(800)-573-8597		(800)-705-0766		(501)-223-9088		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H5703	001	0	1	01	01	H5703_001_0	3	1	2	07/21/2011	2012.02	07/21/2011 03:04:01 PM Central Daylight Time	08/04/2011 05:32:08 PM Central Daylight Time	08/04/2011 05:32:08 PM Central Daylight Time		08/08/2011 01:13:21 PM Central Daylight Time	SOUTH COUNTRY HEALTH ALLIANCE	South Country Health Alliance	www.mnscha.org	AbilityCare (HMO SNP)	01	01		1			H5703	001	0	2012	Select Counties in Minnesota		2	768	1	1		1	3		1	5		www.mnscha.org	https://www.myprime.com	www.primetherapeutics.com	(866)-567-7242		(866)-567-7242		(866)-567-7242		(866)-567-7242		(866)-567-7242		(866)-567-7242		(866)-567-7242		(866)-567-7242		(877)-824-5611		(877)-824-5611		(877)-824-5611		(877)-824-5611		(877)-824-5611		(877)-824-5611		(877)-824-5611		(877)-824-5611		2	2	2
H5732	001	0	1	01	01	H5732_001_0	19	1		08/01/2011	2012.02	08/01/2011 01:37:34 PM SA Western Standard Time	08/05/2011 05:17:12 PM SA Western Standard Time	08/04/2011 10:29:32 AM SA Western Standard Time		08/08/2011 05:22:58 PM SA Western Standard Time	TRIPLE-S SALUD, INC.	Triple-S Salud, INC.	www.sssplanesmedicare.com	Triple-S Medicare Optimo Premier (HMO)	01	01		1			H5732	001	0	2012	Island of Puerto Rico		2		2			2						http://www.ssspr.com/SSSPortal/ProviderSearch.ASPX	http://www.ssspr.com/sssportal/	http://www.sssplanesmedicare.com/planes-medicare/auxilio-platino/farmacias-aceptan-plan.htm	(800)-510-0722		(787)-774-6083		(877)-207-8777		(877)-207-8777		(800)-510-0722		(787)-774-6083		(877)-207-8777		(877)-207-8777		(800)-383-4457		(787)-749-4059		(800)-383-4457		(787)-749-4059		(800)-383-4457		(787)-749-4059		(800)-383-4457		(787)-749-4059		2	2	2
H5732	005	0	1	02	01	H5732_005_0	19	1		08/01/2011	2012.02	08/01/2011 01:40:01 PM SA Western Standard Time	08/05/2011 05:17:20 PM SA Western Standard Time	08/04/2011 10:39:32 AM SA Western Standard Time		08/08/2011 05:22:58 PM SA Western Standard Time	TRIPLE-S SALUD, INC.	Triple-S Salud, INC.	www.sssplanesmedicare.com	Triple-S Medicare Optimo POS (HMO-POS)	01	02		1			H5732	005	0	2012	Island of Puerto Rico		2		2			2						http://www.ssspr.com/SSSPortal/ProviderSearch.ASPX	http://www.ssspr.com/sssportal/	http://www.sssplanesmedicare.com/planes-medicare/auxilio-platino/farmacias-aceptan-plan.htm	(800)-510-0722		(787)-774-6083		(877)-207-8777		(877)-207-8777		(800)-510-0722		(787)-774-6083		(877)-207-8777		(877)-207-8777		(800)-383-4457		(787)-749-4059		(800)-383-4457		(787)-749-4059		(800)-383-4457		(787)-749-4059		(800)-383-4457		(787)-749-4059		2	2	2
H5746	006	0	1	01	01	H5746_006_0	7	1	2	08/05/2011	2012.02	08/05/2011 10:24:06 AM Eastern Daylight Time	08/05/2011 09:57:00 AM Eastern Daylight Time	08/04/2011 05:27:00 PM Eastern Daylight Time		08/09/2011 05:31:53 PM Eastern Daylight Time	AMERIGROUP NEW MEXICO, INC.	Amerigroup Community Care of New Mexico	www.myamerigroup.com/medicare	Amerivantage Specialty + Rx (HMO SNP)	01	01		1			H5746	006	0	2012	Albuquerque / Central New Mexico		2	598	2			1	3		1	1		www.myamerigroup.com/medicare	https://www.myamerigroup.com/english/pages/2009medicarememberlogin.aspx	https://www.myamerigroup.com/english/pages/2009medicarememberlogin.aspx	(866)-805-4589		(866)-805-4589		(877)-470-4131		(877)-470-4131		(866)-805-4589		(866)-805-4589		(877)-470-4131		(877)-470-4131		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		2	2	2
H5746	012	0	1	02	01	H5746_012_0	9	1		07/19/2011	2012.02	07/19/2011 07:53:13 AM Eastern Daylight Time	08/08/2011 01:51:00 PM Eastern Daylight Time	08/04/2011 05:27:00 PM Eastern Daylight Time		08/09/2011 05:31:53 PM Eastern Daylight Time	AMERIGROUP NEW MEXICO, INC.	Amerigroup Community Care of New Mexico	www.myamerigroup.com/medicare	Amerivantage Choice + Rx (HMO-POS)	01	02		1			H5746	012	0	2012	Albuquerque / Northwest / Central New Mexico		2	1196	2			2						www.myamerigroup.com/medicare	https://www.myamerigroup.com/english/pages/2009medicarememberlogin.aspx	https://www.myamerigroup.com/english/pages/2009medicarememberlogin.aspx	(866)-805-4589		(866)-805-4589		(877)-470-4131		(877)-470-4131		(866)-805-4589		(866)-805-4589		(877)-470-4131		(877)-470-4131		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		2	2	2
H5749	001	0	1	02	01	H5749_001_0	6	1		08/08/2011	2012.02	08/08/2011 11:18:34 AM Central Daylight Time	08/04/2011 08:15:11 PM Central Daylight Time	08/05/2011 01:45:28 PM Central Daylight Time		08/09/2011 03:57:48 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus Plan 1 (HMO-POS)	01	02		1			H5749	001	0	2012	Johnson, Cass, Jackson, and Lafayette Counties		2		2			2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5750	004	0	1	01	01	H5750_004_0	2	1	2	06/03/2011	2012.02	06/03/2011 09:49:17 AM Central Daylight Time	08/04/2011 11:06:13 AM Central Daylight Time	08/04/2011 11:06:31 AM Central Daylight Time		08/04/2011 01:41:29 PM Central Daylight Time	METROPOLITAN HEALTH PLAN	Cornerstone Solutions	www.cornerstone-solutions.org	Cornerstone Solutions (HMO SNP)	01	01		1			H5750	004	0	2012	Hennepin County		2	309	2			1	3		1	5		www.cornerstone-solutions.org	www.cornerstone-solutions.org	http://www.advancerx.com	(888)-562-8000		(888)-562-8000		(888)-562-8000		(888)-562-8000		(888)-562-8000		(888)-562-8000		(888)-562-8000		(888)-562-8000		(800)-627-3529		(800)-627-3529		(800)-627-3529		(800)-627-3529		(800)-627-3529		(800)-627-3529		(800)-627-3529		(800)-627-3529		2	2	2
H5774	003	0	1	01	01	H5774_003_0	4	1		06/29/2011	2012.02	06/29/2011 02:37:32 PM SA Western Standard Time	07/14/2011 02:36:12 PM SA Western Standard Time			07/14/2011 04:10:34 PM SA Western Standard Time	AMERICAN HEALTH, INC.	American Health Medicare	www.ahmpr.com	AHM_Basic (HMO)	01	01		1			H5774	003	0	2012	Puerto Rico		2		2			2						www.ahmpr.com	www.caremark.com	www.caremark.com	(888)-620-1919		(888)-620-1919		(866)-620-2420		(866)-620-2420										(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520										2	2	2
H5774	005	0	1	01	01	H5774_005_0	7	1		06/06/2011	2012.02	06/06/2011 02:29:31 PM SA Western Standard Time	08/05/2011 01:24:00 PM SA Western Standard Time	08/04/2011 09:48:00 AM SA Western Standard Time		08/08/2011 11:55:25 AM SA Western Standard Time	AMERICAN HEALTH, INC.	American Health Medicare	www.ahmpr.com	AHM_Standard (HMO)	01	01		1			H5774	005	0	2012	Puerto Rico		2		2			2						www.ahmpr.com	www.caremark.com	www.caremark.com	(888)-620-1919		(888)-620-1919		(866)-620-2420		(866)-620-2420		(888)-620-1919		(888)-620-1919		(866)-620-2420		(866)-620-2420		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		2	2	2
H5774	008	0	1	01	01	H5774_008_0	8	1		06/06/2011	2012.02	06/06/2011 02:30:04 PM SA Western Standard Time	08/05/2011 01:24:00 PM SA Western Standard Time	08/04/2011 09:50:00 AM SA Western Standard Time		08/08/2011 11:55:25 AM SA Western Standard Time	AMERICAN HEALTH, INC.	American Health Medicare	www.ahmpr.com	AHM_Classic (HMO)	01	01		1			H5774	008	0	2012	Puerto Rico		2		2			2						www.ahmpr.com	www.caremark.com	www.caremark.com	(888)-620-1919		(888)-620-1919		(866)-620-2420		(866)-620-2420		(888)-620-1919		(888)-620-1919		(866)-620-2420		(866)-620-2420		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		2	2	2
H5774	009	0	1	01	01	H5774_009_0	8	1		07/21/2011	2012.02	07/21/2011 05:08:27 PM SA Western Standard Time	08/05/2011 01:24:00 PM SA Western Standard Time	08/04/2011 09:51:00 AM SA Western Standard Time		08/08/2011 11:55:25 AM SA Western Standard Time	AMERICAN HEALTH, INC.	American Health Medicare	www.ahmpr.com	AHM_Classic Plus (HMO SNP)	01	01		1			H5774	009	0	2012	Puerto Rico		2		2			1	4		1		00000010000000000000	www.ahmpr.com	www.caremark.com	www.caremark.com	(888)-620-1919		(888)-620-1919		(866)-620-2420		(866)-620-2420		(888)-620-1919		(888)-620-1919		(866)-620-2420		(866)-620-2420		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		2	2	2
H5774	014	0	1	02	01	H5774_014_0	9	1		07/21/2011	2012.02	07/21/2011 06:02:57 PM SA Western Standard Time	08/05/2011 01:25:00 PM SA Western Standard Time	08/04/2011 09:52:00 AM SA Western Standard Time		08/08/2011 11:55:25 AM SA Western Standard Time	AMERICAN HEALTH, INC.	American Health Medicare	www.ahmpr.com	AHM_Opal (HMO-POS)	01	02		1			H5774	014	0	2012	Puerto Rico		2		2			2						www.ahmpr.com	www.caremark.com	www.caremark.com	(888)-620-1919		(888)-620-1919		(866)-620-2420		(866)-620-2420		(888)-620-1919		(888)-620-1919		(866)-620-2420		(866)-620-2420		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		2	2	2
H5774	019	0	1	01	01	H5774_019_0	6	1	1	08/08/2011	2012.02	08/08/2011 11:39:56 AM SA Western Standard Time	08/05/2011 01:25:00 PM SA Western Standard Time	08/04/2011 09:53:00 AM SA Western Standard Time		08/08/2011 11:55:25 AM SA Western Standard Time	AMERICAN HEALTH, INC.	American Health Medicare	www.ahmpr.com	AHM_Platino Plus (HMO SNP)	01	01		1			H5774	019	0	2012	Puerto Rico		2		2		1	1	3		1	3		www.ahmpr.com	www.caremark.com	www.caremark.com	(888)-620-1919		(888)-620-1919		(866)-620-2420		(866)-620-2420		(888)-620-1919		(888)-620-1919		(866)-620-2420		(866)-620-2420		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		2	2	2
H5774	802	0	1	01	01	H5774_802_0	2	1		06/01/2011	2012.02	06/01/2011 10:24:53 AM SA Western Standard Time	06/06/2011 09:11:24 AM SA Western Standard Time			06/06/2011 10:03:26 AM SA Western Standard Time	AMERICAN HEALTH, INC.	American Health Medicare	www.ahmpr.com	AHM_Executive Group (HMO)	01	01		1			H5774	802	0	2012	Puerto Rico		1		2			2						www.ahmpr.com	www.caremark.com	www.caremark.com	(888)-620-1919		(888)-620-1919		(866)-620-2420		(866)-620-2420										(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520										2	2	2
H5774	806	0	1	01	01	H5774_806_0	2	1		06/03/2011	2012.02	06/03/2011 04:36:16 PM SA Western Standard Time	06/06/2011 09:11:44 AM SA Western Standard Time			06/06/2011 10:03:26 AM SA Western Standard Time	AMERICAN HEALTH, INC.	American Health Medicare	www.ahmpr.com	AHM_ELA Premier (HMO)	01	01		1			H5774	806	0	2012	Puerto Rico		1		2			2						www.ahmpr.com	www.caremark.com	www.caremark.com	(888)-620-1919		(888)-620-1919		(866)-620-2420		(866)-620-2420		(888)-620-1919		(888)-620-1919		(866)-620-2420		(866)-620-2420		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		2	2	2
H5774	808	0	1	01	01	H5774_808_0	2	1		06/01/2011	2012.02	06/01/2011 11:09:48 AM SA Western Standard Time	06/06/2011 09:11:52 AM SA Western Standard Time			06/06/2011 10:03:26 AM SA Western Standard Time	AMERICAN HEALTH, INC.	American Health Medicare	www.ahmpr.com	AHM_Executive Group Plus (HMO)	01	01		1			H5774	808	0	2012	Puerto Rico		1		2			2						www.ahmpr.com	www.caremark.com	www.caremark.com	(888)-620-1919		(888)-620-1919		(866)-620-2420		(866)-620-2420		(888)-620-1919		(888)-620-1919		(866)-620-2420		(866)-620-2420		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		(866)-620-2520		2	2	2
H5782	001	0	1	01	01	H5782_001_0	3	1	2	05/31/2011	2012.02	05/31/2011 05:25:25 PM Pacific Daylight Time	08/08/2011 01:36:33 PM Pacific Daylight Time	08/08/2011 01:36:30 PM Pacific Daylight Time		08/08/2011 01:40:52 PM Pacific Daylight Time	PARTNERSHIP HEALTHPLAN OF CALIFORNIA	Partnership HealthPlan of California	www.partnershiphp.org	PartnershipAdvantage (HMO SNP)	01	01		1			H5782	001	0	2012	Napa, Solano, and Yolo Counties		2	7697	2			1	3		1	5		www.partnershiphp.org	www.partnershiphp.org	www.partnershiphp.org	(866)-264-3626		(866)-264-3626		(866)-249-9933		(866)-249-9933		(866)-264-3626		(866)-264-3626		(866)-249-9933		(866)-249-9933		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5783	002	0	1	01	01	H5783_002_0	9	1		08/08/2011	2012.02	08/08/2011 10:22:22 AM Central Daylight Time	08/07/2011 01:23:14 PM Central Daylight Time	08/04/2011 02:20:59 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARCADIAN HEALTH PLAN, INC.	Southeast Community Care	www.southeastcommunitycare.com	Southeast Community Care- Plus (HMO)	01	01		1			H5783	002	0	2012	Charleston		2		2			2							www.southeastcommunitycare.com	www.southeastcommunitycare.com	(800)-573-8597		(800)-573-8597		(888)-998-3055		(843)-553-9996		(800)-573-8597		(800)-573-8597		(888)-998-3055		(843)-553-9996		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H5783	006	0	1	01	01	H5783_006_0	9	1		08/08/2011	2012.02	08/08/2011 10:22:46 AM Central Daylight Time	08/08/2011 08:03:17 AM Central Daylight Time	08/04/2011 02:21:51 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARCADIAN HEALTH PLAN, INC.	Southeast Community Care	www.southeastcommunitycare.com	Southeast Community Care - Plus (HMO)	01	01		1			H5783	006	0	2012	Greenville / Spartanburg		2		2			2							www.southeastcommunitycare.com	www.southeastcommunitycare.com	(800)-573-8597		(800)-573-8597		(888)-998-3055		(843)-553-9996		(800)-573-8597		(800)-573-8597		(888)-998-3055		(843)-553-9996		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H5783	008	0	1	01	01	H5783_008_0	7	1	2	07/07/2011	2012.02	07/07/2011 11:10:16 AM Central Daylight Time	07/17/2011 07:11:42 PM Central Daylight Time	07/20/2011 11:27:01 AM Central Daylight Time		07/20/2011 04:17:07 PM Central Daylight Time	ARCADIAN HEALTH PLAN, INC.	Southeast Community Care	www.southeastcommunitycare.com	Southeast Community Care - Dual Plus (HMO SNP)	01	01		1			H5783	008	0	2012	Greenville, Pickens, Spartanburg		2		2			1	3		1	1			www.southeastcommunitycare.com	www.southeastcommunitycare.com	(800)-573-8597		(800)-573-8597		(888)-998-3055		(843)-553-9996		(800)-573-8597		(800)-573-8597		(888)-998-3055		(843)-553-9996		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H5783	011	0	1	01	01	H5783_011_0	7	1	2	07/07/2011	2012.02	07/07/2011 11:10:33 AM Central Daylight Time	07/17/2011 07:13:13 PM Central Daylight Time	07/19/2011 08:53:04 PM Central Daylight Time		07/20/2011 04:17:07 PM Central Daylight Time	ARCADIAN HEALTH PLAN, INC.	Southeast Community Care	www.southeastcommunitycare.com	Southeast Community Care - Dual Plus (HMO SNP)	01	01		1			H5783	011	0	2012	South Carolina		2		2			1	3		1	5			www.southeastcommunitycare.com	www.southeastcommunitycare.com	(800)-573-8597		(800)-573-8597		(888)-998-3055		(843)-553-9996		(800)-573-8597		(800)-573-8597		(888)-998-3055		(843)-553-9996		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H5783	012	0	1	01	01	H5783_012_0	9	1		08/08/2011	2012.02	08/08/2011 10:23:15 AM Central Daylight Time	08/07/2011 01:26:04 PM Central Daylight Time	08/04/2011 02:28:15 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARCADIAN HEALTH PLAN, INC.	Southeast Community Care	www.southeastcommunitycare.com	Southeast Community Care - Plus (HMO)	01	01		1			H5783	012	0	2012	Pickens		2		2			2							www.southeastcommunitycare.com	www.southeastcommunitycare.com	(800)-573-8597		(800)-573-8597		(888)-998-3055		(843)-553-9996		(800)-573-8597		(800)-573-8597		(888)-998-3055		(843)-553-9996		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H5793	001	0	1	01	01	H5793_001_0	5	1		07/12/2011	2012.02	07/12/2011 03:24:43 PM Central Daylight Time	08/04/2011 01:52:15 PM Central Daylight Time	08/04/2011 10:09:42 AM Central Daylight Time		08/08/2011 09:51:11 AM Central Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (HMO)	01	01		1			H5793	001	0	2012	Connecticut		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H5793	008	0	1	01	01	H5793_008_0	5	1		07/12/2011	2012.02	07/12/2011 03:27:09 PM Central Daylight Time	08/05/2011 02:46:43 PM Central Daylight Time	08/04/2011 10:10:19 AM Central Daylight Time		08/08/2011 09:51:11 AM Central Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Standard Plan (HMO)	01	01		1			H5793	008	0	2012	Connecticut		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H5793	801	0	1	01	01	H5793_801_0	2	1		04/22/2011	2012.02	04/22/2011 10:08:45 AM Eastern Daylight Time	07/19/2011 10:47:39 AM Central Daylight Time			07/19/2011 04:49:36 PM Central Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan (HMO)	01	01		1			H5793	801	0	2012	Connecticut		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748										1	1	1
H5793	802	0	1	01	01	H5793_802_0	2	1		04/22/2011	2012.02	04/22/2011 10:09:18 AM Eastern Daylight Time	07/19/2011 10:47:56 AM Central Daylight Time			07/19/2011 04:49:36 PM Central Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan w/Rx CY (HMO)	01	01		1			H5793	802	0	2012	Connecticut		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		1	1	1
H5810	001	0	1	01	01	H5810_001_0	4	1	2	07/28/2011	2012.02	07/28/2011 11:33:31 AM Pacific Daylight Time	08/04/2011 07:16:00 PM Pacific Daylight Time	08/04/2011 02:06:00 PM Pacific Daylight Time		08/05/2011 02:51:40 PM Pacific Daylight Time	MOLINA HEALTHCARE OF CALIFORNIA	Molina Healthcare of California	www.molinamedicare.com	Molina Medicare Options Plus (HMO SNP)	01	01		1			H5810	001	0	2012	Southern California		2		2			1	3		1	1		www.molinamedicare.com	www.molinamedicare.com	www.molinamedicare.com	(800)-665-0898		(800)-665-0898		(866)-403-8293		(866)-403-8293		(800)-665-0898		(800)-665-0898		(866)-403-8293		(866)-403-8293		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		2	2	2
H5810	002	0	1	01	01	H5810_002_0	3	1		07/28/2011	2012.02	07/28/2011 11:33:36 AM Pacific Daylight Time	08/04/2011 07:16:00 PM Pacific Daylight Time	08/04/2011 02:06:00 PM Pacific Daylight Time		08/05/2011 02:51:40 PM Pacific Daylight Time	MOLINA HEALTHCARE OF CALIFORNIA	Molina Healthcare of California	www.molinamedicare.com	Molina Medicare Options (HMO)	01	01		1			H5810	002	0	2012	Southern California		2		2			2						www.molinamedicare.com	www.molinamedicare.com	www.molinamedicare.com	(800)-665-0898		(800)-665-0898		(866)-403-8293		(866)-403-8293		(800)-665-0898		(800)-665-0898		(866)-403-8293		(866)-403-8293		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		2	2	2
H5810	007	0	1	01	01	H5810_007_0	2	1	2	07/28/2011	2012.02	07/28/2011 11:33:47 AM Pacific Daylight Time	08/04/2011 07:17:00 PM Pacific Daylight Time	08/04/2011 02:06:00 PM Pacific Daylight Time		08/05/2011 02:51:40 PM Pacific Daylight Time	MOLINA HEALTHCARE OF CALIFORNIA	Molina Healthcare of California	www.molinamedicare.com	Molina Medicare Options Plus (HMO SNP)	01	01		1			H5810	007	0	2012	Sacramento County		2		2			1	3		1	5		www.molinamedicare.com	www.molinamedicare.com	www.molinamedicare.com	(800)-665-0898		(800)-665-0898		(866)-403-8293		(866)-403-8293		(800)-665-0898		(800)-665-0898		(866)-403-8293		(866)-403-8293		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		2	2	2
H5810	009	0	1	01	01	H5810_009_0	3	1		07/28/2011	2012.02	07/28/2011 11:34:04 AM Pacific Daylight Time	08/04/2011 07:17:00 PM Pacific Daylight Time	08/04/2011 02:07:00 PM Pacific Daylight Time		08/05/2011 02:51:40 PM Pacific Daylight Time	MOLINA HEALTHCARE OF CALIFORNIA	Molina Healthcare of California	www.molinamedicare.com	Molina Medicare Options (HMO)	01	01		1			H5810	009	0	2012	Sacramento County		2		2			2						www.molinamedicare.com	www.molinamedicare.com	www.molinamedicare.com	(800)-665-0898		(800)-665-0898		(866)-403-8293		(866)-403-8293		(800)-665-0898		(800)-665-0898		(866)-403-8293		(866)-403-8293		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		2	2	2
H5811	001	0	1	01	01	H5811_001_0	5	1		08/08/2011	2012.02	08/08/2011 10:24:04 AM Pacific Daylight Time	08/08/2011 07:38:16 PM Pacific Daylight Time	08/03/2011 03:24:00 PM Pacific Daylight Time		08/09/2011 03:46:53 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Classic (HMO)	01	01		1			H5811	001	0	2012	San Joaquin County		2		2			2						www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5811	002	0	1	01	01	H5811_002_0	4	1	2	07/12/2011	2012.02	07/12/2011 04:01:05 PM Pacific Daylight Time	08/09/2011 03:25:56 PM Pacific Daylight Time	08/03/2011 03:25:00 PM Pacific Daylight Time		08/09/2011 03:46:53 PM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Connections (HMO SNP)	01	01		1			H5811	002	0	2012	San Joaquin County		2		2			1	3		1	2		www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(866)-722-6725		(866)-722-6725		(800)-915-7226		(800)-915-7226		(866)-722-6725		(866)-722-6725		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5811	005	0	1	01	01	H5811_005_0	6	1		08/08/2011	2012.02	08/08/2011 10:24:05 AM Pacific Daylight Time	08/08/2011 07:46:47 PM Pacific Daylight Time	08/03/2011 03:25:00 PM Pacific Daylight Time		08/09/2011 11:19:50 AM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Options (HMO)	01	01		1			H5811	005	0	2012	San Joaquin County		2		2			2						www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H5813	003	0	1	01	01	H5813_003_0	4	1		07/08/2011	2012.02	07/08/2011 11:10:30 AM Central Daylight Time	08/04/2011 01:01:48 PM Central Daylight Time	08/04/2011 10:10:43 AM Central Daylight Time		08/08/2011 09:51:11 AM Central Daylight Time	AETNA HEALTH, INC	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Standard Plan (HMO)	01	01		1			H5813	003	0	2012	New Castle County		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H5813	006	0	1	01	01	H5813_006_0	4	1		07/08/2011	2012.02	07/08/2011 11:10:44 AM Central Daylight Time	08/04/2011 01:32:08 PM Central Daylight Time	08/04/2011 10:11:22 AM Central Daylight Time		08/08/2011 09:51:11 AM Central Daylight Time	AETNA HEALTH, INC	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (HMO)	01	01		1			H5813	006	0	2012	New Castle County		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H5813	801	0	1	01	01	H5813_801_0	1	1		04/22/2011	2012.02	04/22/2011 10:09:52 AM Eastern Daylight Time	06/01/2011 04:05:35 PM Eastern Daylight Time			06/03/2011 10:51:30 AM Eastern Daylight Time	AETNA HEALTH, INC	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan (HMO)	01	01		1			H5813	801	0	2012	Delaware		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748										1	1	1
H5813	802	0	1	01	01	H5813_802_0	1	1		04/22/2011	2012.02	04/22/2011 10:10:41 AM Eastern Daylight Time	06/01/2011 04:11:39 PM Eastern Daylight Time			06/03/2011 10:51:30 AM Eastern Daylight Time	AETNA HEALTH, INC	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan w/Rx CY (HMO)	01	01		1			H5813	802	0	2012	Delaware		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		1	1	1
H5817	009	0	1	01	01	H5817_009_0	7	1	2	07/19/2011	2012.02	07/19/2011 07:56:50 AM Eastern Daylight Time	08/05/2011 09:53:00 AM Eastern Daylight Time	08/04/2011 05:27:00 PM Eastern Daylight Time		08/09/2011 05:31:53 PM Eastern Daylight Time	AMERIGROUP TEXAS, INC.	Amerigroup Community Care	www.myamerigroup.com/medicare	Amerivantage Specialty + Rx (HMO SNP)	01	01		1			H5817	009	0	2012	Houston Metro Area / San Antonio / Fort Worth		2	7011	2			1	3		1	1		www.myamerigroup.com/medicare	https://www.amerigroupcorp.com/members/amerivantage/_documents/Amvtg_FORMULARY.pdf	https://www.amerigroupcorp.com/members/amerivantage/	(866)-805-4589		(866)-805-4589		(877)-470-4131		(877)-470-4131		(866)-805-4589		(866)-805-4589		(877)-470-4131		(877)-470-4131		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		2	2	2
H5817	010	0	1	02	01	H5817_010_0	7	1		07/19/2011	2012.02	07/19/2011 07:56:36 AM Eastern Daylight Time	08/09/2011 11:08:00 AM Eastern Daylight Time	08/04/2011 05:27:00 PM Eastern Daylight Time		08/09/2011 05:31:53 PM Eastern Daylight Time	AMERIGROUP TEXAS, INC.	Amerigroup Community Care	www.myamerigroup.com/medicare	Amerivantage Classic Choice + Rx (HMO-POS)	01	02		1			H5817	010	0	2012	Houston Metro Area / San Antonio / Fort Worth		2	1658	2			2						www.myamerigroup.com/medicare	https://www.amerigroupcorp.com/members/amerivantage/_documents/Amvtg_FORMULARY.pdf	https://www.amerigroupcorp.com/members/amerivantage/	(866)-805-4589		(866)-805-4589		(877)-470-4131		(877)-470-4131		(866)-805-4589		(866)-805-4589		(877)-470-4131		(877)-470-4131		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		2	2	2
H5820	002	0	1	09	04	H5820_002_0	6	1		08/09/2011	2012.02	08/09/2011 10:36:39 AM Eastern Daylight Time	08/09/2011 01:24:32 PM Eastern Daylight Time	08/09/2011 02:15:15 PM Eastern Daylight Time		08/09/2011 06:43:35 PM Eastern Daylight Time	UNIVERSAL HEALTH CARE INSURANCE COMPANY	UNIVERSAL HEALTH CARE INSURANCE COMPANY, INC.	http://www.univhc.com	Any, Any, Any Gold (PFFS)	04	09	2	1			H5820	002	0	2012	National PFFS		2		2			2							www.univhc.com/medicare/members/medicare-formulary.php	http://www.univhc.com	(866)-690-4842		(866)-690-4842		(800)-965-7034		(800)-965-7034		(877)-204-8149		(877)-204-8149		(800)-965-7034		(800)-965-7034		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-759-1089		(800)-759-1089		(800)-617-0177		(800)-617-0177		2		2
H5820	026	0	1	09	04	H5820_026_0	2	1		06/02/2011	2012.02	06/02/2011 03:38:09 PM Eastern Daylight Time	07/22/2011 04:27:50 PM Eastern Daylight Time			07/22/2011 04:38:56 PM Eastern Daylight Time	UNIVERSAL HEALTH CARE INSURANCE COMPANY	UNIVERSAL HEALTH CARE INSURANCE COMPANY, INC.	http://www.univhc.com	Any, Any, Any Gold MA Only (PFFS)	04	09	2	1			H5820	026	0	2012	National PFFS		2		2			2							www.univhc.com/medicare/members/medicare-formulary.php	http://www.univhc.com	(866)-690-4842		(866)-690-4842		(800)-965-7034		(800)-965-7034										(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-617-0177										2		2
H5821	001	0	1	02	01	H5821_001_0	9	1		08/08/2011	2012.02	08/08/2011 03:48:01 PM SA Western Standard Time	08/04/2011 05:22:06 PM SA Western Standard Time	08/04/2011 03:27:21 PM SA Western Standard Time		08/08/2011 03:53:19 PM SA Western Standard Time	MAPFRE LIFE INSURANCE COMPANY	MAPFRE LIFE INSURANCE COMPANY	www.mapfremedicare.com	MAPFRE Medicare Excel (HMO-POS)	01	02		1			H5821	001	0	2012	State of Puerto Rico		2	1098	2			2						www.mapfremedicare.com	http://ww2.mapfremedicare.com/MAPFREMedicare/Formularios.htm	www.mapfremedicare.com	(888)-750-5288		(787)-250-5288		(888)-750-5288		(787)-250-5288		(888)-750-5288		(787)-250-5288		(888)-750-5288		(787)-250-5288		(877)-486-2048		(866)-479-6677		(877)-486-2048		(866)-479-6677		(877)-486-2048		(866)-479-6677		(877)-486-2048		(866)-479-6677		2	2	2
H5821	013	0	1	02	01	H5821_013_0	10	1		08/08/2011	2012.02	08/08/2011 03:48:28 PM SA Western Standard Time	08/08/2011 11:01:36 AM SA Western Standard Time	08/04/2011 03:28:11 PM SA Western Standard Time		08/08/2011 03:53:19 PM SA Western Standard Time	MAPFRE LIFE INSURANCE COMPANY	MAPFRE LIFE INSURANCE COMPANY	www.mapfremedicare.com	MAPFRE Medicare Excel Extended (HMO-POS)	01	02		1			H5821	013	0	2012	State of Puerto Rico		2	10216	2			2						www.mapfremedicare.com	http://ww2.mapfremedicare.com/MAPFREMedicare/Formularios.htm	www.mapfremedicare.com	(888)-750-5288		(787)-250-5288		(888)-750-5288		(787)-250-5288		(888)-750-5288		(787)-250-5288		(888)-750-5288		(787)-250-5288		(877)-486-2048		(866)-479-6677		(877)-486-2048		(866)-479-6677		(877)-486-2048		(866)-479-6677		(877)-486-2048		(866)-479-6677		2	2	2
H5821	020	0	1	01	01	H5821_020_0	8	1		08/08/2011	2012.02	08/08/2011 03:48:57 PM SA Western Standard Time	08/04/2011 04:22:09 PM SA Western Standard Time	08/04/2011 03:29:02 PM SA Western Standard Time		08/08/2011 03:53:19 PM SA Western Standard Time	MAPFRE LIFE INSURANCE COMPANY	MAPFRE LIFE INSURANCE COMPANY	www.mapfremedicare.com	MAPFRE Medicare Excel VIP (HMO)	01	01		1			H5821	020	0	2012	State of Puerto Rico		2	3566	2			2						www.mapfremedicare.com	http://ww2.mapfremedicare.com/MAPFREMedicare/Formularios.htm	www.mapfremedicare.com	(888)-750-5288		(787)-250-5288		(888)-750-5288		(787)-250-5288		(888)-750-5288		(787)-250-5288		(888)-750-5288		(787)-250-5288		(877)-486-2048		(866)-479-6677		(877)-486-2048		(866)-479-6677		(877)-486-2048		(866)-479-6677		(877)-486-2048		(866)-479-6677		2	2	2
H5821	804	0	1	02	01	H5821_804_0	6	1		07/12/2011	2012.02	07/12/2011 08:45:49 AM SA Western Standard Time	07/21/2011 08:31:39 AM SA Western Standard Time			07/21/2011 09:57:43 AM SA Western Standard Time	MAPFRE LIFE INSURANCE COMPANY	MAPFRE LIFE INSURANCE COMPANY	www.mapfremedicare.com	MAPFRE Medicare Excel Employer Plan (HMO-POS)	01	02		1			H5821	804	0	2012	State of Puerto Rico		1	735	2			2						www.mapfremedicare.com	http://ww2.mapfremedicare.com/MAPFREMedicare/Formularios.htm	www.mapfremedicare.com	(888)-750-5288		(787)-250-5288		(888)-750-5288		(787)-250-5288		(888)-750-5288		(787)-250-5288		(888)-750-5288		(787)-250-5288		(877)-486-2048		(866)-479-6677		(877)-486-2048		(866)-479-6677		(877)-486-2048		(866)-479-6677		(877)-486-2048		(866)-479-6677		2	2	2
H5822	001	0	1	20	08	H5822_001_0	1	1		05/23/2011	2012.02	05/23/2011 12:15:52 PM Central Daylight Time		05/23/2011 09:34:22 AM Central Daylight Time		05/23/2011 12:20:47 PM Central Daylight Time	MIDLAND CARE CONNECTION	Midland Care PACE	www.midlandcc.org	Midland Care Connection - Dual Eligibles (PACE)	08	20		1			H5822	001	0	2012	Counties: DG, JA, JF, OS, PT, SN, WB		2		2			2							www.midlandcc.org	www.midlandcc.org									(800)-491-3691		(785)-232-2044		(800)-491-3691		(785)-232-2044										(800)-491-3691		(785)-232-2044		(800)-491-3691		(785)-232-2044				
H5822	002	0	1	20	08	H5822_002_0	1	1		05/23/2011	2012.02	05/23/2011 12:16:14 PM Central Daylight Time		05/23/2011 09:34:22 AM Central Daylight Time		05/23/2011 12:20:47 PM Central Daylight Time	MIDLAND CARE CONNECTION	Midland Care PACE	www.midlandcc.org	Midland Care Connection - Medicare Only (PACE)	08	20		1			H5822	002	0	2012	Counties: DG, JA, JF, OS, PT, SN, WB		2		2			2							www.midlandcc.org	www.midlandcc.org									(800)-491-3691		(785)-232-2044		(800)-491-3691		(785)-232-2044										(800)-491-3691		(785)-232-2044		(800)-491-3691		(785)-232-2044				
H5823	002	0	1	01	01	H5823_002_0	5	1		07/28/2011	2012.02	07/28/2011 11:29:57 AM Pacific Daylight Time	08/04/2011 07:17:00 PM Pacific Daylight Time	08/04/2011 02:07:00 PM Pacific Daylight Time		08/05/2011 02:51:40 PM Pacific Daylight Time	MOLINA HEALTHCARE OF WASHINGTON, INC.	Molina Healthcare of Washington, Inc.	www.molinamedicare.com	Molina Medicare Options (HMO)	01	01		1			H5823	002	0	2012	Western and Eastern Washington		2		2			2						www.molinamedicare.com	www.molinamedicare.com	www.molinamedicare.com	(800)-665-1029		(800)-665-1029		(866)-403-8293		(866)-403-8293		(800)-665-1029		(800)-665-1029		(866)-403-8293		(866)-403-8293		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		2	2	2
H5823	006	0	1	01	01	H5823_006_0	3	1	2	07/28/2011	2012.02	07/28/2011 11:30:07 AM Pacific Daylight Time	08/04/2011 07:26:00 PM Pacific Daylight Time	08/04/2011 06:41:00 PM Pacific Daylight Time		08/05/2011 02:51:40 PM Pacific Daylight Time	MOLINA HEALTHCARE OF WASHINGTON, INC.	Molina Healthcare of Washington, Inc.	www.molinamedicare.com	Molina Medicare Options Plus (HMO SNP)	01	01		1			H5823	006	0	2012	Western and Eastern Washington		2		2			1	3		1	5		www.molinamedicare.com	www.molinamedicare.com	www.molinamedicare.com	(800)-665-1029		(800)-665-1029		(866)-403-8293		(866)-403-8293		(800)-665-1029		(800)-665-1029		(866)-403-8293		(866)-403-8293		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		2	2	2
H5826	005	0	1	01	01	H5826_005_0	8	1	2	07/19/2011	2012.02	07/19/2011 01:20:54 PM Pacific Daylight Time	08/08/2011 07:23:19 AM Pacific Daylight Time	08/08/2011 07:25:50 AM Pacific Daylight Time		08/08/2011 12:44:40 PM Pacific Daylight Time	COMMUNITY HEALTH PLAN OF WASHINGTON	Community HealthFirst Medicare Advantage Plan	www.healthfirst.chpw.org	Community HealthFirst Medicare Advantage SNP (HMO SNP)	01	01		1			H5826	005	0	2012	Eastern and Western Washington State		2		2			1	3		1	3		www.healthfirst.chpw.org	www.healthfirst.chpw.org	www.healthfirst.chpw.org	(800)-942-0247		(800)-942-0247		(800)-944-1247		(800)-944-1247		(800)-942-0247		(800)-942-0247		(800)-944-1247		(800)-944-1247		(866)-816-2479		(866)-816-2479		(866)-816-2479		(866)-816-2479		(866)-816-2479		(866)-816-2479		(866)-816-2479		(866)-816-2479		2	2	2
H5826	006	0	1	01	01	H5826_006_0	3	1		07/19/2011	2012.02	07/19/2011 01:21:25 PM Pacific Daylight Time	05/31/2011 07:45:52 AM Pacific Daylight Time			07/20/2011 08:34:04 AM Pacific Daylight Time	COMMUNITY HEALTH PLAN OF WASHINGTON	Community HealthFirst Medicare Advantage Plan	www.healthfirst.chpw.org	Community HealthFirst Medicare Advantage (HMO)	01	01		1			H5826	006	0	2012	Western Washington, Spokane and Yakima Counties		2		2			2						www.healthfirst.chpw.org	www.healthfirst.chpw.org	www.healthfirst.chpw.org	(800)-942-0247		(800)-942-0247		(800)-944-1247		(800)-944-1247										(866)-816-2479		(866)-816-2479		(866)-816-2479		(866)-816-2479										2	2	2
H5826	008	0	1	01	01	H5826_008_0	5	1		07/19/2011	2012.02	07/19/2011 01:22:04 PM Pacific Daylight Time	08/08/2011 07:23:33 AM Pacific Daylight Time	08/08/2011 07:25:58 AM Pacific Daylight Time		08/08/2011 12:44:40 PM Pacific Daylight Time	COMMUNITY HEALTH PLAN OF WASHINGTON	Community HealthFirst Medicare Advantage Plan	www.healthfirst.chpw.org	Community HealthFirst MA Plan with Pharmacy (HMO)	01	01		1			H5826	008	0	2012	Western Washington, Spokane and Yakima Counties		2		2			2						www.healthfirst.chpw.org	www.healthfirst.chpw.org	www.healthfirst.chpw.org	(800)-942-0247		(800)-942-0247		(800)-944-1247		(800)-944-1247		(800)-942-0247		(800)-942-0247		(800)-944-1247		(800)-944-1247		(866)-816-2479		(866)-816-2479		(866)-816-2479		(866)-816-2479		(866)-816-2479		(866)-816-2479		(866)-816-2479		(866)-816-2479		2	2	2
H5826	009	0	1	01	01	H5826_009_0	5	1		08/08/2011	2012.02	08/08/2011 11:38:15 AM Pacific Daylight Time	08/08/2011 07:24:05 AM Pacific Daylight Time	08/08/2011 07:26:04 AM Pacific Daylight Time		08/08/2011 12:44:40 PM Pacific Daylight Time	COMMUNITY HEALTH PLAN OF WASHINGTON	Community HealthFirst Medicare Advantage Plan	www.healthfirst.chpw.org	Community HealthFirst MA Plan with Pharmacy (HMO)	01	01		1			H5826	009	0	2012	Eastern and Western Washington State		2		2			2						www.healthfirst.chpw.org	www.healthfirst.chpw.org	www.healthfirst.chpw.org	(800)-942-0247		(800)-942-0247		(800)-944-1247		(800)-944-1247		(800)-942-0247		(800)-942-0247		(800)-944-1247		(800)-944-1247		(866)-816-2479		(866)-816-2479		(866)-816-2479		(866)-816-2479		(866)-816-2479		(866)-816-2479		(866)-816-2479		(866)-816-2479		2	2	2
H5826	010	0	1	01	01	H5826_010_0	6	1		08/08/2011	2012.02	08/08/2011 11:38:29 AM Pacific Daylight Time	08/08/2011 07:24:30 AM Pacific Daylight Time	08/08/2011 07:26:09 AM Pacific Daylight Time		08/08/2011 12:44:40 PM Pacific Daylight Time	COMMUNITY HEALTH PLAN OF WASHINGTON	Community HealthFirst Medicare Advantage Plan	www.healthfirst.chpw.org	Community HealthFirst Medicare Advantage Extra (HMO)	01	01		1			H5826	010	0	2012	Western Washington, Spokane and Yakima Counties		2		2			2						www.healthfirst.chpw.org	www.healthfirst.chpw.org	www.healthfirst.chpw.org	(800)-942-0247		(800)-942-0247		(800)-944-1247		(800)-944-1247		(800)-942-0247		(800)-942-0247		(800)-944-1247		(800)-944-1247		(866)-816-2479		(866)-816-2479		(866)-816-2479		(866)-816-2479		(866)-816-2479		(866)-816-2479		(866)-816-2479		(866)-816-2479		2	2	2
H5826	011	0	1	02	01	H5826_011_0	7	1		08/08/2011	2012.02	08/08/2011 11:38:44 AM Pacific Daylight Time	08/08/2011 07:24:48 AM Pacific Daylight Time	08/11/2011 08:49:01 AM Pacific Daylight Time		08/12/2011 10:56:49 AM Pacific Daylight Time	COMMUNITY HEALTH PLAN OF WASHINGTON	Community HealthFirst Medicare Advantage Plan	www.healthfirst.chpw.org	Community HealthFirst Medicare Advantage Premium (HMO-POS)	01	02		1			H5826	011	0	2012	Eastern and Western Washington State		2		2			2						www.healthfirst.chpw.org	www.healthfirst.chpw.org	www.healthfirst.chpw.org	(800)-942-0247		(800)-942-0247		(800)-944-1247		(800)-944-1247		(800)-942-0247		(800)-942-0247		(800)-944-1247		(800)-944-1247		(866)-816-2479		(866)-816-2479		(866)-816-2479		(866)-816-2479		(866)-816-2479		(866)-816-2479		(866)-816-2479		(866)-816-2479		2	2	2
H5826	012	0	1	01	01	H5826_012_0	4	1		08/08/2011	2012.02	08/08/2011 11:38:59 AM Pacific Daylight Time	08/08/2011 07:25:14 AM Pacific Daylight Time	08/11/2011 08:52:10 AM Pacific Daylight Time		08/12/2011 10:56:49 AM Pacific Daylight Time	COMMUNITY HEALTH PLAN OF WASHINGTON	Community HealthFirst Medicare Advantage Plan	www.healthfirst.chpw.org	Community HealthFirst MA Plan, Enhanced Pharmacy (HMO)	01	01		1			H5826	012	0	2012	Eastern and Western Washington State		2		2			2						www.healthfirst.chpw.org	www.healthfirst.chpw.org	www.healthfirst.chpw.org	(800)-942-0247		(800)-942-0247		(800)-944-1247		(800)-944-1247		(800)-942-0247		(800)-942-0247		(800)-944-1247		(800)-944-1247		(866)-816-2479		(866)-816-2479		(866)-816-2479		(866)-816-2479		(866)-816-2479		(866)-816-2479		(866)-816-2479		(866)-816-2479		2	2	2
H5832	001	0	1	01	01	H5832_001_0	4	1		07/18/2011	2012.02	07/18/2011 10:14:32 AM Central Daylight Time	08/04/2011 01:27:01 PM Central Daylight Time	08/04/2011 10:11:49 AM Central Daylight Time		08/08/2011 08:23:16 AM Central Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (HMO)	01	01		1			H5832	001	0	2012	Oklahoma County		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H5832	801	0	1	01	01	H5832_801_0	1	1		04/22/2011	2012.02	04/22/2011 10:11:12 AM Eastern Daylight Time	06/01/2011 04:28:18 PM Eastern Daylight Time			06/03/2011 10:51:30 AM Eastern Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan (HMO)	01	01		1			H5832	801	0	2012	Oklahoma		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748										1	1	1
H5832	802	0	1	01	01	H5832_802_0	1	1		04/22/2011	2012.02	04/22/2011 10:11:50 AM Eastern Daylight Time	06/01/2011 04:32:20 PM Eastern Daylight Time			06/03/2011 10:51:30 AM Eastern Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan w/Rx CY (HMO)	01	01		1			H5832	802	0	2012	Oklahoma		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		1	1	1
H5850	002	0	1	01	01	H5850_002_0	8	1	2	08/10/2011	2012.02	08/10/2011 06:44:54 PM Eastern Daylight Time	08/08/2011 12:34:32 PM Eastern Daylight Time	08/04/2011 02:43:47 PM Eastern Daylight Time		08/10/2011 07:49:17 PM Eastern Daylight Time	COVENTRY SUMMIT HEALTH PLAN, INC.	Coventry Summit Health Plan	http://www.chcflorida.coventry-medicare.com	Coventry Summit Maximum (HMO SNP)	01	01		1			H5850	002	0	2012	Broward and Miami-Dade counties		2	5865	2			1	3		1	2		http://www.chcflorida.coventry-medicare.com	http://www.chcflorida-formulary.coventry-medicare.com	http://www.ProviderDirectory.coventry-medicare.com	(800)-847-3995		(800)-847-3995		(877)-886-3405		(877)-886-3405		(866)-797-8648		(866)-797-8648		(877)-886-3405		(877)-886-3405		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5850	003	0	1	01	01	H5850_003_0	8	1		08/10/2011	2012.02	08/10/2011 06:45:11 PM Eastern Daylight Time	08/08/2011 12:49:38 PM Eastern Daylight Time	08/04/2011 02:48:57 PM Eastern Daylight Time		08/10/2011 07:49:17 PM Eastern Daylight Time	COVENTRY SUMMIT HEALTH PLAN, INC.	Coventry Summit Health Plan	http://www.chcflorida.coventry-medicare.com	Coventry Summit Ideal (HMO)	01	01		1			H5850	003	0	2012	Broward County		2	3601	2			2						http://www.chcflorida.coventry-medicare.com	http://www.chcflorida-formulary.coventry-medicare.com	http://www.ProviderDirectory.coventry-medicare.com	(800)-847-3995		(800)-847-3995		(877)-886-3405		(877)-886-3405		(866)-797-8648		(866)-797-8648		(877)-886-3405		(877)-886-3405		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5850	004	0	1	01	01	H5850_004_0	7	1		08/10/2011	2012.02	08/10/2011 06:45:31 PM Eastern Daylight Time	08/08/2011 01:27:08 PM Eastern Daylight Time	08/04/2011 02:54:49 PM Eastern Daylight Time		08/10/2011 07:49:17 PM Eastern Daylight Time	COVENTRY SUMMIT HEALTH PLAN, INC.	Coventry Summit Health Plan	http://www.chcflorida.coventry-medicare.com	Coventry Summit Ideal (HMO)	01	01		1			H5850	004	0	2012	Palm Beach County		2	1872	2			2						http://www.chcflorida.coventry-medicare.com	http://www.chcflorida-formulary.coventry-medicare.com	http://www.ProviderDirectory.coventry-medicare.com	(800)-847-3995		(800)-847-3995		(877)-886-3405		(877)-886-3405		(866)-797-8648		(866)-797-8648		(877)-886-3405		(877)-886-3405		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5850	005	0	1	01	01	H5850_005_0	7	1		08/10/2011	2012.02	08/10/2011 06:45:47 PM Eastern Daylight Time	08/08/2011 01:31:31 PM Eastern Daylight Time	08/04/2011 03:00:13 PM Eastern Daylight Time		08/10/2011 07:49:17 PM Eastern Daylight Time	COVENTRY SUMMIT HEALTH PLAN, INC.	Coventry Summit Health Plan	http://www.chcflorida.coventry-medicare.com	Coventry Summit Ideal (HMO)	01	01		1			H5850	005	0	2012	Martin County		2	562	2			2						http://www.chcflorida.coventry-medicare.com	http://www.chcflorida-formulary.coventry-medicare.com	http://www.ProviderDirectory.coventry-medicare.com	(800)-847-3995		(800)-847-3995		(877)-886-3405		(877)-886-3405		(866)-797-8648		(866)-797-8648		(877)-886-3405		(877)-886-3405		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5850	006	0	1	01	01	H5850_006_0	7	1		08/10/2011	2012.02	08/10/2011 06:46:06 PM Eastern Daylight Time	08/08/2011 01:29:56 PM Eastern Daylight Time	08/04/2011 03:06:04 PM Eastern Daylight Time		08/10/2011 07:49:17 PM Eastern Daylight Time	COVENTRY SUMMIT HEALTH PLAN, INC.	Coventry Summit Health Plan	http://www.chcflorida.coventry-medicare.com	Coventry Summit Plus (HMO)	01	01		1			H5850	006	0	2012	Miami-Dade County		2	3064	2			2						http://www.chcflorida.coventry-medicare.com	http://www.chcflorida-formulary.coventry-medicare.com	http://www.ProviderDirectory.coventry-medicare.com	(800)-847-3995		(800)-847-3995		(877)-886-3405		(877)-886-3405		(866)-797-8648		(866)-797-8648		(877)-886-3405		(877)-886-3405		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5850	007	0	1	01	01	H5850_007_0	8	1		08/10/2011	2012.02	08/10/2011 06:46:26 PM Eastern Daylight Time	08/08/2011 01:28:01 PM Eastern Daylight Time	08/04/2011 03:11:24 PM Eastern Daylight Time		08/10/2011 07:49:17 PM Eastern Daylight Time	COVENTRY SUMMIT HEALTH PLAN, INC.	Coventry Summit Health Plan	http://www.chcflorida.coventry-medicare.com	Coventry Summit Ideal (HMO)	01	01		1			H5850	007	0	2012	St. Lucie County		2	2393	2			2						http://www.chcflorida.coventry-medicare.com	http://www.chcflorida-formulary.coventry-medicare.com	http://www.ProviderDirectory.coventry-medicare.com	(800)-847-3995		(800)-847-3995		(877)-886-3405		(877)-886-3405		(866)-797-8648		(866)-797-8648		(877)-886-3405		(877)-886-3405		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5850	012	0	1	01	01	H5850_012_0	7	1		08/10/2011	2012.02	08/10/2011 06:46:40 PM Eastern Daylight Time	08/08/2011 01:25:27 PM Eastern Daylight Time	08/04/2011 03:24:29 PM Eastern Daylight Time		08/10/2011 07:49:17 PM Eastern Daylight Time	COVENTRY SUMMIT HEALTH PLAN, INC.	Coventry Summit Health Plan	http://www.chcflorida.coventry-medicare.com	Coventry Summit Ideal (HMO)	01	01		1			H5850	012	0	2012	Miami-Dade County		2	3412	2			2						http://www.chcflorida.coventry-medicare.com	http://www.chcflorida-formulary.coventry-medicare.com	http://www.ProviderDirectory.coventry-medicare.com	(800)-847-3995		(800)-847-3995		(877)-886-3405		(877)-886-3405		(866)-797-8648		(866)-797-8648		(877)-886-3405		(877)-886-3405		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5850	020	0	1	01	01	H5850_020_0	7	1		08/10/2011	2012.02	08/10/2011 06:46:57 PM Eastern Daylight Time	08/08/2011 01:23:31 PM Eastern Daylight Time	08/04/2011 03:05:13 PM Eastern Daylight Time		08/10/2011 07:49:17 PM Eastern Daylight Time	COVENTRY SUMMIT HEALTH PLAN, INC.	Coventry Summit Health Plan	http://www.chcflorida.coventry-medicare.com	Coventry Advantra Ideal (HMO)	01	01		1			H5850	020	0	2012	Hernando County		2	210	2			2						http://www.chcflorida.coventry-medicare.com	http://www.chcflorida-formulary.coventry-medicare.com	http://www.ProviderDirectory.coventry-medicare.com	(800)-847-3995		(800)-847-3995		(877)-886-3405		(877)-886-3405		(866)-797-8648		(866)-797-8648		(877)-886-3405		(877)-886-3405		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5850	021	0	1	01	01	H5850_021_0	7	1	2	08/10/2011	2012.02	08/10/2011 06:47:17 PM Eastern Daylight Time	08/08/2011 01:21:28 PM Eastern Daylight Time	08/04/2011 02:54:12 PM Eastern Daylight Time		08/10/2011 07:49:17 PM Eastern Daylight Time	COVENTRY SUMMIT HEALTH PLAN, INC.	Coventry Summit Health Plan	http://www.chcflorida.coventry-medicare.com	Coventry Advantra Maximum (HMO SNP)	01	01		1			H5850	021	0	2012	Hernando, Hillsborough, Pasco, Pinellas, Polk area		2	3737	2			1	3		1	2		http://www.chcflorida.coventry-medicare.com	http://www.chcflorida-formulary.coventry-medicare.com	http://www.ProviderDirectory.coventry-medicare.com	(800)-847-3995		(800)-847-3995		(877)-886-3405		(877)-886-3405		(866)-797-8648		(866)-797-8648		(877)-886-3405		(877)-886-3405		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5850	022	0	1	01	01	H5850_022_0	7	1		08/10/2011	2012.02	08/10/2011 06:47:31 PM Eastern Daylight Time	08/08/2011 01:18:46 PM Eastern Daylight Time	08/04/2011 02:15:47 PM Eastern Daylight Time		08/10/2011 07:49:17 PM Eastern Daylight Time	COVENTRY SUMMIT HEALTH PLAN, INC.	Coventry Summit Health Plan	http://www.chcflorida.coventry-medicare.com	Coventry Summit Plus (HMO)	01	01		1			H5850	022	0	2012	Broward and St. Lucie Counties		2	764	2			2						http://www.chcflorida.coventry-medicare.com	http://www.chcflorida-formulary.coventry-medicare.com	http://www.ProviderDirectory.coventry-medicare.com	(800)-847-3995		(800)-847-3995		(877)-886-3405		(877)-886-3405		(866)-797-8648		(866)-797-8648		(877)-886-3405		(877)-886-3405		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5850	023	0	1	01	01	H5850_023_0	6	1	2	08/10/2011	2012.02	08/10/2011 06:47:46 PM Eastern Daylight Time	08/08/2011 01:16:33 PM Eastern Daylight Time	08/04/2011 01:20:48 PM Eastern Daylight Time		08/10/2011 07:49:17 PM Eastern Daylight Time	COVENTRY SUMMIT HEALTH PLAN, INC.	Coventry Summit Health Plan	http://www.chcflorida.coventry-medicare.com	Coventry Summit Maximum (HMO SNP)	01	01		1			H5850	023	0	2012	St. Lucie County		2	456	2			1	3		1	2		http://www.chcflorida.coventry-medicare.com	http://www.chcflorida-formulary.coventry-medicare.com	http://www.ProviderDirectory.coventry-medicare.com	(800)-847-3995		(800)-847-3995		(877)-886-3405		(877)-886-3405		(866)-797-8648		(866)-797-8648		(877)-886-3405		(877)-886-3405		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5850	024	0	1	02	01	H5850_024_0	7	1		08/10/2011	2012.02	08/10/2011 06:48:00 PM Eastern Daylight Time	08/08/2011 01:14:21 PM Eastern Daylight Time	08/04/2011 01:10:14 PM Eastern Daylight Time		08/10/2011 07:49:17 PM Eastern Daylight Time	COVENTRY SUMMIT HEALTH PLAN, INC.	Coventry Summit Health Plan	http://www.chcflorida.coventry-medicare.com	Coventry Summit Select (HMO-POS)	01	02		1			H5850	024	0	2012	Broward and Palm Beach Counties		2	680	2			2						http://www.chcflorida.coventry-medicare.com	http://www.chcflorida-formulary.coventry-medicare.com	http://www.ProviderDirectory.coventry-medicare.com	(800)-847-3995		(800)-847-3995		(877)-886-3405		(877)-886-3405		(866)-797-8648		(866)-797-8648		(877)-886-3405		(877)-886-3405		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5850	025	0	1	01	01	H5850_025_0	7	1		08/10/2011	2012.02	08/10/2011 06:48:16 PM Eastern Daylight Time	08/08/2011 01:10:42 PM Eastern Daylight Time	08/04/2011 12:15:35 PM Eastern Daylight Time		08/10/2011 07:49:17 PM Eastern Daylight Time	COVENTRY SUMMIT HEALTH PLAN, INC.	Coventry Summit Health Plan	http://www.chcflorida.coventry-medicare.com	Coventry Advantra Ideal (HMO)	01	01		1			H5850	025	0	2012	Hillsborough, Pinellas and Polk counties		2	812	2			2						http://www.chcflorida.coventry-medicare.com	http://www.chcflorida-formulary.coventry-medicare.com	http://www.ProviderDirectory.coventry-medicare.com	(800)-847-3995		(800)-847-3995		(877)-886-3405		(877)-886-3405		(866)-797-8648		(866)-797-8648		(877)-886-3405		(877)-886-3405		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5850	026	0	1	02	01	H5850_026_0	8	1		08/10/2011	2012.02	08/10/2011 06:48:33 PM Eastern Daylight Time	08/08/2011 01:07:40 PM Eastern Daylight Time	08/04/2011 11:59:17 AM Eastern Daylight Time		08/10/2011 07:49:17 PM Eastern Daylight Time	COVENTRY SUMMIT HEALTH PLAN, INC.	Coventry Summit Health Plan	http://www.chcflorida.coventry-medicare.com	Coventry Advantra Select Plus (HMO-POS)	01	02		1			H5850	026	0	2012	Hernando, Hillsborough, Pinellas counties		2	1616	2			2						http://www.chcflorida.coventry-medicare.com	http://www.chcflorida-formulary.coventry-medicare.com	http://www.ProviderDirectory.coventry-medicare.com	(800)-847-3995		(800)-847-3995		(877)-886-3405		(877)-886-3405		(866)-797-8648		(866)-797-8648		(877)-886-3405		(877)-886-3405		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5850	802	0	1	01	01	H5850_802_0	5	1		05/27/2011	2012.02	05/27/2011 09:45:27 PM Eastern Daylight Time	07/27/2011 11:40:42 AM Eastern Daylight Time			07/28/2011 04:56:54 PM Eastern Daylight Time	COVENTRY SUMMIT HEALTH PLAN, INC.	Coventry Summit Health Plan	http://www.chcflorida.coventry-medicare.com	Coventry Summit Group Ideal (HMO)	01	01		1			H5850	802	0	2012	Nationwide		1	116	2			2						http://www.chcflorida.coventry-medicare.com	http://www.chcflorida-formulary.coventry-medicare.com	http://www.ProviderDirectory.coventry-medicare.com	(800)-847-3995		(800)-847-3995		(877)-886-3405		(877)-886-3405		(866)-797-8648		(866)-797-8648		(877)-886-3405		(877)-886-3405		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H5850	803	0	1	01	01	H5850_803_0	5	1		05/27/2011	2012.02	05/27/2011 09:46:11 PM Eastern Daylight Time	07/27/2011 12:02:06 PM Eastern Daylight Time			07/28/2011 04:56:54 PM Eastern Daylight Time	COVENTRY SUMMIT HEALTH PLAN, INC.	Coventry Summit Health Plan	http://www.chcflorida.coventry-medicare.com	Coventry Summit Group Value (HMO)	01	01		1			H5850	803	0	2012	Nationwide		1	116	2			2						http://www.chcflorida.coventry-medicare.com	http://www.chcflorida-formulary.coventry-medicare.com	http://www.ProviderDirectory.coventry-medicare.com	(800)-847-3995		(800)-847-3995		(877)-886-3405		(877)-886-3405										(711)		(711)		(711)		(711)										1	1	1
H5850	805	0	1	01	01	H5850_805_0	5	1		05/27/2011	2012.02	05/27/2011 09:47:12 PM Eastern Daylight Time	07/27/2011 12:21:08 PM Eastern Daylight Time			07/28/2011 04:56:54 PM Eastern Daylight Time	COVENTRY SUMMIT HEALTH PLAN, INC.	Coventry Summit Health Plan	http://www.chcflorida.coventry-medicare.com	Coventry Summit Group Choice (HMO)	01	01		1			H5850	805	0	2012	Nationwide		1	116	2			2						http://www.chcflorida.coventry-medicare.com	http://www.chcflorida-formulary.coventry-medicare.com	http://www.ProviderDirectory.coventry-medicare.com	(800)-847-3995		(800)-847-3995		(877)-886-3405		(877)-886-3405		(866)-797-8648		(866)-797-8648		(877)-886-3405		(877)-886-3405		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H5852	001	0	1	01	01	H5852_001_0	6	1		08/10/2011	2012.02	08/10/2011 09:49:39 AM Pacific Daylight Time	08/08/2011 02:30:02 PM Pacific Daylight Time	08/08/2011 02:30:02 PM Pacific Daylight Time		08/10/2011 11:21:19 AM Pacific Daylight Time	AIDS HEALTHCARE FOUNDATION	POSITIVE HEALTHCARE PARTNERS	www.positivehealthcare.org	POSITIVE HEALTHCARE PARTNERS (HMO SNP)	01	01		1			H5852	001	0	2012	POSITIVE HEALTHCARE PARTNERS LOS ANGELES COUNTY		2	884	2			1	4		1		00000000001000000000	www.positivehealthcare.org	www.positivehealthcare.org	www.positivehealthcare.org	(800)-263-0067		(800)-263-0067		(800)-263-0067		(800)-263-0067		(888)-436-5018		(888)-436-5018		(800)-263-0067		(800)-263-0067		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5854	005	0	1	01	01	H5854_005_0	10	1		08/04/2011	2012.02	08/04/2011 03:59:33 PM Eastern Daylight Time	08/08/2011 06:21:53 PM Eastern Daylight Time	08/08/2011 06:22:30 PM Eastern Daylight Time		08/08/2011 06:27:58 PM Eastern Daylight Time	ANTHEM HEALTH PLANS, INC	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem MediBlue Value (HMO)	01	01		1			H5854	005	0	2012	State of Connecticut		2	2003	2			2						www.anthem.com/medicare	www.anthem.com	www.anthem.com	(866)-673-4157		(866)-673-4157		(800)-797-0984		(800)-797-0984		(866)-673-4157		(866)-673-4157		(800)-797-0984		(800)-797-0984		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		2	2	2
H5854	801	0	1	01	01	H5854_801_0	3	1		06/04/2011	2012.02	06/04/2011 09:17:05 AM Pacific Daylight Time	06/06/2011 09:02:55 PM Pacific Daylight Time			06/06/2011 09:11:31 PM Pacific Daylight Time	ANTHEM HEALTH PLANS, INC	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem MediBlue (HMO)	01	01		1			H5854	801	0	2012	Connecticut		1	500	2			2						www.anthem.com/medicare	www.anthem.com	www.anthem.com	(866)-220-9827		(866)-220-9827		(866)-220-9827		(866)-220-9827		(866)-220-9827		(866)-220-9827		(866)-220-9827		(866)-220-9827		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		2	2	2
H5854	803	0	1	01	01	H5854_803_0	2	1		06/04/2011	2012.02	06/04/2011 06:24:23 PM Pacific Daylight Time	06/06/2011 09:02:55 PM Pacific Daylight Time			06/06/2011 09:11:31 PM Pacific Daylight Time	ANTHEM HEALTH PLANS, INC	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem MediBlue (HMO)	01	01		1			H5854	803	0	2012	Connecticut		1	50	2			2						www.anthem.com/medicare	www.anthem.com	www.anthem.com	(866)-220-9827		(866)-220-9827		(866)-220-9827		(866)-220-9827										(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894										2	2	2
H5854	805	0	1	01	01	H5854_805_0	2	1		06/04/2011	2012.02	06/04/2011 06:24:32 PM Pacific Daylight Time	06/06/2011 09:02:55 PM Pacific Daylight Time			06/06/2011 09:11:31 PM Pacific Daylight Time	ANTHEM HEALTH PLANS, INC	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Anthem MediBlue (HMO)	01	01		1			H5854	805	0	2012	Connecticut		1	50	2			2						www.anthem.com/medicare	www.anthem.com	www.anthem.com	(866)-220-9827		(866)-220-9827		(866)-220-9827		(866)-220-9827		(866)-220-9827		(866)-220-9827		(866)-220-9827		(866)-220-9827		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		(800)-241-6894		2	2	2
H5859	001	0	1	02	01	H5859_001_0	6	1	2	07/18/2011	2012.02	07/18/2011 03:59:01 PM Pacific Daylight Time	08/04/2011 03:21:05 PM Pacific Daylight Time	08/04/2011 03:21:06 PM Pacific Daylight Time		08/04/2011 04:18:42 PM Pacific Daylight Time	HEALTH PLAN OF CAREOREGON, INC.	CareOregon Advantage	www.careoregonadvantage.org	CareOregon Advantage Plus (HMO-POS SNP)	01	02		1			H5859	001	0	2012	Portland/Salem Area, Northwest and Southern Oregon		2	90000	2			1	3		1	3		http://www.careoregonadvantage.org	http://www.careoregon.org/medicare/formulary.html	http://www.careoregonadvantage.org	(800)-224-4840		(503)-416-4100		(800)-224-4840		(503)-416-4100		(800)-224-4840		(503)-416-4100		(800)-224-4840		(503)-416-4100		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		2	2	2
H5859	003	0	1	02	01	H5859_003_0	8	1		07/18/2011	2012.02	07/18/2011 03:32:39 PM Pacific Daylight Time	08/04/2011 03:21:06 PM Pacific Daylight Time	08/04/2011 03:21:05 PM Pacific Daylight Time		08/04/2011 04:18:42 PM Pacific Daylight Time	HEALTH PLAN OF CAREOREGON, INC.	CareOregon Advantage	www.careoregonadvantage.org	CareOregon Advantage Star (HMO-POS)	01	02		1			H5859	003	0	2012	Portland/Salem Area, Northwest and Southern Oregon		2	11000	2			2						http://www.careoregonadvantage.org	http://www.careoregon.org/medicare/formulary.html	http://www.careoregonadvantage.org	(800)-224-4840		(503)-416-4100		(800)-224-4840		(503)-416-4100		(800)-224-4840		(503)-416-4100		(800)-224-4840		(503)-416-4100		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		2	2	2
H5868	001	0	1	04	01	H5868_001_0	8	1		07/08/2011	2012.02	07/08/2011 10:16:28 AM Eastern Daylight Time	05/27/2011 03:16:13 PM Eastern Daylight Time	08/04/2011 12:42:05 PM Eastern Daylight Time		08/09/2011 10:58:20 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H5868-001 (PPO)	01	04		1			H5868	001	0	2012	Iowa Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5868	004	0	1	04	01	H5868_004_0	7	1		07/06/2011	2012.02	07/06/2011 01:14:53 PM Eastern Daylight Time	05/27/2011 03:15:16 PM Eastern Daylight Time			07/08/2011 12:45:11 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H5868-004 (PPO)	01	04		1			H5868	004	0	2012	Iowa Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H5883	001	1	1	02	01	H5883_001_1	5	1		07/13/2011	2012.02	07/13/2011 04:49:24 PM Eastern Daylight Time	07/18/2011 01:41:08 PM Eastern Daylight Time			07/19/2011 11:52:50 AM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	http://www.mibcn.com/medicare	BCN Advantage HMO-POS Elements (HMO-POS)	01	02		1			H5883	001	1	2012	Michigan	Cnty: Kent, Newaygo, Ott, Musk, Algn, VanB, Oceana	2	360	2			2						http://www.mibcn.com/medicareproviders	http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicarepharmacies	(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583										(711)		(711)		(800)-481-8704		(800)-481-8704										2	2	2
H5883	001	2	1	02	01	H5883_001_2	5	1		07/01/2011	2012.02	07/01/2011 02:06:37 PM Eastern Daylight Time	07/18/2011 01:41:17 PM Eastern Daylight Time			07/19/2011 11:52:50 AM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	http://www.mibcn.com/medicare	BCN Advantage HMO-POS Elements (HMO-POS)	01	02		1			H5883	001	2	2012	Michigan	Cnty: Clin, Eat, Ing, Kzoo, Barry, Grat, Ion, Mid	2	286	2			2						http://www.mibcn.com/medicareproviders	http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicarepharmacies	(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583										(711)		(711)		(800)-481-8704		(800)-481-8704										2	2	2
H5883	001	3	1	02	01	H5883_001_3	5	1		07/01/2011	2012.02	07/01/2011 02:06:38 PM Eastern Daylight Time	07/18/2011 01:41:27 PM Eastern Daylight Time			07/19/2011 11:52:50 AM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	http://www.mibcn.com/medicare	BCN Advantage HMO-POS Elements (HMO-POS)	01	02		1			H5883	001	3	2012	Michigan	Cnty: Calh, Jack, Liv, Monroe, Mont, Wash	2	244	2			2						http://www.mibcn.com/medicareproviders	http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicarepharmacies	(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583										(711)		(711)		(800)-481-8704		(800)-481-8704										2	2	2
H5883	001	4	1	02	01	H5883_001_4	5	1		07/01/2011	2012.02	07/01/2011 02:06:38 PM Eastern Daylight Time	07/18/2011 01:41:36 PM Eastern Daylight Time			07/19/2011 11:52:50 AM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	http://www.mibcn.com/medicare	BCN Advantage HMO-POS Elements (HMO-POS)	01	02		1			H5883	001	4	2012	Michigan	Cnty: Bay, Gen, Lap, Sag, Shia, Tus	2	203	2			2						http://www.mibcn.com/medicareproviders	http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicarepharmacies	(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583										(711)		(711)		(800)-481-8704		(800)-481-8704										2	2	2
H5883	001	5	1	02	01	H5883_001_5	5	1		07/01/2011	2012.02	07/01/2011 02:06:39 PM Eastern Daylight Time	07/18/2011 01:41:46 PM Eastern Daylight Time			07/19/2011 11:52:50 AM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	http://www.mibcn.com/medicare	BCN Advantage HMO-POS Elements (HMO-POS)	01	02		1			H5883	001	5	2012	Michigan	Macomb, Oakland, St. Clair, Wayne counties	2	674	2			2						http://www.mibcn.com/medicareproviders	http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicarepharmacies	(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583										(711)		(711)		(800)-481-8704		(800)-481-8704										2	2	2
H5883	002	1	1	02	01	H5883_002_1	7	1		07/14/2011	2012.02	07/14/2011 10:56:48 AM Eastern Daylight Time	08/04/2011 05:29:44 PM Eastern Daylight Time	08/05/2011 11:01:01 AM Eastern Daylight Time		08/08/2011 03:22:27 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	http://www.mibcn.com/medicare	BCN Advantage HMO-POS Classic (HMO-POS)	01	02		1			H5883	002	1	2012	Michigan	Cnty: Kent, Newaygo, Ott, Musk, Algn, VanB, Oceana	2	4122	2			2						http://www.mibcn.com/medicareproviders	http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicarepharmacies	(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583		(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583		(711)		(711)		(800)-481-8704		(800)-481-8704		(711)		(711)		(800)-481-8704		(800)-481-8704		2	2	2
H5883	002	2	1	02	01	H5883_002_2	6	1		07/12/2011	2012.02	07/12/2011 03:17:08 PM Eastern Daylight Time	08/04/2011 05:29:53 PM Eastern Daylight Time	08/05/2011 11:01:05 AM Eastern Daylight Time		08/08/2011 03:22:27 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	http://www.mibcn.com/medicare	BCN Advantage HMO-POS Classic (HMO-POS)	01	02		1			H5883	002	2	2012	Michigan	Cnty: Clin, Eat, Ing, Kzoo, Barry, Grat, Ion, Mid	2	2121	2			2						http://www.mibcn.com/medicareproviders	http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicarepharmacies	(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583		(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583		(711)		(711)		(800)-481-8704		(800)-481-8704		(711)		(711)		(800)-481-8704		(800)-481-8704		2	2	2
H5883	002	3	1	02	01	H5883_002_3	6	1		07/14/2011	2012.02	07/14/2011 11:43:21 AM Eastern Daylight Time	08/04/2011 05:30:02 PM Eastern Daylight Time	08/05/2011 11:01:09 AM Eastern Daylight Time		08/08/2011 03:22:27 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	http://www.mibcn.com/medicare	BCN Advantage HMO-POS Classic (HMO-POS)	01	02		1			H5883	002	3	2012	Michigan	Cnty: Calh, Jack, Liv, Monroe, Mont, Wash	2	2460	2			2						http://www.mibcn.com/medicareproviders	http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicarepharmacies	(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583		(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583		(711)		(711)		(800)-481-8704		(800)-481-8704		(711)		(711)		(800)-481-8704		(800)-481-8704		2	2	2
H5883	002	4	1	02	01	H5883_002_4	6	1		07/08/2011	2012.02	07/08/2011 01:50:49 PM Eastern Daylight Time	08/04/2011 05:30:11 PM Eastern Daylight Time	08/05/2011 11:01:13 AM Eastern Daylight Time		08/08/2011 03:22:27 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	http://www.mibcn.com/medicare	BCN Advantage HMO-POS Classic (HMO-POS)	01	02		1			H5883	002	4	2012	Michigan	Cnty: Bay, Gen, Lap, Sag, Shia, Tus	2	2232	2			2						http://www.mibcn.com/medicareproviders	http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicarepharmacies	(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583		(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583		(711)		(711)		(800)-481-8704		(800)-481-8704		(711)		(711)		(800)-481-8704		(800)-481-8704		2	2	2
H5883	002	7	1	02	01	H5883_002_7	6	1		07/01/2011	2012.02	07/01/2011 01:58:07 PM Eastern Daylight Time	08/04/2011 05:30:20 PM Eastern Daylight Time	08/05/2011 11:01:17 AM Eastern Daylight Time		08/08/2011 03:22:27 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	http://www.mibcn.com/medicare	BCN Advantage HMO-POS Classic (HMO-POS)	01	02		1			H5883	002	7	2012	Michigan	Macomb, Oakland, St. Clair, Wayne counties	2	7869	2			2						http://www.mibcn.com/medicareproviders	http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicarepharmacies	(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583		(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583		(711)		(711)		(800)-481-8704		(800)-481-8704		(711)		(711)		(800)-481-8704		(800)-481-8704		2	2	2
H5883	003	1	1	02	01	H5883_003_1	7	1		07/12/2011	2012.02	07/12/2011 03:45:40 PM Eastern Daylight Time	08/04/2011 05:30:28 PM Eastern Daylight Time	08/05/2011 11:01:21 AM Eastern Daylight Time		08/08/2011 03:22:27 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	http://www.mibcn.com/medicare	BCN Advantage HMO-POS Prestige (HMO-POS)	01	02		1			H5883	003	1	2012	Michigan	Cnty: Kent, Newaygo, Ott, Musk, Algn, VanB, Oceana	2	586	2			2						http://www.mibcn.com/medicareproviders	http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicarepharmacies	(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583		(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583		(711)		(711)		(800)-481-8704		(800)-481-8704		(711)		(711)		(800)-481-8704		(800)-481-8704		2	2	2
H5883	003	2	1	02	01	H5883_003_2	7	1		07/01/2011	2012.02	07/01/2011 02:07:16 PM Eastern Daylight Time	08/04/2011 05:30:37 PM Eastern Daylight Time	08/05/2011 11:01:26 AM Eastern Daylight Time		08/08/2011 03:22:27 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	http://www.mibcn.com/medicare	BCN Advantage HMO-POS Prestige (HMO-POS)	01	02		1			H5883	003	2	2012	Michigan	Cnty: Clin, Eat, Ing, Kzoo, Barry, Grat, Ion, Mid	2	586	2			2						http://www.mibcn.com/medicareproviders	http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicarepharmacies	(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583		(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583		(711)		(711)		(800)-481-8704		(800)-481-8704		(711)		(711)		(800)-481-8704		(800)-481-8704		2	2	2
H5883	003	3	1	02	01	H5883_003_3	7	1		07/14/2011	2012.02	07/14/2011 11:44:26 AM Eastern Daylight Time	08/04/2011 05:30:46 PM Eastern Daylight Time	08/05/2011 11:01:30 AM Eastern Daylight Time		08/08/2011 03:22:27 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	http://www.mibcn.com/medicare	BCN Advantage HMO-POS Prestige (HMO-POS)	01	02		1			H5883	003	3	2012	Michigan	Cnty: Calh, Jack, Liv, Monroe, Mont, Wash	2	921	2			2						http://www.mibcn.com/medicareproviders	http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicarepharmacies	(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583		(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583		(711)		(711)		(800)-481-8704		(800)-481-8704		(711)		(711)		(800)-481-8704		(800)-481-8704		2	2	2
H5883	003	4	1	02	01	H5883_003_4	7	1		07/01/2011	2012.02	07/01/2011 02:07:17 PM Eastern Daylight Time	08/04/2011 05:30:55 PM Eastern Daylight Time	08/05/2011 11:01:34 AM Eastern Daylight Time		08/08/2011 03:22:27 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	http://www.mibcn.com/medicare	BCN Advantage HMO-POS Prestige (HMO-POS)	01	02		1			H5883	003	4	2012	Michigan	Cnty: Bay, Gen, Lap, Sag, Shia, Tus	2	517	2			2						http://www.mibcn.com/medicareproviders	http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicarepharmacies	(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583		(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583		(711)		(711)		(800)-481-8704		(800)-481-8704		(711)		(711)		(800)-481-8704		(800)-481-8704		2	2	2
H5883	003	5	1	02	01	H5883_003_5	7	1		07/01/2011	2012.02	07/01/2011 02:07:18 PM Eastern Daylight Time	08/04/2011 05:31:04 PM Eastern Daylight Time	08/05/2011 11:01:38 AM Eastern Daylight Time		08/08/2011 03:22:27 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	http://www.mibcn.com/medicare	BCN Advantage HMO-POS Prestige (HMO-POS)	01	02		1			H5883	003	5	2012	Michigan	Macomb, Oakland, St. Clair, Wayne counties	2	3103	2			2						http://www.mibcn.com/medicareproviders	http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicarepharmacies	(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583		(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583		(711)		(711)		(800)-481-8704		(800)-481-8704		(711)		(711)		(800)-481-8704		(800)-481-8704		2	2	2
H5883	004	1	1	02	01	H5883_004_1	8	1		08/09/2011	2012.02	08/09/2011 02:38:29 PM Eastern Daylight Time	08/04/2011 05:31:12 PM Eastern Daylight Time	08/05/2011 11:01:43 AM Eastern Daylight Time		08/09/2011 03:51:33 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	http://www.mibcn.com/medicare	BCN Advantage HMO-POS Basic (HMO-POS)	01	02		1			H5883	004	1	2012	Michigan	Cnty: Kent, Newaygo, Ott, Musk, Algn, VanB, Oceana	2	187	2			2						http://www.mibcn.com/medicareproviders	http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicarepharmacies	(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583		(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583		(711)		(711)		(800)-481-8704		(800)-481-8704		(711)		(711)		(800)-481-8704		(800)-481-8704		2	2	2
H5883	004	2	1	02	01	H5883_004_2	7	1		08/09/2011	2012.02	08/09/2011 02:36:27 PM Eastern Daylight Time	08/04/2011 05:31:21 PM Eastern Daylight Time	08/05/2011 11:01:47 AM Eastern Daylight Time		08/09/2011 03:51:33 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	http://www.mibcn.com/medicare	BCN Advantage HMO-POS Basic (HMO-POS)	01	02		1			H5883	004	2	2012	Michigan	Cnty: Clin, Eat, Ing, Kzoo, Barry, Grat, Ion, Mid	2	271	2			2						http://www.mibcn.com/medicareproviders	http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicarepharmacies	(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583		(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583		(711)		(711)		(800)-481-8704		(800)-481-8704		(711)		(711)		(800)-481-8704		(800)-481-8704		2	2	2
H5883	004	3	1	02	01	H5883_004_3	8	1		08/09/2011	2012.02	08/09/2011 02:37:08 PM Eastern Daylight Time	08/04/2011 05:31:29 PM Eastern Daylight Time	08/05/2011 11:01:52 AM Eastern Daylight Time		08/09/2011 03:51:33 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	http://www.mibcn.com/medicare	BCN Advantage HMO-POS Basic (HMO-POS)	01	02		1			H5883	004	3	2012	Michigan	Cnty: Calh, Jack, Liv, Monroe, Mont, Wash	2	183	2			2						http://www.mibcn.com/medicareproviders	http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicarepharmacies	(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583		(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583		(711)		(711)		(800)-481-8704		(800)-481-8704		(711)		(711)		(800)-481-8704		(800)-481-8704		2	2	2
H5883	004	4	1	02	01	H5883_004_4	8	1		08/09/2011	2012.02	08/09/2011 02:37:36 PM Eastern Daylight Time	08/04/2011 05:31:37 PM Eastern Daylight Time	08/05/2011 11:01:57 AM Eastern Daylight Time		08/09/2011 03:51:33 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	http://www.mibcn.com/medicare	BCN Advantage HMO-POS Basic (HMO-POS)	01	02		1			H5883	004	4	2012	Michigan	Cnty: Bay, Gen, Lap, Sag, Shia, Tus	2	119	2			2						http://www.mibcn.com/medicareproviders	http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicarepharmacies	(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583		(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583		(711)		(711)		(800)-481-8704		(800)-481-8704		(711)		(711)		(800)-481-8704		(800)-481-8704		2	2	2
H5883	004	5	1	02	01	H5883_004_5	8	1		08/09/2011	2012.02	08/09/2011 02:38:09 PM Eastern Daylight Time	08/04/2011 05:31:46 PM Eastern Daylight Time	08/05/2011 11:02:02 AM Eastern Daylight Time		08/09/2011 03:51:33 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	http://www.mibcn.com/medicare	BCN Advantage HMO-POS Basic (HMO-POS)	01	02		1			H5883	004	5	2012	Michigan	Macomb, Oakland, St. Clair, Wayne counties	2	506	2			2						http://www.mibcn.com/medicareproviders	http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicarepharmacies	(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583		(800)-450-3680		(800)-450-3680		(877)-469-2583		(877)-469-2583		(711)		(711)		(800)-481-8704		(800)-481-8704		(711)		(711)		(800)-481-8704		(800)-481-8704		2	2	2
H5883	801	0	1	02	01	H5883_801_0	7	1		06/29/2011	2012.02	06/29/2011 03:35:10 PM Eastern Daylight Time	07/28/2011 10:12:30 AM Eastern Daylight Time			07/28/2011 02:45:45 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	http://www.mibcn.com/medicare	BCN Advantage (HMO-POS)	01	02		1			H5883	801	0	2012	Employer Group		1	12886	2			2						http://www.mibcn.com/medicareproviders	http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicarepharmacies	(800)-450-3680		(800)-450-3680		(866)-966-2583		(866)-966-2583										(711)		(711)		(800)-431-7944		(800)-431-7944										2	2	2
H5883	805	0	1	02	01	H5883_805_0	7	1		06/03/2011	2012.02	06/03/2011 05:40:08 PM Eastern Daylight Time	07/28/2011 10:09:14 AM Eastern Daylight Time			07/28/2011 02:45:45 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	http://www.mibcn.com/medicare	BCN Advantage (HMO-POS)	01	02		1			H5883	805	0	2012	Employer Group		1	2209	2			2						http://www.mibcn.com/medicareproviders	http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicarepharmacies	(800)-450-3680		(800)-450-3680		(866)-966-2583		(866)-966-2583		(800)-450-3680		(800)-450-3680		(866)-966-2583		(866)-966-2583		(711)		(711)		(800)-431-7944		(800)-431-7944		(711)		(711)		(800)-431-7944		(800)-431-7944		2	2	2
H5883	807	0	1	02	01	H5883_807_0	6	1		06/03/2011	2012.02	06/03/2011 05:40:23 PM Eastern Daylight Time	07/28/2011 10:14:03 AM Eastern Daylight Time			07/28/2011 02:45:45 PM Eastern Daylight Time	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	http://www.mibcn.com/medicare	BCN Advantage (HMO-POS)	01	02		1			H5883	807	0	2012	Employer Group		1	3314	2			2						http://www.mibcn.com/medicareproviders	http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicarepharmacies	(800)-450-3680		(800)-450-3680		(866)-966-2583		(866)-966-2583		(800)-450-3680		(800)-450-3680		(866)-966-2583		(866)-966-2583		(711)		(711)		(800)-431-7944		(800)-431-7944		(711)		(711)		(800)-431-7944		(800)-431-7944		2	2	2
H5884	007	0	1	09	04	H5884_007_0	9	1		07/18/2011	2012.02	07/18/2011 09:04:51 PM Eastern Daylight Time	08/05/2011 03:56:03 PM Eastern Daylight Time	08/05/2011 03:56:10 PM Eastern Daylight Time		08/08/2011 03:25:39 PM Eastern Daylight Time	BLUECROSS BLUESHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	BlueAdvantage Gold (PFFS)	04	09	2	1			H5884	007	0	2012	East Tennessee		2	1500	1	1		2							http://www.medicareplanrx.com/MedicationPricingTool/planInfo.do?clientId=74regionId=1year=2011con	http://www.medicareplanrx.com/PharmacyLocator/?contractID=H7917lang=enyear=2011	(800)-841-7434		(800)-841-7434		(800)-292-5146		(800)-292-5146		(800)-841-7434		(800)-841-7434		(800)-292-5146		(800)-292-5146		(888)-423-9490		(888)-423-9490		(877)-664-6422		(877)-664-6422		(888)-423-9490		(888)-423-9490		(877)-664-6422		(877)-664-6422		2		2
H5887	001	0	1	01	01	H5887_001_0	6	1		07/07/2011	2012.02	07/07/2011 03:48:38 PM SA Western Standard Time	08/08/2011 09:25:33 AM SA Western Standard Time	08/08/2011 09:25:00 AM SA Western Standard Time		08/08/2011 09:27:14 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	First Care+Plus (HMO)	01	01		1			H5887	001	0	2012	Entire Island Puerto Rico		2		2			2						www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		2	2	2
H5887	007	0	1	01	01	H5887_007_0	4	1		06/03/2011	2012.02	06/03/2011 06:49:50 PM SA Western Standard Time	08/08/2011 09:25:33 AM SA Western Standard Time	08/08/2011 09:25:00 AM SA Western Standard Time		08/08/2011 09:27:14 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	First+Plus Complete (HMO SNP)	01	01		1			H5887	007	0	2012	Entire Island Puerto Rico		2		2			1	4		1		00000010000000000000	www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		2	2	2
H5887	010	0	1	01	01	H5887_010_0	3	1	1	06/05/2011	2012.02	06/05/2011 10:42:24 AM SA Western Standard Time	08/08/2011 09:25:33 AM SA Western Standard Time	08/08/2011 09:25:00 AM SA Western Standard Time		08/08/2011 09:27:14 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	First+Plus Platino (HMO SNP)	01	01		1			H5887	010	0	2012	Entire Island of Puerto Rico		2		2		1	1	3		1	5		www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		2	2	2
H5887	806	0	1	01	01	H5887_806_0	2	1		06/01/2011	2012.02	06/01/2011 07:21:25 PM SA Western Standard Time	06/04/2011 11:11:50 AM SA Western Standard Time			06/06/2011 09:52:09 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	Employer Group Plan 1 (HMO)	01	01		1			H5887	806	0	2012	Entire Island of Puerto Rico		1		2			2						www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		1	1	1
H5887	807	0	1	01	01	H5887_807_0	2	1		06/01/2011	2012.02	06/01/2011 07:22:07 PM SA Western Standard Time	06/04/2011 11:12:10 AM SA Western Standard Time			06/06/2011 09:52:09 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	Employer Group Plan 2 (HMO)	01	01		1			H5887	807	0	2012	Entire Island of Puerto Rico		1		2			2						www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242										(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242										1	1	1
H5887	808	0	1	01	01	H5887_808_0	2	1		06/01/2011	2012.02	06/01/2011 07:22:14 PM SA Western Standard Time	06/04/2011 11:12:28 AM SA Western Standard Time			06/06/2011 09:52:09 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	Employer Group Plan 3 (HMO)	01	01		1			H5887	808	0	2012	Entire Island of Puerto Rico		1		2			2						www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		1	1	1
H5887	809	0	1	01	01	H5887_809_0	2	1		06/01/2011	2012.02	06/01/2011 07:22:22 PM SA Western Standard Time	06/04/2011 11:12:56 AM SA Western Standard Time			06/06/2011 09:52:09 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	Employer Group Plan 4 (HMO)	01	01		1			H5887	809	0	2012	Entire Island of Puerto Rico		1		2			2						www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		1	1	1
H5887	810	0	1	01	01	H5887_810_0	2	1		06/01/2011	2012.02	06/01/2011 07:22:30 PM SA Western Standard Time	06/04/2011 11:13:14 AM SA Western Standard Time			06/06/2011 09:52:09 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	Employer Group Plan 5 (HMO)	01	01		1			H5887	810	0	2012	Entire Island of Puerto Rico		1		2			2						www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242										(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242										1	1	1
H5887	811	0	1	01	01	H5887_811_0	2	1		06/01/2011	2012.02	06/01/2011 07:22:38 PM SA Western Standard Time	06/04/2011 11:13:38 AM SA Western Standard Time			06/06/2011 09:52:09 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	Employer Group Plan 6 (HMO)	01	01		1			H5887	811	0	2012	Entire Island of Puerto Rico		1		2			2						www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		1	1	1
H5887	812	0	1	01	01	H5887_812_0	2	1		06/01/2011	2012.02	06/01/2011 07:22:45 PM SA Western Standard Time	06/04/2011 11:13:58 AM SA Western Standard Time			06/06/2011 09:52:09 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	Employer Group Plan 7 (HMO)	01	01		1			H5887	812	0	2012	Entire Island of Puerto Rico		1		2			2						www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		1	1	1
H5887	813	0	1	01	01	H5887_813_0	2	1		06/01/2011	2012.02	06/01/2011 07:22:54 PM SA Western Standard Time	06/04/2011 11:14:16 AM SA Western Standard Time			06/06/2011 09:52:09 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	Employer Group Plan 8 (HMO)	01	01		1			H5887	813	0	2012	Entire Island of Puerto Rico		1		2			2						www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242										(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242										1	1	1
H5887	814	0	1	01	01	H5887_814_0	2	1		06/01/2011	2012.02	06/01/2011 07:23:02 PM SA Western Standard Time	06/04/2011 11:14:34 AM SA Western Standard Time			06/06/2011 09:52:09 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	Employer Group Plan 9 (HMO)	01	01		1			H5887	814	0	2012	Entire Island of Puerto Rico		1		2			2						www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		1	1	1
H5887	815	0	1	01	01	H5887_815_0	2	1		06/01/2011	2012.02	06/01/2011 07:23:10 PM SA Western Standard Time	06/04/2011 11:15:02 AM SA Western Standard Time			06/06/2011 09:52:09 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	Employer Group Plan 10 (HMO)	01	01		1			H5887	815	0	2012	Entire Island of Puerto Rico		1		2			2						www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		1	1	1
H5887	816	0	1	01	01	H5887_816_0	2	1		06/01/2011	2012.02	06/01/2011 07:23:18 PM SA Western Standard Time	06/04/2011 11:15:22 AM SA Western Standard Time			06/06/2011 09:52:09 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	Employer Group Plan 11 (HMO)	01	01		1			H5887	816	0	2012	Entire Island of Puerto Rico		1		2			2						www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242										(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242										1	1	1
H5887	817	0	1	01	01	H5887_817_0	2	1		06/01/2011	2012.02	06/01/2011 07:23:27 PM SA Western Standard Time	06/04/2011 11:15:42 AM SA Western Standard Time			06/06/2011 09:52:09 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	Employer Group Plan 12 (HMO)	01	01		1			H5887	817	0	2012	Entire Island of Puerto Rico		1		2			2						www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		1	1	1
H5887	818	0	1	01	01	H5887_818_0	2	1		06/01/2011	2012.02	06/01/2011 07:23:35 PM SA Western Standard Time	06/04/2011 11:16:00 AM SA Western Standard Time			06/06/2011 09:52:09 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	Employer Group Plan 13 (HMO)	01	01		1			H5887	818	0	2012	Entire Island of Puerto Rico		1		2			2						www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		1	1	1
H5887	819	0	1	01	01	H5887_819_0	2	1		06/01/2011	2012.02	06/01/2011 07:23:43 PM SA Western Standard Time	06/04/2011 11:16:20 AM SA Western Standard Time			06/06/2011 09:52:09 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	Employer Group Plan 14 (HMO)	01	01		1			H5887	819	0	2012	Entire Island of Puerto Rico		1		2			2						www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242										(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242										1	1	1
H5887	820	0	1	01	01	H5887_820_0	2	1		06/01/2011	2012.02	06/01/2011 07:23:52 PM SA Western Standard Time	06/04/2011 11:16:48 AM SA Western Standard Time			06/06/2011 09:52:09 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	Employer Group Plan 15 (HMO)	01	01		1			H5887	820	0	2012	Entire Island of Puerto Rico		1		2			2						www.firstpluspr.com	http://www.firstpluspr.com	http://www.firstpluspr.com	(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242		1	1	1
H5896	007	0	1	01	01	H5896_007_0	6	1	2	08/08/2011	2012.02	08/08/2011 01:26:32 PM Eastern Daylight Time	08/05/2011 09:54:00 AM Eastern Daylight Time	08/04/2011 05:27:00 PM Eastern Daylight Time		08/09/2011 05:31:53 PM Eastern Daylight Time	AMERIGROUP MARYLAND, INC.	Amerigroup Community Care	www.myamerigroup.com	Amerivantage Specialty + Rx (HMO SNP)	01	01		1			H5896	007	0	2012	Central Maryland		2	1153	2			1	3		1	1		www.myamerigroup.com/medicare	https://www.amerigroupcorp.com/members/Amerivantage/_documents/Amvtg_Formulary	https://amerigroupcorp.com/members/amerivantage	(866)-805-4589		(866)-805-4589		(877)-470-4131		(877)-470-4131		(866)-805-4589		(866)-805-4589		(877)-470-4131		(877)-470-4131		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		2	2	2
H5902	001	0	1	20	08	H5902_001_0	2	1		05/24/2011	2012.01	05/24/2011 07:01:51 PM Eastern Daylight Time		05/24/2011 06:52:30 PM Eastern Daylight Time		05/24/2011 07:17:07 PM Eastern Daylight Time	SENIOR LIFE ALTOONA, INC.	Senior LIFE Ebensburg	www.seniorlifeebensburg.com	Senior LIFE Altoona, Inc. - Dual Eligible (PACE)	08	20		1			H5902	001	0	2012	Cambria, Blair, Indiana Senior LIFE		2	60	2			2							NA	NA									(877)-998-5433	102	(814)-535-6000	102	(877)-998-5433	102	(814)-535-6000	102									(877)-998-5433		(814)-535-6000		(877)-998-5433		(814)-535-6000				
H5902	002	0	1	20	08	H5902_002_0	2	1		05/19/2011	2012.01	05/19/2011 03:31:05 PM Eastern Daylight Time		05/24/2011 06:52:31 PM Eastern Daylight Time		05/24/2011 07:17:07 PM Eastern Daylight Time	SENIOR LIFE ALTOONA, INC.	Senior LIFE Ebensburg	www.seniorlifeebensburg.com	Senior LIFE Altoona, Inc. - Medicare Only (PACE)	08	20		1			H5902	002	0	2012	Cambria, Balir, Indiana - Senior LIFE Medicare Onl		2	1	2			2							NA	NA									(877)-998-5433	102	(814)-535-6000	102	(877)-998-5433	102	(814)-535-6000	102									(877)-998-5433		(814)-535-6000		(877)-998-5433		(814)-535-6000				
H5926	001	0	1	01	01	H5926_001_0	4	1	2	08/01/2011	2012.02	08/01/2011 10:51:41 AM Pacific Daylight Time	08/05/2011 09:45:00 AM Pacific Daylight Time	08/04/2011 02:08:00 PM Pacific Daylight Time		08/05/2011 02:51:40 PM Pacific Daylight Time	MOLINA HEALTHCARE OF MICHIGAN	Molina Healthcare of Michigan	www.molinamedicare.com	Molina Medicare Options Plus (HMO SNP)	01	01		1			H5926	001	0	2012	Western and Metro Detroit Michigan		2		2			1	3		1	5		www.molinamedicare.com	www.molinamedicare.com	www.molinamedicare.com	(800)-665-3072		(800)-665-3072		(866)-403-8293		(866)-403-8293		(800)-665-3072		(800)-665-3072		(866)-403-8293		(866)-403-8293		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		2	2	2
H5926	002	0	1	01	01	H5926_002_0	4	1		08/01/2011	2012.02	08/01/2011 10:51:49 AM Pacific Daylight Time	08/05/2011 11:15:00 AM Pacific Daylight Time	08/04/2011 02:08:00 PM Pacific Daylight Time		08/05/2011 02:51:40 PM Pacific Daylight Time	MOLINA HEALTHCARE OF MICHIGAN	Molina Healthcare of Michigan	www.molinamedicare.com	Molina Medicare Options (HMO)	01	01		1			H5926	002	0	2012	Metro Detroit Michigan		2		2			2						www.molinamedicare.com	www.molinamedicare.com	www.molinamedicare.com	(800)-665-3072		(800)-665-3072		(866)-403-8293		(866)-403-8293		(800)-665-3072		(800)-665-3072		(866)-403-8293		(866)-403-8293		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		2	2	2
H5928	001	0	1	01	01	H5928_001_0	6	1	2	08/09/2011	2012.02	08/09/2011 12:51:18 PM Pacific Daylight Time	08/08/2011 12:52:13 PM Pacific Daylight Time	08/05/2011 01:41:07 PM Pacific Daylight Time		08/09/2011 02:19:33 PM Pacific Daylight Time	CARE1ST HEALTH PLAN	Care1st Medicare Advantage Plan	www.care1st.com/ca/medicare	Care1st TotalDual Plan (HMO SNP)	01	01		1			H5928	001	0	2012	Care1st Health Plan Los Angeles County		2		2			1	3		1	2		www.care1st.com/ca/medicare	www.care1st.com	www.care1st.com	(800)-544-0088		(800)-544-0088		(800)-847-1222		(800)-847-1222		(800)-544-0088		(800)-544-0088		(800)-847-1222		(800)-847-1222		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	1	2
H5928	004	0	1	01	01	H5928_004_0	8	1		08/12/2011	2012.02	08/12/2011 09:03:09 AM Pacific Daylight Time	08/08/2011 01:39:41 PM Pacific Daylight Time	08/05/2011 01:42:05 PM Pacific Daylight Time		08/12/2011 09:54:37 AM Pacific Daylight Time	CARE1ST HEALTH PLAN	Care1st Medicare Advantage Plan	www.care1st.com/ca/medicare	Care1st AdvantageOptimum Plan (HMO)	01	01		1			H5928	004	0	2012	Care1st Health Plan Los Angeles County		2		2			2						www.care1st.com/ca/medicare	www.care1st.com	www.care1st.com	(800)-544-0088		(800)-544-0088		(800)-847-1222		(800)-847-1222		(800)-544-0088		(800)-544-0088		(800)-847-1222		(800)-847-1222		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	1	2
H5928	005	0	1	01	01	H5928_005_0	6	1	2	08/09/2011	2012.02	08/09/2011 12:51:59 PM Pacific Daylight Time	08/08/2011 01:11:13 PM Pacific Daylight Time	08/05/2011 01:42:45 PM Pacific Daylight Time		08/09/2011 02:19:33 PM Pacific Daylight Time	CARE1ST HEALTH PLAN	Care1st Medicare Advantage Plan	www.care1st.com/ca/medicare	Care1st TotalDual Plan (HMO SNP)	01	01		1			H5928	005	0	2012	Care1st Health Plan Orange County		2		2			1	3		1	2		www.care1st.com/ca/medicare	www.care1st.com	www.care1st.com	(800)-544-0088		(800)-544-0088		(800)-847-1222		(800)-847-1222		(800)-544-0088		(800)-544-0088		(800)-847-1222		(800)-847-1222		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	1	2
H5928	006	0	1	01	01	H5928_006_0	7	1		08/12/2011	2012.02	08/12/2011 09:03:29 AM Pacific Daylight Time	08/08/2011 10:52:27 AM Pacific Daylight Time	08/05/2011 01:43:20 PM Pacific Daylight Time		08/12/2011 09:54:37 AM Pacific Daylight Time	CARE1ST HEALTH PLAN	Care1st Medicare Advantage Plan	www.care1st.com/ca/medicare	Care1st AdvantageOptimum Plan (HMO)	01	01		1			H5928	006	0	2012	Care1st Health Plan Orange County		2		2			2						www.care1st.com/ca/medicare	www.care1st.com	www.care1st.com	(800)-544-0088		(800)-544-0088		(800)-847-1222		(800)-847-1222		(800)-544-0088		(800)-544-0088		(800)-847-1222		(800)-847-1222		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	1	2
H5928	007	0	1	01	01	H5928_007_0	5	1	2	07/25/2011	2012.02	07/25/2011 09:10:39 AM Pacific Daylight Time	08/08/2011 01:16:24 PM Pacific Daylight Time	08/05/2011 01:44:00 PM Pacific Daylight Time		08/09/2011 02:19:33 PM Pacific Daylight Time	CARE1ST HEALTH PLAN	Care1st Medicare Advantage Plan	www.care1st.com/ca/medicare	Care1st TotalDual Plan (HMO SNP)	01	01		1			H5928	007	0	2012	Care1st Health Plan San Bernardino County		2		2			1	3		1	2		www.care1st.com/ca/medicare	www.care1st.com	www.care1st.com	(800)-544-0088		(800)-544-0088		(800)-847-1222		(800)-847-1222		(800)-544-0088		(800)-544-0088		(800)-847-1222		(800)-847-1222		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	1	2
H5928	008	0	1	01	01	H5928_008_0	6	1		08/12/2011	2012.02	08/12/2011 09:04:41 AM Pacific Daylight Time	08/08/2011 01:50:53 PM Pacific Daylight Time	08/05/2011 01:44:37 PM Pacific Daylight Time		08/12/2011 09:54:37 AM Pacific Daylight Time	CARE1ST HEALTH PLAN	Care1st Medicare Advantage Plan	www.care1st.com/ca/medicare	Care1st AdvantageOptimum Plan (HMO)	01	01		1			H5928	008	0	2012	Care1st Health Plan San Bernardino County		2		2			2						www.care1st.com/ca/medicare	www.care1st.com	www.care1st.com	(800)-544-0088		(800)-544-0088		(800)-847-1222		(800)-847-1222		(800)-544-0088		(800)-544-0088		(800)-847-1222		(800)-847-1222		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	1	2
H5928	009	0	1	01	01	H5928_009_0	5	1	2	07/25/2011	2012.02	07/25/2011 09:11:17 AM Pacific Daylight Time	08/08/2011 01:17:20 PM Pacific Daylight Time	08/05/2011 01:45:08 PM Pacific Daylight Time		08/09/2011 02:19:33 PM Pacific Daylight Time	CARE1ST HEALTH PLAN	Care1st Medicare Advantage Plan	www.care1st.com/ca/medicare	Care1st TotalDual Plan (HMO SNP)	01	01		1			H5928	009	0	2012	Care1st Health Plan San Diego County		2		2			1	3		1	2		www.care1st.com/ca/medicare	www.care1st.com	www.care1st.com	(800)-544-0088		(800)-544-0088		(800)-847-1222		(800)-847-1222		(800)-544-0088		(800)-544-0088		(800)-847-1222		(800)-847-1222		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	1	2
H5928	010	0	1	01	01	H5928_010_0	6	1		08/12/2011	2012.02	08/12/2011 09:05:04 AM Pacific Daylight Time	08/08/2011 01:53:07 PM Pacific Daylight Time	08/05/2011 01:46:06 PM Pacific Daylight Time		08/12/2011 09:54:37 AM Pacific Daylight Time	CARE1ST HEALTH PLAN	Care1st Medicare Advantage Plan	www.care1st.com/ca/medicare	Care1st AdvantageOptimum Plan (HMO)	01	01		1			H5928	010	0	2012	Care1st Health Plan San Diego County		2		2			2						www.care1st.com/ca/medicare	www.care1st.com	www.care1st.com	(800)-544-0088		(800)-544-0088		(800)-847-1222		(800)-847-1222		(800)-544-0088		(800)-544-0088		(800)-847-1222		(800)-847-1222		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	1	2
H5928	012	0	1	01	01	H5928_012_0	5	1		08/12/2011	2012.02	08/12/2011 09:05:43 AM Pacific Daylight Time	08/08/2011 01:55:42 PM Pacific Daylight Time	08/05/2011 01:46:38 PM Pacific Daylight Time		08/12/2011 09:54:37 AM Pacific Daylight Time	CARE1ST HEALTH PLAN	Care1st Medicare Advantage Plan	www.care1st.com/ca/medicare	Care1st AdvantageOptimum Plan (HMO)	01	01		1			H5928	012	0	2012	Care1st Health Plan Riverside County		2		2			2						www.care1st.com/ca/medicare	www.care1st.com	www.care1st.com	(800)-544-0088		(800)-544-0088		(800)-847-1222		(800)-847-1222		(800)-544-0088		(800)-544-0088		(800)-847-1222		(800)-847-1222		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	1	2
H5928	016	0	1	01	01	H5928_016_0	7	1		08/12/2011	2012.02	08/12/2011 09:06:33 AM Pacific Daylight Time	08/08/2011 01:58:20 PM Pacific Daylight Time	08/05/2011 01:47:48 PM Pacific Daylight Time		08/12/2011 09:54:37 AM Pacific Daylight Time	CARE1ST HEALTH PLAN	Care1st Medicare Advantage Plan	www.care1st.com/ca/medicare	Care1st AdvantageOptimum Plan (HMO)	01	01		1			H5928	016	0	2012	Care1st Health Plan Santa Clara County		2		2			2						www.care1st.com/ca/medicare	www.care1st.com	www.care1st.com	(800)-544-0088		(800)-544-0088		(800)-847-1222		(800)-847-1222		(800)-544-0088		(800)-544-0088		(800)-847-1222		(800)-847-1222		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	1	2
H5928	018	0	1	01	01	H5928_018_0	8	1		08/12/2011	2012.02	08/12/2011 09:07:09 AM Pacific Daylight Time	08/08/2011 02:00:52 PM Pacific Daylight Time	08/05/2011 01:49:04 PM Pacific Daylight Time		08/12/2011 09:54:37 AM Pacific Daylight Time	CARE1ST HEALTH PLAN	Care1st Medicare Advantage Plan	www.care1st.com/ca/medicare	Care1st TotalAdvantage Plan (HMO)	01	01		1			H5928	018	0	2012	Care1st Health Plan Los Angeles County		2		2			2						www.care1st.com/ca/medicare	www.care1st.com	www.care1st.com	(800)-544-0088		(800)-544-0088		(800)-847-1222		(800)-847-1222		(800)-544-0088		(800)-544-0088		(800)-847-1222		(800)-847-1222		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	1	2
H5928	020	0	1	01	01	H5928_020_0	7	1		08/12/2011	2012.02	08/12/2011 09:07:26 AM Pacific Daylight Time	08/08/2011 02:19:41 PM Pacific Daylight Time	08/05/2011 01:50:22 PM Pacific Daylight Time		08/12/2011 09:54:37 AM Pacific Daylight Time	CARE1ST HEALTH PLAN	Care1st Medicare Advantage Plan	www.care1st.com/ca/medicare	Care1st AdvantageOptimum Plan (HMO)	01	01		1			H5928	020	0	2012	Care1st Health Plan San Joaquin County		2		2			2						www.care1st.com/ca/medicare	www.care1st.com	www.care1st.com	(800)-544-0088		(800)-544-0088		(800)-847-1222		(800)-847-1222		(800)-544-0088		(800)-544-0088		(800)-847-1222		(800)-847-1222		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	1	2
H5928	022	0	1	01	01	H5928_022_0	7	1		08/12/2011	2012.02	08/12/2011 09:07:52 AM Pacific Daylight Time	08/08/2011 02:30:46 PM Pacific Daylight Time	08/08/2011 12:25:30 PM Pacific Daylight Time		08/12/2011 09:54:37 AM Pacific Daylight Time	CARE1ST HEALTH PLAN	Care1st Medicare Advantage Plan	www.care1st.com/ca/medicare	Care1st AdvantageOptimum Plan (HMO)	01	01		1			H5928	022	0	2012	Care1st Health Plan Stanislaus County		2		2			2						www.care1st.com/ca/medicare	www.care1st.com	www.care1st.com	(800)-544-0088		(800)-544-0088		(800)-847-1222		(800)-847-1222		(800)-544-0088		(800)-544-0088		(800)-847-1222		(800)-847-1222		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	1	2
H5932	001	0	1	01	01	H5932_001_0	5	1	2	07/15/2011	2012.02	07/15/2011 09:42:37 AM Eastern Daylight Time	08/04/2011 02:13:25 PM Eastern Daylight Time	08/04/2011 02:13:38 PM Eastern Daylight Time		08/04/2011 02:31:30 PM Eastern Daylight Time	GATEWAY HEALTH PLAN, INC.	Gateway Health Plan Medicare Assured	www.gatewayhealthplan.com/Medicare	Gateway Health Plan Medicare Assured (HMO SNP)	01	01		1			H5932	001	0	2012	Pennsylvania		2	28314	2			1	3		1	1		www.GatewayHealthPlan.com/Medicare	www.gatewayhealthplan.com	www.gatewayhealthplan.com	(800)-685-5209		(412)-255-1323		(877)-428-3929		(412)-255-1323		(800)-685-5209		(412)-255-1323		(877)-428-3929		(412)-255-1323		(800)-654-5988		(800)-654-5988		(800)-654-5988		(800)-654-5988		(800)-654-5988		(800)-654-5988		(800)-654-5988		(800)-654-5988		2	1	2
H5934	001	0	1	20	08	H5934_001_0	1	1		06/02/2011	2012.01	06/02/2011 10:19:58 AM Eastern Daylight Time		06/02/2011 08:36:57 AM Eastern Daylight Time		06/02/2011 10:22:24 AM Eastern Daylight Time	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	Hope PACE	http://hopehcs.org/pace	Hope PACE (PACE)	08	20		1			H5934	001	0	2012	Lee and Charlotte Counties Florida		2		2			2							hopehcs.org/pace	hopehcs.org/pace									(186)-665-9722		(239)-985-6400	67406	(186)-665-9722		(239)-985-6400										(186)-665-9722		(239)-985-6400	67406	(186)-665-9722		(239)-985-6400	67406			
H5934	002	0	1	20	08	H5934_002_0	1	1		06/02/2011	2012.01	06/02/2011 10:20:28 AM Eastern Daylight Time		06/02/2011 08:36:57 AM Eastern Daylight Time		06/02/2011 10:22:24 AM Eastern Daylight Time	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	Hope PACE	http://hopehcs.org/pace	Hope PACE (PACE)	08	20		1			H5934	002	0	2012	Lee and Charlotte Counties Florida		2		2			2							hopehcs.org/pace	hopehcs.org/pace									(186)-665-9722		(239)-985-6400	67406	(186)-665-9722		(239)-985-6400	67406									(186)-665-9722		(239)-985-6400	67406	(186)-665-9722		(239)-985-6400	67406			
H5938	001	0	1	01	01	H5938_001_0	10	1		08/18/2011	2012.02	08/18/2011 01:12:01 PM Eastern Daylight Time	08/05/2011 12:28:09 PM Eastern Daylight Time	08/05/2011 01:08:44 PM Eastern Daylight Time		08/18/2011 01:27:09 PM Eastern Daylight Time	CAPITAL HEALTH PLAN	Capital Health Plan	www.capitalhealth.com/Medicare	Capital Health Plan Advantage Plus (HMO)	01	01		1			H5938	001	0	2012	Leon and surrounding counties		2	4764	2			2						www.capitalhealth.com/Medicare	www.capitalhealth.com/Medicare	www.capitalhealth.com/Medicare	(877)-247-6512		(850)-523-7441		(877)-247-6512		(850)-523-7441		(877)-247-6512		(850)-523-7441		(877)-247-6512		(850)-523-7441		(877)-870-8943		(850)-383-3534		(877)-870-8943		(850)-383-3534		(877)-870-8943		(850)-383-3534		(877)-870-8943		(850)-383-3534		2	2	2
H5938	006	0	1	01	01	H5938_006_0	9	1		08/18/2011	2012.02	08/18/2011 01:09:20 PM Eastern Daylight Time	08/05/2011 12:33:23 PM Eastern Daylight Time	08/05/2011 01:09:16 PM Eastern Daylight Time		08/18/2011 01:27:09 PM Eastern Daylight Time	CAPITAL HEALTH PLAN	Capital Health Plan	www.capitalhealth.com/Medicare	Capital Health Plan Preferred Advantage (HMO)	01	01		1			H5938	006	0	2012	Leon and surrounding counties		2	1283	2			2						www.capitalhealth.com/Medicare	www.capitalhealth.com/Medicare	www.capitalhealth.com/Medicare	(877)-247-6512		(850)-523-7441		(877)-247-6512		(850)-523-7441		(877)-247-6512		(850)-523-7441		(877)-247-6512		(850)-523-7441		(877)-870-8943		(850)-383-3534		(877)-870-8943		(850)-383-3534		(877)-870-8943		(850)-383-3534		(877)-870-8943		(850)-383-3534		2	2	2
H5938	802	0	1	01	01	H5938_802_0	5	1		06/03/2011	2012.02	06/03/2011 09:46:08 AM Eastern Daylight Time	07/29/2011 04:07:19 PM Eastern Daylight Time			07/29/2011 04:55:06 PM Eastern Daylight Time	CAPITAL HEALTH PLAN	Capital Health Plan	www.capitalhealth.com/Medicare	Capital Health Plan Retiree Advantage (HMO)	01	01		1			H5938	802	0	2012	Leon and surrounding counties		1	5418	2			2						www.capitalhealth.com/Medicare	www.capitalhealth.com/Medicare	www.capitalhealth.com/Medicare	(877)-247-6512		(850)-523-7441		(877)-247-6512		(850)-523-7441		(877)-247-6512		(850)-523-7441		(877)-247-6512		(850)-523-7441		(877)-870-8943		(850)-383-3534		(877)-870-8943		(850)-383-3534		(877)-870-8943		(850)-383-3534		(877)-870-8943		(850)-383-3534		1	1	1
H5938	803	0	1	01	01	H5938_803_0	5	1		06/03/2011	2012.02	06/03/2011 09:46:54 AM Eastern Daylight Time	07/29/2011 04:08:18 PM Eastern Daylight Time			07/29/2011 04:55:06 PM Eastern Daylight Time	CAPITAL HEALTH PLAN	Capital Health Plan	www.capitalhealth.com/Medicare	Capital Health Plan Retiree Advantage (HMO)	01	01		1			H5938	803	0	2012	Leon and surrounding counties		1	567	2			2						www.capitalhealth.com/Medicare	www.capitalhealth.com/Medicare	www.capitalhealth.com/Medicare	(877)-247-6512		(850)-523-7441		(877)-247-6512		(850)-523-7441										(877)-870-8943		(850)-383-3534		(877)-870-8943		(850)-383-3534										1	1	1
H5938	804	0	1	01	01	H5938_804_0	5	1		06/03/2011	2012.02	06/03/2011 09:47:15 AM Eastern Daylight Time	07/29/2011 04:09:34 PM Eastern Daylight Time			07/29/2011 04:55:06 PM Eastern Daylight Time	CAPITAL HEALTH PLAN	Capital Health Plan	www.capitalhealth.com/Medicare	Capital Health Plan Retiree Advantage (HMO)	01	01		1			H5938	804	0	2012	Leon and surrounding counties		1	1206	2			2						www.capitalhealth.com/Medicare	www.capitalhealth.com/Medicare	www.capitalhealth.com/Medicare	(877)-247-6512		(850)-523-7441		(877)-247-6512		(850)-523-7441		(877)-247-6512		(850)-523-7441		(877)-247-6512		(850)-523-7441		(877)-870-8943		(850)-383-3534		(877)-870-8943		(850)-383-3534		(877)-870-8943		(850)-383-3534		(877)-870-8943		(850)-383-3534		1	1	1
H5943	001	0	1	02	01	H5943_001_0	6	1		08/12/2011	2012.02	08/12/2011 11:40:18 AM Pacific Daylight Time		08/09/2011 11:12:28 AM Pacific Daylight Time		08/12/2011 11:53:09 AM Pacific Daylight Time	SCAN HEALTH PLAN	VillageHealth	www.villagehealthca.com	VillageHealth (HMO-POS SNP)	01	02		1			H5943	001	0	2012	Riverside and  San Bernardino County		2		2			1	4		1		00000000100000000000	www.villagehealthca.com	http://www.villagehealthca.com	http://www.villagehealthca.com	(877)-586-1648		(877)-586-1648		(877)-916-1234		(877)-916-1234		(877)-586-1648		(877)-586-1648		(877)-916-1234		(877)-916-1234		(866)-525-7833		(866)-525-7833		(866)-525-7833		(866)-525-7833		(866)-525-7833		(866)-525-7833		(866)-525-7833		(866)-525-7833		2	2	2
H5950	001	0	1	01	01	H5950_001_0	4	1		07/08/2011	2012.02	07/08/2011 11:21:43 AM Central Daylight Time	08/04/2011 01:09:24 PM Central Daylight Time	08/04/2011 10:12:26 AM Central Daylight Time		08/08/2011 08:57:36 AM Central Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Value Plan (HMO)	01	01		1			H5950	001	0	2012	Nashville		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H5950	801	0	1	01	01	H5950_801_0	1	1		04/22/2011	2012.02	04/22/2011 10:12:32 AM Eastern Daylight Time	06/01/2011 03:51:52 PM Eastern Daylight Time			06/03/2011 10:51:30 AM Eastern Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan (HMO)	01	01		1			H5950	801	0	2012	Tennessee		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748										1	1	1
H5950	802	0	1	01	01	H5950_802_0	1	1		04/22/2011	2012.02	04/22/2011 10:12:51 AM Eastern Daylight Time	06/01/2011 03:59:13 PM Eastern Daylight Time			06/03/2011 10:51:30 AM Eastern Daylight Time	AETNA HEALTH INC.	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan w/Rx CY (HMO)	01	01		1			H5950	802	0	2012	Tennessee		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		1	1	1
H5969	001	0	1	01	01	H5969_001_0	7	1		08/09/2011	2012.02	08/09/2011 02:04:25 PM Hawaiian Standard Time	08/09/2011 12:38:12 PM Hawaiian Standard Time	08/09/2011 12:38:18 PM Hawaiian Standard Time		08/09/2011 02:19:11 PM Hawaiian Standard Time	ALOHACARE	AlohaCare	AlohaCare.org	AlohaCare Advantage (HMO)	01	01		1			H5969	001	0	2012	State of Hawaii		2	2139	2			2						http://www.AlohaCare.org/ProviderSearch	http://www.AlohaCare.org/formulary	http://www.AlohaCare.org/providersearch	(866)-973-6395		(808)-973-6395		(866)-973-6395		(808)-973-6395		(866)-973-6395		(808)-973-6395		(866)-973-6395		(808)-973-6395		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		2	2	2
H5969	002	0	1	01	01	H5969_002_0	6	1	2	08/09/2011	2012.02	08/09/2011 02:05:22 PM Hawaiian Standard Time	08/09/2011 12:38:25 PM Hawaiian Standard Time	08/09/2011 12:38:28 PM Hawaiian Standard Time		08/09/2011 02:19:11 PM Hawaiian Standard Time	ALOHACARE	AlohaCare	AlohaCare.org	AlohaCare Advantage Plus (HMO SNP)	01	01		1			H5969	002	0	2012	State of Hawaii		2	862	2			1	3		1	3		http://www.AlohaCare.org/ProviderSearch	http://www.AlohaCare.org/formulary	http://www.AlohaCare.org/providersearch	(866)-973-6395		(808)-973-6395		(866)-973-6395		(808)-973-6395		(866)-973-6395		(808)-973-6395		(866)-973-6395		(808)-973-6395		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		2	2	2
H5969	801	0	1	01	01	H5969_801_0	4	1		07/11/2011	2012.02	07/11/2011 05:03:30 PM Hawaiian Standard Time	06/06/2011 05:24:00 PM Hawaiian Standard Time			07/12/2011 10:52:53 AM Hawaiian Standard Time	ALOHACARE	AlohaCare	AlohaCare.org	AlohaCare Advantage for Groups (HMO)	01	01		1			H5969	801	0	2012	State of Hawaii		1	135	2			2						http://www.AlohaCare.org/ProviderSearch	http://www.AlohaCare.org/formulary	http://www.AlohaCare.org/providersearch	(866)-973-6395		(808)-973-6395		(866)-973-6395		(808)-973-6395		(866)-973-6395		(808)-973-6395		(866)-973-6395		(808)-973-6395		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		(877)-447-5990		2	2	2
H5970	001	0	1	04	01	H5970_001_0	10	1		07/07/2011	2012.02	07/07/2011 05:10:29 PM Eastern Daylight Time	08/05/2011 10:45:05 PM Eastern Daylight Time	08/04/2011 12:42:27 PM Eastern Daylight Time		08/09/2011 10:03:12 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	HumanaChoice H5970-001 (PPO)	01	04		1			H5970	001	0	2012	Southern Tier Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5970	002	0	1	04	01	H5970_002_0	10	1		07/07/2011	2012.02	07/07/2011 04:38:34 PM Eastern Daylight Time	08/05/2011 10:45:36 PM Eastern Daylight Time	08/04/2011 12:42:46 PM Eastern Daylight Time		08/09/2011 10:03:12 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	HumanaChoice H5970-002 (PPO)	01	04		1			H5970	002	0	2012	Syracuse Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5970	004	0	1	04	01	H5970_004_0	7	1		08/05/2011	2012.02	08/05/2011 10:33:22 AM Eastern Daylight Time	08/05/2011 10:52:08 PM Eastern Daylight Time	08/04/2011 12:43:05 PM Eastern Daylight Time		08/09/2011 08:38:04 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	Humana Reader's Digest Healthy Living Plan (PPO)	01	04		1			H5970	004	0	2012	Upstate Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5970	005	0	1	04	01	H5970_005_0	12	1		07/07/2011	2012.02	07/07/2011 05:11:04 PM Eastern Daylight Time	08/05/2011 10:53:07 PM Eastern Daylight Time	08/04/2011 12:43:23 PM Eastern Daylight Time		08/09/2011 08:38:04 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	HumanaChoice H5970-005 (PPO)	01	04		1			H5970	005	0	2012	Clinton County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5970	006	0	1	04	01	H5970_006_0	10	1		08/05/2011	2012.02	08/05/2011 10:33:41 AM Eastern Daylight Time	08/05/2011 10:54:55 PM Eastern Daylight Time	08/04/2011 12:43:41 PM Eastern Daylight Time		08/09/2011 10:07:06 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	Humana Reader's Digest Healthy Living Plan (PPO)	01	04		1			H5970	006	0	2012	Clinton County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H5970	801	0	1	04	01	H5970_801_0	3	1		06/21/2011	2012.02	06/21/2011 08:58:57 AM Eastern Daylight Time	05/31/2011 08:44:26 AM Eastern Daylight Time			06/21/2011 11:00:31 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	Humana Employer Sponsored (PPO)	01	04		1			H5970	801	0	2012	State of New York		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H5970	802	0	1	04	01	H5970_802_0	3	1		06/21/2011	2012.02	06/21/2011 08:59:23 AM Eastern Daylight Time	05/31/2011 09:17:20 AM Eastern Daylight Time			06/21/2011 11:00:31 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	Humana Employer Sponsored (PPO)	01	04		1			H5970	802	0	2012	State of New York		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
H5970	803	0	1	04	01	H5970_803_0	3	1		06/21/2011	2012.02	06/21/2011 08:59:45 AM Eastern Daylight Time	05/31/2011 09:18:14 AM Eastern Daylight Time			06/21/2011 11:00:31 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	Humana Employer Sponsored Non-CY (PPO)	01	04		1			H5970	803	0	2012	State of New York		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H5970	805	0	2	04	01	H5970_805_0	3	1		06/21/2011	2012.02	06/21/2011 09:15:17 AM Eastern Daylight Time	06/01/2011 08:37:20 AM Eastern Daylight Time			06/21/2011 11:00:31 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	Humana Employer Sponsored (PPO)	01	04		2	2		H5970	805	0	2012	State of New York		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H5970	806	0	2	04	01	H5970_806_0	3	1		06/21/2011	2012.02	06/21/2011 09:15:42 AM Eastern Daylight Time	05/31/2011 10:18:43 AM Eastern Daylight Time			06/21/2011 11:00:31 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	Humana Employer Sponsored (PPO)	01	04		2	2		H5970	806	0	2012	State of New York		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
H5970	807	0	2	04	01	H5970_807_0	3	1		06/21/2011	2012.02	06/21/2011 09:16:05 AM Eastern Daylight Time	06/01/2011 08:43:10 AM Eastern Daylight Time			06/21/2011 11:00:31 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	Humana Employer Sponsored Non-CY (PPO)	01	04		2	2		H5970	807	0	2012	State of New York		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H5970	808	0	1	04	01	H5970_808_0	6	1		06/21/2011	2012.02	06/21/2011 09:00:07 AM Eastern Daylight Time	07/19/2011 10:12:17 AM Eastern Daylight Time			07/22/2011 06:28:25 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	Humana Employer Sponsored (PPO)	01	04		1			H5970	808	0	2012	State of New York		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H5970	809	0	1	04	01	H5970_809_0	6	1		06/21/2011	2012.02	06/21/2011 09:00:33 AM Eastern Daylight Time	07/19/2011 10:13:45 AM Eastern Daylight Time			07/22/2011 06:28:25 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	Humana Employer Sponsored (PPO)	01	04		1			H5970	809	0	2012	State of New York		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
H5970	810	0	1	04	01	H5970_810_0	4	1		06/21/2011	2012.02	06/21/2011 09:00:56 AM Eastern Daylight Time	07/19/2011 10:15:08 AM Eastern Daylight Time			07/22/2011 06:28:25 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	Humana Employer Sponsored Non-CY (PPO)	01	04		1			H5970	810	0	2012	State of New York		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H5970	811	0	2	04	01	H5970_811_0	7	1		06/21/2011	2012.02	06/21/2011 09:16:27 AM Eastern Daylight Time	07/22/2011 06:59:39 PM Eastern Daylight Time			07/22/2011 09:15:17 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	Humana Employer Sponsored (PPO)	01	04		2	2		H5970	811	0	2012	State of New York		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H5970	812	0	2	04	01	H5970_812_0	4	1		06/21/2011	2012.02	06/21/2011 09:16:52 AM Eastern Daylight Time	07/19/2011 10:19:02 AM Eastern Daylight Time			07/22/2011 06:28:25 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	Humana Employer Sponsored (PPO)	01	04		2	2		H5970	812	0	2012	State of New York		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
H5970	813	0	2	04	01	H5970_813_0	7	1		06/21/2011	2012.02	06/21/2011 09:17:14 AM Eastern Daylight Time	07/22/2011 06:58:08 PM Eastern Daylight Time			07/22/2011 09:15:17 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	Humana Employer Sponsored Non-CY (PPO)	01	04		2	2		H5970	813	0	2012	State of New York		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H5970	814	0	1	04	01	H5970_814_0	4	1		06/21/2011	2012.02	06/21/2011 09:01:18 AM Eastern Daylight Time	07/19/2011 12:51:48 PM Eastern Daylight Time			07/22/2011 06:28:25 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	Humana Employer Sponsored - Walmart (PPO)	01	04		1			H5970	814	0	2012	Select counties in New York		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H5970	815	0	1	04	01	H5970_815_0	4	1		06/21/2011	2012.02	06/21/2011 09:01:41 AM Eastern Daylight Time	07/19/2011 12:53:14 PM Eastern Daylight Time			07/22/2011 06:28:25 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	Humana Employer Sponsored - Walmart (PPO)	01	04		1			H5970	815	0	2012	Select counties in New York		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H5978	001	0	1	20	08	H5978_001_0	1	1		05/23/2011	2012.02	05/23/2011 10:08:00 AM Eastern Daylight Time		05/20/2011 04:27:00 PM Eastern Daylight Time		05/23/2011 10:41:04 AM Eastern Daylight Time	PHI LIFE	PHI LIFE dba everyday LIFE	www.everydaylifecenters.org	PHI LIFE dba everyday LIFE (PACE)	08	20		1			H5978	001	0	2012	Northampton and Lehigh counties		2		2			2							www.everydaylifecenters.org	www.everydaylifecenters.org									(877)-895-4330		(610)-954-5433		(877)-895-4330		(610)-954-5433										(877)-895-4330		(610)-954-5433		(877)-895-4330		(610)-954-5433				
H5978	002	0	1	20	08	H5978_002_0	1	1		05/23/2011	2012.02	05/23/2011 10:08:13 AM Eastern Daylight Time		05/20/2011 04:27:00 PM Eastern Daylight Time		05/23/2011 10:41:04 AM Eastern Daylight Time	PHI LIFE	PHI LIFE dba everyday LIFE	www.everydaylifecenters.org	PHI LIFE dba everyday LIFE (PACE)	08	20		1			H5978	002	0	2012	Lehigh and Northampton counties		2		2			2							www.everydaylifecenters.org	www.everydaylifecenters.org									(877)-895-4330		(610)-954-5433		(877)-895-4330		(610)-954-5433										(877)-895-4330		(610)-954-5433		(877)-895-4330		(610)-954-5433				
H5980	005	0	1	01	01	H5980_005_0	6	1		08/12/2011	2012.02	08/12/2011 03:18:55 PM Central Daylight Time	08/12/2011 03:11:27 PM Central Daylight Time	08/12/2011 03:11:24 PM Central Daylight Time		08/12/2011 04:27:26 PM Central Daylight Time	FIDELIS SECURECARE OF TEXAS, INC.	Fidelis SecureCare of Texas, Inc.	www.fidelissc.com	Fidelis Secure Comfort (HMO SNP)	01	01		1			H5980	005	0	2012	Texas Area		2		2			1	1	1	1			http://www.fidelissc.com/pdfs/TX-ProviderDirectory.pdf	http://www.fidelissc.com/pdfs/2010-Formulary-with-Disclaimers.pdf	http://www.fidelissc.com/pharmacy/index.asp	(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		2	2	2
H5980	006	0	1	01	01	H5980_006_0	7	1		06/07/2011	2012.02	06/07/2011 02:16:16 PM Central Daylight Time	06/30/2011 01:46:00 PM Central Daylight Time	07/22/2011 12:50:00 PM Central Daylight Time		07/25/2011 06:29:36 PM Central Daylight Time	FIDELIS SECURECARE OF TEXAS, INC.	Fidelis SecureCare of Texas, Inc.	www.fidelissc.com	Fidelis Secure Comfort Plus (HMO SNP)	01	01		1			H5980	006	0	2012	Texas Area		2		2			1	1	1	1			http://www.fidelissc.com/pdfs/TX-ProviderDirectory.pdf	http://www.fidelissc.com/pdfs/2010-Formulary-with-Disclaimers.pdf	http://www.fidelissc.com/pharmacy/index.asp	(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		2	2	2
H5980	007	0	1	01	01	H5980_007_0	10	1		07/19/2011	2012.02	07/19/2011 11:55:24 AM Central Daylight Time	08/09/2011 11:03:50 AM Central Daylight Time	08/09/2011 11:03:48 AM Central Daylight Time		08/09/2011 11:27:59 AM Central Daylight Time	FIDELIS SECURECARE OF TEXAS, INC.	Fidelis SecureCare of Texas, Inc.	www.fidelissc.com	Fidelis Secure Independence (HMO SNP)	01	01		1			H5980	007	0	2012	Texas Area		2		2			1	1	2	1			http://www.fidelissc.com/pdfs/TX-ProviderDirectory.pdf	http://www.fidelissc.com/pdfs/2010-Formulary-with-Disclaimers.pdf	http://www.fidelissc.com/pharmacy/index.asp	(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		2	2	2
H5980	011	0	1	01	01	H5980_011_0	9	1		08/12/2011	2012.02	08/12/2011 03:54:02 PM Central Daylight Time	08/12/2011 03:11:24 PM Central Daylight Time	08/12/2011 03:11:22 PM Central Daylight Time		08/12/2011 04:27:26 PM Central Daylight Time	FIDELIS SECURECARE OF TEXAS, INC.	Fidelis SecureCare of Texas, Inc.	www.fidelissc.com	Fidelis Secure Freedom (HMO SNP)	01	01		1			H5980	011	0	2012	TEXAS AREA		2		2			1	1	2	1			http://www.fidelissc.com/pdfs/TX-ProviderDirectory.pdf	http://www.fidelissc.com/pdfs/2010-Formulary-with-Disclaimers.pdf	http://www.fidelissc.com/pharmacy/index.asp	(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(877)-372-8085		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		(888)-844-5530		2	2	2
H5985	001	0	1	01	01	H5985_001_0	5	1		06/03/2011	2012.02	06/03/2011 10:20:38 AM US Mountain Standard Time	08/05/2011 03:23:46 PM US Mountain Standard Time	08/05/2011 03:23:46 PM US Mountain Standard Time		08/05/2011 06:08:35 PM US Mountain Standard Time	ABRAZO ADVANTAGE HEALTH PLAN	Abrazo Advantage Health Plan	www.abrazoadvantage.com	Abrazo Advantage (HMO)	01	01		1			H5985	001	0	2012	Central Arizona		2	2385	2			2						http://www.abrazoadvantage.com/find_a_doctor.aspx	AbrazoAdvantage.com	AbrazoAdvantage.com	(888)-864-1114		(602)-824-3900		(888)-864-1114		(602)-824-3900		(888)-864-1114		(602)-824-3900		(888)-864-1114		(602)-824-3900		(800)-489-1472		(602)-824-3909		(800)-489-1472		(602)-824-3909		(800)-489-1472		(602)-824-3909		(800)-489-1472		(602)-824-3909		2	2	2
H5985	002	0	1	01	01	H5985_002_0	4	1	2	06/03/2011	2012.02	06/03/2011 04:08:03 PM US Mountain Standard Time	08/05/2011 03:23:46 PM US Mountain Standard Time	08/05/2011 03:23:46 PM US Mountain Standard Time		08/05/2011 06:21:20 PM US Mountain Standard Time	ABRAZO ADVANTAGE HEALTH PLAN	Abrazo Advantage Health Plan	www.abrazoadvantage.com	Abrazo Advantage Plus (HMO SNP)	01	01		1			H5985	002	0	2012	Central Arizona		2	2753	2			1	3		1	3		http://www.abrazoadvantage.com/find_a_doctor.aspx	AbrazoAdvantage.com	AbrazoAdvantage.com	(888)-864-1114		(602)-824-3900		(888)-864-1114		(602)-824-3900		(888)-864-1114		(602)-824-3900		(888)-864-1114		(602)-824-3900		(800)-489-1472		(602)-824-3909		(800)-489-1472		(602)-824-3909		(800)-489-1472		(602)-824-3909		(800)-489-1472		(602)-824-3909		2	2	2
H5989	002	0	1	01	01	H5989_002_0	7	1		08/04/2011	2012.02	08/04/2011 02:40:14 PM Central Daylight Time	08/05/2011 01:04:57 PM Central Daylight Time	08/05/2011 10:36:12 AM Central Daylight Time		08/08/2011 02:59:32 PM Central Daylight Time	COMPREHENSIVE CARE MANAGEMENT CORP.	Comprehensive Care Management Corp.	www.ccmny.org	CCM Direct Complete Plan (HMO SNP)	01	01		1			H5989	002	0	2012	New York City Metro Area and Westchester County		2	340	2			1	1	3	1			www.ccmny.org	http://www.ccmny.org	http://www.ccmny.org	(877)-226-8500		(347)-640-6280		(877)-226-8500		(347)-640-6280		(877)-226-8500		(347)-640-6280		(877)-226-8500		(347)-640-6280		(800)-650-2774		(800)-650-2774		(800)-650-2774		(800)-650-2774		(800)-650-2774		(800)-650-2774		(800)-650-2774		(800)-650-2774		2	2	2
H5989	008	0	1	01	01	H5989_008_0	5	1	2	08/04/2011	2012.02	08/04/2011 02:40:40 PM Central Daylight Time	08/08/2011 11:47:20 AM Central Daylight Time	08/05/2011 10:36:38 AM Central Daylight Time		08/08/2011 02:59:32 PM Central Daylight Time	COMPREHENSIVE CARE MANAGEMENT CORP.	Comprehensive Care Management Corp.	www.ccmny.org	CCM Total Plan (HMO SNP)	01	01		1			H5989	008	0	2012	New York City Metro Area and Westchester County		2	39	2			1	3		1	3		www.ccmny.org	http://www.ccmny.org	http://www.ccmny.org	(877)-226-8500		(347)-640-6280		(877)-226-8500		(347)-640-6280		(877)-226-8500		(347)-640-6280		(877)-226-8500		(347)-640-6280		(800)-650-2774		(800)-650-2774		(800)-650-2774		(800)-650-2774		(800)-650-2774		(800)-650-2774		(800)-650-2774		(800)-650-2774		2	2	2
H5991	001	0	1	01	01	H5991_001_0	9	1	2	08/12/2011	2012.02	08/12/2011 05:23:46 PM Eastern Daylight Time	08/08/2011 09:51:55 AM Eastern Daylight Time	08/10/2011 04:16:21 PM Eastern Daylight Time		08/12/2011 05:24:51 PM Eastern Daylight Time	AFFINITY HEALTH PLAN, INC.	Affinity Health Plan	www.affinityplan.org	Affinity Medicare Ultimate (HMO SNP)	01	01		1			H5991	001	0	2012	New York City (5 Boroughs)		2	3500	2			1	3		1	3		www.affinityplan.org	www.affinityplan.org	www.affinityplan.org	(877)-234-4499		(877)-234-4499		(877)-234-4499		(877)-234-4499		(800)-417-3367		(800)-417-3367		(877)-234-4499		(877)-234-4499		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-899-2114		(800)-899-2114		(800)-662-1220		(800)-662-1220		2	2	2
H5991	002	0	1	01	01	H5991_002_0	5	1	2	08/07/2011	2012.02	08/07/2011 09:09:01 AM Eastern Daylight Time	08/08/2011 09:51:44 AM Eastern Daylight Time	08/07/2011 09:04:27 AM Eastern Daylight Time		08/08/2011 10:22:03 AM Eastern Daylight Time	AFFINITY HEALTH PLAN, INC.	Affinity Health Plan	www.affinityplan.org	Affinity Medicare Solutions (HMO SNP)	01	01		1			H5991	002	0	2012	New York City (5 Boroughs)		2	1045	2			1	3		1	2		www.affinityplan.org	www.affinityplan.org	www.affinityplan.org	(877)-234-4499		(877)-234-4499		(877)-234-4499		(877)-234-4499		(800)-417-3367		(800)-417-3367		(877)-234-4499		(877)-234-4499		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-899-2114		(800)-899-2114		(800)-662-1220		(800)-662-1220		2	2	2
H5992	005	0	1	01	01	H5992_005_0	6	1	2	08/08/2011	2012.02	08/08/2011 04:30:36 PM Eastern Daylight Time	08/08/2011 10:54:08 AM Eastern Daylight Time	08/08/2011 01:03:34 PM Eastern Daylight Time		08/09/2011 06:59:46 PM Eastern Daylight Time	SENIOR WHOLE HEALTH, LLC	Senior Whole Health of New York	www.seniorwholehealth.com	Senior Whole Health of New York (HMO SNP)	01	01		1			H5992	005	0	2012	Capital District, Hudson Valley, Adirondacks		2	1600	2			1	3		1	5		www.seniorwholehealth.com	www.seniorwholehealth.com	www.seniorwholehealth.com	(866)-211-1777		(518)-472-5200		(866)-211-1777		(518)-472-5200		(866)-211-1777		(518)-472-5200		(866)-211-1777		(518)-472-5200		(866)-404-9507		(518)-472-5219		(866)-404-9507		(518)-472-5219		(866)-404-9507		(518)-472-5219		(866)-404-9507		(518)-472-5219		2	2	1
H5992	006	0	1	01	01	H5992_006_0	5	1	2	08/09/2011	2012.02	08/09/2011 06:10:16 PM Eastern Daylight Time	08/09/2011 05:01:56 PM Eastern Daylight Time	08/08/2011 01:07:48 PM Eastern Daylight Time		08/09/2011 07:03:09 PM Eastern Daylight Time	SENIOR WHOLE HEALTH, LLC	Senior Whole Health of New York	www.seniorwholehealth.com	Senior Whole Health of New York (HMO SNP)	01	01		1			H5992	006	0	2012	Bronx, Kings, Queens, and New York counties		2	158	2			1	3		1	5		www.seniorwholehealth.com	www.seniorwholehealth.com	www.seniorwholehealth.com	(866)-211-1777		(518)-472-5200		(866)-211-1777		(518)-472-5200		(866)-211-1777		(518)-472-5200		(866)-211-1777		(518)-472-5200		(866)-404-9507		(518)-472-5219		(866)-404-9507		(518)-472-5219		(866)-404-9507		(518)-472-5219		(866)-404-9507		(518)-472-5219		2	2	1
H5995	001	0	1	01	01	H5995_001_0	7	1	2	08/09/2011	2012.02	08/09/2011 04:32:13 PM Pacific Daylight Time	08/09/2011 02:34:23 PM Pacific Daylight Time	08/09/2011 02:34:23 PM Pacific Daylight Time		08/09/2011 04:48:49 PM Pacific Daylight Time	MARION POLK COMMUNITY HEALTH PLAN ADVANTAGE, INC.	Marion Polk Community Health Plan Advantage, Inc.	www.mpchpa.org	Marion Polk Community Health Plan Advantage (HMO SNP)	01	01		1			H5995	001	0	2012	Marion and Polk Counties In Oregon		2	3260	2			1	3		1	3		www.mpchpa.org/providersearch.php	www.mpchpa.org	www.mpchpa.org	(888)-462-2708		(503)-584-4210		(888)-236-2496		(503)-315-4101		(888)-462-2708		(503)-584-4210		(888)-236-2496		(503)-315-4101		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		2	2	2
H6059	001	0	1	20	08	H6059_001_0	1	1		05/23/2011	2012.02	05/23/2011 01:20:39 PM Eastern Daylight Time		05/23/2011 04:15:43 PM Eastern Daylight Time		05/27/2011 09:50:07 AM Eastern Daylight Time	PACE OF GUILFORD AND ROCKINGHAM COUNTIES, INC.	PACE OF THE TRIAD	www.pacetriad.org	PACE of The Triad - Dual (PACE)	08	20		1			H6059	001	0	2012	PACE of The Triad - Dual		2		2			2							www.pacetriad.org	www.pacetriad.org									(336)-550-4040		(336)-550-4040		(336)-550-4040		(336)-550-4040										(336)-621-2478		(336)-621-2478		(336)-621-2478		(336)-621-2478				
H6059	002	0	1	20	08	H6059_002_0	1	1		05/23/2011	2012.02	05/23/2011 01:21:25 PM Eastern Daylight Time		05/23/2011 04:15:47 PM Eastern Daylight Time		05/27/2011 09:50:07 AM Eastern Daylight Time	PACE OF GUILFORD AND ROCKINGHAM COUNTIES, INC.	PACE OF THE TRIAD	www.pacetriad.org	PACE of The Triad - Medicare only (PACE)	08	20		1			H6059	002	0	2012	PACE of The Triad - Medicare only		2		2			2							www.pacetriad.org	www.pacetriad.org									(336)-550-4040		(336)-550-4040		(336)-550-4040		(336)-550-4040										(336)-621-2478		(336)-621-2478		(336)-621-2478		(336)-621-2478				
H6169	001	0	1	09	04	H6169_001_0	3	1		07/13/2011	2012.02	07/13/2011 01:44:45 PM Central Daylight Time	06/05/2011 11:08:42 PM Central Daylight Time			07/14/2011 05:11:53 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier 200 (PFFS)	04	09	1	1			H6169	001	0	2012	Select counties in Midwest, Southeast, Southwest		2	327	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										2	2	2
H6169	011	0	1	09	04	H6169_011_0	4	1		07/13/2011	2012.02	07/13/2011 01:45:11 PM Central Daylight Time	06/05/2011 11:08:58 PM Central Daylight Time			07/14/2011 05:11:53 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier 400 (PFFS)	04	09	1	1			H6169	011	0	2012	Select counties in Midwest, Southeast, Southwest		2	8665	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										2	2	2
H6169	012	0	1	09	04	H6169_012_0	4	1		07/13/2011	2012.02	07/13/2011 01:45:33 PM Central Daylight Time	06/05/2011 11:09:19 PM Central Daylight Time			07/14/2011 05:11:53 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier 400 (PFFS)	04	09	1	1			H6169	012	0	2012	Select counties in Midwest, Southeast, Southwest		2	2170	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										2	2	2
H6169	013	0	1	09	04	H6169_013_0	4	1		07/13/2011	2012.02	07/13/2011 01:45:53 PM Central Daylight Time	06/05/2011 11:09:37 PM Central Daylight Time			07/14/2011 05:11:53 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier 400 (PFFS)	04	09	1	1			H6169	013	0	2012	Select counties in Midwest, Southeast, Southwest		2	3519	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										2	2	2
H6169	015	0	1	09	04	H6169_015_0	4	1		07/13/2011	2012.02	07/13/2011 01:47:28 PM Central Daylight Time	06/05/2011 11:09:55 PM Central Daylight Time			07/14/2011 05:11:53 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier 400 (PFFS)	04	09	1	1			H6169	015	0	2012	Select counties in Midwest, Southeast, Southwest		2	165	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										2	2	2
H6169	016	0	1	09	04	H6169_016_0	5	1		07/13/2011	2012.02	07/13/2011 01:48:10 PM Central Daylight Time	07/15/2011 02:51:50 PM Central Daylight Time			07/18/2011 11:20:32 AM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier 400 (PFFS)	04	09	1	1			H6169	016	0	2012	Select counties in Midwest, Southeast, Southwest		2	468	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										2	2	2
H6169	021	0	1	09	04	H6169_021_0	5	1		07/13/2011	2012.02	07/13/2011 01:48:33 PM Central Daylight Time	08/05/2011 11:12:10 AM Central Daylight Time	08/04/2011 12:15:50 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier Plus 250A (PFFS)	04	09	1	1			H6169	021	0	2012	Select counties in Midwest, Southeast, Southwest		2	1519	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		2	2	2
H6169	024	0	1	09	04	H6169_024_0	4	1		07/13/2011	2012.02	07/13/2011 01:49:10 PM Central Daylight Time	08/05/2011 11:29:00 AM Central Daylight Time	08/04/2011 12:24:06 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier Plus 250A (PFFS)	04	09	1	1			H6169	024	0	2012	Select counties in Midwest, Southeast, Southwest		2	532	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		2	2	2
H6169	031	0	1	09	04	H6169_031_0	6	1		07/13/2011	2012.02	07/13/2011 01:49:45 PM Central Daylight Time	08/05/2011 11:37:58 AM Central Daylight Time	08/04/2011 12:37:02 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier Plus 450B (PFFS)	04	09	1	1			H6169	031	0	2012	Select counties in Midwest, Southeast, Southwest		2	1411	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		2	2	2
H6169	032	0	1	09	04	H6169_032_0	6	1		07/13/2011	2012.02	07/13/2011 01:50:18 PM Central Daylight Time	08/05/2011 01:04:08 PM Central Daylight Time	08/04/2011 12:28:24 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier Plus 450B (PFFS)	04	09	1	1			H6169	032	0	2012	Select counties in Midwest, Southeast, Southwest		2	1431	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		2	2	2
H6169	033	0	1	09	04	H6169_033_0	8	1		07/13/2011	2012.02	07/13/2011 01:50:46 PM Central Daylight Time	08/05/2011 01:14:56 PM Central Daylight Time	08/04/2011 12:50:00 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier Plus 450C (PFFS)	04	09	1	1			H6169	033	0	2012	Select counties in Midwest, Southeast, Southwest		2	2903	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		2	2	2
H6169	035	0	1	09	04	H6169_035_0	8	1		07/13/2011	2012.02	07/13/2011 01:51:11 PM Central Daylight Time	08/05/2011 01:24:50 PM Central Daylight Time	08/04/2011 12:49:16 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier Plus 450C (PFFS)	04	09	1	1			H6169	035	0	2012	Select counties in Midwest, Southeast, Southwest		2	193	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		2	2	2
H6169	036	0	1	09	04	H6169_036_0	9	1		07/13/2011	2012.02	07/13/2011 01:52:11 PM Central Daylight Time	08/05/2011 01:34:57 PM Central Daylight Time	08/04/2011 12:53:02 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier Plus 450D (PFFS)	04	09	1	1			H6169	036	0	2012	Select counties in Midwest, Southeast, Southwest		2	660	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		2	2	2
H6169	050	0	1	09	04	H6169_050_0	3	1		07/13/2011	2012.02	07/13/2011 01:52:53 PM Central Daylight Time	06/05/2011 11:12:45 PM Central Daylight Time			07/14/2011 05:11:53 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier 200 (PFFS)	04	09	1	1			H6169	050	0	2012	Select counties in Midwest, Southeast, Southwest		2	307	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										2	2	2
H6169	051	0	1	09	04	H6169_051_0	3	1		07/13/2011	2012.02	07/13/2011 03:41:04 PM Central Daylight Time	06/05/2011 11:13:02 PM Central Daylight Time			07/14/2011 05:11:53 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier 200 (PFFS)	04	09	1	1			H6169	051	0	2012	Select counties in Midwest, Southeast, Southwest		2	307	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										2	2	2
H6169	052	0	1	09	04	H6169_052_0	3	1		07/13/2011	2012.02	07/13/2011 01:53:44 PM Central Daylight Time	06/05/2011 11:13:21 PM Central Daylight Time			07/14/2011 05:11:53 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier 200 (PFFS)	04	09	1	1			H6169	052	0	2012	Select counties in Midwest, Southeast, Southwest		2	307	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										2	2	2
H6169	053	0	1	09	04	H6169_053_0	3	1		07/13/2011	2012.02	07/13/2011 01:54:04 PM Central Daylight Time	06/05/2011 11:13:42 PM Central Daylight Time			07/14/2011 05:11:53 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier 200 (PFFS)	04	09	1	1			H6169	053	0	2012	Select counties in Midwest, Southeast, Southwest		2	307	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										2	2	2
H6169	054	0	1	09	04	H6169_054_0	5	1		07/13/2011	2012.02	07/13/2011 01:55:00 PM Central Daylight Time	08/05/2011 01:44:32 PM Central Daylight Time	08/04/2011 12:17:08 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier Plus 250A (PFFS)	04	09	1	1			H6169	054	0	2012	Select counties in Midwest, Southeast, Southwest		2	173	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		2	2	2
H6169	056	0	1	09	04	H6169_056_0	5	1		07/13/2011	2012.02	07/13/2011 01:55:21 PM Central Daylight Time	08/05/2011 01:54:14 PM Central Daylight Time	08/04/2011 12:13:36 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier Plus 250A (PFFS)	04	09	1	1			H6169	056	0	2012	Select counties in Midwest, Southeast, Southwest		2	173	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		2	2	2
H6169	057	0	1	09	04	H6169_057_0	4	1		07/13/2011	2012.02	07/13/2011 01:55:43 PM Central Daylight Time	08/05/2011 02:02:58 PM Central Daylight Time	08/04/2011 12:07:06 PM Central Daylight Time		08/08/2011 03:45:45 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options Premier Plus 250A (PFFS)	04	09	1	1			H6169	057	0	2012	Select counties in Midwest, Southeast, Southwest		2	173	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		2	2	2
H6169	801	0	1	09	04	H6169_801_0	4	1		06/03/2011	2012.02	06/03/2011 03:03:02 PM Central Daylight Time	06/06/2011 12:23:20 AM Central Daylight Time			07/14/2011 05:11:53 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options PFFS - MA Group Plan (PFFS)	04	09	1	1			H6169	801	0	2012	National		1	100	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923										(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089										1	1	1
H6169	802	0	1	09	04	H6169_802_0	4	1		06/03/2011	2012.02	06/03/2011 03:04:48 PM Central Daylight Time	06/06/2011 12:33:05 AM Central Daylight Time			07/14/2011 05:11:53 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options PFFS - MAPD Group Plan (PFFS)	04	09	1	1			H6169	802	0	2012	National		1	100	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		1	1	1
H6169	803	0	1	09	04	H6169_803_0	4	1		06/03/2011	2012.02	06/03/2011 03:05:11 PM Central Daylight Time	06/06/2011 12:41:34 AM Central Daylight Time			07/14/2011 05:11:53 PM Central Daylight Time	THE PYRAMID LIFE INSURANCE COMPANY	Universal American	www.TodaysOptions.com	Today's Options PFFS - MAPD Group Plan - NCY (PFFS)	04	09	1	1			H6169	803	0	2012	National		1	100	2			2							www.TodaysOptions.com	www.TodaysOptions.com	(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(866)-568-8921		(866)-568-8921		(866)-418-1923		(866)-418-1923		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		(877)-907-2986		(877)-907-2986		(800)-975-8089		(800)-975-8089		1	1	1
H6178	001	0	1	01	01	H6178_001_0	9	1	2	08/09/2011	2012.02	08/09/2011 04:38:21 PM Eastern Daylight Time	08/09/2011 04:50:48 PM Eastern Daylight Time	08/09/2011 04:50:41 PM Eastern Daylight Time		08/09/2011 04:58:02 PM Eastern Daylight Time	CARESOURCE	CareSource	www.caresource.com	CareSource Advantage (HMO SNP)	01	01		1			H6178	001	0	2012	Entire State of Ohio		2	1428	2			1	3		1	3		www.caresource.com	www.caresource.com	www.caresource.com	(800)-708-8729		(800)-708-8729		(800)-708-8729		(800)-708-8729		(800)-708-8729		(800)-708-8729		(800)-708-8729		(800)-708-8729		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		(800)-750-0750		2	2	2
H6181	007	0	1	01	01	H6181_007_0	7	1	2	07/19/2011	2012.02	07/19/2011 07:57:48 AM Eastern Daylight Time	08/05/2011 09:55:00 AM Eastern Daylight Time	08/04/2011 05:28:00 PM Eastern Daylight Time		08/09/2011 05:31:53 PM Eastern Daylight Time	AMERIGROUP NEW YORK, LLC	Amerigroup Community Care	www.myamerigroup.com/medicare	Amerivantage Specialty + Rx (HMO SNP)	01	01		1			H6181	007	0	2012	New York City Area		2	493	2			1	3		1	1		www.myamerigroup.com/medicare	http://www.amerigroupcorp.com/Members/amerivantage/_documents	http://www.amerigroupcorp.com/Members/amerivantage	(866)-805-4589		(866)-805-4589		(877)-470-4131		(877)-470-4131		(866)-805-4589		(866)-805-4589		(877)-470-4131		(877)-470-4131		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		2	2	2
H6181	009	0	1	01	01	H6181_009_0	7	1		07/19/2011	2012.02	07/19/2011 07:58:12 AM Eastern Daylight Time	08/05/2011 09:53:00 AM Eastern Daylight Time	08/04/2011 05:28:00 PM Eastern Daylight Time		08/09/2011 05:31:53 PM Eastern Daylight Time	AMERIGROUP NEW YORK, LLC	Amerigroup Community Care	www.myamerigroup.com/medicare	Amerivantage Balance + Rx (HMO)	01	01		1			H6181	009	0	2012	New York City Area		2	527	2			2						www.myamerigroup.com/medicare	http://www.amerigroupcorp.com/Members/amerivantage/_documents	http://www.amerigroupcorp.com/Members/amerivantage	(866)-805-4589		(866)-805-4589		(877)-470-4131		(877)-470-4131		(866)-805-4589		(866)-805-4589		(877)-470-4131		(877)-470-4131		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		2	2	2
H6231	001	0	1	20	08	H6231_001_0	1	1		05/23/2011	2012.02	05/23/2011 12:16:53 PM Central Daylight Time		05/23/2011 11:57:01 AM Central Daylight Time		05/23/2011 12:19:42 PM Central Daylight Time	FRANCISCAN PACE, INC.	PACE Baton Rouge	www.fmolhs.org	Franciscan PACE, Inc. (PACE)	08	20		1			H6231	001	0	2012	PACE Baton Rouge		2		2			2							www.ololrmc.com	www.ololrmc.com									(800)-789-2863		(225)-490-0604		(800)-789-2863		(225)-490-0604										(800)-789-2863		(225)-490-0604		(800)-789-2863		(225)-490-0604				
H6231	002	0	1	20	08	H6231_002_0	1	1		05/23/2011	2012.02	05/23/2011 12:16:30 PM Central Daylight Time		05/23/2011 11:57:01 AM Central Daylight Time		05/23/2011 12:19:42 PM Central Daylight Time	FRANCISCAN PACE, INC.	PACE Baton Rouge	www.fmolhs.org	Franciscan PACE, Inc. (PACE)	08	20		1			H6231	002	0	2012	PACE Baton Rouge		2		2			2							www.ololrmc.com	www.ololrmc.com									(800)-789-2863		(225)-490-0604		(800)-789-2863		(225)-490-0604										(800)-789-2863		(225)-490-0604		(800)-789-2863		(225)-490-0604				
H6264	001	0	1	01	01	H6264_001_0	5	1		06/24/2011	2012.02	06/24/2011 01:29:04 PM Eastern Daylight Time	06/06/2011 12:45:18 PM Eastern Daylight Time	08/05/2011 01:53:34 PM Eastern Daylight Time		08/08/2011 04:55:24 PM Eastern Daylight Time	HEALTHPLUS PHSP, INC.	Health Plus Elite	www.healthplus-ny.org	Health Plus Advantage (HMO)	01	01		1			H6264	001	0	2012	New York City and Nassau		2	65	2			2						www.healthplus-ny.org	https://mp.medimpact.com/pharmacyportal/public/Login.jsp?viewtype=mi	https://mp.medimpact.com/pharmacyportal/public/Login.jsp?viewtype=mi	(888)-493-5390		(718)-369-5400		(866)-509-7999		(718)-369-5400		(888)-493-5390		(718)-369-5400		(866)-509-7999		(718)-369-5400		(800)-421-1220		(800)-421-1220		(800)-662-1220		(800)-662-1220		(800)-421-1220		(800)-421-1220		(800)-662-1220		(800)-662-1220		2	2	2
H6264	002	0	1	01	01	H6264_002_0	5	1	2	08/08/2011	2012.02	08/08/2011 04:16:21 PM Eastern Daylight Time	08/08/2011 10:12:10 AM Eastern Daylight Time	08/05/2011 01:50:58 PM Eastern Daylight Time		08/08/2011 05:13:24 PM Eastern Daylight Time	HEALTHPLUS PHSP, INC.	Health Plus Elite	www.healthplus-ny.org	Health Plus Elite (HMO SNP)	01	01		1			H6264	002	0	2012	New York City and Nassau		2	325	2			1	3		1	5		www.healthplus-ny.org	https://mp.medimpact.com/pharmacyportal/public/Login.jsp?viewtype=mi	https://mp.medimpact.com/pharmacyportal/public/Login.jsp?viewtype=mi	(888)-493-5390		(718)-369-5400		(866)-509-7999		(718)-369-5400		(800)-300-8181		(718)-369-5400		(888)-493-5390		(718)-369-5400		(800)-421-1220		(800)-421-1220		(800)-662-1220		(800)-662-1220		(800)-421-1220		(800)-421-1220		(800)-662-1220		(800)-662-1220		2	2	2
H6310	001	0	1	20	08	H6310_001_0	1	1		12/09/2011	2012.02	12/09/2011 04:15:23 PM Eastern Standard Time		12/06/2011 02:29:25 PM Eastern Standard Time		12/09/2011 04:17:52 PM Eastern Standard Time	INOVA HEALTH SYSTEM	InovaCares for Seniors	www.Inova.org	InovaCares for Seniors Dual Eligible (PACE)	08	20		1			H6310	001	0	2012	Northern Virginia		2		2			2							www.inova.org	www.omnicare.com									(877)-409-2811		(866)-288-4938		(877)-409-2811		(866)-288-4938										(888)-206-8041		(888)-206-8041		(888)-206-8041		(888)-206-8041				
H6310	002	0	1	20	08	H6310_002_0	1	1		12/09/2011	2012.02	12/09/2011 04:15:46 PM Eastern Standard Time		12/06/2011 02:29:25 PM Eastern Standard Time		12/09/2011 04:17:52 PM Eastern Standard Time	INOVA HEALTH SYSTEM	InovaCares for Seniors	www.Inova.org	InovaCares for Seniors Medicare Only (PACE)	08	20		1			H6310	002	0	2012	Northern Virginia		2		2			2							www.inova.org	www.omnicare.com									(877)-409-2811		(866)-288-4938		(877)-409-2811		(866)-288-4938										(888)-206-8041		(888)-206-8041		(888)-206-8041		(888)-206-8041				
H6328	001	0	1	04	01	H6328_001_0	8	1		08/05/2011	2012.02	08/05/2011 09:34:56 AM Central Daylight Time	08/08/2011 05:49:48 PM Central Daylight Time	08/08/2011 05:49:48 PM Central Daylight Time		08/08/2011 05:52:55 PM Central Daylight Time	CARE N' CARE INSURANCE COMPANY, INC.	Care N' Care Health Plan	www.cnchealthplan.com	Care N' Care Health Plan I (PPO)	01	04		1			H6328	001	0	2012	Tarrant County, Johnson County and Parker County		2		2			2						www.cnchealthplan.com	www.cnchealthplan.com	www.cnchealthplan.com	(877)-374-7993		(817)-529-5267		(800)-665-2622		(817)-810-5213		(800)-260-1327		(800)-260-1327		(800)-665-2622		(817)-810-5213		(877)-374-7994		(817)-529-5268		(877)-374-7994		(817)-529-5268		(866)-547-0773		(866)-547-0773		(877)-374-7994		(817)-529-5268		2	2	2
H6328	002	0	1	04	01	H6328_002_0	6	1		07/06/2011	2012.02	07/06/2011 01:15:33 PM Central Daylight Time	08/08/2011 05:49:48 PM Central Daylight Time	08/08/2011 05:49:48 PM Central Daylight Time		08/08/2011 05:52:55 PM Central Daylight Time	CARE N' CARE INSURANCE COMPANY, INC.	Care N' Care Health Plan	www.cnchealthplan.com	Care N' Care Health Plan II (PPO)	01	04		1			H6328	002	0	2012	Tarrant County, Johnson County and Parker County		2		2			2						www.cnchealthplan.com	www.cnchealthplan.com	www.cnchealthplan.com	(877)-374-7993		(817)-529-5267		(800)-665-2622		(817)-810-5213		(800)-260-1327		(800)-260-1327		(800)-665-2622		(817)-810-5213		(877)-374-7994		(817)-529-5268		(877)-374-7994		(817)-529-5268		(866)-547-0773		(866)-547-0773		(877)-374-7994		(817)-529-5268		2	2	2
H6328	003	0	1	04	01	H6328_003_0	5	1		07/06/2011	2012.02	07/06/2011 01:15:56 PM Central Daylight Time	08/08/2011 05:49:48 PM Central Daylight Time	08/08/2011 05:49:48 PM Central Daylight Time		08/08/2011 05:52:55 PM Central Daylight Time	CARE N' CARE INSURANCE COMPANY, INC.	Care N' Care Health Plan	www.cnchealthplan.com	Care N' Care Health Plan III (PPO)	01	04		1			H6328	003	0	2012	Tarrant County, Johnson County and Parker County		2		2			2						www.cnchealthplan.com	www.cnchealthplan.com	www.cnchealthplan.com	(877)-374-7993		(817)-529-5267		(800)-665-2622		(817)-810-5213		(800)-260-1327		(800)-260-1327		(800)-665-2622		(817)-810-5213		(877)-374-7994		(817)-529-5268		(877)-374-7994		(817)-529-5268		(866)-547-0773		(866)-547-0773		(877)-374-7994		(817)-529-5268		2	2	2
H6328	005	0	1	04	01	H6328_005_0	5	1		07/12/2011	2012.02	07/12/2011 01:56:04 PM Central Daylight Time	07/15/2011 10:39:44 PM Central Daylight Time			07/18/2011 10:32:00 AM Central Daylight Time	CARE N' CARE INSURANCE COMPANY, INC.	Care N' Care Health Plan	www.cnchealthplan.com	Care N' Care Health Plan I MA-Only (PPO)	01	04		1			H6328	005	0	2012	Tarrant County, Johnson County and Parker County		2		2			2						www.cnchealthplan.com	www.cnchealthplan.com	www.cnchealthplan.com	(877)-374-7993		(817)-529-5267		(800)-665-2622		(817)-810-5213										(877)-374-7994		(817)-529-5268		(877)-374-7994		(817)-529-5268										2	2	2
H6328	006	0	1	04	01	H6328_006_0	4	1		06/06/2011	2012.02	06/06/2011 04:10:27 PM Central Daylight Time	07/15/2011 10:40:00 PM Central Daylight Time			07/18/2011 10:32:00 AM Central Daylight Time	CARE N' CARE INSURANCE COMPANY, INC.	Care N' Care Health Plan	www.cnchealthplan.com	Care N' Care Health Plan II MA-Only (PPO)	01	04		1			H6328	006	0	2012	Tarrant County, Johnson County and Parker County		2		2			2						www.cnchealthplan.com	www.cnchealthplan.com	www.cnchealthplan.com	(877)-374-7993		(817)-529-5267		(800)-665-2622		(817)-810-5213										(877)-374-7994		(817)-529-5268		(877)-374-7994		(817)-529-5268										2	2	2
H6328	801	0	1	04	01	H6328_801_0	5	1		06/02/2011	2012.02	06/02/2011 05:07:57 PM Central Daylight Time	07/15/2011 10:40:05 PM Central Daylight Time			07/18/2011 10:32:00 AM Central Daylight Time	CARE N' CARE INSURANCE COMPANY, INC.	Care N' Care Health Plan	www.cnchealthplan.com	Care N' Care Health Plan Employer Group CY (PPO)	01	04		1			H6328	801	0	2012	Tarrant County, Johnson County and Parker County		1		2			2						www.cnchealthplan.com	www.cnchealthplan.com	www.cnchealthplan.com	(877)-374-7993		(817)-529-5267		(800)-665-2622		(817)-810-5213		(800)-260-1327		(800)-260-1327		(800)-665-2622		(817)-810-5213		(877)-374-7994		(817)-529-5268		(877)-374-7994		(817)-529-5268		(866)-547-0773		(866)-547-0773		(877)-374-7994		(817)-529-5268		2	2	2
H6328	802	0	1	04	01	H6328_802_0	2	1		06/02/2011	2012.02	06/02/2011 05:14:08 PM Central Daylight Time	06/08/2011 03:07:59 PM Central Daylight Time			06/08/2011 03:17:40 PM Central Daylight Time	CARE N' CARE INSURANCE COMPANY, INC.	Care N' Care Health Plan	www.cnchealthplan.com	Care N' Care Health Plan Employer Group NCY (PPO)	01	04		1			H6328	802	0	2012	Tarrant County, Johnson County and Parker County		1		2			2						www.cnchealthplan.com	www.cnchealthplan.com	www.cnchealthplan.com	(877)-374-7993		(817)-529-5267		(800)-665-2622		(817)-810-5213		(800)-260-1327		(800)-260-1327		(800)-665-2622		(817)-810-5213		(877)-374-7994		(817)-529-5268		(877)-374-7994		(817)-529-5268		(866)-547-0773		(866)-547-0773		(877)-374-7994		(817)-529-5268		2	2	2
H6328	803	0	1	04	01	H6328_803_0	2	1		06/02/2011	2012.02	06/02/2011 05:14:16 PM Central Daylight Time	06/08/2011 03:08:29 PM Central Daylight Time			06/08/2011 03:17:40 PM Central Daylight Time	CARE N' CARE INSURANCE COMPANY, INC.	Care N' Care Health Plan	www.cnchealthplan.com	Care N' Care Health Plan Employer Group CY (PPO)	01	04		1			H6328	803	0	2012	Tarrant County, Johnson County and Parker County		1		2			2						www.cnchealthplan.com	www.cnchealthplan.com	www.cnchealthplan.com	(877)-374-7993		(817)-529-5267		(800)-665-2622		(817)-810-5213										(877)-374-7994		(817)-529-5268		(877)-374-7994		(817)-529-5268										2	2	2
H6328	804	0	1	04	01	H6328_804_0	2	1		06/02/2011	2012.02	06/02/2011 05:14:22 PM Central Daylight Time	06/08/2011 03:08:25 PM Central Daylight Time			06/08/2011 03:17:40 PM Central Daylight Time	CARE N' CARE INSURANCE COMPANY, INC.	Care N' Care Health Plan	www.cnchealthplan.com	Care N' Care Health Plan Employer Group NCY (PPO)	01	04		1			H6328	804	0	2012	Tarrant County, Johnson County and Parker County		1		2			2						www.cnchealthplan.com	www.cnchealthplan.com	www.cnchealthplan.com	(877)-374-7993		(817)-529-5267		(800)-665-2622		(817)-810-5213										(877)-374-7994		(817)-529-5268		(877)-374-7994		(817)-529-5268										2	2	2
H6360	001	0	1	18	06	H6360_001_0	7	1		08/05/2011	2012.02	08/05/2011 09:17:41 AM Eastern Daylight Time		08/04/2011 12:09:17 PM Eastern Daylight Time		08/05/2011 09:50:57 AM Eastern Daylight Time	KAISER FOUNDATION HP OF OHIO	Kaiser Permanente Medicare Plus	kp.org	Kaiser Permanente Medicare Plus I (Cost)	06	18		1			H6360	001	0	2012	Counties: Cuy, Gea, Lak, Lor, Med, Por, Sum		2	7988	2			2							www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-493-6004		(216)-621-7100		(877)-408-3495		(877)-408-3495		(800)-493-6004		(216)-621-7100		(877)-408-3495		(877)-408-3495		(866)-513-9966		(216)-635-4444		(888)-758-6054		(888)-758-6054		(866)-513-9966		(216)-635-4444		(888)-758-6054		(888)-758-6054		2	2	2
H6360	002	0	1	18	06	H6360_002_0	7	1		08/05/2011	2012.02	08/05/2011 09:19:07 AM Eastern Daylight Time		08/04/2011 12:14:22 PM Eastern Daylight Time		08/05/2011 09:50:57 AM Eastern Daylight Time	KAISER FOUNDATION HP OF OHIO	Kaiser Permanente Medicare Plus	kp.org	Kaiser Permanente Medicare Plus II (Cost)	06	18		1			H6360	002	0	2012	Counties: Cuy, Gea, Lak, Lor, Med, Por, Sum		2	1883	2			2							www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-493-6004		(216)-621-7100		(877)-408-3495		(877)-408-3495		(800)-493-6004		(216)-621-7100		(877)-408-3495		(877)-408-3495		(866)-513-9966		(216)-635-4444		(888)-758-6054		(888)-758-6054		(866)-513-9966		(216)-635-4444		(888)-758-6054		(888)-758-6054		2	2	2
H6360	004	0	1	18	06	H6360_004_0	5	1		07/21/2011	2012.02	07/21/2011 05:04:09 PM Eastern Daylight Time				07/21/2011 05:36:41 PM Eastern Daylight Time	KAISER FOUNDATION HP OF OHIO	Kaiser Permanente Medicare Plus	kp.org	Kaiser Permanente Medicare Plus Basic I (Cost)	06	18		1			H6360	004	0	2012	Counties: Cuy, Gea, Lak, Lor, Med, Por, Sum		2	18	2			2							www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-493-6004		(216)-621-7100		(877)-408-3495		(877)-408-3495										(866)-513-9966		(216)-635-4444		(888)-758-6054		(888)-758-6054										2	2	2
H6360	006	0	1	18	06	H6360_006_0	12	1		08/05/2011	2012.02	08/05/2011 09:19:46 AM Eastern Daylight Time		08/04/2011 12:24:17 PM Eastern Daylight Time		08/05/2011 09:50:57 AM Eastern Daylight Time	KAISER FOUNDATION HP OF OHIO	Kaiser Permanente Medicare Plus	kp.org	Kaiser Permanente Medicare Plus III (Cost)	06	18		1			H6360	006	0	2012	Counties: Cuy, Gea, Lak, Lor, Med, Por, Sum		2	999	2			2							www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-493-6004		(216)-621-7100		(877)-408-3495		(877)-408-3495		(800)-493-6004		(216)-621-7100		(877)-408-3495		(877)-408-3495		(866)-513-9966		(216)-635-4444		(888)-758-6054		(888)-758-6054		(866)-513-9966		(216)-635-4444		(888)-758-6054		(888)-758-6054		2	2	2
H6360	007	0	1	18	06	H6360_007_0	5	1		07/21/2011	2012.02	07/21/2011 05:05:17 PM Eastern Daylight Time				07/21/2011 05:36:41 PM Eastern Daylight Time	KAISER FOUNDATION HP OF OHIO	Kaiser Permanente Medicare Plus	kp.org	Kaiser Permanente Medicare Plus Basic II (Cost)	06	18		1			H6360	007	0	2012	Counties: Cuy, Gea, Lak, Lor, Med, Por, Sum		2	66	2			2							www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-493-6004		(216)-621-7100		(877)-408-3495		(877)-408-3495										(866)-513-9966		(216)-635-4444		(888)-758-6054		(888)-758-6054										2	2	2
H6360	008	0	1	18	06	H6360_008_0	6	1		07/21/2011	2012.02	07/21/2011 05:05:56 PM Eastern Daylight Time				07/21/2011 05:36:41 PM Eastern Daylight Time	KAISER FOUNDATION HP OF OHIO	Kaiser Permanente Medicare Plus	kp.org	Kaiser Permanente Medicare Plus Basic III (Cost)	06	18		1			H6360	008	0	2012	Counties: Cuy, Gea, Lak, Lor, Med, Por, Sum		2	277	2			2							www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-493-6004		(216)-621-7100		(877)-408-3495		(877)-408-3495										(866)-513-9966		(216)-635-4444		(888)-758-6054		(888)-758-6054										2	2	2
H6360	009	0	2	18	06	H6360_009_0	11	1		08/05/2011	2012.02	08/05/2011 09:18:38 AM Eastern Daylight Time		08/04/2011 12:29:19 PM Eastern Daylight Time		08/05/2011 09:50:57 AM Eastern Daylight Time	KAISER FOUNDATION HP OF OHIO	Kaiser Permanente Medicare Plus	kp.org	Kaiser Permanente Medicare Plus I - B only (Cost)	06	18		2	1		H6360	009	0	2012	Counties: Cuy, Gea, Lak, Lor, Med, Por, Sum		2	1	2			2							www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-493-6004		(216)-621-7100		(877)-408-3495		(877)-408-3495		(800)-493-6004		(216)-621-7100		(877)-408-3495		(877)-408-3495		(866)-513-9966		(216)-635-4444		(888)-758-6054		(888)-758-6054		(866)-513-9966		(216)-635-4444		(888)-758-6054		(888)-758-6054		2	2	2
H6360	010	0	1	18	06	H6360_010_0	12	1		08/05/2011	2012.02	08/05/2011 09:26:20 AM Eastern Daylight Time		08/04/2011 03:44:51 PM Eastern Daylight Time		08/05/2011 09:50:57 AM Eastern Daylight Time	KAISER FOUNDATION HP OF OHIO	Kaiser Permanente Medicare Plus	kp.org	Kaiser Permanente Medicare Plus IV (Cost)	06	18		1			H6360	010	0	2012	Counties: Cuy, Gea, Lak, Lor, Med, Por, Sum		2	350	2			2							www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-493-6004		(216)-621-7100		(877)-408-3495		(877)-408-3495		(800)-493-6004		(216)-621-7100		(877)-408-3495		(877)-408-3495		(866)-513-9966		(216)-635-4444		(888)-758-6054		(888)-758-6054		(866)-513-9966		(216)-635-4444		(888)-758-6054		(888)-758-6054		2	2	2
H6360	011	0	1	18	06	H6360_011_0	6	1		07/21/2011	2012.02	07/21/2011 05:08:06 PM Eastern Daylight Time				07/21/2011 05:36:41 PM Eastern Daylight Time	KAISER FOUNDATION HP OF OHIO	Kaiser Permanente Medicare Plus	kp.org	Kaiser Permanente Medicare Plus Basic IV (Cost)	06	18		1			H6360	011	0	2012	Counties: Cuy, Gea, Lak, Lor, Med, Por, Sum		2	20	2			2							www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-493-6004		(216)-621-7100		(877)-408-3495		(877)-408-3495										(866)-513-9966		(216)-635-4444		(888)-758-6054		(888)-758-6054										2	2	2
H6360	012	0	1	18	06	H6360_012_0	5	1		07/21/2011	2012.02	07/21/2011 05:08:35 PM Eastern Daylight Time				07/21/2011 05:36:41 PM Eastern Daylight Time	KAISER FOUNDATION HP OF OHIO	Kaiser Permanente Medicare Plus	kp.org	Kaiser Permanente Medicare Only Basic (Cost)	06	18		1			H6360	012	0	2012	Counties: Cuy, Gea, Lak, Lor, Med, Por, Sum		2	5	2			2							www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-493-6004		(216)-621-7100		(877)-408-3495		(877)-408-3495										(866)-513-9966		(216)-635-4444		(888)-758-6054		(888)-758-6054										2	2	2
H6360	013	0	2	18	06	H6360_013_0	6	1		09/20/2011	2012.02	09/20/2011 01:23:06 PM Eastern Daylight Time				09/20/2011 01:30:34 PM Eastern Daylight Time	KAISER FOUNDATION HP OF OHIO	Kaiser Permanente Medicare Plus	kp.org	Kaiser Permanente Medicare Only Basic - B Only (Cost)	06	18		2	1		H6360	013	0	2012	Counties: Cuy, Gea, Lak, Lor, Med, Por, Sum		2	5	2			2							www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-493-6004		(216)-621-7100		(877)-408-3495		(877)-408-3495										(866)-513-9966		(216)-635-4444		(888)-758-6054		(888)-758-6054										2	2	2
H6360	801	0		18	06	H6360_801_0	3	1		05/02/2011	2012.02						KAISER FOUNDATION HP OF OHIO	Kaiser Permanente Medicare Plus	kp.org	Kaiser Permanente Medicare Plus Group (Cost)	06	18					H6360	801	0	2012	Ohio		1					2							www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-493-6004		(216)-621-7100		(800)-551-5353				(800)-493-6004		(216)-621-7100		(800)-551-5353		(800)-551-5353		(866)-513-9966		(216)-635-4444		(877)-479-5741		(877)-479-5741		(866)-513-9966		(216)-635-4444		(877)-479-5741		(877)-479-5741				
H6360	805	0		18	06	H6360_805_0	3	1		05/02/2011	2012.02						KAISER FOUNDATION HP OF OHIO	Kaiser Permanente Medicare Plus	kp.org	Kaiser Permanente Medicare Plus Group - B only (Cost)	06	18					H6360	805	0	2012	Ohio		1					2							www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-493-6004		(216)-621-7100		(800)-551-5353				(800)-493-6004		(216)-621-7100		(800)-551-5353		(800)-551-5353		(866)-513-9966		(216)-635-4444		(877)-479-5741		(877)-479-5741		(866)-513-9966		(216)-635-4444		(877)-479-5741		(877)-479-5741				
H6360	806	0		18	06	H6360_806_0	3	1		05/02/2011	2012.02						KAISER FOUNDATION HP OF OHIO	Kaiser Permanente Medicare Plus	kp.org	FEHB AB with D (Cost)	06	18					H6360	806	0	2012	Ohio		1					2							www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-493-6004		(216)-621-7100		(800)-551-5353				(800)-493-6004		(216)-621-7100		(800)-551-5353		(800)-551-5353		(866)-513-9966		(216)-635-4444		(877)-479-5741		(877)-479-5741		(866)-513-9966		(216)-635-4444		(877)-479-5741		(877)-479-5741				
H6360	807	0		18	06	H6360_807_0	3	1		05/02/2011	2012.02						KAISER FOUNDATION HP OF OHIO	Kaiser Permanente Medicare Plus	kp.org	FEHB B only with D (Cost)	06	18					H6360	807	0	2012	Ohio		1					2							www.kp.org/seniorrx	www.kp.org/seniorrx	(800)-493-6004		(216)-621-7100		(800)-551-5353				(800)-493-6004		(216)-621-7100		(800)-551-5353		(800)-551-5353		(866)-513-9966		(216)-635-4444		(877)-479-5741		(877)-479-5741		(866)-513-9966		(216)-635-4444		(877)-479-5741		(877)-479-5741				
H6371	001	0	1	20	08	H6371_001_0	1	1		05/23/2011	2012.02	05/23/2011 01:14:42 PM Eastern Daylight Time		05/20/2011 03:58:27 PM Eastern Daylight Time		05/23/2011 01:19:39 PM Eastern Daylight Time	LUTERHAN SENIOR HEALTHCARE, INC.	Lutheran Senior LIFE	www.lsmnj.org	Lutheran Senior Healthcare (PACE)	08	20		1			H6371	001	0	2012	Lutheran Senior LIFE		2		2			2							www.lsmnj.org	www.lsmnj.org									(877)-543-3188		(201)-706-2091		(877)-543-3188		(201)-706-2091										(877)-543-3188		(201)-706-2091		(877)-543-3188		(201)-706-2091				
H6371	002	0	1	20	08	H6371_002_0	1	1		05/23/2011	2012.02	05/23/2011 01:15:17 PM Eastern Daylight Time		05/20/2011 03:58:27 PM Eastern Daylight Time		05/23/2011 01:19:39 PM Eastern Daylight Time	LUTERHAN SENIOR HEALTHCARE, INC.	Lutheran Senior LIFE	lsmjn.org	Lutheran Senior Healthcare (PACE)	08	20		1			H6371	002	0	2012	Lutheran Senior LIFE		2		2			2							www.lsmnj.org	www.lsmnj.org									(877)-543-3188		(201)-706-2091		(877)-543-3188		(201)-706-2091										(877)-543-3188		(201)-706-2091		(877)-543-3188		(201)-706-2091				
H6411	002	0	1	04	01	H6411_002_0	7	1		08/05/2011	2012.02	08/05/2011 01:11:52 PM Eastern Daylight Time	08/08/2011 09:50:57 AM Eastern Daylight Time	08/04/2011 12:43:58 PM Eastern Daylight Time		08/08/2011 03:49:43 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H6411-002 (PPO)	01	04		1			H6411	002	0	2012	Dona Ana, Luna, Otero, and El Paso (TX) Counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6411	007	0	1	04	01	H6411_007_0	6	1		07/08/2011	2012.02	07/08/2011 10:18:19 AM Eastern Daylight Time	08/07/2011 04:16:17 PM Eastern Daylight Time	08/04/2011 12:44:16 PM Eastern Daylight Time		08/08/2011 03:49:43 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H6411-007 (PPO)	01	04		1			H6411	007	0	2012	Select Counties of New Mexico		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6411	008	0	1	04	01	H6411_008_0	4	1		07/08/2011	2012.02	07/08/2011 10:21:55 AM Eastern Daylight Time	05/27/2011 03:49:47 PM Eastern Daylight Time			07/12/2011 08:11:36 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H6411-008 (PPO)	01	04		1			H6411	008	0	2012	Select Counties of New Mexico and Texas		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H6528	001	0	1	04	01	H6528_001_0	8	1		08/09/2011	2012.02	08/09/2011 09:14:20 AM Eastern Daylight Time	08/06/2011 04:37:00 PM Eastern Daylight Time	08/09/2011 10:05:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Medicare Advantage (PPO)	01	04		1			H6528	001	0	2012	Arkansas		2	488	2			2						http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-711-1656		(800)-711-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6528	005	0	1	04	01	H6528_005_0	5	1		08/09/2011	2012.02	08/09/2011 09:16:37 AM Eastern Daylight Time	08/07/2011 12:46:00 AM Eastern Daylight Time	08/09/2011 10:05:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Medicare Advantage (PPO)	01	04		1			H6528	005	0	2012	Missouri		2	417	2			2						http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-711-1656		(800)-711-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6528	006	0	1	04	01	H6528_006_0	5	1		08/09/2011	2012.02	08/09/2011 09:20:04 AM Eastern Daylight Time	08/07/2011 12:47:00 AM Eastern Daylight Time	08/09/2011 10:06:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Medicare Advantage (PPO)	01	04		1			H6528	006	0	2012	Georgia		2	275	2			2						http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-711-1656		(800)-711-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6528	007	0	1	04	01	H6528_007_0	5	1		08/09/2011	2012.02	08/09/2011 09:18:57 AM Eastern Daylight Time	08/07/2011 12:48:00 AM Eastern Daylight Time	08/09/2011 10:06:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Medicare Advantage (PPO)	01	04		1			H6528	007	0	2012	South Carolina		2	50	2			2						http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-711-1656		(800)-711-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6528	009	0	1	04	01	H6528_009_0	7	1		08/08/2011	2012.02	08/08/2011 01:40:35 PM Eastern Daylight Time	08/05/2011 05:23:00 PM Eastern Daylight Time	08/09/2011 10:06:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Silver Rx (PPO SNP)	01	04		1			H6528	009	0	2012	Arkansas		2		2			1	4		1		00000000000000000100	http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-711-1656		(800)-711-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6528	010	0	1	04	01	H6528_010_0	6	1		08/09/2011	2012.02	08/09/2011 09:15:10 AM Eastern Daylight Time	08/08/2011 05:55:00 PM Eastern Daylight Time	08/09/2011 10:06:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Gold Rx (PPO SNP)	01	04		1			H6528	010	0	2012	Arkansas		2	488	2			1	4		1		00000000000000000100	http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-711-1656		(800)-711-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6528	011	0	1	04	01	H6528_011_0	6	1	2	08/08/2011	2012.02	08/08/2011 01:42:47 PM Eastern Daylight Time	08/08/2011 05:56:00 PM Eastern Daylight Time	08/09/2011 10:06:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Dual Advantage (PPO SNP)	01	04		1			H6528	011	0	2012	Arkansas		2		2			1	3		1	1		http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-711-1656		(800)-711-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6528	012	0	1	04	01	H6528_012_0	7	1		08/08/2011	2012.02	08/08/2011 02:12:56 PM Eastern Daylight Time	08/08/2011 08:26:00 AM Eastern Daylight Time	08/09/2011 10:06:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Silver Rx (PPO SNP)	01	04		1			H6528	012	0	2012	Missouri		2		2			1	4		1		00000000000000000100	http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-711-1656		(800)-711-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6528	013	0	1	04	01	H6528_013_0	6	1		08/09/2011	2012.02	08/09/2011 09:15:56 AM Eastern Daylight Time	08/05/2011 05:24:00 PM Eastern Daylight Time	08/09/2011 10:06:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Gold Rx (PPO SNP)	01	04		1			H6528	013	0	2012	Missouri		2	488	2			1	4		1		00000000000000000100	http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-711-1656		(800)-711-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6528	014	0	1	04	01	H6528_014_0	6	1	2	08/08/2011	2012.02	08/08/2011 01:45:32 PM Eastern Daylight Time	08/07/2011 12:48:00 AM Eastern Daylight Time	08/09/2011 10:06:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Dual Advantage (PPO SNP)	01	04		1			H6528	014	0	2012	Missouri		2		2			1	3		1	1		http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-711-1656		(800)-711-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6528	015	0	1	04	01	H6528_015_0	7	1		08/08/2011	2012.02	08/08/2011 01:47:32 PM Eastern Daylight Time	08/05/2011 05:24:00 PM Eastern Daylight Time	08/09/2011 10:06:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Silver Rx (PPO SNP)	01	04		1			H6528	015	0	2012	Georgia		2		2			1	4		1		00000000000000000100	http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-711-1656		(800)-711-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6528	016	0	1	04	01	H6528_016_0	6	1		08/09/2011	2012.02	08/09/2011 09:17:27 AM Eastern Daylight Time	08/05/2011 05:25:00 PM Eastern Daylight Time	08/09/2011 10:06:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Gold Rx (PPO SNP)	01	04		1			H6528	016	0	2012	Georgia		2	488	2			1	4		1		00000000000000000100	http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-711-1656		(800)-711-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6528	017	0	1	04	01	H6528_017_0	6	1	2	08/08/2011	2012.02	08/08/2011 01:49:11 PM Eastern Daylight Time	08/05/2011 05:25:00 PM Eastern Daylight Time	08/09/2011 10:06:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Dual Advantage (PPO SNP)	01	04		1			H6528	017	0	2012	Georgia		2		2			1	3		1	1		http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-711-1656		(800)-711-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6528	018	0	1	04	01	H6528_018_0	7	1		08/08/2011	2012.02	08/08/2011 01:52:13 PM Eastern Daylight Time	08/05/2011 05:25:00 PM Eastern Daylight Time	08/09/2011 10:07:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Silver Rx (PPO SNP)	01	04		1			H6528	018	0	2012	South Carolina		2		2			1	4		1		00000000000000000100	http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-711-1656		(800)-711-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6528	019	0	1	04	01	H6528_019_0	6	1		08/09/2011	2012.02	08/09/2011 09:18:10 AM Eastern Daylight Time	08/05/2011 05:25:00 PM Eastern Daylight Time	08/09/2011 10:07:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Gold Rx (PPO SNP)	01	04		1			H6528	019	0	2012	South Carolina		2	488	2			1	4		1		00000000000000000100	http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-711-1656		(800)-711-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6528	020	0	1	04	01	H6528_020_0	7	1	2	08/08/2011	2012.02	08/08/2011 01:53:39 PM Eastern Daylight Time	08/05/2011 05:25:00 PM Eastern Daylight Time	08/09/2011 10:07:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Dual Advantage (PPO SNP)	01	04		1			H6528	020	0	2012	South Carolina		2		2			1	3		1	1		http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-711-1656		(800)-711-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6551	001	0	1	20	08	H6551_001_0	1	1		05/25/2011	2012.02	05/25/2011 01:10:56 PM Eastern Daylight Time		05/24/2011 12:48:55 PM Eastern Daylight Time		05/25/2011 01:14:18 PM Eastern Daylight Time	LIFE ST. MARY, INC.	LIFE St. Mary	www.stmaryhealthcare.org	LIFE St. Mary (PACE)	08	20		1			H6551	001	0	2012	LIFE St. Mary		2		2			2							stmaryhealthcare.org	stmaryhealthcare.org									(800)-630-8147		(215)-630-8147		(267)-991-7601		(267)-991-7601										(800)-630-8147		(215)-630-8147		(267)-991-7601		(267)-991-7601				
H6551	002	0	1	20	08	H6551_002_0	1	1		05/25/2011	2012.02	05/25/2011 01:11:28 PM Eastern Daylight Time		05/24/2011 12:48:56 PM Eastern Daylight Time		05/25/2011 01:14:18 PM Eastern Daylight Time	LIFE ST. MARY, INC.	LIFE St. Mary	stmaryhealthcare.org	LIFE St. Mary (PACE)	08	20		1			H6551	002	0	2012	LIFE St. Mary		2		2			2							stmaryhealthcare.org	stmaryhealthcare.org									(800)-630-8147		(215)-630-8147		(267)-991-7601		(267)-991-7601										(800)-630-8147		(215)-630-8147		(267)-991-7601		(267)-991-7601				
H6609	001	0	1	04	01	H6609_001_0	9	1		07/07/2011	2012.02	07/07/2011 02:17:19 PM Eastern Daylight Time	08/05/2011 11:29:36 AM Eastern Daylight Time	08/04/2011 12:44:32 PM Eastern Daylight Time		08/09/2011 10:58:20 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H6609-001 (PPO)	01	04		1			H6609	001	0	2012	South Dakota Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6609	002	0	1	04	01	H6609_002_0	6	1		07/07/2011	2012.02	07/07/2011 02:17:59 PM Eastern Daylight Time	05/27/2011 03:16:42 PM Eastern Daylight Time			07/08/2011 12:45:11 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H6609-002 (PPO)	01	04		1			H6609	002	0	2012	South Dakota Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H6609	003	0	1	04	01	H6609_003_0	9	1		07/07/2011	2012.02	07/07/2011 02:19:06 PM Eastern Daylight Time	08/05/2011 11:28:37 AM Eastern Daylight Time	08/04/2011 12:44:52 PM Eastern Daylight Time		08/09/2011 10:58:20 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H6609-003 (PPO)	01	04		1			H6609	003	0	2012	Omaha Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6609	004	0	1	04	01	H6609_004_0	7	1		07/07/2011	2012.02	07/07/2011 02:20:00 PM Eastern Daylight Time	05/27/2011 03:13:50 PM Eastern Daylight Time			07/08/2011 12:45:11 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H6609-004 (PPO)	01	04		1			H6609	004	0	2012	Omaha Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H6609	005	0	1	04	01	H6609_005_0	9	1		07/07/2011	2012.02	07/07/2011 02:20:41 PM Eastern Daylight Time	08/05/2011 11:30:16 AM Eastern Daylight Time	08/04/2011 12:45:12 PM Eastern Daylight Time		08/09/2011 10:58:20 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H6609-005 (PPO)	01	04		1			H6609	005	0	2012	Minnesota Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6609	006	0	1	04	01	H6609_006_0	8	1		07/07/2011	2012.02	07/07/2011 02:21:13 PM Eastern Daylight Time	05/27/2011 03:17:12 PM Eastern Daylight Time			07/25/2011 03:00:09 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H6609-006 (PPO)	01	04		1			H6609	006	0	2012	Minnesota Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H6609	009	0	1	04	01	H6609_009_0	6	1		07/08/2011	2012.02	07/08/2011 03:15:10 PM Eastern Daylight Time	08/04/2011 03:15:54 PM Eastern Daylight Time	08/04/2011 12:45:33 PM Eastern Daylight Time		08/08/2011 04:20:07 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H6609-009 (PPO)	01	04		1			H6609	009	0	2012	Select Counties in Idaho		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6609	011	0	1	04	01	H6609_011_0	6	1		07/08/2011	2012.02	07/08/2011 10:46:31 AM Eastern Daylight Time	08/05/2011 09:47:30 AM Eastern Daylight Time	08/04/2011 12:45:51 PM Eastern Daylight Time		08/08/2011 04:20:07 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H6609-011 (PPO)	01	04		1			H6609	011	0	2012	Select Counties in Idaho		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6609	012	0	1	04	01	H6609_012_0	4	1		07/08/2011	2012.02	07/08/2011 10:43:18 AM Eastern Daylight Time	06/04/2011 03:20:36 PM Eastern Daylight Time			07/11/2011 01:48:58 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H6609-012 (PPO)	01	04		1			H6609	012	0	2012	Select Counties in Idaho		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H6609	013	0	1	04	01	H6609_013_0	8	1		07/06/2011	2012.02	07/06/2011 04:29:10 PM Eastern Daylight Time	08/04/2011 03:29:18 PM Eastern Daylight Time	08/04/2011 12:46:10 PM Eastern Daylight Time		08/09/2011 09:19:44 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H6609-013 (PPO)	01	04		1			H6609	013	0	2012	Select Counties in Washington		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6609	015	0	1	04	01	H6609_015_0	7	1		07/11/2011	2012.02	07/11/2011 08:21:01 AM Eastern Daylight Time	08/04/2011 03:29:47 PM Eastern Daylight Time	08/04/2011 12:46:53 PM Eastern Daylight Time		08/08/2011 05:33:16 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H6609-015 (PPO)	01	04		1			H6609	015	0	2012	Select Counties in Oregon and Washington		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6609	017	0	1	04	01	H6609_017_0	7	1		07/07/2011	2012.02	07/07/2011 02:21:49 PM Eastern Daylight Time	08/05/2011 11:30:44 AM Eastern Daylight Time	08/04/2011 12:47:14 PM Eastern Daylight Time		08/09/2011 10:58:20 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H6609-017 (PPO)	01	04		1			H6609	017	0	2012	North Dakota Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6609	019	0	1	04	01	H6609_019_0	8	1		07/21/2011	2012.02	07/21/2011 03:06:44 PM Eastern Daylight Time	07/22/2011 11:03:19 AM Eastern Daylight Time	08/04/2011 12:47:56 PM Eastern Daylight Time		08/09/2011 10:58:20 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H6609-019 (PPO)	01	04		1			H6609	019	0	2012	South Dakota Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6609	021	0	1	04	01	H6609_021_0	6	1		07/07/2011	2012.02	07/07/2011 02:25:38 PM Eastern Daylight Time	08/05/2011 11:31:16 AM Eastern Daylight Time	08/04/2011 12:48:15 PM Eastern Daylight Time		08/09/2011 10:58:20 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H6609-021 (PPO)	01	04		1			H6609	021	0	2012	Rochester Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6609	022	0	1	04	01	H6609_022_0	8	1		07/21/2011	2012.02	07/21/2011 03:10:26 PM Eastern Daylight Time	06/03/2011 09:29:48 AM Eastern Daylight Time	08/04/2011 12:48:34 PM Eastern Daylight Time		08/09/2011 10:58:20 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H6609-022 (PPO)	01	04		1			H6609	022	0	2012	Minnesota Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6609	023	0	1	04	01	H6609_023_0	7	1		07/21/2011	2012.02	07/21/2011 03:13:41 PM Eastern Daylight Time	06/03/2011 09:30:33 AM Eastern Daylight Time	08/04/2011 12:48:53 PM Eastern Daylight Time		08/09/2011 10:58:20 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H6609-023 (PPO)	01	04		1			H6609	023	0	2012	Omaha Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6609	024	0	1	04	01	H6609_024_0	4	1		07/07/2011	2012.02	07/07/2011 02:28:33 PM Eastern Daylight Time	05/27/2011 03:18:11 PM Eastern Daylight Time			07/08/2011 12:45:11 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H6609-024 (PPO)	01	04		1			H6609	024	0	2012	North Dakota Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H6609	028	0	1	04	01	H6609_028_0	9	1		07/07/2011	2012.02	07/07/2011 02:30:40 PM Eastern Daylight Time	08/05/2011 11:32:46 AM Eastern Daylight Time	08/04/2011 12:49:12 PM Eastern Daylight Time		08/09/2011 10:58:20 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H6609-028 (PPO)	01	04		1			H6609	028	0	2012	Rochester Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6609	029	0	1	04	01	H6609_029_0	6	1		07/11/2011	2012.02	07/11/2011 08:20:31 AM Eastern Daylight Time	08/04/2011 03:31:38 PM Eastern Daylight Time	08/04/2011 12:49:32 PM Eastern Daylight Time		08/08/2011 04:52:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H6609-029 (PPO)	01	04		1			H6609	029	0	2012	Select Counties in Montana and Wyoming		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6609	038	0	1	04	01	H6609_038_0	6	1		07/08/2011	2012.02	07/08/2011 10:39:40 AM Eastern Daylight Time	08/04/2011 03:19:16 PM Eastern Daylight Time	08/04/2011 12:50:09 PM Eastern Daylight Time		08/08/2011 04:24:44 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H6609-038 (PPO)	01	04		1			H6609	038	0	2012	Twin Falls County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6609	051	0	1	04	01	H6609_051_0	7	1		07/07/2011	2012.02	07/07/2011 02:30:22 PM Eastern Daylight Time	08/05/2011 11:33:14 AM Eastern Daylight Time	08/04/2011 12:50:27 PM Eastern Daylight Time		08/09/2011 10:58:20 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H6609-051 (PPO)	01	04		1			H6609	051	0	2012	Minnesota Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6609	801	0	1	04	01	H6609_801_0	5	1		06/21/2011	2012.02	06/21/2011 09:02:05 AM Eastern Daylight Time	07/19/2011 10:02:30 AM Eastern Daylight Time			07/26/2011 02:10:49 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (PPO)	01	04		1			H6609	801	0	2012	Select Counties in Multi-States		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H6609	802	0	1	04	01	H6609_802_0	6	1		06/21/2011	2012.02	06/21/2011 09:02:32 AM Eastern Daylight Time	07/27/2011 04:57:37 PM Eastern Daylight Time			07/28/2011 08:22:57 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (PPO)	01	04		1			H6609	802	0	2012	Select Counties in Multi-States		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
H6609	803	0	1	04	01	H6609_803_0	6	1		06/21/2011	2012.02	06/21/2011 09:02:57 AM Eastern Daylight Time	07/27/2011 04:53:32 PM Eastern Daylight Time			07/28/2011 08:22:57 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored Non-CY (PPO)	01	04		1			H6609	803	0	2012	Select Counties in Multi-States		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H6609	805	0	2	04	01	H6609_805_0	4	1		06/21/2011	2012.02	06/21/2011 09:17:37 AM Eastern Daylight Time	06/03/2011 07:59:19 AM Eastern Daylight Time			06/21/2011 11:00:31 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (PPO)	01	04		2	2		H6609	805	0	2012	Select Counties in Multi-States		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H6609	806	0	2	04	01	H6609_806_0	4	1		06/21/2011	2012.02	06/21/2011 09:18:02 AM Eastern Daylight Time	06/02/2011 04:56:36 PM Eastern Daylight Time			06/21/2011 11:00:31 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (PPO)	01	04		2	2		H6609	806	0	2012	Select Counties in Multi-States		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
H6609	807	0	2	04	01	H6609_807_0	4	1		06/21/2011	2012.02	06/21/2011 09:18:24 AM Eastern Daylight Time	06/03/2011 01:26:28 PM Eastern Daylight Time			06/21/2011 11:00:31 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored Non-CY (PPO)	01	04		2	2		H6609	807	0	2012	Select Counties in Multi-States		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H6609	808	0	1	04	01	H6609_808_0	5	1		06/21/2011	2012.02	06/21/2011 09:03:22 AM Eastern Daylight Time	07/19/2011 10:24:15 AM Eastern Daylight Time			07/22/2011 06:28:25 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (PPO)	01	04		1			H6609	808	0	2012	Select Counties in Multi-States		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H6609	809	0	1	04	01	H6609_809_0	5	1		06/21/2011	2012.02	06/21/2011 09:03:50 AM Eastern Daylight Time	07/19/2011 10:26:26 AM Eastern Daylight Time			07/22/2011 06:28:25 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (PPO)	01	04		1			H6609	809	0	2012	Select Counties in Multi-States		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
H6609	810	0	1	04	01	H6609_810_0	5	1		06/21/2011	2012.02	06/21/2011 09:04:20 AM Eastern Daylight Time	07/19/2011 10:28:28 AM Eastern Daylight Time			07/22/2011 06:28:25 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored Non-CY (PPO)	01	04		1			H6609	810	0	2012	Select Counties in Multi-States		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H6609	811	0	2	04	01	H6609_811_0	7	1		06/21/2011	2012.02	06/21/2011 09:18:46 AM Eastern Daylight Time	07/19/2011 10:30:33 AM Eastern Daylight Time			07/22/2011 06:28:25 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (PPO)	01	04		2	2		H6609	811	0	2012	Select Counties in Multi-States		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H6609	812	0	2	04	01	H6609_812_0	5	1		06/21/2011	2012.02	06/21/2011 09:19:11 AM Eastern Daylight Time	07/19/2011 10:33:00 AM Eastern Daylight Time			07/22/2011 06:28:25 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (PPO)	01	04		2	2		H6609	812	0	2012	Select Counties in Multi-States		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
H6609	813	0	2	04	01	H6609_813_0	5	1		06/21/2011	2012.02	06/21/2011 09:19:34 AM Eastern Daylight Time	07/19/2011 10:35:00 AM Eastern Daylight Time			07/22/2011 06:28:25 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored Non-CY (PPO)	01	04		2	2		H6609	813	0	2012	Select Counties in Multi-States		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H6609	814	0	1	04	01	H6609_814_0	5	1		06/21/2011	2012.02	06/21/2011 09:04:43 AM Eastern Daylight Time	07/19/2011 10:36:26 AM Eastern Daylight Time			07/22/2011 06:28:25 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored - Walmart (PPO)	01	04		1			H6609	814	0	2012	Select Counties in Multi-States		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H6609	815	0	1	04	01	H6609_815_0	5	1		06/21/2011	2012.02	06/21/2011 09:05:07 AM Eastern Daylight Time	07/19/2011 12:47:16 PM Eastern Daylight Time			07/22/2011 06:28:25 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored - Walmart (PPO)	01	04		1			H6609	815	0	2012	Select Counties in Multi-States		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H6622	001	0	1	02	01	H6622_001_0	4	1		07/06/2011	2012.02	07/06/2011 01:27:38 PM Eastern Daylight Time	08/04/2011 02:32:43 PM Eastern Daylight Time	08/04/2011 12:50:46 PM Eastern Daylight Time		08/08/2011 03:33:45 PM Eastern Daylight Time	HUMANA WISCONSINHEALTH ORGANIZATION INSURANCE CORP	Humana WisconsinHealth Organization Insurance Corp	www.humana-medicare.com	Humana Gold Plus H6622-001 (HMO-POS)	01	02		1			H6622	001	0	2012	Select Counties in Wisconsin		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6622	002	0	1	02	01	H6622_002_0	6	1		08/08/2011	2012.02	08/08/2011 01:47:21 PM Eastern Daylight Time	08/05/2011 09:59:48 AM Eastern Daylight Time	08/04/2011 12:51:06 PM Eastern Daylight Time		08/08/2011 03:33:45 PM Eastern Daylight Time	HUMANA WISCONSINHEALTH ORGANIZATION INSURANCE CORP	Humana WisconsinHealth Organization Insurance Corp	www.humana-medicare.com	Humana Gold Plus H6622-002 (HMO-POS)	01	02		1			H6622	002	0	2012	Select Counties in Wisconsin		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6622	003	0	1	01	01	H6622_003_0	5	1		07/06/2011	2012.02	07/06/2011 09:46:12 AM Eastern Daylight Time	08/04/2011 02:37:22 PM Eastern Daylight Time	08/04/2011 12:51:25 PM Eastern Daylight Time		08/09/2011 09:35:59 AM Eastern Daylight Time	HUMANA WISCONSINHEALTH ORGANIZATION INSURANCE CORP	Humana WisconsinHealth Organization Insurance Corp	www.humana-medicare.com	Humana Gold Plus H6622-003 (HMO)	01	01		1			H6622	003	0	2012	Select Counties in Wisconsin		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6622	801	0	1	01	01	H6622_801_0	4	1		07/06/2011	2012.02	07/06/2011 10:57:42 AM Eastern Daylight Time	06/02/2011 10:18:59 AM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA WISCONSINHEALTH ORGANIZATION INSURANCE CORP	Humana WisconsinHealth Organization Insurance Corp	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H6622	801	0	2012	Select counties in Wisconsin		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H6622	802	0	1	01	01	H6622_802_0	4	1		07/06/2011	2012.02	07/06/2011 10:57:49 AM Eastern Daylight Time	06/02/2011 10:20:14 AM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA WISCONSINHEALTH ORGANIZATION INSURANCE CORP	Humana WisconsinHealth Organization Insurance Corp	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H6622	802	0	2012	Select counties in Wisconsin		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
H6622	803	0	1	01	01	H6622_803_0	4	1		07/06/2011	2012.02	07/06/2011 10:57:53 AM Eastern Daylight Time	06/02/2011 10:21:34 AM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA WISCONSINHEALTH ORGANIZATION INSURANCE CORP	Humana WisconsinHealth Organization Insurance Corp	www.humana-medicare.com	Humana Employer Sponsored Non-CY (HMO)	01	01		1			H6622	803	0	2012	Select counties in Wisconsin		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H6642	001	0	1	02	01	H6642_001_0	5	1		08/09/2011	2012.02	08/09/2011 10:37:59 AM Eastern Daylight Time	08/09/2011 11:03:52 AM Eastern Daylight Time	08/09/2011 11:05:58 AM Eastern Daylight Time		08/09/2011 11:08:17 AM Eastern Daylight Time	UNIVERSAL HMO OF TEXAS, INC.	Universal HMO of Texas, Inc.	http://www.univhc.com	Texas Hassle-Free (HMO-POS)	01	02		1			H6642	001	0	2012	Texas HMO		2		2			2						www.univhc.com	www.univhc.com/medicare/members/medicare-formulary.php	http://www.univhc.com	(866)-690-4842		(866)-690-4842		(800)-965-7034		(800)-965-7034		(877)-204-8149		(877)-204-8149		(800)-965-7034		(800)-965-7034		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-759-1089		(800)-759-1089		(800)-617-0177		(800)-617-0177		2	2	2
H6642	004	0	1	02	01	H6642_004_0	2	1		07/12/2011	2012.02	07/12/2011 10:39:40 AM Eastern Daylight Time	07/22/2011 04:28:49 PM Eastern Daylight Time			07/22/2011 04:38:56 PM Eastern Daylight Time	UNIVERSAL HMO OF TEXAS, INC.	Universal HMO of Texas, Inc.	http://www.univhc.com	Texas Hassle-Free MA Only (HMO-POS)	01	02		1			H6642	004	0	2012	Texas HMO		2		2			2						www.univhc.com	www.univhc.com/medicare/members/medicare-formulary.php	http://www.univhc.com	(866)-690-4842		(866)-690-4842		(800)-965-7034		(800)-965-7034										(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-617-0177										2	2	2
H6642	007	0	1	02	01	H6642_007_0	5	1		08/09/2011	2012.02	08/09/2011 10:38:17 AM Eastern Daylight Time	08/09/2011 01:25:19 PM Eastern Daylight Time	08/09/2011 02:15:39 PM Eastern Daylight Time		08/09/2011 06:43:35 PM Eastern Daylight Time	UNIVERSAL HMO OF TEXAS, INC.	Universal HMO of Texas, Inc.	http://www.univhc.com	Texas Hassle-Free C-SNP (HMO-POS SNP)	01	02		1			H6642	007	0	2012	Texas HMO		2		2			1	4		1		00000000000000000010	www.univhc.com	www.univhc.com/medicare/members/medicare-formulary.php	http://www.univhc.com	(866)-690-4842		(866)-690-4842		(800)-965-7034		(800)-965-7034		(877)-204-8149		(877)-204-8149		(800)-965-7034		(800)-965-7034		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-759-1089		(800)-759-1089		(800)-617-0177		(800)-617-0177		2	2	2
H6642	008	0	1	02	01	H6642_008_0	4	1	2	08/09/2011	2012.02	08/09/2011 04:30:06 PM Eastern Daylight Time	08/09/2011 04:20:44 PM Eastern Daylight Time	08/09/2011 04:27:26 PM Eastern Daylight Time		08/09/2011 06:43:35 PM Eastern Daylight Time	UNIVERSAL HMO OF TEXAS, INC.	Universal HMO of Texas, Inc.	www.univhc.com	Texas Hassle-Free D-SNP (HMO-POS SNP)	01	02		1			H6642	008	0	2012	Texas		2		2			1	3		1	2		www.univhc.com	www.univhc.com/medicare/members/medicare-formulary.php	http://www.univhc.com	(866)-690-4842		(866)-690-4842		(800)-965-7034		(800)-965-7034		(877)-204-8149		(877)-204-8149		(800)-965-7034		(800)-965-7034		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-759-1089		(800)-759-1089		(800)-617-0177		(800)-617-0177		2	2	2
H6705	001	0	1	02	01	H6705_001_0	5	1		08/09/2011	2012.02	08/09/2011 10:38:36 AM Eastern Daylight Time	08/09/2011 01:25:57 PM Eastern Daylight Time	08/09/2011 02:16:04 PM Eastern Daylight Time		08/09/2011 06:43:35 PM Eastern Daylight Time	UNIVERSAL HEALTH CARE OF NEVADA, INC.	Universal Health Care of Nevada, Inc.	http://www.univhc.com	Nevada Hassle-Free (HMO-POS)	01	02		1			H6705	001	0	2012	Nevada HMO		2		2			2						www.univhc.com	www.univhc.com/medicare/members/medicare-formulary.php	http://www.univhc.com	(866)-690-4842		(866)-690-4842		(800)-965-7034		(800)-965-7034		(877)-204-8149		(877)-204-8149		(800)-965-7034		(800)-965-7034		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-759-1089		(800)-759-1089		(800)-617-0177		(800)-617-0177		2	2	2
H6705	003	0	1	02	01	H6705_003_0	5	1		08/09/2011	2012.02	08/09/2011 10:38:46 AM Eastern Daylight Time	08/09/2011 01:26:36 PM Eastern Daylight Time	08/09/2011 02:16:31 PM Eastern Daylight Time		08/09/2011 06:43:35 PM Eastern Daylight Time	UNIVERSAL HEALTH CARE OF NEVADA, INC.	Universal Health Care of Nevada, Inc.	www.univhc.com	Nevada Hassle-Free C-SNP (HMO-POS SNP)	01	02		1			H6705	003	0	2012	Clark County		2		2			1	4		1		00000000000000000010	www.univhc.com	www.univhc.com/medicare/members/medicare-formulary.php	http://www.univhc.com	(866)-690-4842		(866)-690-4842		(800)-965-7034		(800)-965-7034		(877)-204-8149		(877)-204-8149		(800)-965-7034		(800)-965-7034		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-759-1089		(800)-759-1089		(800)-617-0177		(800)-617-0177		2	2	2
H6743	001	0	1	04	01	H6743_001_0	8	1		07/12/2011	2012.02	07/12/2011 01:27:17 PM Pacific Daylight Time	08/09/2011 09:51:30 AM Pacific Daylight Time	08/08/2011 10:57:20 AM Pacific Daylight Time		08/09/2011 04:06:53 PM Pacific Daylight Time	ATRIO HEALTH PLANS	ATRIO Health Plans	www.atriohp.com	ATRIO Bronze Rx (PPO)	01	04		1			H6743	001	0	2012	Douglas and Klamath Counties		2	429	1	1		2						www.atriohp.com	http://www.atriohp.com/index.cfm?nav=Current%20Memberslev1=Formulary%20Information	http://www.atriohp.com/index.cfm?nav=Current%20Memberslev1=Pharmacy%20Directory	(877)-672-8620		(541)-672-8620		(877)-672-8620		(541)-672-8620		(877)-672-8620		(541)-672-8620		(877)-672-8620		(541)-672-8620		(800)-735-2900		(541)-735-2900		(800)-735-2900		(541)-735-2900		(800)-735-2900		(541)-735-2900		(800)-735-2900		(541)-735-2900		2	2	2
H6743	002	0	1	04	01	H6743_002_0	7	1		08/04/2011	2012.02	08/04/2011 04:44:56 PM Pacific Daylight Time	08/08/2011 07:58:12 PM Pacific Daylight Time			08/09/2011 04:06:53 PM Pacific Daylight Time	ATRIO HEALTH PLANS	ATRIO Health Plans	www.atriohp.com	ATRIO Silver (PPO)	01	04		1			H6743	002	0	2012	Douglas and Klamath Counties		2	410	1	1		2						www.atriohp.com	http://www.atriohp.com/index.cfm?nav=Current%20Memberslev1=Formulary%20Information	http://www.atriohp.com/index.cfm?nav=Current%20Memberslev1=Pharmacy%20Directory	(877)-672-8620		(541)-672-8620		(877)-672-8620		(541)-672-8620										(800)-735-2900		(541)-735-2900		(800)-735-2900		(541)-735-2900										2	2	2
H6743	003	0	1	04	01	H6743_003_0	10	1		08/04/2011	2012.02	08/04/2011 04:45:34 PM Pacific Daylight Time	08/09/2011 11:41:26 AM Pacific Daylight Time	08/08/2011 11:10:58 AM Pacific Daylight Time		08/09/2011 04:06:53 PM Pacific Daylight Time	ATRIO HEALTH PLANS	ATRIO Health Plans	www.atriohp.com	ATRIO Silver Rx (PPO)	01	04		1			H6743	003	0	2012	Douglas and Klamath Counties		2	1332	1	1		2						www.atriohp.com	http://www.atriohp.com/index.cfm?nav=Current%20Memberslev1=Formulary%20Information	http://www.atriohp.com/index.cfm?nav=Current%20Memberslev1=Pharmacy%20Directory	(877)-672-8620		(541)-672-8620		(877)-672-8620		(541)-672-8620		(877)-672-8620		(541)-672-8620		(877)-672-8620		(541)-672-8620		(800)-735-2900		(541)-735-2900		(800)-735-2900		(541)-735-2900		(800)-735-2900		(541)-735-2900		(800)-735-2900		(541)-735-2900		2	2	2
H6743	004	0	1	04	01	H6743_004_0	8	1		08/08/2011	2012.02	08/08/2011 02:51:47 PM Pacific Daylight Time	08/08/2011 07:59:05 PM Pacific Daylight Time	08/08/2011 11:13:34 AM Pacific Daylight Time		08/09/2011 04:06:53 PM Pacific Daylight Time	ATRIO HEALTH PLANS	ATRIO Health Plans	www.atriohp.com	ATRIO Gold Rx (PPO)	01	04		1			H6743	004	0	2012	Douglas and Klamath Counties		2	821	1	1		2						www.atriohp.com	http://www.atriohp.com/index.cfm?nav=Current%20Memberslev1=Formulary%20Information	http://www.atriohp.com/index.cfm?nav=Current%20Memberslev1=Pharmacy%20Directory	(877)-672-8620		(541)-672-8620		(877)-672-8620		(541)-672-8620		(877)-672-8620		(541)-672-8620		(877)-672-8620		(541)-672-8620		(800)-735-2900		(541)-735-2900		(800)-735-2900		(541)-735-2900		(800)-735-2900		(541)-735-2900		(800)-735-2900		(541)-735-2900		2	2	2
H6743	005	0	1	04	01	H6743_005_0	9	1		08/08/2011	2012.02	08/08/2011 02:51:35 PM Pacific Daylight Time	08/08/2011 02:48:48 PM Pacific Daylight Time	08/08/2011 11:16:46 AM Pacific Daylight Time		08/08/2011 03:07:25 PM Pacific Daylight Time	ATRIO HEALTH PLANS	ATRIO Health Plans	www.atriohp.com	ATRIO Platinum Rx (PPO)	01	04		1			H6743	005	0	2012	Douglas and Klamath Counties		2	721	1	1		2						www.atriohp.com	http://www.atriohp.com/index.cfm?nav=Current%20Memberslev1=Formulary%20Information	http://www.atriohp.com/index.cfm?nav=Current%20Memberslev1=Pharmacy%20Directory	(877)-672-8620		(541)-672-8620		(877)-672-8620		(541)-672-8620		(877)-672-8620		(541)-672-8620		(877)-672-8620		(541)-672-8620		(800)-735-2900		(541)-735-2900		(800)-735-2900		(541)-735-2900		(800)-735-2900		(541)-735-2900		(800)-735-2900		(541)-735-2900		2	2	2
H6743	006	0	1	04	01	H6743_006_0	4	1		07/06/2011	2012.02	07/06/2011 11:31:34 AM Pacific Daylight Time	06/06/2011 10:08:57 AM Pacific Daylight Time			07/06/2011 02:08:18 PM Pacific Daylight Time	ATRIO HEALTH PLANS	ATRIO Health Plans	www.atriohp.com	ATRIO Bronze (PPO)	01	04		1			H6743	006	0	2012	Douglas and Klamath Counties		2	710	2			2						www.atriohp.com	http://www.atriohp.com/index.cfm?nav=Current%20Memberslev1=Formulary%20Information	http://www.atriohp.com/index.cfm?nav=Current%20Memberslev1=Pharmacy%20Directory	(877)-672-8620		(541)-672-8620		(877)-672-8620		(541)-672-8620										(800)-735-2900		(541)-735-2900		(800)-735-2900		(541)-735-2900										2	2	2
H6801	002	0	1	01	01	H6801_002_0	8	1		08/02/2011	2012.02	08/02/2011 12:45:44 PM Mountain Daylight Time	08/04/2011 05:12:02 PM Mountain Daylight Time	08/08/2011 08:51:20 AM Mountain Daylight Time		08/08/2011 09:05:41 AM Mountain Daylight Time	AHS - TULSA OKLAHOMA HEALTH PLAN, INC	Lovelace Medicare Plan	www.lovelacemedicareplan.com	Lovelace Medicare Plan (HMO)	01	01		1			H6801	002	0	2012	Oklahoma Counties - Mayes, Oklahoma, Payne, Tulsa		2	1100	2			2						www.lovelacemedicareplan.com	www.lovelacemedicareplan.com	www.lovelacemedicareplan.com	(855)-730-5683		(855)-730-5683		(800)-262-3757		(800)-262-3757		(855)-730-5683		(855)-730-5683		(800)-262-3757		(800)-262-3757		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6801	003	0	1	01	01	H6801_003_0	6	1		08/02/2011	2012.02	08/02/2011 12:46:09 PM Mountain Daylight Time	07/21/2011 01:23:45 PM Mountain Daylight Time			08/02/2011 01:15:26 PM Mountain Daylight Time	AHS - TULSA OKLAHOMA HEALTH PLAN, INC	Lovelace Medicare Plan	www.lovelacemedicareplan.com	Lovelace Medicare Plan Medical-Only (HMO)	01	01		1			H6801	003	0	2012	Oklahoma Counties - Mayes, Oklahoma, Payne, Tulsa		2	300	2			2						www.lovelacemedicareplan.com	www.lovelacemedicareplan.com	www.lovelacemedicareplan.com	(855)-730-5683		(855)-730-5683		(800)-262-3757		(800)-262-3757										(711)		(711)		(711)		(711)										2	2	2
H6801	801	0	1	01	01	H6801_801_0	2	1		06/05/2011	2012.02	06/05/2011 10:13:06 AM Mountain Daylight Time	06/06/2011 08:28:19 AM Mountain Daylight Time			06/06/2011 09:00:15 AM Mountain Daylight Time	AHS - TULSA OKLAHOMA HEALTH PLAN, INC	Lovelace Medicare Plan	www.lovelacemedicareplan.com	Lovelace Employer Group Medicare Plan (HMO)	01	01		1			H6801	801	0	2012	Oklahoma counties, Mayes, Oklahoma, Payne, Tulsa		1	100	2			2						www.lovelacemedicareplan.com	www.lovelacemedicareplan.com	www.lovelacemedicareplan.com	(855)-730-5683		(855)-730-5683		(800)-262-3757		(800)-262-3757		(855)-730-5683		(855)-730-5683		(800)-262-3757		(800)-262-3757		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H6815	001	0	1	01	01	H6815_001_0	5	1		07/12/2011	2012.02	07/12/2011 05:09:25 PM Pacific Daylight Time	08/05/2011 10:02:00 AM Pacific Daylight Time	08/04/2011 02:39:56 PM Pacific Daylight Time		08/05/2011 02:47:19 PM Pacific Daylight Time	HEALTH NET HEALTH PLAN OF OREGON	Health Net Medicare Advantage	www.healthnet.com	Health Net Ruby (HMO)	01	01		1			H6815	001	0	2012	Clackamas, Multnomah, Washington, OR		2		2			2						www.healthnet.com	https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm	(888)-445-8913		(888)-445-8913		(800)-822-7698		(800)-822-7698		(888)-445-8913		(888)-445-8913		(800)-822-7698		(800)-822-7698		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955		2	2	2
H6864	001	0	1	02	01	H6864_001_0	13	1	2	08/08/2011	2012.02	08/08/2011 08:44:45 AM Eastern Daylight Time	08/09/2011 01:28:27 PM Eastern Daylight Time	08/09/2011 01:28:48 PM Eastern Daylight Time		08/09/2011 01:30:37 PM Eastern Daylight Time	GUILDNET, INC.	GuildNet	www.jgb.org	GuildNet Gold (HMO-POS SNP)	01	02		1			H6864	001	0	2012	Bronx, Kings, New York, Queens, Nassau, Suffolk		2	482	2			1	3		1	5		www.jgb.org/guildnet	http://www.jgb.org/guildnet	http://www.jgb.org/guildnet	(800)-815-0000		(800)-815-0000		(800)-815-0000		(800)-815-0000		(877)-444-3973		(877)-444-3973		(800)-815-0000		(800)-815-0000		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(866)-248-0640		(866)-248-0640		(800)-662-1220		(800)-662-1220		2	2	2
H6864	002	0	1	02	01	H6864_002_0	11	1	2	08/08/2011	2012.02	08/08/2011 10:56:51 AM Eastern Daylight Time	08/09/2011 01:29:11 PM Eastern Daylight Time	08/09/2011 01:29:30 PM Eastern Daylight Time		08/09/2011 01:30:37 PM Eastern Daylight Time	GUILDNET, INC.	GuildNet	www.jgb.org	GuildNet Health Advantage (HMO-POS SNP)	01	02		1			H6864	002	0	2012	Bronx, Kings, New York, Queens, Nassau and Suffolk		2	408	2			1	3		1	3		www.jgb.org/guildnet	http://www.jgb.org/guildnet	http://www.jgb.org/guildnet	(800)-815-0000		(800)-815-0000		(800)-815-0000		(800)-815-0000		(877)-444-3973		(877)-444-3973		(800)-815-0000		(800)-815-0000		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(866)-248-0640		(866)-248-0640		(800)-662-1220		(800)-662-1220		2	2	2
H6881	001	0	1	04	01	H6881_001_0	6	1		07/12/2011	2012.02	07/12/2011 01:08:49 PM Eastern Daylight Time	07/08/2011 02:14:46 PM Eastern Daylight Time			07/18/2011 10:55:49 AM Eastern Daylight Time	AMERICA'S 1ST CHOICE INSURANCE COMPANY OF NC, INC.	America's 1st Choice Insurance Company of NC	www.Americas1stChoice.com	Ambassador (PPO)	01	04		1			H6881	001	0	2012	Select Counties in NC		2	1	2			2						www.americas1stchoice.com	www.americas1stchoice.com	www.americas1stchoice.com	(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947										(800)-735-2962		(800)-735-2962		(800)-735-2962		(800)-735-2962										2	2	2
H6881	002	0	1	04	01	H6881_002_0	7	1		07/12/2011	2012.02	07/12/2011 01:09:19 PM Eastern Daylight Time	08/05/2011 03:02:57 PM Eastern Daylight Time	08/05/2011 03:02:57 PM Eastern Daylight Time		08/05/2011 04:51:31 PM Eastern Daylight Time	AMERICA'S 1ST CHOICE INSURANCE COMPANY OF NC, INC.	America's 1st Choice Insurance Company of NC	www.Americas1stChoice.com	Ambassador Plus (PPO)	01	04		1			H6881	002	0	2012	Select Counties in NC		2	1	2			2						www.americas1stchoice.com	www.americas1stchoice.com	www.americas1stchoice.com	(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947		(800)-735-2962		(800)-735-2962		(800)-735-2962		(800)-735-2962		(800)-735-2962		(800)-735-2962		(800)-735-2962		(800)-735-2962		2	2	2
H6887	001	0	1	20	08	H6887_001_0	1	1		08/21/2011	2012.02	08/21/2011 03:24:59 PM Mountain Daylight Time		08/17/2011 08:09:39 AM Mountain Daylight Time		08/21/2011 03:26:42 PM Mountain Daylight Time	SJH LIFE, INC.	SJH LIFE	www.sjhealthcare.net	SJH LIFE (PACE)	08	20		1			H6887	001	0	2012	SJH LIFE		2		2			2							www.sjhealthcare.net	www.sjhealthcare.net									(800)-000-0000		(856)-759-2132		(800)-000-0000		(856)-759-2132										(800)-000-0000		(856)-759-2132		(800)-000-0000		(856)-759-2132				
H6887	002	0	1	20	08	H6887_002_0	1	1		08/21/2011	2012.02	08/21/2011 03:25:16 PM Mountain Daylight Time		08/17/2011 08:09:39 AM Mountain Daylight Time		08/21/2011 03:26:42 PM Mountain Daylight Time	SJH LIFE, INC.	SJH LIFE	www.sjhealthcare.net	SJH LIFE (PACE)	08	20		1			H6887	002	0	2012	SJH LIFE		2		2			2							www.sjhealthcare.net	www.sjhealthcare.net									(800)-000-0000		(856)-759-2132		(800)-000-0000		(856)-759-2132										(800)-000-0000		(856)-759-2132		(800)-000-0000		(856)-759-2132				
H6900	001	0	1	04	01	H6900_001_0	7	1		07/06/2011	2012.02	07/06/2011 01:37:00 PM Eastern Daylight Time	08/05/2011 10:41:02 PM Eastern Daylight Time	08/04/2011 12:51:45 PM Eastern Daylight Time		08/09/2011 09:18:45 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H6900-001 (PPO)	01	04		1			H6900	001	0	2012	North Central Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6900	002	0	1	04	01	H6900_002_0	8	1		07/06/2011	2012.02	07/06/2011 01:41:53 PM Eastern Daylight Time	08/05/2011 10:41:42 PM Eastern Daylight Time	08/04/2011 12:52:05 PM Eastern Daylight Time		08/09/2011 10:11:01 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H6900-002 (PPO)	01	04		1			H6900	002	0	2012	Erie County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6900	004	0	1	04	01	H6900_004_0	10	1		07/06/2011	2012.02	07/06/2011 01:46:02 PM Eastern Daylight Time	05/27/2011 02:15:09 PM Eastern Daylight Time	08/04/2011 12:52:25 PM Eastern Daylight Time		08/09/2011 10:11:01 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H6900-004 (PPO)	01	04		1			H6900	004	0	2012	South Central Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6900	005	0	1	04	01	H6900_005_0	7	1		08/05/2011	2012.02	08/05/2011 10:31:54 AM Eastern Daylight Time	08/05/2011 10:52:22 PM Eastern Daylight Time	08/04/2011 12:52:45 PM Eastern Daylight Time		08/08/2011 06:35:50 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H6900-005 (PPO)	01	04		1			H6900	005	0	2012	South Central Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6900	006	0	1	04	01	H6900_006_0	6	1		08/05/2011	2012.02	08/05/2011 10:32:25 AM Eastern Daylight Time	08/05/2011 10:55:37 PM Eastern Daylight Time	08/04/2011 12:53:06 PM Eastern Daylight Time		08/08/2011 06:42:01 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H6900-006 (PPO)	01	04		1			H6900	006	0	2012	Erie County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6900	007	0	1	04	01	H6900_007_0	6	1		08/05/2011	2012.02	08/05/2011 10:32:57 AM Eastern Daylight Time	05/27/2011 02:24:36 PM Eastern Daylight Time	08/04/2011 12:53:25 PM Eastern Daylight Time		08/08/2011 06:42:01 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H6900-007 (PPO)	01	04		1			H6900	007	0	2012	Lycoming and Lackawanna counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H6923	001	0	1	01	01	H6923_001_0	5	1		07/12/2011	2012.02	07/12/2011 03:33:05 PM Central Daylight Time	08/04/2011 02:24:28 PM Central Daylight Time	08/04/2011 10:12:51 AM Central Daylight Time		08/08/2011 07:54:55 AM Central Daylight Time	AETNA HEALTH	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Select Plan (HMO)	01	01		1			H6923	001	0	2012	Denver and Surrounding Counties		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H6923	801	0	1	01	01	H6923_801_0	1	1		04/22/2011	2012.02	04/22/2011 10:13:28 AM Eastern Daylight Time	06/01/2011 01:39:09 PM Eastern Daylight Time			06/03/2011 10:51:30 AM Eastern Daylight Time	AETNA HEALTH	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan (HMO)	01	01		1			H6923	801	0	2012	Colorado		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748										1	1	1
H6923	802	0	1	01	01	H6923_802_0	2	1		04/22/2011	2012.02	04/22/2011 10:13:54 AM Eastern Daylight Time	06/03/2011 03:33:57 PM Eastern Daylight Time			06/03/2011 05:38:29 PM Eastern Daylight Time	AETNA HEALTH	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan w/ RX CY (HMO)	01	01		1			H6923	802	0	2012	Colorado		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		1	1	1
H6952	002	0	1	01	01	H6952_002_0	6	1	2	08/04/2011	2012.02	08/04/2011 08:10:57 PM Central Daylight Time	08/05/2011 09:37:10 AM Central Daylight Time	08/05/2011 01:15:51 PM Central Daylight Time		08/09/2011 01:10:13 PM Central Daylight Time	UNITEDHEALTHCARE OF THE GREAT LAKES HLTH PLAN, INC	UnitedHealthcare Community Plan	www.UHCDualComplete.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H6952	002	0	2012	Michigan Counties		2		2			1	3		1	5		www.UHCDualComplete.com	www.glhp.com	www.rxamerica.com	(888)-903-7587		(888)-903-7587		(888)-565-8170		(888)-565-8170		(888)-903-7587		(888)-903-7587		(888)-565-8170		(888)-565-8170		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H7002	002	0	1	04	01	H7002_002_0	7	1		07/07/2011	2012.02	07/07/2011 02:23:00 PM Eastern Daylight Time	08/05/2011 03:57:26 PM Eastern Daylight Time	08/04/2011 12:54:10 PM Eastern Daylight Time		08/08/2011 04:05:26 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Reader's Digest Healthy Living Plan (PPO)	01	04		1			H7002	002	0	2012	Select Louisiana Parishes		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H7006	001	0	1	04	01	H7006_001_0	9	1		08/05/2011	2012.02	08/05/2011 11:05:24 AM Pacific Daylight Time	08/09/2011 02:34:23 PM Pacific Daylight Time	08/09/2011 02:34:23 PM Pacific Daylight Time		08/09/2011 04:48:49 PM Pacific Daylight Time	MARION POLK COMMUNITY HEALTH PLAN ADVANTAGE, INC.	Marion Polk Community Health Plan Advantage, Inc.	www.physicianschoiceplans.com	Physicians Choice Preferred + Rx (PPO)	01	04		1			H7006	001	0	2012	Marion and Polk Counties in Oregon		2	2185	2			2						www.physicianschoiceplans.com/providersearch.php	www.physicianschoiceplans.com	www.physicianschoiceplans.com	(888)-462-2708		(503)-584-4210		(888)-236-2496		(503)-315-4101		(888)-462-2708		(503)-584-4210		(888)-236-2496		(503)-315-4101		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		2	2	2
H7006	002	0	1	04	01	H7006_002_0	6	1		06/28/2011	2012.02	06/28/2011 11:26:17 AM Pacific Daylight Time	06/06/2011 04:32:44 PM Pacific Daylight Time			06/28/2011 11:34:04 AM Pacific Daylight Time	MARION POLK COMMUNITY HEALTH PLAN ADVANTAGE, INC.	Marion Polk Community Health Plan Advantage, Inc.	www.physicianschoiceplans.com	Physicians Choice Preferred (PPO)	01	04		1			H7006	002	0	2012	Marion and Polk Counties in Oregon		2	444	2			2						www.physicianschoiceplans.com/providersearch.php	www.physicianschoiceplans.com	www.physicianschoiceplans.com	(888)-462-2708		(503)-584-4210		(888)-236-2496		(503)-315-4101										(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900										2	2	2
H7015	001	0	1	01	01	H7015_001_0	6	1		08/09/2011	2012.02	08/09/2011 08:39:25 AM Eastern Daylight Time	08/09/2011 04:19:44 PM Eastern Daylight Time	08/09/2011 04:20:13 PM Eastern Daylight Time		08/09/2011 05:52:14 PM Eastern Daylight Time	HEALTHFIRST HEALTH PLAN OF NEW JERSEY, INC.	Healthfirst NJ Medicare Plan	www.healthfirstnj.org	Healthfirst NJ Medicare Plus Plan (HMO)	01	01		1			H7015	001	0	2012	Northeastern New Jersey		2	3290	2			2						www.healthfirstnj.org	www.healthfirstnj.org	www.healthfirstnj.org	(877)-464-4365		(877)-464-4365		(877)-237-1308		(877)-237-1308		(877)-464-4365		(877)-464-4365		(877)-237-1308		(877)-237-1308		(800)-852-7897		(800)-852-7897		(800)-852-7897		(800)-852-7897		(800)-852-7897		(800)-852-7897		(800)-852-7897		(800)-852-7897		2	2	2
H7015	002	0	1	01	01	H7015_002_0	6	1		08/09/2011	2012.02	08/09/2011 08:48:19 AM Eastern Daylight Time	08/09/2011 04:20:53 PM Eastern Daylight Time	08/09/2011 04:21:22 PM Eastern Daylight Time		08/09/2011 05:52:14 PM Eastern Daylight Time	HEALTHFIRST HEALTH PLAN OF NEW JERSEY, INC.	Healthfirst NJ Medicare Plan	www.healthfirstnj.org	Healthfirst NJ Increased Benefits Plan (HMO)	01	01		1			H7015	002	0	2012	Northeastern New Jersey		2	3348	2			2						www.healthfirstnj.org	www.healthfirstnj.org	www.healthfirstnj.org	(877)-464-4365		(877)-464-4365		(877)-237-1308		(877)-237-1308		(877)-464-4365		(877)-464-4365		(877)-237-1308		(877)-237-1308		(800)-852-7897		(800)-852-7897		(800)-852-7897		(800)-852-7897		(800)-852-7897		(800)-852-7897		(800)-852-7897		(800)-852-7897		2	2	2
H7015	003	0	1	01	01	H7015_003_0	6	1		07/08/2011	2012.02	07/08/2011 11:23:28 AM Eastern Daylight Time	07/22/2011 03:45:16 PM Eastern Daylight Time			07/22/2011 03:47:59 PM Eastern Daylight Time	HEALTHFIRST HEALTH PLAN OF NEW JERSEY, INC.	Healthfirst NJ Medicare Plan	www.healthfirstnj.org	Healthfirst NJ Coordinated Benefits Plan (HMO)	01	01		1			H7015	003	0	2012	Northeastern New Jersey		2	222	2			2						www.healthfirstnj.org	www.healthfirstnj.org	www.healthfirstnj.org	(877)-464-4365		(877)-464-4365		(877)-237-1308		(877)-237-1308										(800)-852-7897		(800)-852-7897		(800)-852-7897		(800)-852-7897										2	2	2
H7015	004	0	1	01	01	H7015_004_0	6	1	2	08/09/2011	2012.02	08/09/2011 08:49:34 AM Eastern Daylight Time	08/09/2011 04:22:01 PM Eastern Daylight Time	08/09/2011 04:22:27 PM Eastern Daylight Time		08/09/2011 05:52:14 PM Eastern Daylight Time	HEALTHFIRST HEALTH PLAN OF NEW JERSEY, INC.	Healthfirst NJ Medicare Plan	www.healthfirstnj.org	Healthfirst NJ Maximum Plan (HMO SNP)	01	01		1			H7015	004	0	2012	Northeastern New Jersey		2	2944	2			1	3		1	2		www.healthfirstnj.org	www.healthfirstnj.org	www.healthfirstnj.org	(877)-464-4365		(877)-464-4365		(877)-237-1308		(877)-237-1308		(877)-464-4365		(877)-464-4365		(877)-237-1308		(877)-237-1308		(800)-852-7897		(800)-852-7897		(800)-852-7897		(800)-852-7897		(800)-852-7897		(800)-852-7897		(800)-852-7897		(800)-852-7897		2	2	2
H7015	801	0	1	01	01	H7015_801_0	3	1		06/03/2011	2012.02	06/03/2011 02:48:47 PM Eastern Daylight Time	06/03/2011 06:24:33 PM Eastern Daylight Time			06/03/2011 06:49:00 PM Eastern Daylight Time	HEALTHFIRST HEALTH PLAN OF NEW JERSEY, INC.	Healthfirst NJ Medicare Plan	www.healthfirstnj.org	Employer Group 1 (HMO)	01	01		1			H7015	801	0	2012	National		1	2	2			2						www.healthfirstnj.org	www.healthfirstnj.org	www.healthfirstnj.org	(877)-464-4365		(877)-464-4365		(877)-237-1308		(877)-237-1308		(877)-464-4365		(877)-464-4365		(877)-237-1308		(877)-237-1308		(800)-852-7897		(800)-852-7897		(800)-852-7897		(800)-852-7897		(800)-852-7897		(800)-852-7897		(800)-852-7897		(800)-852-7897		2	2	2
H7015	802	0	1	01	01	H7015_802_0	2	1		05/26/2011	2012.02	05/26/2011 03:53:14 PM Eastern Daylight Time	06/03/2011 06:25:22 PM Eastern Daylight Time			06/03/2011 06:49:00 PM Eastern Daylight Time	HEALTHFIRST HEALTH PLAN OF NEW JERSEY, INC.	Healthfirst NJ Medicare Plan	www.healthfirstnj.org	Employer Group 2 (HMO)	01	01		1			H7015	802	0	2012	National		1	2	2			2						www.healthfirstnj.org	www.healthfirstnj.org	www.healthfirstnj.org	(877)-464-4365		(877)-464-4365		(877)-237-1308		(877)-237-1308										(800)-852-7897		(800)-852-7897		(800)-852-7897		(800)-852-7897										2	2	2
H7086	001	0	1	01	01	H7086_001_0	5	1	2	08/09/2011	2012.02	08/09/2011 02:27:27 PM Pacific Daylight Time	08/09/2011 09:24:38 AM Pacific Daylight Time	08/09/2011 09:26:26 AM Pacific Daylight Time		08/09/2011 02:46:57 PM Pacific Daylight Time	COMMUNITY HEALTH GROUP	Community Health Group	www.chgsd.com	CommuniCare Advantage (HMO SNP)	01	01		1			H7086	001	0	2012	San Diego County California		2		2			1	3		1	5		www.chgsd.com/CHGSDphysHospFinder/physicianFinderLite.aspx	www.chgsd.com	www.chgsd.com	(888)-244-4430		(619)-422-0422		(888)-244-4430		(619)-422-0422		(888)-244-4430		(619)-422-0422		(888)-244-4430		(619)-422-0422		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H7149	001	0	1	01	01	H7149_001_0	9	1		08/08/2011	2012.02	08/08/2011 03:21:46 PM Central Daylight Time	08/08/2011 11:21:12 AM Central Daylight Time	08/04/2011 10:47:05 AM Central Daylight Time		08/09/2011 01:51:29 PM Central Daylight Time	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Coventry Health Care	http://iowa-nebraska.chcadvantra.com	Advantra Silver (HMO)	01	01		1			H7149	001	0	2012	Partial State of Nebraska		2	4611	2			2						http://iowa-nebraska.chcadvantra.com	http://iowa-nebraska.chcadvantra.com	http://www.medcoonline.com	(866)-901-4692		(866)-901-4692		(877)-886-7564		(877)-886-7564		(800)-707-7051		(800)-707-7051		(877)-886-7564		(877)-886-7564		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H7149	801	0	1	01	01	H7149_801_0	2	1		05/26/2011	2012.02	05/26/2011 09:44:19 AM Central Daylight Time	07/25/2011 02:18:44 PM Central Daylight Time			07/27/2011 01:53:07 PM Central Daylight Time	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Coventry Health Care	http://iowa-nebraska.chcadvantra.com	Advantra Silver Employee Plan (HMO)	01	01		1			H7149	801	0	2012	Nebraska		1	100	2			2						http://iowa-nebraska.chcadvantra.com	http://iowa-nebraska.chcadvantra.com	http://www.medcoonline.com	(866)-901-4692		(866)-901-4692		(877)-886-8141		(877)-886-8141										(711)		(711)		(711)		(711)										1	1	1
H7149	802	0	1	01	01	H7149_802_0	2	1		05/26/2011	2012.02	05/26/2011 09:44:48 AM Central Daylight Time	07/25/2011 02:22:56 PM Central Daylight Time			07/27/2011 01:53:07 PM Central Daylight Time	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Coventry Health Care	http://iowa-nebraska.chcadvantra.com	Advantra Silver Rx CY Employee Plan (HMO)	01	01		1			H7149	802	0	2012	Nebraska		1	100	2			2						http://iowa-nebraska.chcadvantra.com	http://iowa-nebraska.chcadvantra.com	http://www.medcoonline.com	(866)-901-4692		(866)-901-4692		(877)-886-7564		(877)-886-7564		(800)-707-7051		(800)-707-7051		(877)-886-7564		(877)-886-7564		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H7149	803	0	1	01	01	H7149_803_0	2	1		05/26/2011	2012.02	05/26/2011 09:50:49 AM Central Daylight Time	07/25/2011 02:41:42 PM Central Daylight Time			07/27/2011 01:53:07 PM Central Daylight Time	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Coventry Health Care	http://iowa-nebraska.chcadvantra.com	Advantra Silver Rx Employee Plan (HMO)	01	01		1			H7149	803	0	2012	Nebraska		1	100	2			2						http://iowa-nebraska.chcadvantra.com	http://iowa-nebraska.chcadvantra.com	http://www.medcoonline.com	(866)-901-4692		(866)-901-4692		(877)-886-7564		(877)-886-7564		(800)-707-7051		(800)-707-7051		(877)-886-7564		(877)-886-7564		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H7173	001	0	1	01	01	H7173_001_0	6	1	2	07/29/2011	2012.02	07/29/2011 12:45:43 PM Pacific Daylight Time	08/04/2011 12:40:27 PM Pacific Daylight Time	08/04/2011 12:23:37 PM Pacific Daylight Time		08/05/2011 02:37:22 PM Pacific Daylight Time	PEACH STATE HEALTH PLAN, INC.	Advantage by Peach State	http://advantage.pshpgeorgia.com	Advantage by Peach State Health Plan (HMO SNP)	01	01		1			H7173	001	0	2012	DeKalb, Fulton, and Gwinnett Counties		2	225	2			1	3		1	5		www.pshpgeorgia.com	http://www.pshpgeorgia.com/	http://www.pshpgeorgia.com/	(877)-725-7748		(877)-725-7748		(877)-725-7748		(877)-725-7748		(877)-725-7748		(877)-725-7748		(877)-725-7748		(877)-725-7748		(800)-659-7487		(800)-659-7487		(800)-659-7487		(800)-659-7487		(800)-659-7487		(800)-659-7487		(800)-659-7487		(800)-659-7487		2	1	2
H7179	002	0	1	01	01	H7179_002_0	9	1		08/08/2011	2012.02	08/08/2011 10:25:17 AM Central Daylight Time	08/07/2011 08:06:40 PM Central Daylight Time	08/04/2011 02:31:32 PM Central Daylight Time		08/08/2011 07:49:30 PM Central Daylight Time	ARCADIAN HEALTH PLAN OF LOUISIANA, INC.	Arcadian Community Care	www.arcadiancommunitycare.com	Arcadian Community Care - Plus (HMO)	01	01		1			H7179	002	0	2012	Monroe		2		2			2						www.arcadiancommunitycare.com	www.arcadiancommunitycare.com	www.arcadiancommunitycare.com	(800)-573-8597		(800)-573-8597		(888)-261-1061		(318)-865-1061		(800)-573-8597		(800)-573-8597		(888)-261-1061		(318)-865-1061		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H7179	003	0	1	01	01	H7179_003_0	7	1	2	07/07/2011	2012.02	07/07/2011 11:11:11 AM Central Daylight Time	07/17/2011 07:16:27 PM Central Daylight Time	07/19/2011 08:54:22 PM Central Daylight Time		07/20/2011 04:17:07 PM Central Daylight Time	ARCADIAN HEALTH PLAN OF LOUISIANA, INC.	Arcadian Community Care	www.arcadiancommunitycare.com	Arcadian Community Care - Dual Plus (HMO SNP)	01	01		1			H7179	003	0	2012	Shreveport, Monroe and Lake Charles		2		2			1	3		1	1		www.arcadiancommunitycare.com	www.arcadiancommunitycare.com	www.arcadiancommunitycare.com	(800)-573-8597		(800)-573-8597		(888)-261-1061		(318)-865-1061		(800)-573-8597		(800)-573-8597		(888)-261-1061		(318)-865-1061		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H7179	013	0	1	01	01	H7179_013_0	7	1	2	07/07/2011	2012.02	07/07/2011 11:11:15 AM Central Daylight Time	07/17/2011 07:17:58 PM Central Daylight Time	07/19/2011 08:55:05 PM Central Daylight Time		07/20/2011 04:17:07 PM Central Daylight Time	ARCADIAN HEALTH PLAN OF LOUISIANA, INC.	Arcadian Community Care	www.arcadiancommunitycare.com	Arcadian Community Care - Dual Plus (HMO SNP)	01	01		1			H7179	013	0	2012	Alexandria, Baton Rouge, Lafayette		2		2			1	3		1	5		www.arcadiancommunitycare.com	www.arcadiancommunitycare.com	www.arcadiancommunitycare.com	(800)-573-8597		(800)-573-8597		(888)-261-1061		(318)-865-1061		(800)-573-8597		(800)-573-8597		(888)-261-1061		(318)-865-1061		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		(866)-573-8591		(866)-573-8591		(866)-573-8613		(866)-573-8613		2	2	2
H7187	003	0	1	02	01	H7187_003_0	5	1		08/08/2011	2012.02	08/08/2011 09:48:08 AM Central Daylight Time	08/04/2011 10:20:29 PM Central Daylight Time	08/05/2011 01:45:43 PM Central Daylight Time		08/09/2011 04:41:25 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H7187	003	0	2012	Richmond and Roanoke areas		2		2			2							www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H7187	009	0	1	02	01	H7187_009_0	4	1		08/09/2011	2012.02	08/09/2011 11:11:18 AM Central Daylight Time	08/04/2011 10:21:01 PM Central Daylight Time	08/05/2011 01:45:59 PM Central Daylight Time		08/09/2011 04:41:25 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H7187	009	0	2012	Portsmouth, Norfolk, Newport News counties		2		2			2							www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H7187	801	0	1	02	01	H7187_801_0	2	1		07/06/2011	2012.02	07/06/2011 04:50:23 PM Central Daylight Time	06/03/2011 01:28:50 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO-POS)	01	02		1			H7187	801	0	2012	Chest.,Goochl.,Hanover,Henrico,Richmond City Cos		1		2			2							www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H7188	003	0	1	04	01	H7188_003_0	4	1		08/08/2011	2012.02	08/08/2011 11:56:33 AM Eastern Daylight Time	08/05/2011 05:42:47 PM Eastern Daylight Time	08/04/2011 12:54:28 PM Eastern Daylight Time		08/08/2011 04:32:56 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H7188-003 (PPO)	01	04		1			H7188	003	0	2012	Select Counties in AR, KS and MO		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H7188	005	0	1	04	01	H7188_005_0	5	1		08/08/2011	2012.02	08/08/2011 11:56:41 AM Eastern Daylight Time	08/05/2011 05:43:26 PM Eastern Daylight Time	08/04/2011 12:54:48 PM Eastern Daylight Time		08/08/2011 04:32:56 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H7188-005 (PPO)	01	04		1			H7188	005	0	2012	Faulkner and Pulaski Counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H7188	006	0	1	04	01	H7188_006_0	6	1		08/08/2011	2012.02	08/08/2011 11:56:51 AM Eastern Daylight Time	08/05/2011 05:45:42 PM Eastern Daylight Time	08/04/2011 12:55:05 PM Eastern Daylight Time		08/08/2011 04:32:56 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H7188-006 (PPO)	01	04		1			H7188	006	0	2012	Select Counties in AR, KS and MO		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H7195	001	0	1	20	08	H7195_001_0	1	1		05/20/2011	2012.02	05/20/2011 03:08:27 PM Central Daylight Time		05/20/2011 03:04:14 PM Central Daylight Time		05/20/2011 03:09:52 PM Central Daylight Time	NORTHLAND PACE PROGRAM	Northland PACE Program	www.northlandhealth.com	Northland PACE - Dual (PACE)	08	20		1			H7195	001	0	2012	Burleigh, Morton, and Stark Counties		2		2			2							n/a	n/a									(888)-883-8959		(701)-751-3050		(888)-883-8959		(701)-751-3050										(888)-838-8959		(701)-751-3050		(888)-838-8959		(701)-751-3050				
H7195	002	0	1	20	08	H7195_002_0	1	1		05/20/2011	2012.02	05/20/2011 03:08:43 PM Central Daylight Time		05/20/2011 03:04:14 PM Central Daylight Time		05/20/2011 03:09:52 PM Central Daylight Time	NORTHLAND PACE PROGRAM	Northland PACE Program	www.northlandhealth.com	Northland PACE - Medicare Only (PACE)	08	20		1			H7195	002	0	2012	Burleigh, Morton, and Stark Counties		2		2			2							n/a	n/a									(888)-883-8959		(701)-751-3050		(888)-883-8959		(701)-751-3050										(888)-838-8959		(701)-751-3050		(888)-838-8959		(701)-751-3050				
H7200	006	0	1	01	01	H7200_006_0	7	1	2	08/09/2011	2012.02	08/09/2011 02:32:23 PM Eastern Daylight Time	08/05/2011 09:54:00 AM Eastern Daylight Time	08/04/2011 05:28:00 PM Eastern Daylight Time		08/09/2011 05:31:53 PM Eastern Daylight Time	AMERIGROUP TENNESSEE, INC.	Amerigroup Community Care	www.myamerigroup.com/medicare	Amerivantage Specialty + Rx (HMO SNP)	01	01		1			H7200	006	0	2012	Nashville Metro Area		2	1291	2			1	3		1	1		www.myamerigroup.com/medicare	https://www.myamerigroup.com/english/pages/2009medicarememberlogin.aspx	https://www.myamerigroup.com/english/pages/2009medicarememberlogin.aspx	(866)-805-4589		(866)-805-4589		(877)-470-4131		(877)-470-4131		(866)-805-4589		(866)-805-4589		(877)-470-4131		(877)-470-4131		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		2	2	2
H7200	007	0	1	02	01	H7200_007_0	7	1		07/26/2011	2012.02	07/26/2011 08:57:48 AM Eastern Daylight Time	08/08/2011 01:52:00 PM Eastern Daylight Time	08/04/2011 05:28:00 PM Eastern Daylight Time		08/09/2011 05:31:53 PM Eastern Daylight Time	AMERIGROUP TENNESSEE, INC.	Amerigroup Community Care	www.myamerigroup.com/medicare	Amerivantage Classic Choice + Rx (HMO-POS)	01	02		1			H7200	007	0	2012	Nashville Metro Area		2	282	2			2						www.myamerigroup.com/medicare	https://www.myamerigroup.com/english/pages/2009medicarememberlogin.aspx	https://www.myamerigroup.com/english/pages/2009medicarememberlogin.aspx	(866)-805-4589		(866)-805-4589		(877)-470-4131		(877)-470-4131		(866)-805-4589		(866)-805-4589		(877)-470-4131		(877)-470-4131		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		2	2	2
H7220	002	0	1	01	01	H7220_002_0	4	1		07/11/2011	2012.02	07/11/2011 02:38:54 PM Eastern Daylight Time	07/08/2011 04:46:22 PM Eastern Daylight Time			07/20/2011 01:34:49 PM Eastern Daylight Time	CLARIAN HEALTH PLANS, INC.	Clarian Health Plans, Inc. - Clarian Medicare	www.clarianhealthplans.org	Clarian Medicare Select (HMO)	01	01		1			H7220	002	0	2012	State of Indiana - 32 counties		2	376	2			2						www.clarianhealthplans.org	www.clarianhealthplans.org	www.clarianhealthplans.org	(800)-455-9776		(317)-963-9700		(866)-404-4305		(866)-404-4305										(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333										2	2	2
H7220	003	0	1	01	01	H7220_003_0	5	1		08/09/2011	2012.02	08/09/2011 02:49:21 PM Eastern Daylight Time	08/12/2011 11:01:58 AM Eastern Daylight Time	08/12/2011 11:01:32 AM Eastern Daylight Time		08/12/2011 11:06:49 AM Eastern Daylight Time	INDIANA UNIVERSITY HEALTH PLANS, INC.	Indiana University Health Plans - IU Medicare	www.iuhealthplansmedicare.org	IU Health Plans Medicare Select Plus (HMO)	01	01		1			H7220	003	0	2012	State of Indiana - 32 counties		2	678	2			2						iuhealthplansmedicare.org.	www.iuhealthplansmedicare.org	www.iuhealthplansmedicare.org	(800)-455-9776		(317)-963-9700		(866)-404-4305		(866)-404-4305		(866)-907-1587		(866)-907-1587		(866)-907-1587		(866)-907-1587		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		2	2	2
H7220	004	0	1	02	01	H7220_004_0	6	1		08/09/2011	2012.02	08/09/2011 12:42:03 PM Eastern Daylight Time	08/09/2011 04:42:42 PM Eastern Daylight Time	08/09/2011 05:57:43 PM Eastern Daylight Time		08/09/2011 06:04:45 PM Eastern Daylight Time	INDIANA UNIVERSITY HEALTH PLANS, INC.	Indiana University Health Plans - IU Medicare	www.iuhealthplansmedicare.org	IU Health Plans Medicare Choice (HMO-POS)	01	02		1			H7220	004	0	2012	State of Indiana - 32 counties		2	7000	2			2						iuhealthplansmedicare.org.	www.iuhealthplansmedicare.org	www.iuhealthplansmedicare.org	(800)-455-9776		(317)-963-9700		(866)-404-4305		(866)-404-4305		(866)-907-1587		(866)-907-1587		(866)-907-1587		(866)-907-1587		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		2	2	2
H7220	801	0	1	02	01	H7220_801_0	4	1		06/29/2011	2012.02	06/29/2011 05:01:38 PM Eastern Daylight Time	06/29/2011 03:50:08 PM Eastern Daylight Time			07/05/2011 02:56:37 PM Eastern Daylight Time	CLARIAN HEALTH PLANS, INC.	Clarian Health Plans, Inc. - Clarian Medicare	www.clarianhealthplans.org	Premiere Plus EGWP CY (HMO-POS)	01	02		1			H7220	801	0	2012	State of IN -  32 Counties		1	635	2			2						www.clarianhealthplans.org	www.clarianhealthplans.org	www.clarianhealthplans.org	(800)-455-9776		(317)-963-9700		(866)-404-4305		(866)-404-4305		(866)-907-1587		(866)-907-1587		(866)-907-1587		(866)-907-1587		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		2	2	2
H7220	802	0	1	02	01	H7220_802_0	5	1		06/29/2011	2012.02	06/29/2011 05:01:14 PM Eastern Daylight Time	06/29/2011 04:05:46 PM Eastern Daylight Time			07/05/2011 02:56:37 PM Eastern Daylight Time	CLARIAN HEALTH PLANS, INC.	Clarian Health Plans, Inc. - Clarian Medicare	www.clarianhealthplans.org	Premiere Plus EGWP NCY (HMO-POS)	01	02		1			H7220	802	0	2012	State of IN - 32 Counties		1	635	2			2						www.clarianhealthplans.org	www.clarianhealthplans.org	www.clarianhealthplans.org	(800)-455-9776		(317)-963-9700		(866)-404-4305		(866)-404-4305		(866)-907-1587		(866)-907-1587		(866)-907-1587		(866)-907-1587		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		2	2	2
H7220	804	0	1	01	01	H7220_804_0	3	1		06/06/2011	2012.02	06/06/2011 05:23:31 PM Eastern Daylight Time	06/29/2011 04:08:50 PM Eastern Daylight Time			07/05/2011 02:56:37 PM Eastern Daylight Time	CLARIAN HEALTH PLANS, INC.	Clarian Health Plans, Inc. - Clarian Medicare	www.clarianhealthplans.org	Premiere EGWP CY (HMO)	01	01		1			H7220	804	0	2012	State of IN - 32 Counties		1	635	2			2						www.clarianhealthplans.org	www.clarianhealthplans.org	www.clarianhealthplans.org	(800)-455-9776		(317)-963-9700		(866)-404-4305		(866)-404-4305		(866)-907-1587		(866)-907-1587		(866)-907-1587		(866)-907-1587		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		2	2	2
H7220	805	0	1	01	01	H7220_805_0	3	1		06/06/2011	2012.02	06/06/2011 05:23:39 PM Eastern Daylight Time	06/29/2011 04:11:06 PM Eastern Daylight Time			07/05/2011 02:56:37 PM Eastern Daylight Time	CLARIAN HEALTH PLANS, INC.	Clarian Health Plans, Inc. - Clarian Medicare	www.clarianhealthplans.org	Premiere EGWP NCY (HMO)	01	01		1			H7220	805	0	2012	State of IN- 32 Counties		1	635	2			2						www.clarianhealthplans.org	www.clarianhealthplans.org	www.clarianhealthplans.org	(800)-455-9776		(317)-963-9700		(866)-404-4305		(866)-404-4305		(866)-907-1587		(866)-907-1587		(866)-907-1587		(866)-907-1587		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		2	2	2
H7281	001	0	1	02	01	H7281_001_0	8	1		07/18/2011	2012.02	07/18/2011 03:30:16 PM Eastern Daylight Time	08/08/2011 09:12:13 AM Central Daylight Time	08/04/2011 05:01:12 PM Central Daylight Time		08/09/2011 04:46:11 PM Central Daylight Time	BRAVO HEALTH PENNSYLVANIA, INC.	Bravo Health	www.mybravohealth.com	Bravo Classic Plus (HMO-POS)	01	02		1			H7281	001	0	2012	Select New Jersey Counties		2		2			2						www.mybravohealth.com	www.mybravohealth.com/formulary	www.mybravohealth.com	(800)-291-0396		(800)-291-0396		(866)-862-4624		(866)-862-4624		(800)-291-0396		(800)-291-0396		(866)-862-4624		(866)-862-4624		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H7281	002	0	1	02	01	H7281_002_0	8	1		08/05/2011	2012.02	08/05/2011 03:06:01 PM Eastern Daylight Time	08/08/2011 09:13:03 AM Central Daylight Time	08/04/2011 05:02:00 PM Central Daylight Time		08/09/2011 04:46:11 PM Central Daylight Time	BRAVO HEALTH PENNSYLVANIA, INC.	Bravo Health	www.mybravohealth.com	Bravo Premier Plus (HMO-POS)	01	02		1			H7281	002	0	2012	Select New Jersey Counties		2		2			2						www.mybravohealth.com	www.mybravohealth.com/formulary	www.mybravohealth.com	(800)-291-0396		(800)-291-0396		(866)-862-4624		(866)-862-4624		(800)-291-0396		(800)-291-0396		(866)-862-4624		(866)-862-4624		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H7281	003	0	1	01	01	H7281_003_0	8	1		08/05/2011	2012.02	08/05/2011 03:07:52 PM Eastern Daylight Time	08/08/2011 09:13:54 AM Central Daylight Time	08/04/2011 05:02:48 PM Central Daylight Time		08/09/2011 04:46:11 PM Central Daylight Time	BRAVO HEALTH PENNSYLVANIA, INC.	Bravo Health	www.mybravohealth.com	Bravo Complete (HMO)	01	01		1			H7281	003	0	2012	Select New Jersey Counties		2		2			2						www.mybravohealth.com	www.mybravohealth.com/formulary	www.mybravohealth.com	(800)-291-0396		(800)-291-0396		(866)-862-4624		(866)-862-4624		(800)-291-0396		(800)-291-0396		(866)-862-4624		(866)-862-4624		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H7281	004	0	1	01	01	H7281_004_0	8	1		08/08/2011	2012.02	08/08/2011 10:00:55 AM Eastern Daylight Time	08/08/2011 09:14:43 AM Central Daylight Time	08/04/2011 05:03:35 PM Central Daylight Time		08/09/2011 04:46:11 PM Central Daylight Time	BRAVO HEALTH PENNSYLVANIA, INC.	Bravo Health	www.mybravohealth.com	Bravo Traditions (HMO SNP)	01	01		1			H7281	004	0	2012	Select New Jersey Counties		2		2			1	1	1	1			www.mybravohealth.com	www.mybravohealth.com/formulary	www.mybravohealth.com	(800)-291-0396		(800)-291-0396		(866)-862-4624		(866)-862-4624		(800)-291-0396		(800)-291-0396		(866)-862-4624		(866)-862-4624		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H7281	005	0	1	01	01	H7281_005_0	8	1		07/13/2011	2012.02	07/13/2011 03:36:54 PM Eastern Daylight Time	08/08/2011 09:15:31 AM Central Daylight Time	08/04/2011 05:04:17 PM Central Daylight Time		08/09/2011 04:46:11 PM Central Daylight Time	BRAVO HEALTH PENNSYLVANIA, INC.	Bravo Health	www.mybravohealth.com	Bravo Achieve (HMO SNP)	01	01		1			H7281	005	0	2012	Select New Jersey Counties		2		2			1	4		1		00000010000000000000	www.mybravohealth.com	www.mybravohealth.com/formulary	www.mybravohealth.com	(800)-291-0396		(800)-291-0396		(866)-862-4624		(866)-862-4624		(800)-291-0396		(800)-291-0396		(866)-862-4624		(866)-862-4624		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H7292	001	0	1	01	01	H7292_001_0	4	1	2	08/05/2011	2012.02	08/05/2011 02:22:27 PM Pacific Daylight Time	08/05/2011 02:25:31 PM Pacific Daylight Time	08/05/2011 02:25:31 PM Pacific Daylight Time		08/05/2011 02:33:11 PM Pacific Daylight Time	ALAMEDA ALLIANCE JOINT POWERS AUTHORITY (JPA)	Alameda Alliance for Health	http://www.alliancecompletecare.org	Alliance CompleteCare (HMO SNP)	01	01		1			H7292	001	0	2012	Alameda County		2	5433	2			1	3		1	5		http://www.alliancecompletecare.org	http://www.alliancecompletecare.org	http://www.alliancecompletecare.org	(877)-585-7526		(510)-747-4560		(877)-585-7526		(510)-747-4560		(877)-585-7526		(510)-747-4560		(877)-585-7526		(510)-747-4560		(800)-735-2929		(711)		(800)-735-2929		(711)		(800)-735-2929		(711)		(800)-735-2929		(711)		2	2	2
H7301	002	0	1	04	01	H7301_002_0	10	1		08/09/2011	2012.02	08/09/2011 01:25:20 PM Central Daylight Time	08/08/2011 03:39:13 PM Central Daylight Time	08/08/2011 04:18:59 PM Central Daylight Time		08/09/2011 01:36:28 PM Central Daylight Time	PERSONAL CARE INSURANCE OF ILLINOIS	PersonalCare	www.advantraplans.com	PersonalCare (PPO)	01	04		1			H7301	002	0	2012	Central and Northern Illinois		2	11071	2			2						www.pcadvantra.com	www.pcadvantra.com	www.pcadvantra.com	(866)-784-4916		(866)-784-4916		(877)-983-7775		(877)-983-7775		(800)-707-9372		(800)-707-9372		(877)-983-7775		(877)-983-7775		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H7301	801	0	1	04	01	H7301_801_0	3	1		06/01/2011	2012.02	06/01/2011 03:09:12 PM Central Daylight Time	07/27/2011 01:58:07 PM Central Daylight Time			07/28/2011 04:12:51 PM Central Daylight Time	PERSONAL CARE INSURANCE OF ILLINOIS	PersonalCare	www.advantraplans.com	PersonalCare MA Integrated Calendar (PPO)	01	04		1			H7301	801	0	2012	Central and Northern Illinois		1	100	2			2						www.pcadvantra.com	www.pcadvantra.com	www.pcadvantra.com	(866)-784-4916		(866)-784-4916		(877)-983-7775		(877)-983-7775		(800)-707-9372		(800)-707-9372		(877)-983-7775		(877)-983-7775		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H7301	802	0	1	04	01	H7301_802_0	3	1		06/01/2011	2012.02	06/01/2011 03:09:31 PM Central Daylight Time	07/27/2011 01:58:24 PM Central Daylight Time			07/28/2011 04:12:51 PM Central Daylight Time	PERSONAL CARE INSURANCE OF ILLINOIS	PersonalCare	www.advantraplans.com	PersonalCare MA Integrated Non-Calendar (PPO)	01	04		1			H7301	802	0	2012	Central and Northern Illinois		1	100	2			2						www.pcadvantra.com	www.pcadvantra.com	www.pcadvantra.com	(866)-784-4916		(866)-784-4916		(877)-983-7775		(877)-983-7775		(800)-707-9372		(800)-707-9372		(877)-983-7775		(877)-983-7775		(866)-784-4931		(866)-784-4931		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H7301	803	0	1	04	01	H7301_803_0	3	1		06/01/2011	2012.02	06/01/2011 03:09:47 PM Central Daylight Time	07/27/2011 01:58:43 PM Central Daylight Time			07/28/2011 04:12:51 PM Central Daylight Time	PERSONAL CARE INSURANCE OF ILLINOIS	PersonalCare	www.advantraplans.com	PersonalCare MA Only (PPO)	01	04		1			H7301	803	0	2012	Central and Northern Illinois		1	100	2			2						www.pcadvantra.com	www.pcadvantra.com	www.pcadvantra.com	(866)-784-4916		(866)-784-4916		(877)-983-7775		(877)-983-7775										(711)		(711)		(711)		(711)										1	1	1
H7306	001	0	1	04	01	H7306_001_0	7	1		08/09/2011	2012.02	08/09/2011 01:12:05 PM Central Daylight Time	08/08/2011 04:09:34 PM Central Daylight Time	08/04/2011 10:27:00 AM Central Daylight Time		08/09/2011 01:42:58 PM Central Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	Coventry Health Care	www.tx.chcadvantra.com	Advantra (PPO)	01	04		1			H7306	001	0	2012	Dallas/Houston and select Texas counties		2		2			2						www.ProviderDirectory.coventry-medicare.com	www.TXFormulary.coventry-medicare.com	www.tx.chcadvantra.com	(866)-731-9570		(866)-731-9570		(877)-887-4796		(877)-887-4796		(866)-544-2965		(866)-544-2965		(877)-887-4796		(877)-887-4796		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H7306	003	0	1	04	01	H7306_003_0	8	1		08/09/2011	2012.02	08/09/2011 01:11:42 PM Central Daylight Time	08/08/2011 04:18:14 PM Central Daylight Time	08/04/2011 09:54:24 AM Central Daylight Time		08/09/2011 01:42:58 PM Central Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	Coventry Health Care	www.tx.chcadvantra.com	Advantra Total Care (PPO)	01	04		1			H7306	003	0	2012	Bexar County		2		2			2						www.ProviderDirectory.coventry-medicare.com	www.TXFormulary.coventry-medicare.com	www.tx.chcadvantra.com	(866)-731-9570		(866)-731-9570		(877)-887-4796		(877)-887-4796		(866)-544-2965		(866)-544-2965		(877)-887-4796		(877)-887-4796		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H7306	801	0	1	04	01	H7306_801_0	2	1		06/06/2011	2012.02	06/06/2011 06:13:03 AM Central Daylight Time	07/25/2011 01:28:42 PM Central Daylight Time			07/27/2011 02:35:56 PM Central Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	Coventry Health Care	www.tx.chcadvantra.com	Advantra (PPO)	01	04		1			H7306	801	0	2012	Texas		1		2			2						www.ProviderDirectory.coventry-medicare.com	www.TXFormulary.coventry-medicare.com	www.tx.chcadvantra.com	(866)-731-9570		(866)-731-9570		(877)-887-4796		(877)-887-4796										(711)		(711)		(711)		(711)										1	1	1
H7306	803	0	1	04	01	H7306_803_0	2	1		06/06/2011	2012.02	06/06/2011 06:12:35 AM Central Daylight Time	07/25/2011 01:33:00 PM Central Daylight Time			07/27/2011 02:35:56 PM Central Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	Coventry Health Care	www.tx.chcadvantra.com	Advantra (PPO)	01	04		1			H7306	803	0	2012	Texas		1		2			2						www.ProviderDirectory.coventry-medicare.com	www.TXFormulary.coventry-medicare.com	www.tx.chcadvantra.com	(866)-731-9570		(866)-731-9570		(877)-887-4796		(877)-887-4796		(866)-544-2965		(866)-544-2965		(877)-887-4796		(877)-887-4796		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H7306	804	0	1	04	01	H7306_804_0	2	1		06/06/2011	2012.02	06/06/2011 06:08:51 AM Central Daylight Time	07/25/2011 01:37:52 PM Central Daylight Time			07/27/2011 02:35:56 PM Central Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	Coventry Health Care	www.tx.chcadvantra.com	Advantra (PPO)	01	04		1			H7306	804	0	2012	Texas		1		2			2						www.ProviderDirectory.coventry-medicare.com	www.TXFormulary.coventry-medicare.com	www.tx.chcadvantra.com	(866)-731-9570		(866)-731-9570		(877)-887-4796		(877)-887-4796		(866)-544-2965		(866)-544-2965		(877)-887-4796		(877)-887-4796		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H7352	002	0	1	01	01	H7352_002_0	3	1	2	06/03/2011	2012.02	06/03/2011 05:34:50 PM Central Daylight Time	06/06/2011 01:18:15 AM Central Daylight Time	06/04/2011 01:54:08 PM Central Daylight Time		06/06/2011 08:04:27 AM Central Daylight Time	UNIVERSITY CARE ADVANTAGE, L.L.C	University Physicians/Maricopa Care Advantage	www.upcareaz.com and www.mcareaz.com	University Physicians Care Advantage (HMO SNP)	01	01		1			H7352	002	0	2012	Pima County		2		2			1	3		1	2		www.upcareaz.com and www.mcareaz.com	www.express-scripts.com	www.express-scripts.com	(877)-874-3930		(520)-874-3930		(877)-874-3938		(520)-874-3938		(877)-874-3930		(520)-874-3930		(877)-874-3938		(520)-874-3938		(800)-367-8939		(866)-327-8877		(800)-367-8939		(866)-327-8877		(800)-367-8939		(866)-327-8877		(800)-367-8939		(866)-327-8877		2	2	2
H7352	003	0	1	01	01	H7352_003_0	3	1	2	06/03/2011	2012.02	06/03/2011 05:34:55 PM Central Daylight Time	06/06/2011 01:19:35 AM Central Daylight Time	06/04/2011 01:54:38 PM Central Daylight Time		06/06/2011 08:04:27 AM Central Daylight Time	UNIVERSITY CARE ADVANTAGE, L.L.C	University Physicians/Maricopa Care Advantage	www.upcareaz.com and www.mcareaz.com	Maricopa Care Advantage (HMO SNP)	01	01		1			H7352	003	0	2012	Maricopa County		2		2			1	3		1	2		www.upcareaz.com and www.mcareaz.com	www.express-scripts.com	www.express-scripts.com	(877)-874-3935		(520)-874-3935		(877)-874-3938		(520)-874-3938		(877)-874-3935		(520)-874-3935		(877)-874-3938		(520)-874-3938		(800)-367-8939		(866)-327-8877		(800)-367-8939		(866)-327-8877		(800)-367-8939		(866)-327-8877		(800)-367-8939		(866)-327-8877		2	2	2
H7352	004	0	1	01	01	H7352_004_0	4	1	2	06/03/2011	2012.02	06/03/2011 05:35:27 PM Central Daylight Time	06/28/2011 03:50:36 PM Central Daylight Time	06/04/2011 01:55:09 PM Central Daylight Time		06/28/2011 03:51:03 PM Central Daylight Time	UNIVERSITY CARE ADVANTAGE, L.L.C	University Physicians/Maricopa Care Advantage	www.upcareaz.com and www.mcareaz.com	University Physicians Care Advantage (HMO SNP)	01	01		1			H7352	004	0	2012	Pinal, Cochise, Santa Cruz Counties		2		2			1	3		1	5		www.upcareaz.com and www.mcareaz.com	www.express-scripts.com	www.express-scripts.com	(877)-874-3930		(520)-874-3930		(877)-874-3938		(520)-874-3938		(877)-874-3930		(520)-874-3930		(877)-874-3938		(520)-874-3938		(800)-367-8939		(866)-327-8877		(800)-367-8939		(866)-327-8877		(800)-367-8939		(866)-327-8877		(800)-367-8939		(866)-327-8877		2	2	2
H7475	001	0	1	01	01	H7475_001_0	6	1	2	04/22/2011	2012.01	04/22/2011 04:34:18 PM Central Daylight Time	08/04/2011 02:32:58 PM Central Daylight Time	08/04/2011 02:10:22 PM Central Daylight Time		08/05/2011 03:41:22 PM Central Daylight Time	CARE WISCONSIN HEALTH PLAN, INC.	Care Wisconsin Health Plan, Inc.	www.carewisconsinhealthplan.org	Partnership (HMO SNP)	01	01		1			H7475	001	0	2012	Columbia, Dodge, Jefferson and Sauk Counties		2		2			1	3		1	5		www.carewisconsinhealthplan.org	www.carewisconsinhealthplan.org	www.carewisconsinhealthplan.org	(800)-963-0035		(608)-240-0035		(800)-963-0035		(608)-245-3075		(800)-963-0035		(608)-240-0035		(800)-963-0035		(608)-245-3075		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		(800)-947-3529		2	1	1
H7526	001	0	1	01	01	H7526_001_0	7	1		08/05/2011	2012.02	08/05/2011 10:06:31 AM Central Daylight Time	08/08/2011 03:47:28 PM Central Daylight Time	08/08/2011 03:56:04 PM Central Daylight Time		08/09/2011 08:52:55 AM Central Daylight Time	MEDICA HEALTH PLANS	Medica Health Plans	www.medica.com	Medica Complete Solution - Dementia (HMO SNP)	01	01		1			H7526	001	0	2012	Specific Minnesota Counties		2	1449	2			1	4		1		00000100000000000000	https://www.medica.com/C11/FindADoctor/default.aspx	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	(800)-234-8755		(952)-992-2300		(800)-266-2157		(952)-992-2030		(800)-234-8755		(952)-992-2300		(800)-266-2157		(952)-992-2030		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		2	2	2
H7526	003	0	1	01	01	H7526_003_0	8	1		08/05/2011	2012.02	08/05/2011 10:06:43 AM Central Daylight Time	08/08/2011 03:54:10 PM Central Daylight Time	08/08/2011 03:56:42 PM Central Daylight Time		08/09/2011 08:52:55 AM Central Daylight Time	MEDICA HEALTH PLANS	Medica Health Plans	www.medica.com	Medica Complete Solution - Chronic Lung Disorders (HMO SNP)	01	01		1			H7526	003	0	2012	Select Minnesota Counties		2	472	2			1	4		1		00000000000100000000	https://www.medica.com/C11/FindADoctor/default.aspx	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	(800)-234-8755		(952)-992-2300		(800)-266-2157		(952)-992-2030		(800)-234-8755		(952)-992-2300		(800)-266-2157		(952)-992-2030		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		2	2	2
H7526	004	0	1	01	01	H7526_004_0	6	1		08/05/2011	2012.02	08/05/2011 10:06:55 AM Central Daylight Time	08/08/2011 03:54:55 PM Central Daylight Time	08/08/2011 03:57:12 PM Central Daylight Time		08/09/2011 08:32:50 AM Central Daylight Time	MEDICA HEALTH PLANS	Medica Health Plans	www.medica.com	Medica Complete Solution-Diabetes, Cardio Dis, HF (HMO SNP)	01	01		1			H7526	004	0	2012	Selected Minnesota Counties		2	1229	2			1	4		1		00000000000000000010	https://www.medica.com/C11/FindADoctor/default.aspx	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	(800)-234-8755		(952)-992-2300		(800)-266-2157		(952)-992-2030		(800)-234-8755		(952)-992-2300		(800)-266-2157		(952)-992-2030		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		2	2	2
H7660	001	0	1	20	08	H7660_001_0	1	1		06/01/2011	2012.02	06/01/2011 02:40:20 PM Eastern Daylight Time		05/20/2011 04:44:13 PM Eastern Daylight Time		06/01/2011 02:42:13 PM Eastern Daylight Time	VIECARE BEAVER LLC DBA LIFE BEAVER COUNTY	LIFE-Beaver County	http://www.lutheranseniorlife.org	LIFE Beaver-Dual (PACE)	08	20		1			H7660	001	0	2012	LIFE-Beaver County		2		2			2							www.lutheranseniorlife.org	www.lutheranseniorlife.org									(724)-378-5400		(724)-378-5400		(724)-378-5400		(724)-378-5400										(724)-378-5400		(724)-378-5400		(724)-378-5400		(724)-378-5400				
H7660	002	0	1	20	08	H7660_002_0	1	1		06/01/2011	2012.02	06/01/2011 02:40:54 PM Eastern Daylight Time		05/20/2011 04:44:13 PM Eastern Daylight Time		06/01/2011 02:42:13 PM Eastern Daylight Time	VIECARE BEAVER LLC DBA LIFE BEAVER COUNTY	LIFE-Beaver County	www.Lutheran SeniorLife.org	LIFE Beaver-Medicare only (PACE)	08	20		1			H7660	002	0	2012	LIFE Beaver County		2		2			2							www.lutheranseniorlife.org	www.lutheranseniorlife.org									(724)-378-5400		(724)-378-5400		(724)-378-5400		(724)-378-5400										(724)-378-5400		(724)-378-5400		(724)-378-5400		(724)-378-5400				
H7678	001	0	1	01	01	H7678_001_0	8	1	2	07/28/2011	2012.02	07/28/2011 11:30:38 AM Pacific Daylight Time	08/05/2011 09:48:00 AM Pacific Daylight Time	08/04/2011 02:08:00 PM Pacific Daylight Time		08/05/2011 02:51:40 PM Pacific Daylight Time	MOLINA HEALTHCARE OF TEXAS, INC.	Molina Healthcare of Texas, Inc.	www.molinamedicare.com	Molina Medicare Options Plus (HMO SNP)	01	01		1			H7678	001	0	2012	Bexar/Collin/Dallas/Harris		2		2			1	3		1	1		www.molinamedicare.com	www.molinamedicare.com	www.molinamedicare.com	(866)-440-0012		(866)-440-0012		(866)-403-8293		(866)-403-8293		(866)-440-0012		(866)-440-0012		(866)-403-8293		(866)-403-8293		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		2	2	2
H7678	002	0	1	01	01	H7678_002_0	8	1		07/28/2011	2012.02	07/28/2011 11:30:50 AM Pacific Daylight Time	08/04/2011 10:59:00 AM Pacific Daylight Time	08/04/2011 02:09:00 PM Pacific Daylight Time		08/05/2011 02:51:40 PM Pacific Daylight Time	MOLINA HEALTHCARE OF TEXAS, INC.	Molina Healthcare of Texas, Inc.	www.molinamedicare.com	Molina Medicare Options (HMO)	01	01		1			H7678	002	0	2012	Bexar/Collin/Dallas/Harris		2		2			2						www.molinamedicare.com	www.molinamedicare.com	www.molinamedicare.com	(866)-440-0012		(866)-440-0012		(866)-403-8293		(866)-403-8293		(866)-440-0012		(866)-440-0012		(866)-403-8293		(866)-403-8293		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		2	2	2
H7731	001	0	1	01	01	H7731_001_0	12	1		08/08/2011	2012.02	08/08/2011 03:56:04 PM Eastern Daylight Time	08/08/2011 03:55:00 PM Eastern Daylight Time	08/08/2011 03:55:00 PM Eastern Daylight Time		08/08/2011 04:01:27 PM Eastern Daylight Time	MD CARE, INC.	MD Care Healthplan	www.mdcareadvantage.com	Advantage 1 MAPD (HMO)	01	01		1			H7731	001	0	2012	Counties:  LA, OC, RV, SB		2	13057	2			2						www.mdcarehealthplan.com	www.mdcarehealthplan.com	https://www.caremark.com/	(888)-285-9676		(562)-344-3400		(888)-285-9676		(562)-344-3400		(888)-816-7978		(888)-816-7978		(888)-285-9676		(562)-344-3400		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(866)-236-1069		(866)-236-1069		(800)-735-2929		(800)-735-2929		2	2	2
H7731	007	0	1	01	01	H7731_007_0	7	1		07/13/2011	2012.02	07/13/2011 10:40:12 AM Eastern Daylight Time	07/25/2011 02:30:00 PM Eastern Daylight Time			07/25/2011 02:33:00 PM Eastern Daylight Time	MD CARE, INC.	MD Care Healthplan	www.mdcareadvantage.com	Advantage Select MA (HMO)	01	01		1			H7731	007	0	2012	Counties:  LA, OC, RV, SB		2	230	2			2						www.mdcarehealthplan.com	www.mdcarehealthplan.com	https://www.caremark.com/	(888)-285-9676		(562)-344-3400		(888)-285-9676		(562)-344-3400										(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929										2	2	2
H7731	008	0	1	01	01	H7731_008_0	8	1	2	08/02/2011	2012.02	08/02/2011 06:29:34 AM Eastern Daylight Time	08/08/2011 03:55:00 PM Eastern Daylight Time	08/08/2011 03:55:00 PM Eastern Daylight Time		08/08/2011 04:01:27 PM Eastern Daylight Time	MD CARE, INC.	MD Care Healthplan	www.mdcareadvantage.com	Preferred Dual SNP (HMO SNP)	01	01		1			H7731	008	0	2012	Counties:  LA, OC, RV, SB		2	5226	2			1	3		1	3		www.mdcarehealthplan.com	www.mdcarehealthplan.com	https://www.caremark.com/	(888)-285-9676		(562)-344-3400		(888)-285-9676		(562)-344-3400		(888)-816-7978		(888)-816-7978		(888)-285-9676		(562)-344-3400		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(866)-236-1069		(866)-236-1069		(800)-735-2929		(800)-735-2929		2	2	2
H7787	001	0	1	04	01	H7787_001_0	7	1		08/08/2011	2012.02	08/08/2011 10:52:03 AM Central Daylight Time	08/05/2011 02:49:19 PM Central Daylight Time	08/04/2011 05:50:08 PM Central Daylight Time		08/08/2011 06:14:25 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Medicare Advantage PPO	www.healthspring.com	HealthyAdvantage Preferred DFW (PPO)	01	04		1			H7787	001	0	2012	North Texas		2		2			2						www.healthspring.com	www.healthspring.com	www.healthspring.com	(888)-501-1120		(888)-501-1120		(800)-846-4896		(800)-846-4896		(800)-331-6293		(800)-331-6293		(800)-331-6293		(800)-331-6293		(877)-893-1504		(877)-893-1504		(877)-893-1504		(877)-893-1504		(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230		2	2	2
H7787	002	0	1	04	01	H7787_002_0	2	1		07/19/2011	2012.02	07/19/2011 11:28:16 AM Central Daylight Time	05/27/2011 03:03:41 PM Central Daylight Time			07/20/2011 06:58:50 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Medicare Advantage PPO	www.healthspring.com	HealthyAdvantage (PPO)	01	04		1			H7787	002	0	2012	North Texas		2		2			2						www.healthspring.com	www.healthspring.com	www.healthspring.com	(888)-501-1120		(888)-501-1120		(800)-846-4896		(800)-846-4896										(877)-893-1504		(877)-893-1504		(877)-893-1504		(877)-893-1504										2	2	2
H7787	004	0	1	04	01	H7787_004_0	7	1		08/08/2011	2012.02	08/08/2011 05:05:19 PM Central Daylight Time	08/05/2011 02:50:32 PM Central Daylight Time	08/04/2011 05:50:55 PM Central Daylight Time		08/08/2011 07:14:27 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Medicare Advantage PPO	www.healthspring.com	HealthyAdvantage Preferred (PPO)	01	04		1			H7787	004	0	2012	North Texas		2		2			2						www.healthspring.com	www.healthspring.com	www.healthspring.com	(888)-501-1120		(888)-501-1120		(800)-846-4896		(800)-846-4896		(800)-331-6293		(800)-331-6293		(800)-331-6293		(800)-331-6293		(877)-893-1504		(877)-893-1504		(877)-893-1504		(877)-893-1504		(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230		2	2	2
H7908	001	0	1	01	01	H7908_001_0	5	1		07/12/2011	2012.02	07/12/2011 03:34:07 PM Central Daylight Time	08/04/2011 02:26:35 PM Central Daylight Time	08/04/2011 10:13:20 AM Central Daylight Time		08/08/2011 07:54:55 AM Central Daylight Time	AETNA HEALTH	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Select Plan (HMO)	01	01		1			H7908	001	0	2012	Clark County		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H7908	801	0	1	01	01	H7908_801_0	1	1		04/22/2011	2012.02	04/22/2011 10:14:27 AM Eastern Daylight Time	06/01/2011 01:56:21 PM Eastern Daylight Time			06/03/2011 10:51:30 AM Eastern Daylight Time	AETNA HEALTH	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan (HMO)	01	01		1			H7908	801	0	2012	Nevada		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748										1	1	1
H7908	802	0	1	01	01	H7908_802_0	1	1		04/25/2011	2012.02	04/25/2011 04:44:34 PM Eastern Daylight Time	06/01/2011 01:51:21 PM Eastern Daylight Time			06/03/2011 10:51:30 AM Eastern Daylight Time	AETNA HEALTH	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan w/Rx CY (HMO)	01	01		1			H7908	802	0	2012	Nevada		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		1	1	1
H7917	008	0	1	04	01	H7917_008_0	7	1		08/05/2011	2012.02	08/05/2011 10:13:07 AM Eastern Daylight Time	08/05/2011 03:56:20 PM Eastern Daylight Time	08/05/2011 03:56:26 PM Eastern Daylight Time		08/08/2011 03:28:15 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	BlueAdvantage Diamond (PPO)	01	04		1			H7917	008	0	2012	West Tennessee		2	1184	1	1		2						www.bcbst-medicare.com	http://www.medicareplanrx.com/MedicationPricingTool/planInfo.do?clientId=74regionId=1year=2011con	http://www.medicareplanrx.com/PharmacyLocator/?contractID=H7917lang=enyear=2011	(800)-841-7434		(800)-841-7434		(800)-292-5146		(800)-292-5146		(800)-841-7434		(800)-841-7434		(800)-292-5146		(800)-292-5146		(888)-423-9490		(888)-423-9490		(877)-664-6422		(877)-664-6422		(888)-423-9490		(888)-423-9490		(877)-664-6422		(877)-664-6422		2	2	2
H7917	009	0	1	04	01	H7917_009_0	6	1		08/08/2011	2012.02	08/08/2011 03:22:32 PM Eastern Daylight Time	08/05/2011 03:56:39 PM Eastern Daylight Time	08/05/2011 03:56:46 PM Eastern Daylight Time		08/08/2011 03:30:40 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	BlueAdvantage Diamond (PPO)	01	04		1			H7917	009	0	2012	Middle Tennessee		2	3818	1	1		2						www.bcbst-medicare.com	http://www.medicareplanrx.com/MedicationPricingTool/planInfo.do?clientId=74regionId=1year=2011con	http://www.medicareplanrx.com/PharmacyLocator/?contractID=H7917lang=enyear=2011	(800)-841-7434		(800)-841-7434		(800)-292-5146		(800)-292-5146		(800)-841-7434		(800)-841-7434		(800)-292-5146		(800)-292-5146		(888)-423-9490		(888)-423-9490		(877)-664-6422		(877)-664-6422		(888)-423-9490		(888)-423-9490		(877)-664-6422		(877)-664-6422		2	2	2
H7917	010	0	1	04	01	H7917_010_0	6	1		07/07/2011	2012.02	07/07/2011 12:21:29 AM Eastern Daylight Time	08/05/2011 03:56:56 PM Eastern Daylight Time	08/05/2011 03:57:02 PM Eastern Daylight Time		08/08/2011 03:32:49 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	BlueAdvantage Diamond (PPO)	01	04		1			H7917	010	0	2012	Southeast Tennessee		2	4270	1	1		2						www.bcbst-medicare.com	http://www.medicareplanrx.com/MedicationPricingTool/planInfo.do?clientId=74regionId=1year=2011con	http://www.medicareplanrx.com/PharmacyLocator/?contractID=H7917lang=enyear=2011	(800)-841-7434		(800)-841-7434		(800)-292-5146		(800)-292-5146		(800)-841-7434		(800)-841-7434		(800)-292-5146		(800)-292-5146		(888)-423-9490		(888)-423-9490		(877)-664-6422		(877)-664-6422		(888)-423-9490		(888)-423-9490		(877)-664-6422		(877)-664-6422		2	2	2
H7917	011	0	1	04	01	H7917_011_0	6	1		07/12/2011	2012.02	07/12/2011 05:49:48 PM Eastern Daylight Time	08/05/2011 03:57:14 PM Eastern Daylight Time	08/05/2011 03:57:19 PM Eastern Daylight Time		08/08/2011 03:34:20 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	BlueAdvantage Diamond (PPO)	01	04		1			H7917	011	0	2012	Northeast Tennessee		2	6771	1	1		2						www.bcbst-medicare.com	http://www.medicareplanrx.com/MedicationPricingTool/planInfo.do?clientId=74regionId=1year=2011con	http://www.medicareplanrx.com/PharmacyLocator/?contractID=H7917lang=enyear=2011	(800)-841-7434		(800)-841-7434		(800)-292-5146		(800)-292-5146		(800)-841-7434		(800)-841-7434		(800)-292-5146		(800)-292-5146		(888)-423-9490		(888)-423-9490		(877)-664-6422		(877)-664-6422		(888)-423-9490		(888)-423-9490		(877)-664-6422		(877)-664-6422		2	2	2
H7917	012	0	1	04	01	H7917_012_0	6	1		07/07/2011	2012.02	07/07/2011 12:18:38 AM Eastern Daylight Time	08/05/2011 03:57:29 PM Eastern Daylight Time	08/05/2011 03:57:33 PM Eastern Daylight Time		08/08/2011 03:36:41 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	BlueAdvantage Ruby (PPO)	01	04		1			H7917	012	0	2012	West Tennessee		2	867	1	1		2						www.bcbst-medicare.com	http://www.medicareplanrx.com/MedicationPricingTool/planInfo.do?clientId=74regionId=1year=2011con	http://www.medicareplanrx.com/PharmacyLocator/?contractID=H7917lang=enyear=2011	(800)-841-7434		(800)-841-7434		(800)-292-5146		(800)-292-5146		(800)-841-7434		(800)-841-7434		(800)-292-5146		(800)-292-5146		(888)-423-9490		(888)-423-9490		(877)-664-6422		(877)-664-6422		(888)-423-9490		(888)-423-9490		(877)-664-6422		(877)-664-6422		2	2	2
H7917	013	0	1	04	01	H7917_013_0	6	1		07/12/2011	2012.02	07/12/2011 05:50:15 PM Eastern Daylight Time	08/05/2011 03:57:42 PM Eastern Daylight Time	08/05/2011 03:57:57 PM Eastern Daylight Time		08/08/2011 03:38:59 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	BlueAdvantage Ruby (PPO)	01	04		1			H7917	013	0	2012	Middle Tennessee		2	2597	1	1		2						www.bcbst-medicare.com	http://www.medicareplanrx.com/MedicationPricingTool/planInfo.do?clientId=74regionId=1year=2011con	http://www.medicareplanrx.com/PharmacyLocator/?contractID=H7917lang=enyear=2011	(800)-841-7434		(800)-841-7434		(800)-292-5146		(800)-292-5146		(800)-841-7434		(800)-841-7434		(800)-292-5146		(800)-292-5146		(888)-423-9490		(888)-423-9490		(877)-664-6422		(877)-664-6422		(888)-423-9490		(888)-423-9490		(877)-664-6422		(877)-664-6422		2	2	2
H7917	014	0	1	04	01	H7917_014_0	6	1		07/12/2011	2012.02	07/12/2011 05:50:24 PM Eastern Daylight Time	08/05/2011 03:58:08 PM Eastern Daylight Time	08/05/2011 03:58:14 PM Eastern Daylight Time		08/08/2011 03:40:34 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	BlueAdvantage Ruby (PPO)	01	04		1			H7917	014	0	2012	Southeast Tennessee		2	8170	1	1		2						www.bcbst-medicare.com	http://www.medicareplanrx.com/MedicationPricingTool/planInfo.do?clientId=74regionId=1year=2011con	http://www.medicareplanrx.com/PharmacyLocator/?contractID=H7917lang=enyear=2011	(800)-841-7434		(800)-841-7434		(800)-292-5146		(800)-292-5146		(800)-841-7434		(800)-841-7434		(800)-292-5146		(800)-292-5146		(888)-423-9490		(888)-423-9490		(877)-664-6422		(877)-664-6422		(888)-423-9490		(888)-423-9490		(877)-664-6422		(877)-664-6422		2	2	2
H7917	015	0	1	04	01	H7917_015_0	6	1		07/12/2011	2012.02	07/12/2011 05:50:52 PM Eastern Daylight Time	08/05/2011 03:58:27 PM Eastern Daylight Time	08/05/2011 03:58:36 PM Eastern Daylight Time		08/08/2011 03:42:28 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	BlueAdvantage Ruby (PPO)	01	04		1			H7917	015	0	2012	Northeast Tennessee		2	1650	1	1		2						www.bcbst-medicare.com	http://www.medicareplanrx.com/MedicationPricingTool/planInfo.do?clientId=74regionId=1year=2011con	http://www.medicareplanrx.com/PharmacyLocator/?contractID=H7917lang=enyear=2011	(800)-841-7434		(800)-841-7434		(800)-292-5146		(800)-292-5146		(800)-841-7434		(800)-841-7434		(800)-292-5146		(800)-292-5146		(888)-423-9490		(888)-423-9490		(877)-664-6422		(877)-664-6422		(888)-423-9490		(888)-423-9490		(877)-664-6422		(877)-664-6422		2	2	2
H7917	030	0	1	04	01	H7917_030_0	6	1		08/08/2011	2012.02	08/08/2011 03:18:56 PM Eastern Daylight Time	08/05/2011 03:58:58 PM Eastern Daylight Time	08/05/2011 03:59:05 PM Eastern Daylight Time		08/08/2011 03:44:29 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	BlueAdvantage Sapphire (PPO)	01	04		1			H7917	030	0	2012	Southeast Tennessee		2	3002	1	1		2						www.bcbst-medicare.com	http://www.medicareplanrx.com/MedicationPricingTool/planInfo.do?clientId=74regionId=1year=2011con	http://www.medicareplanrx.com/PharmacyLocator/?contractID=H7917lang=enyear=2011	(800)-841-7434		(800)-841-7434		(800)-292-5146		(800)-292-5146		(800)-841-7434		(800)-841-7434		(800)-292-5146		(800)-292-5146		(888)-423-9490		(888)-423-9490		(877)-664-6422		(877)-664-6422		(888)-423-9490		(888)-423-9490		(877)-664-6422		(877)-664-6422		2	2	2
H7917	031	0	1	04	01	H7917_031_0	7	1		08/08/2011	2012.02	08/08/2011 03:19:37 PM Eastern Daylight Time	08/05/2011 03:59:15 PM Eastern Daylight Time	08/05/2011 03:59:25 PM Eastern Daylight Time		08/08/2011 03:47:03 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	BlueAdvantage Sapphire (PPO)	01	04		1			H7917	031	0	2012	Northeast Tennessee		2	1274	1	1		2						www.bcbst-medicare.com	http://www.medicareplanrx.com/MedicationPricingTool/planInfo.do?clientId=74regionId=1year=2011con	http://www.medicareplanrx.com/PharmacyLocator/?contractID=H7917lang=enyear=2011	(800)-841-7434		(800)-841-7434		(800)-292-5146		(800)-292-5146		(800)-841-7434		(800)-841-7434		(800)-292-5146		(800)-292-5146		(888)-423-9490		(888)-423-9490		(877)-664-6422		(877)-664-6422		(888)-423-9490		(888)-423-9490		(877)-664-6422		(877)-664-6422		2	2	2
H7917	032	0	1	04	01	H7917_032_0	6	1		08/08/2011	2012.02	08/08/2011 03:18:43 PM Eastern Daylight Time	08/05/2011 03:59:45 PM Eastern Daylight Time	08/05/2011 03:59:50 PM Eastern Daylight Time		08/08/2011 03:49:33 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	BlueAdvantage Garnet (PPO)	01	04		1			H7917	032	0	2012	Middle Trennessee		2	776	2			2						www.bcbst-medicare.com	http://www.medicareplanrx.com/MedicationPricingTool/planInfo.do?clientId=74regionId=1year=2011con	http://www.medicareplanrx.com/PharmacyLocator/?contractID=H7917lang=enyear=2011	(800)-841-7434		(800)-841-7434		(800)-292-5146		(800)-292-5146		(800)-841-7434		(800)-841-7434		(800)-292-5146		(800)-292-5146		(888)-423-9490		(888)-423-9490		(877)-664-6422		(877)-664-6422		(888)-423-9490		(888)-423-9490		(877)-664-6422		(877)-664-6422		2	2	2
H7917	033	0	1	04	01	H7917_033_0	6	1		08/08/2011	2012.02	08/08/2011 03:22:46 PM Eastern Daylight Time	08/05/2011 04:00:00 PM Eastern Daylight Time	08/05/2011 04:00:10 PM Eastern Daylight Time		08/08/2011 03:51:25 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	BlueAdvantage Garnet (PPO)	01	04		1			H7917	033	0	2012	West Tennessee		2	677	2			2						www.bcbst-medicare.com	http://www.medicareplanrx.com/MedicationPricingTool/planInfo.do?clientId=74regionId=1year=2011con	http://www.medicareplanrx.com/PharmacyLocator/?contractID=H7917lang=enyear=2011	(800)-841-7434		(800)-841-7434		(800)-292-5146		(800)-292-5146		(800)-841-7434		(800)-841-7434		(800)-292-5146		(800)-292-5146		(888)-423-9490		(888)-423-9490		(877)-664-6422		(877)-664-6422		(888)-423-9490		(888)-423-9490		(877)-664-6422		(877)-664-6422		2	2	2
H7917	801	0	1	04	01	H7917_801_0	5	1		07/28/2011	2012.02	07/28/2011 12:06:48 PM Eastern Daylight Time	05/30/2011 09:32:05 PM Eastern Daylight Time			07/28/2011 12:26:41 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	BlueAdvantage Plus (PPO)	01	04		1			H7917	801	0	2012	22 County Region		1	12	1	1		2						www.bcbst-medicare.com	http://www.medicareplanrx.com/MedicationPricingTool/planInfo.do?clientId=74regionId=1year=2011con	http://www.medicareplanrx.com/PharmacyLocator/?contractID=H7917lang=enyear=2011	(800)-841-7434		(800)-841-7434		(800)-292-5146		(800)-292-5146		(800)-841-7434		(800)-841-7434		(800)-292-5146		(800)-292-5146		(888)-423-9490		(888)-423-9490		(877)-664-6422		(877)-664-6422		(888)-423-9490		(888)-423-9490		(877)-664-6422		(877)-664-6422		2	2	2
H7917	802	0	1	04	01	H7917_802_0	5	1		07/28/2011	2012.02	07/28/2011 12:07:13 PM Eastern Daylight Time	05/30/2011 09:32:18 PM Eastern Daylight Time			07/28/2011 12:29:09 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	BlueAdvantage Plus (PPO)	01	04		1			H7917	802	0	2012	22 County Region		1	12	1	1		2						www.bcbst-medicare.com	http://www.medicareplanrx.com/MedicationPricingTool/planInfo.do?clientId=74regionId=1year=2011con	http://www.medicareplanrx.com/PharmacyLocator/?contractID=H7917lang=enyear=2011	(800)-841-7434		(800)-841-7434		(800)-292-5146		(800)-292-5146		(800)-841-7434		(800)-841-7434		(800)-292-5146		(800)-292-5146		(888)-423-9490		(888)-423-9490		(877)-664-6422		(877)-664-6422		(888)-423-9490		(888)-423-9490		(877)-664-6422		(877)-664-6422		2	2	2
H7917	803	0	1	04	01	H7917_803_0	5	1		07/28/2011	2012.02	07/28/2011 12:07:21 PM Eastern Daylight Time	05/30/2011 09:32:40 PM Eastern Daylight Time			07/28/2011 12:30:54 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	BlueAdvantage (PPO)	01	04		1			H7917	803	0	2012	22 County Region		1	12	1	1		2						www.bcbst-medicare.com	http://www.medicareplanrx.com/MedicationPricingTool/planInfo.do?clientId=74regionId=1year=2011con	http://www.medicareplanrx.com/PharmacyLocator/?contractID=H7917lang=enyear=2011	(800)-841-7434		(800)-841-7434		(800)-292-5146		(800)-292-5146										(888)-423-9490		(888)-423-9490		(877)-664-6422		(877)-664-6422										2	2	2
H7949	001	0	1	01	01	H7949_001_0	7	1		08/08/2011	2012.02	08/08/2011 09:37:06 AM Central Daylight Time	08/05/2011 02:27:34 PM Central Daylight Time	08/05/2011 01:46:14 PM Central Daylight Time		08/09/2011 01:10:07 PM Central Daylight Time	PACIFICARE OF NEVADA, INC.	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	UnitedHealthcare MedicareComplete (HMO)	01	01		1			H7949	001	0	2012	Clark county		2		2			2							www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-525-2086		(888)-525-2086		(800)-274-6648		(800)-274-6648		(888)-525-2086		(888)-525-2086		(800)-274-6648		(800)-274-6648		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H7949	801	0	1	01	01	H7949_801_0	4	1		07/06/2011	2012.02	07/06/2011 04:50:29 PM Central Daylight Time	06/06/2011 04:33:51 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	PACIFICARE OF NEVADA, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H7949	801	0	2012	NV Employer Sponsored Plan Service Area		1		2			2							www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548										(711)		(711)		(711)		(711)										2	2	2
H7949	803	0	1	01	01	H7949_803_0	4	1		07/06/2011	2012.02	07/06/2011 04:50:34 PM Central Daylight Time	06/06/2011 04:34:24 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	PACIFICARE OF NEVADA, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H7949	803	0	2012	NV Employer Sponsored Plan Service Area		1		2			2							www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(800)-610-2660		(800)-610-2660		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H7949	804	0	1	01	01	H7949_804_0	4	1		07/06/2011	2012.02	07/06/2011 04:50:37 PM Central Daylight Time	06/06/2011 04:34:57 PM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	PACIFICARE OF NEVADA, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H7949	804	0	2012	NV Employer Sponsored Plan Service Area		1		2			2							www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8050	001	0	1	02	01	H8050_001_0	8	1		07/13/2011	2012.02	07/13/2011 08:51:00 AM Central Daylight Time	08/05/2011 01:49:44 PM Central Daylight Time	08/05/2011 01:49:30 PM Central Daylight Time		08/05/2011 01:58:10 PM Central Daylight Time	CARILION CLINIC MEDICARE RESOURCES, LLC	Carilion Clinic Medicare Health Plan	www.carilionmedicare.com	Carilion Clinic Medicare Health Plan Gold (HMO-POS)	01	02		1			H8050	001	0	2012	western Virginia		2	1070	2			2							www.carilionmedicare.com	www.carilionmedicare.com	(877)-233-7055		(877)-233-7055		(800)-778-3032		(800)-778-3032		(866)-544-6981		(866)-544-6981		(800)-778-3032		(800)-778-3032		(888)-844-5530		(888)-844-5530		(877)-225-3157		(877)-225-3157		(800)-716-3231		(800)-716-3231		(877)-225-3157		(877)-225-3157		2	2	2
H8050	005	0	1	02	01	H8050_005_0	8	1		07/13/2011	2012.02	07/13/2011 08:51:10 AM Central Daylight Time	08/05/2011 01:49:43 PM Central Daylight Time	08/05/2011 01:49:31 PM Central Daylight Time		08/05/2011 01:58:10 PM Central Daylight Time	CARILION CLINIC MEDICARE RESOURCES, LLC	Carilion Clinic Medicare Health Plan	www.carilionmedicare.com	Carilion Clinic Medicare Health Plan Bronze (HMO-POS)	01	02		1			H8050	005	0	2012	western Virginia		2	1258	2			2							www.carilionmedicare.com	www.carilionmedicare.com	(877)-233-7055		(877)-233-7055		(800)-778-3032		(800)-778-3032		(866)-544-6981		(866)-544-6981		(800)-778-3032		(800)-778-3032		(888)-844-5530		(888)-844-5530		(877)-225-3157		(877)-225-3157		(800)-716-3231		(800)-716-3231		(877)-225-3157		(877)-225-3157		2	2	2
H8050	006	0	1	02	01	H8050_006_0	8	1		07/13/2011	2012.02	07/13/2011 08:51:24 AM Central Daylight Time	08/05/2011 01:49:44 PM Central Daylight Time	08/05/2011 01:49:44 PM Central Daylight Time		08/05/2011 01:58:10 PM Central Daylight Time	CARILION CLINIC MEDICARE RESOURCES, LLC	Carilion Clinic Medicare Health Plan	www.carilionmedicare.com	Carilion Clinic Medicare Health Plan Silver (HMO-POS)	01	02		1			H8050	006	0	2012	western Virginia		2	1258	2			2							www.carilionmedicare.com	www.carilionmedicare.com	(877)-233-7055		(877)-233-7055		(800)-778-3032		(800)-778-3032		(866)-544-6981		(866)-544-6981		(800)-778-3032		(800)-778-3032		(888)-844-5530		(888)-844-5530		(877)-225-3157		(877)-225-3157		(800)-716-3231		(800)-716-3231		(877)-225-3157		(877)-225-3157		2	2	2
H8050	007	0	1	02	01	H8050_007_0	8	1		07/13/2011	2012.02	07/13/2011 08:50:15 AM Central Daylight Time	08/05/2011 01:49:47 PM Central Daylight Time	08/05/2011 01:49:50 PM Central Daylight Time		08/05/2011 01:58:10 PM Central Daylight Time	CARILION CLINIC MEDICARE RESOURCES, LLC	Carilion Clinic Medicare Health Plan	www.carilionmedicare.com	Carilion Clinic Medicare Health Plan Platinum (HMO-POS)	01	02		1			H8050	007	0	2012	western Virginia		2	141	2			2							www.carilionmedicare.com	www.carilionmedicare.com	(877)-233-7055		(877)-233-7055		(800)-778-3032		(800)-778-3032		(866)-544-6981		(866)-544-6981		(800)-778-3032		(800)-778-3032		(888)-844-5530		(888)-844-5530		(877)-225-3157		(877)-225-3157		(800)-716-3231		(800)-716-3231		(877)-225-3157		(877)-225-3157		2	2	2
H8091	001	0	1	04	01	H8091_001_0	7	1		08/05/2011	2012.02	08/05/2011 04:52:22 PM Central Daylight Time	08/05/2011 04:54:11 PM Central Daylight Time	08/08/2011 09:17:34 AM Central Daylight Time		08/08/2011 09:24:37 AM Central Daylight Time	USABLE MUTUAL INSURANCE COMPANY	ARKANSAS BLUE CROSS AND BLUE SHIELD	www.arkansasbluecross.com	Medi-Pak Advantage (PPO)	01	04		1			H8091	001	0	2012	Pulaski County AR		2	1000	2			2						www.arkansasbluecross.com/providers/MedipakAdvantage.aspx	http://www.arkansasbluecross.com	http://www.arkansasbluecross.com	(877)-233-7022		(877)-233-7022		(888)-242-5017		(888)-242-5017		(877)-233-7022		(877)-233-7022		(888)-242-5017		(888)-242-5017		(888)-844-5530		(888)-844-5530		(800)-370-5869		(800)-370-5869		(888)-844-5530		(888)-844-5530		(800)-370-5869		(800)-370-5869		2	2	2
H8096	001	0	1	20	08	H8096_001_0	1	1		05/31/2011	2012.02	05/31/2011 03:14:05 PM Eastern Daylight Time		05/20/2011 04:02:52 PM Eastern Daylight Time		05/31/2011 03:15:54 PM Eastern Daylight Time	CENTRA HEALTH, INC.	Centra PACE	http://www.centrahealth.com/pace-program	Centra PACE - Dual (PACE)	08	20		1			H8096	001	0	2012	Centra PACE - Lynchburg		2		2			2							http:\\www.centrahealth.com	www.centrahealth.com									(888)-316-9540		(434)-200-6516		(888)-316-9540		(434)-200-6516										(434)-200-6516		(434)-200-6516		(434)-200-6516		(434)-200-6516				
H8096	002	0	1	20	08	H8096_002_0	1	1		05/31/2011	2012.02	05/31/2011 03:14:30 PM Eastern Daylight Time		05/20/2011 04:02:53 PM Eastern Daylight Time		05/31/2011 03:15:54 PM Eastern Daylight Time	CENTRA HEALTH, INC.	Centra PACE	http://www.centrahealth.com/pace-program	Centra PACE - Medicare only (PACE)	08	20		1			H8096	002	0	2012	Centra PACE - Lynchburg		2		2			2							http:\\www.centrahealth.com	www.centrahealth.com									(888)-316-9540		(434)-200-6516		(888)-316-9540		(434)-200-6516										(434)-200-6516		(434)-200-6516		(434)-200-6516		(434)-200-6516				
H8098	001	0	1	09	04	H8098_001_0	6	1		08/09/2011	2012.02	08/09/2011 10:37:09 AM Eastern Daylight Time	08/09/2011 01:27:26 PM Eastern Daylight Time	08/09/2011 02:23:37 PM Eastern Daylight Time		08/09/2011 06:43:35 PM Eastern Daylight Time	UNIVERSAL HEALTH CARE INSURANCE COMPANY	Universal Health Care Insurance Company, Inc.	http://www.univhc.com	Any, Any, Any Gold (PFFS)	04	09	1	1			H8098	001	0	2012	National Network PFFS		2		2			2							www.univhc.com/medicare/members/medicare-formulary.php	http://www.univhc.com	(866)-690-4842		(866)-690-4842		(800)-965-7034		(800)-965-7034		(877)-204-8149		(877)-204-8149		(800)-965-7034		(800)-965-7034		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-759-1089		(800)-759-1089		(800)-617-0177		(800)-617-0177		2	2	2
H8098	003	0	1	09	04	H8098_003_0	3	1		06/02/2011	2012.02	06/02/2011 03:39:36 PM Eastern Daylight Time	07/22/2011 04:32:08 PM Eastern Daylight Time			07/22/2011 04:38:56 PM Eastern Daylight Time	UNIVERSAL HEALTH CARE INSURANCE COMPANY	Universal Health Care Insurance Company, Inc.	http://www.univhc.com	Any, Any, Any Gold MA Only (PFFS)	04	09	1	1			H8098	003	0	2012	National Network PFFS		2		2			2							www.univhc.com/medicare/members/medicare-formulary.php	http://www.univhc.com	(866)-690-4842		(866)-690-4842		(800)-965-7034		(800)-965-7034										(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-617-0177										2	2	2
H8098	801	0	1	09	04	H8098_801_0	3	1		06/02/2011	2012.02	06/02/2011 03:39:46 PM Eastern Daylight Time	07/28/2011 12:48:30 PM Eastern Daylight Time			07/28/2011 12:50:22 PM Eastern Daylight Time	UNIVERSAL HEALTH CARE INSURANCE COMPANY	Universal Health Care Insurance Company, Inc.	http://www.univhc.com	Universal EGWP (PFFS)	04	09	1	1			H8098	801	0	2012	National PFFS		1		2			2							www.univhc.com/medicare/members/medicare-formulary.php	http://www.univhc.com	(866)-690-4842		(866)-690-4842		(800)-965-7034		(800)-965-7034		(877)-204-8149		(877)-204-8149		(800)-965-7034		(800)-965-7034		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-617-0177		(800)-759-1089		(800)-759-1089		(800)-617-0177		(800)-617-0177		2	2	2
H8130	001	0	1	01	01	H8130_001_0	4	1	2	08/01/2011	2012.02	08/01/2011 10:52:02 AM Pacific Daylight Time	08/05/2011 09:47:00 AM Pacific Daylight Time	08/04/2011 02:09:00 PM Pacific Daylight Time		08/05/2011 02:51:40 PM Pacific Daylight Time	MOLINA HEALTHCARE OF FLORIDA, INC.	Molina Healthcare of Florida	www.molinamedicare.com	Molina Medicare Options Plus (HMO SNP)	01	01		1			H8130	001	0	2012	Hillsborough/Pinellas/Southern Florida		2		2			1	3		1	5		www.molinamedicare.com	www.molinamedicare.com	www.molinamedicare.com	(866)-553-9494		(866)-553-9494		(866)-403-8293		(866)-403-8293		(866)-553-9494		(866)-553-9494		(866)-403-8293		(866)-403-8293		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		2	2	2
H8130	002	0	1	01	01	H8130_002_0	6	1		08/01/2011	2012.02	08/01/2011 10:52:10 AM Pacific Daylight Time	08/05/2011 11:16:00 AM Pacific Daylight Time	08/04/2011 02:10:00 PM Pacific Daylight Time		08/05/2011 02:51:40 PM Pacific Daylight Time	MOLINA HEALTHCARE OF FLORIDA, INC.	Molina Healthcare of Florida	www.molinamedicare.com	Molina Medicare Options (HMO)	01	01		1			H8130	002	0	2012	Hillsborough/Pinellas/Southern Florida		2		2			2						www.molinamedicare.com	www.molinamedicare.com	www.molinamedicare.com	(866)-553-9494		(866)-553-9494		(866)-403-8293		(866)-403-8293		(866)-553-9494		(866)-553-9494		(866)-403-8293		(866)-403-8293		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		2	2	2
H8145	001	0	1	09	04	H8145_001_0	5	1		08/08/2011	2012.02	08/08/2011 11:57:53 AM Eastern Daylight Time	08/05/2011 05:45:13 PM Eastern Daylight Time	08/04/2011 12:55:24 PM Eastern Daylight Time		08/08/2011 04:32:56 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-001 (PFFS)	04	09	1	1			H8145	001	0	2012	Select Counties in Oklahoma		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	003	0	1	09	04	H8145_003_0	6	1		07/07/2011	2012.02	07/07/2011 04:23:58 PM Eastern Daylight Time	08/05/2011 10:51:42 PM Eastern Daylight Time	08/04/2011 12:55:44 PM Eastern Daylight Time		08/09/2011 08:55:09 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-003 (PFFS)	04	09	1	1			H8145	003	0	2012	Select Counties in Virginia		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	004	0	1	09	04	H8145_004_0	8	1		07/07/2011	2012.02	07/07/2011 04:24:20 PM Eastern Daylight Time	08/05/2011 10:51:29 PM Eastern Daylight Time	08/04/2011 12:56:04 PM Eastern Daylight Time		08/09/2011 08:58:48 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-004 (PFFS)	04	09	1	1			H8145	004	0	2012	Select Counties in Virginia		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	005	0	1	09	04	H8145_005_0	7	1		07/06/2011	2012.02	07/06/2011 01:29:59 PM Eastern Daylight Time	08/04/2011 02:23:51 PM Eastern Daylight Time	08/04/2011 12:56:23 PM Eastern Daylight Time		08/09/2011 09:35:59 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-005 (PFFS)	04	09	1	1			H8145	005	0	2012	Select Counties in Michigan		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	006	0	1	09	04	H8145_006_0	5	1		07/06/2011	2012.02	07/06/2011 01:30:30 PM Eastern Daylight Time	08/04/2011 02:34:32 PM Eastern Daylight Time	08/04/2011 12:56:43 PM Eastern Daylight Time		08/08/2011 03:43:35 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-006 (PFFS)	04	09	1	1			H8145	006	0	2012	Select counties in Wisconsin		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	007	0	1	09	04	H8145_007_0	5	1		07/06/2011	2012.02	07/06/2011 01:30:54 PM Eastern Daylight Time	08/04/2011 02:35:30 PM Eastern Daylight Time	08/04/2011 12:57:05 PM Eastern Daylight Time		08/08/2011 03:43:35 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-007 (PFFS)	04	09	1	1			H8145	007	0	2012	Select county in Wisconsin		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	008	0	1	09	04	H8145_008_0	5	1		07/06/2011	2012.02	07/06/2011 01:31:26 PM Eastern Daylight Time	08/04/2011 02:21:06 PM Eastern Daylight Time	08/04/2011 12:57:24 PM Eastern Daylight Time		08/08/2011 03:50:01 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-008 (PFFS)	04	09	1	1			H8145	008	0	2012	Select Counties in Illinois		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	009	0	1	09	04	H8145_009_0	5	1		07/06/2011	2012.02	07/06/2011 01:32:03 PM Eastern Daylight Time	08/04/2011 02:22:01 PM Eastern Daylight Time	08/04/2011 12:57:44 PM Eastern Daylight Time		08/08/2011 03:50:01 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-009 (PFFS)	04	09	1	1			H8145	009	0	2012	Select Counties in Illinois		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	011	0	1	09	04	H8145_011_0	8	1		07/08/2011	2012.02	07/08/2011 11:24:32 AM Eastern Daylight Time	05/27/2011 02:19:37 PM Eastern Daylight Time	08/04/2011 12:58:02 PM Eastern Daylight Time		08/09/2011 11:01:34 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-011 (PFFS)	04	09	1	1			H8145	011	0	2012	Select Counties in Indiana		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	012	0	1	09	04	H8145_012_0	9	1		07/08/2011	2012.02	07/08/2011 11:24:54 AM Eastern Daylight Time	08/05/2011 10:49:07 PM Eastern Daylight Time	08/04/2011 12:58:21 PM Eastern Daylight Time		08/09/2011 11:01:34 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-012 (PFFS)	04	09	1	1			H8145	012	0	2012	Select Counties in Indiana		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	020	0	1	09	04	H8145_020_0	11	1		07/08/2011	2012.02	07/08/2011 11:25:12 AM Eastern Daylight Time	08/05/2011 10:49:43 PM Eastern Daylight Time	08/04/2011 12:58:46 PM Eastern Daylight Time		08/09/2011 11:01:34 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-020 (PFFS)	04	09	1	1			H8145	020	0	2012	Select Counties in Kentucky		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	021	0	1	09	04	H8145_021_0	6	1		07/08/2011	2012.02	07/08/2011 11:25:38 AM Eastern Daylight Time	08/05/2011 10:49:56 PM Eastern Daylight Time	08/04/2011 12:59:06 PM Eastern Daylight Time		08/08/2011 04:48:50 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-021 (PFFS)	04	09	1	1			H8145	021	0	2012	Select Counties in Kentucky		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	032	0	1	09	04	H8145_032_0	7	1		07/08/2011	2012.02	07/08/2011 12:35:48 PM Eastern Daylight Time	08/05/2011 10:50:07 PM Eastern Daylight Time	08/04/2011 12:59:29 PM Eastern Daylight Time		08/08/2011 03:50:34 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-032 (PFFS)	04	09	1	1			H8145	032	0	2012	Select Counties in Ohio		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	033	0	1	09	04	H8145_033_0	7	1		07/08/2011	2012.02	07/08/2011 12:42:23 PM Eastern Daylight Time	08/08/2011 02:38:20 PM Eastern Daylight Time	08/04/2011 12:59:48 PM Eastern Daylight Time		08/08/2011 03:50:34 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-033 (PFFS)	04	09	1	1			H8145	033	0	2012	Select Counties in Ohio		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	040	0	1	09	04	H8145_040_0	4	1		07/08/2011	2012.02	07/08/2011 12:46:49 PM Eastern Daylight Time	05/27/2011 02:14:10 PM Eastern Daylight Time	08/04/2011 01:00:12 PM Eastern Daylight Time		08/08/2011 03:50:34 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-040 (PFFS)	04	09	1	1			H8145	040	0	2012	Select Counties in Ohio		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	041	0	1	09	04	H8145_041_0	9	1		07/07/2011	2012.02	07/07/2011 04:24:49 PM Eastern Daylight Time	08/05/2011 10:51:55 PM Eastern Daylight Time	08/04/2011 01:00:32 PM Eastern Daylight Time		08/08/2011 07:21:52 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-041 (PFFS)	04	09	1	1			H8145	041	0	2012	Select Counties in Virginia		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	042	0	1	09	04	H8145_042_0	2	1		07/07/2011	2012.02	07/07/2011 04:25:17 PM Eastern Daylight Time	05/27/2011 02:22:30 PM Eastern Daylight Time			07/08/2011 03:09:07 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-042 (PFFS)	04	09	1	1			H8145	042	0	2012	Select Counties in Virginia		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H8145	044	0	1	09	04	H8145_044_0	3	1		07/07/2011	2012.02	07/07/2011 04:25:36 PM Eastern Daylight Time	05/27/2011 02:22:41 PM Eastern Daylight Time			07/08/2011 03:09:07 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-044 (PFFS)	04	09	1	1			H8145	044	0	2012	Select Counties in Virginia		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H8145	049	0	1	09	04	H8145_049_0	8	1		07/11/2011	2012.02	07/11/2011 10:38:55 AM Eastern Daylight Time	08/05/2011 10:48:29 PM Eastern Daylight Time	08/04/2011 01:00:52 PM Eastern Daylight Time		08/08/2011 04:48:50 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-049 (PFFS)	04	09	1	1			H8145	049	0	2012	Select Counties in West Virginia		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	050	0	1	09	04	H8145_050_0	2	1		07/08/2011	2012.02	07/08/2011 11:18:42 AM Eastern Daylight Time	05/27/2011 02:19:00 PM Eastern Daylight Time			07/08/2011 04:18:54 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-050 (PFFS)	04	09	1	1			H8145	050	0	2012	Select Counties in West Virginia		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H8145	051	0	1	09	04	H8145_051_0	6	1		07/08/2011	2012.02	07/08/2011 11:18:55 AM Eastern Daylight Time	08/05/2011 10:48:42 PM Eastern Daylight Time	08/04/2011 01:01:12 PM Eastern Daylight Time		08/08/2011 04:52:31 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-051 (PFFS)	04	09	1	1			H8145	051	0	2012	Select Counties in West Virginia		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	052	0	1	09	04	H8145_052_0	9	1		07/07/2011	2012.02	07/07/2011 04:25:55 PM Eastern Daylight Time	08/05/2011 10:50:36 PM Eastern Daylight Time	08/04/2011 01:01:31 PM Eastern Daylight Time		08/09/2011 10:18:11 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-052 (PFFS)	04	09	1	1			H8145	052	0	2012	Select Counties in Pennsylvania		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	053	0	1	09	04	H8145_053_0	8	1		07/07/2011	2012.02	07/07/2011 04:26:16 PM Eastern Daylight Time	08/05/2011 10:50:52 PM Eastern Daylight Time	08/04/2011 01:01:51 PM Eastern Daylight Time		08/09/2011 09:33:37 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-053 (PFFS)	04	09	1	1			H8145	053	0	2012	Select Counties in Pennsylvania		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	054	0	1	09	04	H8145_054_0	7	1		07/07/2011	2012.02	07/07/2011 04:26:32 PM Eastern Daylight Time	08/05/2011 10:51:06 PM Eastern Daylight Time	08/04/2011 01:02:10 PM Eastern Daylight Time		08/08/2011 07:09:12 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-054 (PFFS)	04	09	1	1			H8145	054	0	2012	Select Counties in Pennsylvania		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	055	0	1	09	04	H8145_055_0	3	1		10/03/2011	2012.02	10/03/2011 04:34:39 PM Eastern Daylight Time	05/27/2011 02:21:27 PM Eastern Daylight Time			10/03/2011 05:06:35 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-055 (PFFS)	04	09	1	1			H8145	055	0	2012	Select Counties in Pennsylvania		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H8145	061	0	1	09	04	H8145_061_0	5	1		07/06/2011	2012.02	07/06/2011 11:30:14 AM Eastern Daylight Time	08/04/2011 09:46:25 AM Eastern Daylight Time	08/04/2011 01:02:32 PM Eastern Daylight Time		08/08/2011 03:20:12 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-061 (PFFS)	04	09	1	1			H8145	061	0	2012	Select Counties in Florida		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	063	0	1	09	04	H8145_063_0	9	1		07/11/2011	2012.02	07/11/2011 09:07:54 AM Eastern Daylight Time	06/01/2011 10:00:36 AM Eastern Daylight Time	08/04/2011 01:02:52 PM Eastern Daylight Time		08/08/2011 03:57:47 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-063 (PFFS)	04	09	1	1			H8145	063	0	2012	Select Counties in North Carolina		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	069	0	1	09	04	H8145_069_0	7	1		07/06/2011	2012.02	07/06/2011 05:08:41 PM Eastern Daylight Time	08/05/2011 11:57:18 AM Eastern Daylight Time	08/04/2011 01:03:12 PM Eastern Daylight Time		08/09/2011 08:57:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-069 (PFFS)	04	09	1	1			H8145	069	0	2012	Select Counties in South Carolina		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	071	0	1	09	04	H8145_071_0	7	1		07/08/2011	2012.02	07/08/2011 10:10:18 AM Eastern Daylight Time	08/05/2011 11:58:47 AM Eastern Daylight Time	08/04/2011 01:03:31 PM Eastern Daylight Time		08/09/2011 08:57:23 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-071 (PFFS)	04	09	1	1			H8145	071	0	2012	Select Counties in South Carolina		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	073	0	1	09	04	H8145_073_0	6	1		06/04/2011	2012.02	06/04/2011 05:33:26 PM Eastern Daylight Time	08/05/2011 09:30:02 AM Eastern Daylight Time	08/04/2011 01:03:51 PM Eastern Daylight Time		08/08/2011 03:48:16 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-073 (PFFS)	04	09	1	1			H8145	073	0	2012	Select counties in Hawaii		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	075	0	1	09	04	H8145_075_0	10	1		07/06/2011	2012.02	07/06/2011 04:05:14 PM Eastern Daylight Time	08/08/2011 09:45:53 AM Eastern Daylight Time	08/04/2011 01:04:10 PM Eastern Daylight Time		08/08/2011 03:35:45 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-075 (PFFS)	04	09	1	1			H8145	075	0	2012	Select Counties in Alabama		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	078	0	1	09	04	H8145_078_0	5	1		07/08/2011	2012.02	07/08/2011 10:10:35 AM Eastern Daylight Time	08/07/2011 04:19:21 PM Eastern Daylight Time	08/04/2011 01:04:33 PM Eastern Daylight Time		08/08/2011 03:49:43 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-078 (PFFS)	04	09	1	1			H8145	078	0	2012	Select Counties in New Mexico		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	079	0	1	09	04	H8145_079_0	10	1		07/11/2011	2012.02	07/11/2011 09:08:27 AM Eastern Daylight Time	08/05/2011 12:00:18 PM Eastern Daylight Time	08/04/2011 01:04:53 PM Eastern Daylight Time		08/08/2011 03:57:47 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-079 (PFFS)	04	09	1	1			H8145	079	0	2012	Select Counties in Georgia		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	080	0	1	09	04	H8145_080_0	11	1		07/11/2011	2012.02	07/11/2011 01:18:09 PM Eastern Daylight Time	08/08/2011 09:43:23 AM Eastern Daylight Time	08/04/2011 01:05:13 PM Eastern Daylight Time		08/09/2011 09:25:58 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-080 (PFFS)	04	09	1	1			H8145	080	0	2012	Select Counties in Tennessee		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	084	0	1	09	04	H8145_084_0	6	1		07/08/2011	2012.02	07/08/2011 10:13:20 AM Eastern Daylight Time	08/07/2011 04:10:06 PM Eastern Daylight Time	08/04/2011 01:05:33 PM Eastern Daylight Time		08/08/2011 03:49:43 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-084 (PFFS)	04	09	1	1			H8145	084	0	2012	Select Counties in Texas		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	087	0	1	09	04	H8145_087_0	8	1		07/06/2011	2012.02	07/06/2011 04:05:31 PM Eastern Daylight Time	08/05/2011 03:59:41 PM Eastern Daylight Time	08/04/2011 01:05:55 PM Eastern Daylight Time		08/08/2011 04:05:26 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-087 (PFFS)	04	09	1	1			H8145	087	0	2012	Select Counties in Mississippi		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	089	0	1	09	04	H8145_089_0	8	1		07/15/2011	2012.02	07/15/2011 01:11:59 PM Eastern Daylight Time	08/05/2011 11:31:46 AM Eastern Daylight Time	08/04/2011 01:06:16 PM Eastern Daylight Time		08/09/2011 10:58:20 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-089 (PFFS)	04	09	1	1			H8145	089	0	2012	Select Counties in Minnesota		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	091	0	1	09	04	H8145_091_0	11	1		07/11/2011	2012.02	07/11/2011 01:20:05 PM Eastern Daylight Time	05/30/2011 10:01:28 AM Eastern Daylight Time	08/04/2011 01:06:39 PM Eastern Daylight Time		08/09/2011 09:25:58 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-091 (PFFS)	04	09	1	1			H8145	091	0	2012	Select Counties in Virginia		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	093	0	1	09	04	H8145_093_0	6	1		07/07/2011	2012.02	07/07/2011 11:09:00 AM Eastern Daylight Time	08/04/2011 03:20:12 PM Eastern Daylight Time	08/04/2011 01:07:02 PM Eastern Daylight Time		08/08/2011 05:41:07 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-093 (PFFS)	04	09	1	1			H8145	093	0	2012	Clackamas, Multnomah and Washington counties		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	095	0	1	09	04	H8145_095_0	7	1		07/08/2011	2012.02	07/08/2011 10:22:40 AM Eastern Daylight Time	08/04/2011 03:30:48 PM Eastern Daylight Time	08/04/2011 01:07:22 PM Eastern Daylight Time		08/08/2011 04:57:01 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-095 (PFFS)	04	09	1	1			H8145	095	0	2012	Select Counties in Montana		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	097	0	1	09	04	H8145_097_0	3	1		07/07/2011	2012.02	07/07/2011 11:09:38 AM Eastern Daylight Time	06/03/2011 02:55:35 PM Eastern Daylight Time			07/08/2011 12:48:42 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-097 (PFFS)	04	09	1	1			H8145	097	0	2012	Select Counties in ID, MT, OR, UT, WA and WY		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H8145	099	0	1	09	04	H8145_099_0	8	1		07/07/2011	2012.02	07/07/2011 11:08:21 AM Eastern Daylight Time	08/04/2011 03:21:44 PM Eastern Daylight Time	08/04/2011 01:07:41 PM Eastern Daylight Time		08/08/2011 05:41:07 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-099 (PFFS)	04	09	1	1			H8145	099	0	2012	Laramie County		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	103	0	1	09	04	H8145_103_0	7	1		07/08/2011	2012.02	07/08/2011 03:00:36 PM Eastern Daylight Time	08/05/2011 09:29:01 AM Eastern Daylight Time	08/04/2011 01:08:01 PM Eastern Daylight Time		08/08/2011 03:48:16 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-103 (PFFS)	04	09	1	1			H8145	103	0	2012	Select Counties in Arizona		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	104	0	1	09	04	H8145_104_0	7	1		07/08/2011	2012.02	07/08/2011 08:47:53 AM Eastern Daylight Time	08/04/2011 03:19:44 PM Eastern Daylight Time	08/04/2011 01:08:20 PM Eastern Daylight Time		08/08/2011 04:29:50 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-104 (PFFS)	04	09	1	1			H8145	104	0	2012	Select Counties in Idaho		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	107	0	1	09	04	H8145_107_0	5	1		07/07/2011	2012.02	07/07/2011 11:06:56 AM Eastern Daylight Time	08/04/2011 03:20:41 PM Eastern Daylight Time	08/04/2011 01:08:41 PM Eastern Daylight Time		08/08/2011 05:44:54 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-107 (PFFS)	04	09	1	1			H8145	107	0	2012	Select Counties in Utah		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	108	0	1	09	04	H8145_108_0	7	1		07/11/2011	2012.02	07/11/2011 01:23:13 PM Eastern Daylight Time	05/30/2011 10:02:00 AM Eastern Daylight Time			07/20/2011 12:25:35 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-108 (PFFS)	04	09	1	1			H8145	108	0	2012	Select Counties in Virginia		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H8145	109	0	1	09	04	H8145_109_0	7	1		07/08/2011	2012.02	07/08/2011 09:05:29 AM Eastern Daylight Time	08/04/2011 03:21:12 PM Eastern Daylight Time	08/04/2011 01:09:01 PM Eastern Daylight Time		08/08/2011 04:29:50 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-109 (PFFS)	04	09	1	1			H8145	109	0	2012	Select Counties in Washington		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	110	0	1	09	04	H8145_110_0	5	1		07/06/2011	2012.02	07/06/2011 01:32:37 PM Eastern Daylight Time	08/04/2011 02:36:25 PM Eastern Daylight Time	08/04/2011 01:09:20 PM Eastern Daylight Time		08/08/2011 03:58:01 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-110 (PFFS)	04	09	1	1			H8145	110	0	2012	Select counties in Wisconsin		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	111	0	1	09	04	H8145_111_0	8	1		07/11/2011	2012.02	07/11/2011 10:53:51 AM Eastern Daylight Time	05/30/2011 10:02:35 AM Eastern Daylight Time			07/11/2011 03:10:38 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-111 (PFFS)	04	09	1	1			H8145	111	0	2012	Select Counties in Alabama		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H8145	112	0	1	09	04	H8145_112_0	6	1		07/08/2011	2012.02	07/08/2011 09:34:10 AM Eastern Daylight Time	06/05/2011 09:37:30 PM Eastern Daylight Time			07/11/2011 09:51:08 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-112 (PFFS)	04	09	1	1			H8145	112	0	2012	Select Counties in Mississippi		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H8145	113	0	1	09	04	H8145_113_0	6	1		07/11/2011	2012.02	07/11/2011 01:24:50 PM Eastern Daylight Time	05/30/2011 10:03:11 AM Eastern Daylight Time			07/11/2011 04:29:33 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-113 (PFFS)	04	09	1	1			H8145	113	0	2012	Select Counties in Tennessee		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H8145	114	0	1	09	04	H8145_114_0	5	1		07/06/2011	2012.02	07/06/2011 12:38:51 PM Eastern Daylight Time	06/01/2011 10:04:38 AM Eastern Daylight Time			07/11/2011 01:58:53 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-114 (PFFS)	04	09	1	1			H8145	114	0	2012	Select Counties in North Carolina		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H8145	115	0	1	09	04	H8145_115_0	3	1		07/11/2011	2012.02	07/11/2011 02:34:18 PM Eastern Daylight Time	06/01/2011 10:03:50 AM Eastern Daylight Time			07/11/2011 04:32:59 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-115 (PFFS)	04	09	1	1			H8145	115	0	2012	Select Counties in South Carolina		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H8145	117	0	1	09	04	H8145_117_0	5	1		07/06/2011	2012.02	07/06/2011 12:39:15 PM Eastern Daylight Time	06/01/2011 10:05:25 AM Eastern Daylight Time			07/11/2011 01:58:53 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-117 (PFFS)	04	09	1	1			H8145	117	0	2012	Select Counties in Georgia		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H8145	120	0	1	09	04	H8145_120_0	4	1		07/20/2011	2012.02	07/20/2011 01:54:33 PM Eastern Daylight Time	06/03/2011 04:16:41 PM Eastern Daylight Time			07/20/2011 02:00:56 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-120 (PFFS)	04	09	1	1			H8145	120	0	2012	Select Counties in AR, CO, KS, MO and OK		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H8145	121	0	1	09	04	H8145_121_0	3	1		06/01/2011	2012.02	06/01/2011 02:31:33 PM Eastern Daylight Time	05/27/2011 04:34:19 PM Eastern Daylight Time			07/08/2011 12:56:21 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-121 (PFFS)	04	09	1	1			H8145	121	0	2012	Select Counties in Illinois Michigan and Wisconsin		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H8145	122	0	1	09	04	H8145_122_0	5	1		08/08/2011	2012.02	08/08/2011 11:58:39 AM Eastern Daylight Time	08/05/2011 05:44:18 PM Eastern Daylight Time	08/04/2011 01:09:38 PM Eastern Daylight Time		08/08/2011 04:32:56 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-122 (PFFS)	04	09	1	1			H8145	122	0	2012	Select Counties in Arkansas		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	123	0	1	09	04	H8145_123_0	5	1		08/08/2011	2012.02	08/08/2011 11:58:45 AM Eastern Daylight Time	08/05/2011 05:44:32 PM Eastern Daylight Time	08/04/2011 01:09:57 PM Eastern Daylight Time		08/08/2011 04:32:56 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-123 (PFFS)	04	09	1	1			H8145	123	0	2012	Select Counties in Colorado		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	124	0	1	09	04	H8145_124_0	6	1		08/08/2011	2012.02	08/08/2011 11:58:52 AM Eastern Daylight Time	08/05/2011 05:44:47 PM Eastern Daylight Time	08/04/2011 01:10:18 PM Eastern Daylight Time		08/08/2011 04:32:56 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-124 (PFFS)	04	09	1	1			H8145	124	0	2012	Select Counties in Kansas		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	125	0	1	09	04	H8145_125_0	6	1		08/08/2011	2012.02	08/08/2011 11:58:59 AM Eastern Daylight Time	08/05/2011 05:45:00 PM Eastern Daylight Time	08/04/2011 01:10:36 PM Eastern Daylight Time		08/08/2011 04:32:56 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-125 (PFFS)	04	09	1	1			H8145	125	0	2012	Select Counties in Missouri		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	126	0	1	09	04	H8145_126_0	2	1		07/11/2011	2012.02	07/11/2011 07:57:54 AM Eastern Daylight Time	05/27/2011 03:50:47 PM Eastern Daylight Time			07/11/2011 09:22:36 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-126 (PFFS)	04	09	1	1			H8145	126	0	2012	Select Counties of Texas		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H8145	127	0	1	09	04	H8145_127_0	6	1		07/07/2011	2012.02	07/07/2011 02:45:53 PM Eastern Daylight Time	08/05/2011 11:34:12 AM Eastern Daylight Time	08/04/2011 01:10:57 PM Eastern Daylight Time		08/09/2011 10:58:20 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-127 (PFFS)	04	09	1	1			H8145	127	0	2012	Carroll County		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	131	0	1	09	04	H8145_131_0	2	1		07/06/2011	2012.02	07/06/2011 01:59:46 PM Eastern Daylight Time	05/27/2011 03:54:18 PM Eastern Daylight Time			07/11/2011 09:22:36 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-131 (PFFS)	04	09	1	1			H8145	131	0	2012	Select Counties in New Mexico		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H8145	135	0	1	09	04	H8145_135_0	2	1		07/08/2011	2012.02	07/08/2011 12:50:51 PM Eastern Daylight Time	05/27/2011 02:19:31 PM Eastern Daylight Time			07/08/2011 03:39:28 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-135 (PFFS)	04	09	1	1			H8145	135	0	2012	Select Counties in Ohio		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H8145	138	0	1	09	04	H8145_138_0	6	1		07/07/2011	2012.02	07/07/2011 02:45:24 PM Eastern Daylight Time	08/05/2011 11:34:42 AM Eastern Daylight Time	08/04/2011 01:11:17 PM Eastern Daylight Time		08/09/2011 10:58:20 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-138 (PFFS)	04	09	1	1			H8145	138	0	2012	Select Counties in North Dakota		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	139	0	1	09	04	H8145_139_0	6	1		07/07/2011	2012.02	07/07/2011 02:44:50 PM Eastern Daylight Time	08/05/2011 11:35:12 AM Eastern Daylight Time	08/04/2011 01:11:35 PM Eastern Daylight Time		08/09/2011 10:58:20 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-139 (PFFS)	04	09	1	1			H8145	139	0	2012	Select Counties in South Dakota		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8145	140	0	1	09	04	H8145_140_0	4	1		06/06/2011	2012.02	06/06/2011 07:21:58 PM Eastern Daylight Time	06/03/2011 04:06:02 PM Eastern Daylight Time			07/08/2011 04:00:00 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-140 (PFFS)	04	09	1	1			H8145	140	0	2012	Honolulu and Kauai counties		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H8145	150	0	1	09	04	H8145_150_0	3	1		07/11/2011	2012.02	07/11/2011 02:24:07 PM Eastern Daylight Time	06/01/2011 10:07:02 AM Eastern Daylight Time			07/11/2011 04:36:18 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Gold Choice H8145-150 (PFFS)	04	09	1	1			H8145	150	0	2012	Select Counties in South Carolina		2		2			2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H8189	001	0	1	01	01	H8189_001_0	6	1	2	07/29/2011	2012.02	07/29/2011 12:45:49 PM Pacific Daylight Time	08/04/2011 12:41:31 PM Pacific Daylight Time	08/04/2011 12:24:18 PM Pacific Daylight Time		08/05/2011 02:37:22 PM Pacific Daylight Time	MANAGED HEALTH SERVICES, WISCONSIN	Advantage by Managed Health Services	http://advantage.mhswi.com	Advantage by Managed Health Services (HMO SNP)	01	01		1			H8189	001	0	2012	Langlade, Marathon, Milwaukee, Ozaukee, and Taylor		2	342	2			1	3		1	3		https://www.mhswi.com/portal/public/mhs_wi	www.mhswi.com	www.mhswi.com	(888)-713-6180		(888)-713-6180		(888)-713-6180		(888)-713-6180		(888)-713-6180		(888)-713-6180		(888)-713-6180		(888)-713-6180		(800)-446-6136		(800)-446-6136		(800)-446-6136		(800)-446-6136		(800)-446-6136		(800)-446-6136		(800)-446-6136		(800)-446-6136		2	1	2
H8393	001	0	1	04	01	H8393_001_0	9	1		08/08/2011	2012.02	08/08/2011 03:21:59 PM Central Daylight Time	08/08/2011 11:24:28 AM Central Daylight Time	08/04/2011 09:41:25 AM Central Daylight Time		08/09/2011 01:52:46 PM Central Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	http://iowa-nebraska.chcadvantra.com	Advantra Platinum (PPO)	01	04		1			H8393	001	0	2012	Partial State of Nebraska		2	798	2			2						http://iowa-nebraska.chcadvantra.com	http://iowa-nebraska.chcadvantra.com	http://www.medcoonline.com	(866)-901-4692		(866)-901-4692		(877)-886-7564		(877)-886-7564		(800)-707-7052		(800)-707-7052		(877)-886-7564		(877)-886-7564		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8393	801	0	1	04	01	H8393_801_0	3	1		05/26/2011	2012.02	05/26/2011 09:51:12 AM Central Daylight Time	07/25/2011 03:17:49 PM Central Daylight Time			07/27/2011 01:54:18 PM Central Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	http://iowa-nebraska.chcadvantra.com	Advantra Platinum PPO Employee Plan (PPO)	01	04		1			H8393	801	0	2012	Nebraska		1	100	2			2						http://iowa-nebraska.chcadvantra.com	http://iowa-nebraska.chcadvantra.com	http://www.medcoonline.com	(866)-901-4692		(866)-901-4692		(877)-886-8141		(877)-886-8141										(711)		(711)		(711)		(711)										1	1	1
H8393	802	0	1	04	01	H8393_802_0	3	1		05/26/2011	2012.02	05/26/2011 09:51:42 AM Central Daylight Time	07/25/2011 03:26:33 PM Central Daylight Time			07/27/2011 01:54:18 PM Central Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	http://iowa-nebraska.chcadvantra.com	Advantra Platinum PPO Rx CY Employee Plan (PPO)	01	04		1			H8393	802	0	2012	Nebraska		1	100	2			2						http://iowa-nebraska.chcadvantra.com	http://iowa-nebraska.chcadvantra.com	http://www.medcoonline.com	(866)-901-4692		(866)-901-4692		(877)-886-7564		(877)-886-7564		(800)-707-7052		(800)-707-7052		(877)-886-7564		(877)-886-7564		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H8393	803	0	1	04	01	H8393_803_0	3	1		05/26/2011	2012.02	05/26/2011 09:52:13 AM Central Daylight Time	07/25/2011 03:32:17 PM Central Daylight Time			07/27/2011 01:54:18 PM Central Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	http://iowa-nebraska.chcadvantra.com	Advantra Platinum PPO Rx Employee Plan (PPO)	01	04		1			H8393	803	0	2012	Nebraska		1	100	2			2						http://iowa-nebraska.chcadvantra.com	http://iowa-nebraska.chcadvantra.com	http://www.medcoonline.com	(866)-901-4692		(866)-901-4692		(877)-886-7564		(877)-886-7564		(800)-707-7052		(800)-707-7052		(877)-886-7564		(877)-886-7564		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H8424	001	0	1	20	08	H8424_001_0	1	1		05/20/2011	2012.02	05/20/2011 04:33:22 PM Central Daylight Time		05/20/2011 03:59:19 PM Central Daylight Time		05/20/2011 04:56:51 PM Central Daylight Time	SIOUXLAND PACE, INC.	SIOUXLAND PACE, INC.	www.siouxlandpace.org	Siouxland PACE, INC (PACE)	08	20		1			H8424	001	0	2012	Siouxland PACE, INC		2		2			2							www.siouxlandpace.org	www.siouxlandpace.org									(888)-722-3713		(712)-224-7223		(888)-722-3713		(712)-224-7223										(800)-383-4545		(712)-224-7253		(800)-383-4545		(712)-224-7253				
H8424	002	0	1	20	08	H8424_002_0	1	1		05/20/2011	2012.02	05/20/2011 04:33:42 PM Central Daylight Time		05/20/2011 03:59:19 PM Central Daylight Time		05/20/2011 04:56:51 PM Central Daylight Time	SIOUXLAND PACE, INC.	SIOUXLAND PACE, INC.	www.siouxlandpace.org	Siouxland PACE, INC (PACE)	08	20		1			H8424	002	0	2012	Siouxland PACE, INC		2		2			2							www.siouxlandpace.org	www.siouxlandpace.org									(888)-722-3713		(712)-224-7223		(888)-722-3713		(712)-224-7223										(800)-383-4545		(712)-224-7253		(800)-383-4545		(712)-224-7253				
H8468	001	0	1	07	02	H8468_001_0	2	2		05/25/2011	2012.02	05/25/2011 03:09:10 PM Eastern Daylight Time			06/05/2011 04:35:09 PM Eastern Daylight Time	06/06/2011 11:42:55 AM Eastern Daylight Time	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	Geisinger Gold Reserve (MSA)	02	07	2	1			H8468	001	0	2012	Pennsylvania		2		2			2									(800)-498-9731		(570)-271-8771		(800)-514-0138		(800)-514-0138										(711)		(711)		(711)		(711)												
H8552	001	0	1	04	01	H8552_001_0	7	1		08/08/2011	2012.02	08/08/2011 12:27:06 PM Eastern Daylight Time	08/08/2011 07:57:18 PM Eastern Daylight Time	08/08/2011 02:06:25 PM Eastern Daylight Time		08/08/2011 09:33:59 PM Eastern Daylight Time	ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE CO.	Anthem Blue Cross	www.anthem.com/ca/Medicare	Anthem Medicare Preferred Standard (PPO)	01	04		1			H8552	001	0	2012	Select Counties in California		2	28279	2			2						www.anthem.com/ca/medicare	www.anthem.com	www.anthem.com	(877)-811-3107		(877)-811-3107		(800)-797-6438		(800)-797-6438		(877)-811-3107		(877)-811-3107		(800)-797-6438		(800)-797-6438		(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894		(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894		2	2	2
H8552	002	0	1	04	01	H8552_002_0	7	1		08/08/2011	2012.02	08/08/2011 09:24:50 PM Eastern Daylight Time	08/08/2011 07:57:29 PM Eastern Daylight Time	08/08/2011 02:06:35 PM Eastern Daylight Time		08/08/2011 09:33:59 PM Eastern Daylight Time	ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE CO.	Anthem Blue Cross	www.anthem.com/ca/Medicare	Anthem Medicare Preferred Standard (PPO)	01	04		1			H8552	002	0	2012	Select Counties in California		2	5761	2			2						www.anthem.com/ca/medicare	www.anthem.com	www.anthem.com	(877)-811-3107		(877)-811-3107		(800)-797-6438		(800)-797-6438		(877)-811-3107		(877)-811-3107		(800)-797-6438		(800)-797-6438		(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894		(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894		2	2	2
H8552	003	0	1	04	01	H8552_003_0	8	1		08/08/2011	2012.02	08/08/2011 09:22:56 PM Eastern Daylight Time	08/08/2011 07:57:41 PM Eastern Daylight Time	08/08/2011 02:06:44 PM Eastern Daylight Time		08/08/2011 09:33:59 PM Eastern Daylight Time	ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE CO.	Anthem Blue Cross	www.anthem.com/ca/Medicare	Anthem Medicare Preferred Standard (PPO)	01	04		1			H8552	003	0	2012	Select Counties in California		2	134	2			2						www.anthem.com/ca/medicare	www.anthem.com	www.anthem.com	(877)-811-3107		(877)-811-3107		(800)-797-6438		(800)-797-6438		(877)-811-3107		(877)-811-3107		(800)-797-6438		(800)-797-6438		(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894		(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894		2	2	2
H8552	005	0	1	04	01	H8552_005_0	8	1		08/08/2011	2012.02	08/08/2011 09:23:07 PM Eastern Daylight Time	08/08/2011 07:57:49 PM Eastern Daylight Time	08/08/2011 02:07:16 PM Eastern Daylight Time		08/08/2011 09:33:59 PM Eastern Daylight Time	ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE CO.	Anthem Blue Cross	www.anthem.com/ca/Medicare	Anthem Medicare Preferred Standard (PPO)	01	04		1			H8552	005	0	2012	Select Counties in California		2	178	2			2						www.anthem.com/ca/medicare	www.anthem.com	www.anthem.com	(877)-811-3107		(877)-811-3107		(800)-797-6438		(800)-797-6438		(877)-811-3107		(877)-811-3107		(800)-797-6438		(800)-797-6438		(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894		(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894		2	2	2
H8552	801	0	1	04	01	H8552_801_0	7	1		07/12/2011	2012.02	07/12/2011 09:24:14 AM Eastern Daylight Time	07/22/2011 11:46:02 AM Eastern Daylight Time			07/22/2011 01:57:05 PM Eastern Daylight Time	ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE CO.	Anthem Blue Cross	www.anthem.com/ca/Medicare	Anthem Medicare Preferred (PPO)	01	04		1			H8552	801	0	2012	California		1	2429	2			2						www.anthem.com/ca/medicare	www.anthem.com	www.anthem.com	(877)-411-1640		(877)-411-1640		(877)-411-1647		(877)-411-1647		(877)-411-1640		(877)-411-1640		(877)-411-1647		(877)-411-1647		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		2	2	2
H8552	802	0	1	04	01	H8552_802_0	5	1		07/12/2011	2012.02	07/12/2011 09:24:42 AM Eastern Daylight Time	07/22/2011 11:46:03 AM Eastern Daylight Time			07/22/2011 01:57:05 PM Eastern Daylight Time	ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE CO.	Anthem Blue Cross	www.anthem.com/ca/Medicare	Anthem Medicare Preferred (PPO)	01	04		1			H8552	802	0	2012	California		1	50	2			2						www.anthem.com/ca/medicare	www.anthem.com	www.anthem.com	(877)-411-1640		(877)-411-1640		(877)-411-1647		(877)-411-1647										(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657										2	2	2
H8552	803	0	1	04	01	H8552_803_0	5	1		07/12/2011	2012.02	07/12/2011 09:25:29 AM Eastern Daylight Time	07/22/2011 11:46:03 AM Eastern Daylight Time			07/22/2011 01:57:05 PM Eastern Daylight Time	ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE CO.	Anthem Blue Cross	www.anthem.com/ca/Medicare	Anthem Medicare Preferred (PPO)	01	04		1			H8552	803	0	2012	California		1	50	2			2						www.anthem.com/ca/medicare	www.anthem.com	www.anthem.com	(877)-411-1640		(877)-411-1640		(877)-411-1647		(877)-411-1647		(877)-411-1640		(877)-411-1640		(877)-411-1647		(877)-411-1647		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		2	2	2
H8552	804	0	1	04	01	H8552_804_0	5	1		07/12/2011	2012.02	07/12/2011 09:25:56 AM Eastern Daylight Time	07/22/2011 11:46:04 AM Eastern Daylight Time			07/22/2011 01:57:05 PM Eastern Daylight Time	ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE CO.	Anthem Blue Cross	www.anthem.com/ca/Medicare	Anthem Medicare Preferred (PPO)	01	04		1			H8552	804	0	2012	California		1	50	2			2						www.anthem.com/ca/medicare	www.anthem.com	www.anthem.com	(877)-411-1640		(877)-411-1640		(877)-411-1647		(877)-411-1647										(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657										2	2	2
H8558	002	0	1	04	01	H8558_002_0	9	1		08/05/2011	2012.02	08/05/2011 10:29:10 AM Central Daylight Time	08/04/2011 01:59:41 PM Central Daylight Time	08/04/2011 10:29:42 AM Central Daylight Time		08/07/2011 07:53:12 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Plus Plan (PPO)	01	04		1			H8558	002	0	2012	Montana		2	38	2			2						http://www.sterlinghealth.com	http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-839-9079		(888)-839-9079		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H8558	012	0	1	04	01	H8558_012_0	7	1		08/05/2011	2012.02	08/05/2011 10:29:11 AM Central Daylight Time	08/04/2011 02:02:15 PM Central Daylight Time	08/04/2011 10:30:23 AM Central Daylight Time		08/07/2011 07:53:12 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Plus Plan (PPO)	01	04		1			H8558	012	0	2012	Washington		2	52	2			2						http://www.sterlinghealth.com	http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-839-9079		(888)-839-9079		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H8558	013	0	1	04	01	H8558_013_0	7	1		08/05/2011	2012.02	08/05/2011 10:29:11 AM Central Daylight Time	08/04/2011 02:03:31 PM Central Daylight Time	08/04/2011 10:30:45 AM Central Daylight Time		08/07/2011 07:53:12 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	http://www.sterlinghealth.com	WindsorSterling Gold Plus Plan (PPO)	01	04		1			H8558	013	0	2012	Idaho		2	1	2			2						http://www.sterlinghealth.com	http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-839-9079		(888)-839-9079		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H8578	001	0	1	01	01	H8578_001_0	7	1		07/28/2011	2012.02	07/28/2011 10:00:47 AM Eastern Daylight Time	08/09/2011 04:23:49 PM Eastern Daylight Time	08/09/2011 04:23:51 PM Eastern Daylight Time		08/09/2011 06:11:36 PM Eastern Daylight Time	HEALTH NEW ENGLAND, INC.	Health New England, Inc.	www.hne.com/medicare	HNE Medicare Premium (HMO)	01	01		1			H8578	001	0	2012	Hampden, Hampshire and Franklin Counties		2	3373	2			2						www.hne.com/medicare	www.hne.com	www.hne.com	(877)-443-3314		(413)-787-0010		(877)-443-3314		(413)-787-0010		(800)-546-5677		(800)-546-5677		(800)-546-5677		(800)-546-5677		(800)-439-2370		(800)-439-2370		(800)-439-2370		(800)-439-2370		(866)-706-4757		(866)-706-4757		(866)-706-4757		(866)-706-4757		2	2	2
H8578	003	0	1	01	01	H8578_003_0	5	1		07/19/2011	2012.02	07/19/2011 11:23:19 AM Eastern Daylight Time	06/03/2011 03:44:06 PM Eastern Daylight Time			07/19/2011 12:46:15 PM Eastern Daylight Time	HEALTH NEW ENGLAND, INC.	Health New England, Inc.	www.hne.com/medicare	HNE Medicare Premium No Rx (HMO)	01	01		1			H8578	003	0	2012	Hampden, Hampshire and Franklin Counties		2	140	2			2						www.hne.com/medicare	www.hne.com	www.hne.com	(877)-443-3314		(413)-787-0010		(877)-443-3314		(413)-787-0010										(800)-439-2370		(800)-439-2370		(800)-439-2370		(800)-439-2370										2	2	2
H8578	004	0	1	01	01	H8578_004_0	8	1		07/19/2011	2012.02	07/19/2011 11:23:46 AM Eastern Daylight Time	08/09/2011 04:23:52 PM Eastern Daylight Time	08/09/2011 04:23:53 PM Eastern Daylight Time		08/09/2011 07:41:52 PM Eastern Daylight Time	HEALTH NEW ENGLAND, INC.	Health New England, Inc.	www.hne.com/medicare	HNE Medicare Plus (HMO)	01	01		1			H8578	004	0	2012	Hampden, Hampshire and Franklin Counties		2	625	2			2						www.hne.com/medicare	www.hne.com	www.hne.com	(877)-443-3314		(413)-787-0010		(877)-443-3314		(413)-787-0010		(800)-546-5677		(800)-546-5677		(800)-546-5677		(800)-546-5677		(800)-439-2370		(800)-439-2370		(800)-439-2370		(800)-439-2370		(866)-706-4757		(866)-706-4757		(866)-706-4757		(866)-706-4757		2	2	2
H8578	007	0	1	01	01	H8578_007_0	7	1		07/21/2011	2012.02	07/21/2011 07:18:34 AM Eastern Daylight Time	08/09/2011 04:23:54 PM Eastern Daylight Time	08/09/2011 04:23:55 PM Eastern Daylight Time		08/09/2011 06:11:36 PM Eastern Daylight Time	HEALTH NEW ENGLAND, INC.	Health New England, Inc.	www.hne.com/medicare	HNE Medicare Basic (HMO)	01	01		1			H8578	007	0	2012	Hampden, Hampshire and Franklin Counties		2	539	2			2						www.hne.com/medicare	www.hne.com	www.hne.com	(877)-443-3314		(413)-787-0010		(877)-443-3314		(413)-787-0010		(800)-546-5677		(800)-546-5677		(800)-546-5677		(800)-546-5677		(800)-439-2370		(800)-439-2370		(800)-439-2370		(800)-439-2370		(866)-706-4757		(866)-706-4757		(866)-706-4757		(866)-706-4757		2	2	2
H8578	009	0	1	01	01	H8578_009_0	5	1		07/19/2011	2012.02	07/19/2011 11:24:37 AM Eastern Daylight Time	06/03/2011 03:43:16 PM Eastern Daylight Time			07/19/2011 12:46:15 PM Eastern Daylight Time	HEALTH NEW ENGLAND, INC.	Health New England, Inc.	www.hne.com/medicare	HNE Medicare Basic No Rx (HMO)	01	01		1			H8578	009	0	2012	Hampden, Hampshire and Franklin Counties		2	110	2			2						www.hne.com/medicare	www.hne.com	www.hne.com	(877)-443-3314		(413)-787-0010		(877)-443-3314		(413)-787-0010										(800)-439-2370		(800)-439-2370		(800)-439-2370		(800)-439-2370										2	2	2
H8578	010	0	1	02	01	H8578_010_0	7	1		07/19/2011	2012.02	07/19/2011 11:24:59 AM Eastern Daylight Time	08/09/2011 04:23:56 PM Eastern Daylight Time	08/09/2011 04:23:57 PM Eastern Daylight Time		08/09/2011 06:11:36 PM Eastern Daylight Time	HEALTH NEW ENGLAND, INC.	Health New England, Inc.	www.hne.com/medicare	HNE Medicare Freedom (HMO-POS)	01	02		1			H8578	010	0	2012	Franklin, Hampden, Hampshire		2	194	2			2						www.hne.com/medicare	www.hne.com	www.hne.com	(877)-443-3314		(413)-787-0010		(877)-443-3314		(413)-787-0010		(800)-546-5677		(800)-546-5677		(800)-546-5677		(800)-546-5677		(800)-439-2370		(800)-439-2370		(800)-439-2370		(800)-439-2370		(866)-706-4757		(866)-706-4757		(866)-706-4757		(866)-706-4757		2	2	2
H8578	801	0	1	02	01	H8578_801_0	4	1		06/03/2011	2012.02	06/07/2011 03:40:41 PM Eastern Daylight Time	07/15/2011 12:06:14 PM Eastern Daylight Time			07/18/2011 02:06:49 PM Eastern Daylight Time	HEALTH NEW ENGLAND, INC.	Health New England, Inc.	www.hne.com/medicare	HNE Medicare Employer Group RX (HMO-POS)	01	02		1			H8578	801	0	2012	United States		1	790	2			2						www.hne.com/medicare	www.hne.com	www.hne.com	(877)-443-3314		(413)-787-0010		(877)-443-3314		(413)-787-0010		(800)-546-5677		(800)-546-5677		(800)-546-5677		(800)-546-5677		(800)-439-2370		(800)-439-2370		(800)-439-2370		(800)-439-2370		(866)-706-4757		(866)-706-4757		(866)-706-4757		(866)-706-4757		1	1	2
H8578	802	0	1	02	01	H8578_802_0	4	1		06/03/2011	2012.02	06/03/2011 04:02:05 PM Eastern Daylight Time	07/15/2011 12:06:14 PM Eastern Daylight Time			07/18/2011 02:06:49 PM Eastern Daylight Time	HEALTH NEW ENGLAND, INC.	Health New England, Inc.	www.hne.com/medicare	HNE Medicare Employer Group Calendar (HMO-POS)	01	02		1			H8578	802	0	2012	United States		1	8	2			2						www.hne.com/medicare	www.hne.com	www.hne.com	(877)-443-3314		(413)-787-0010		(877)-443-3314		(413)-787-0010										(800)-439-2370		(800)-439-2370		(800)-439-2370		(800)-439-2370										1	1	2
H8578	803	0	1	02	01	H8578_803_0	4	1		06/02/2011	2012.02	06/03/2011 08:23:42 AM Eastern Daylight Time	07/15/2011 12:06:13 PM Eastern Daylight Time			07/18/2011 02:06:49 PM Eastern Daylight Time	HEALTH NEW ENGLAND, INC.	Health New England, Inc.	www.hne.com/medicare	HNE Medicare Employer Group Non-Calendar (HMO-POS)	01	02		1			H8578	803	0	2012	United States		1	8	2			2						www.hne.com/medicare	www.hne.com	www.hne.com	(877)-443-3314		(413)-787-0010		(877)-443-3314		(413)-787-0010		(800)-546-5677		(800)-546-5677		(800)-546-5677		(800)-546-5677		(800)-439-2370		(800)-439-2370		(800)-439-2370		(800)-439-2370		(866)-706-4757		(866)-706-4757		(866)-706-4757		(866)-706-4757		1	1	2
H8604	001	0	1	04	01	H8604_001_0	8	1		07/27/2011	2012.02	07/27/2011 04:05:12 PM Eastern Daylight Time	08/04/2011 03:27:54 PM Eastern Daylight Time	08/04/2011 03:06:25 PM Eastern Daylight Time		08/05/2011 10:26:34 AM Eastern Daylight Time	THP INSURANCE COMPANY	Health Plan SecureChoice	www.healthplan.org	SecureChoice - Option II (PPO)	01	04		1			H8604	001	0	2012	East Central Ohio		2	40	2			2						www.healthplan.org	www.healthplan.org	www.healthplan.org	(877)-847-7907		(740)-695-7907		(877)-236-2290		(740)-695-7915		(877)-847-7907		(740)-695-7907		(877)-236-2290		(740)-695-7915		(800)-622-3925		(740)-695-7919		(800)-622-3925		(740)-695-7919		(800)-622-3925		(740)-695-7919		(800)-622-3925		(740)-695-7919		2	2	2
H8604	002	0	1	04	01	H8604_002_0	5	1		07/19/2011	2012.02	07/19/2011 12:02:12 PM Eastern Daylight Time	07/14/2011 03:04:33 PM Eastern Daylight Time			07/19/2011 03:35:11 PM Eastern Daylight Time	THP INSURANCE COMPANY	Health Plan SecureChoice	www.healthplan.org	SecureChoice - Option I (PPO)	01	04		1			H8604	002	0	2012	East Central Ohio		2	5	2			2						www.healthplan.org	www.healthplan.org	www.healthplan.org	(877)-847-7907		(740)-695-7907		(877)-236-2290		(740)-695-7915										(800)-622-3925		(740)-695-7919		(800)-622-3925		(740)-695-7919										2	2	2
H8604	003	0	1	04	01	H8604_003_0	8	1		07/22/2011	2012.02	07/22/2011 05:03:28 PM Eastern Daylight Time	08/04/2011 03:30:55 PM Eastern Daylight Time	08/04/2011 03:07:10 PM Eastern Daylight Time		08/05/2011 10:26:34 AM Eastern Daylight Time	THP INSURANCE COMPANY	Health Plan SecureChoice	www.healthplan.org	SecureChoice - Option II (PPO)	01	04		1			H8604	003	0	2012	Eastern Ohio and Northern West Virginia		2	115	2			2						www.healthplan.org	www.healthplan.org	www.healthplan.org	(877)-847-7907		(740)-695-7907		(877)-847-7915		(740)-695-7915		(877)-847-7907		(740)-695-7907		(877)-847-7915		(740)-695-7915		(800)-622-3925		(740)-695-7919		(800)-622-3925		(740)-695-7919		(800)-622-3925		(740)-695-7919		(800)-622-3925		(740)-695-7919		2	2	2
H8604	004	0	1	04	01	H8604_004_0	5	1		07/19/2011	2012.02	07/19/2011 12:02:32 PM Eastern Daylight Time	07/14/2011 03:19:47 PM Eastern Daylight Time			07/19/2011 03:35:11 PM Eastern Daylight Time	THP INSURANCE COMPANY	Health Plan SecureChoice	www.healthplan.org	SecureChoice - Option I (PPO)	01	04		1			H8604	004	0	2012	Eastern Ohio and Northern West Virginia		2	15	2			2						www.healthplan.org	www.healthplan.org	www.healthplan.org	(877)-847-7907		(740)-695-7907		(877)-847-7915		(740)-695-7915										(800)-622-3925		(740)-695-7919		(800)-622-3925		(740)-695-7919										2	2	2
H8604	005	0	1	04	01	H8604_005_0	8	1		07/22/2011	2012.02	07/22/2011 05:03:59 PM Eastern Daylight Time	08/04/2011 03:32:49 PM Eastern Daylight Time	08/04/2011 03:07:51 PM Eastern Daylight Time		08/05/2011 10:26:34 AM Eastern Daylight Time	THP INSURANCE COMPANY	Health Plan SecureChoice	www.healthplan.org	SecureChoice - Option III (PPO)	01	04		1			H8604	005	0	2012	East Central Ohio		2	40	2			2						www.healthplan.org	www.healthplan.org	www.healthplan.org	(877)-847-7907		(740)-695-7907		(877)-236-2290		(740)-695-7915		(877)-847-7907		(740)-695-7907		(877)-236-2290		(740)-695-7915		(800)-622-3925		(740)-695-7919		(800)-622-3925		(740)-695-7919		(800)-622-3925		(740)-695-7919		(800)-622-3925		(740)-695-7919		2	2	2
H8604	006	0	1	04	01	H8604_006_0	8	1		07/22/2011	2012.02	07/22/2011 05:04:23 PM Eastern Daylight Time	08/04/2011 03:42:12 PM Eastern Daylight Time	08/04/2011 03:08:31 PM Eastern Daylight Time		08/05/2011 10:26:34 AM Eastern Daylight Time	THP INSURANCE COMPANY	Health Plan SecureChoice	www.healthplan.org	SecureChoice - Option III (PPO)	01	04		1			H8604	006	0	2012	East Ohio, Northern WV		2	130	2			2						www.healthplan.org	www.healthplan.org	www.healthplan.org	(877)-847-7907		(740)-695-7907		(877)-847-7915		(740)-695-7915		(877)-847-7907		(740)-695-7907		(877)-847-7915		(740)-695-7915		(800)-622-3925		(740)-695-7919		(800)-622-3925		(740)-695-7919		(800)-622-3925		(740)-695-7919		(800)-622-3925		(740)-695-7919		2	2	2
H8604	801	0	1	04	01	H8604_801_0	6	1		07/19/2011	2012.02	07/19/2011 12:03:07 PM Eastern Daylight Time	08/18/2011 09:14:01 AM Eastern Daylight Time			08/18/2011 11:45:16 AM Eastern Daylight Time	THP INSURANCE COMPANY	Health Plan SecureChoice	www.healthplan.org	SecureChoice - Employer (PPO)	01	04		1			H8604	801	0	2012	Eastern Ohio and Northern West Virginia		1	55	2			2						www.healthplan.org	www.healthplan.org	www.healthplan.org	(877)-847-7907		(740)-695-7907		(877)-847-7915		(740)-695-7915		(877)-847-7907		(740)-695-7907		(877)-847-7915		(740)-695-7915		(800)-622-3925		(740)-695-7919		(800)-622-3925		(740)-695-7919		(800)-622-3925		(740)-695-7919		(800)-622-3925		(740)-695-7919		2	2	2
H8604	802	0	1	04	01	H8604_802_0	6	1		07/19/2011	2012.02	07/19/2011 12:03:18 PM Eastern Daylight Time	08/18/2011 09:16:27 AM Eastern Daylight Time			08/18/2011 11:45:16 AM Eastern Daylight Time	THP INSURANCE COMPANY	Health Plan SecureChoice	www.healthplan.org	SecureChoice - Employer (PPO)	01	04		1			H8604	802	0	2012	Eastern Ohio and Northern West Virginia		1	5	2			2						www.healthplan.org	www.healthplan.org	www.healthplan.org	(877)-847-7907		(740)-695-7907		(877)-847-7915		(740)-695-7915										(800)-622-3925		(740)-695-7919		(800)-622-3925		(740)-695-7919										2	2	2
H8644	003	0	1	04	01	H8644_003_0	4	1		08/08/2011	2012.02	08/08/2011 11:57:03 AM Eastern Daylight Time	08/05/2011 05:42:59 PM Eastern Daylight Time	08/04/2011 01:11:57 PM Eastern Daylight Time		08/08/2011 04:32:56 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H8644-003 (PPO)	01	04		1			H8644	003	0	2012	Select Counties in Oklahoma		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8644	005	0	1	04	01	H8644_005_0	5	1		08/08/2011	2012.02	08/08/2011 11:57:40 AM Eastern Daylight Time	08/05/2011 05:46:24 PM Eastern Daylight Time	08/04/2011 01:12:15 PM Eastern Daylight Time		08/08/2011 04:32:56 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H8644-005 (PPO)	01	04		1			H8644	005	0	2012	Select Counties in Oklahoma		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8649	003	0	1	02	01	H8649_003_0	8	1		08/08/2011	2012.02	08/08/2011 12:08:53 PM Mountain Daylight Time	08/08/2011 09:59:05 AM Mountain Daylight Time	08/04/2011 08:18:37 AM Mountain Daylight Time		08/08/2011 03:08:49 PM Mountain Daylight Time	ALTIUS HEALTH PLANS, INC. (UTAH)	Altius Health Plans	www.altiusadvantra.com	Altius Advantra (HMO-POS)	01	02		1			H8649	003	0	2012	Northern Utah		2	3700	2			2						www.altiusadvantra.com	www.altiusadvantra.com	www.altiusadvantra.com	(866)-784-4918		(866)-784-4918		(888)-256-3561		(888)-256-3561		(800)-708-3650		(800)-708-3650		(888)-256-3561		(888)-256-3561		(711)		(711)		(711)		(711)		(800)-716-3231		(800)-716-3231		(711)		(711)		2	2	2
H8649	007	0	1	01	01	H8649_007_0	6	1		08/08/2011	2012.02	08/08/2011 12:09:18 PM Mountain Daylight Time	08/08/2011 10:00:31 AM Mountain Daylight Time	08/04/2011 08:09:04 AM Mountain Daylight Time		08/08/2011 03:08:49 PM Mountain Daylight Time	ALTIUS HEALTH PLANS, INC. (UTAH)	Altius Health Plans	www.altiusadvantra.com	Altius Advantra Preference (HMO)	01	01		1			H8649	007	0	2012	Northern Utah Limited		2	400	2			2						www.altiusadvantra.com	www.altiusadvantra.com	www.altiusadvantra.com	(866)-784-4918		(866)-784-4918		(888)-256-3561		(888)-256-3561		(800)-708-3650		(800)-708-3650		(888)-256-3561		(888)-256-3561		(711)		(711)		(711)		(711)		(800)-716-3231		(800)-716-3231		(711)		(711)		2	2	2
H8649	801	0	1	02	01	H8649_801_0	2	1		05/20/2011	2012.02	05/20/2011 01:55:57 PM Mountain Daylight Time	07/22/2011 10:08:00 AM Mountain Daylight Time			07/28/2011 04:20:39 PM Mountain Daylight Time	ALTIUS HEALTH PLANS, INC. (UTAH)	Altius Health Plans	www.altiusadvantra.com	Altius Advantra Emp Calendar Year (HMO-POS)	01	02		1			H8649	801	0	2012	State of Utah		1	1	2			2						www.altiusadvantra.com	www.altiusadvantra.com	www.altiusadvantra.com	(866)-784-4918		(866)-784-4918		(888)-256-3561		(888)-256-3561		(800)-708-3650		(800)-708-3650		(888)-256-3561		(888)-256-3561		(711)		(711)		(711)		(711)		(800)-716-3231		(800)-716-3231		(711)		(711)		1	1	1
H8649	802	0	1	02	01	H8649_802_0	2	1		05/26/2011	2012.02	05/26/2011 08:32:05 AM Mountain Daylight Time	07/22/2011 10:09:45 AM Mountain Daylight Time			07/28/2011 04:20:39 PM Mountain Daylight Time	ALTIUS HEALTH PLANS, INC. (UTAH)	Altius Health Plans	www.altiusadvantra.com	Altius Advantra Emp Non-Calendar Year (HMO-POS)	01	02		1			H8649	802	0	2012	State of Utah		1	1	2			2						www.altiusadvantra.com	www.altiusadvantra.com	www.altiusadvantra.com	(866)-784-4918		(866)-784-4918		(888)-256-3561		(888)-256-3561		(800)-708-3650		(800)-708-3650		(888)-256-3561		(888)-256-3561		(711)		(711)		(711)		(711)		(800)-716-3231		(800)-716-3231		(711)		(711)		1	1	1
H8649	803	0	1	02	01	H8649_803_0	2	1		05/26/2011	2012.02	05/26/2011 08:33:31 AM Mountain Daylight Time	07/22/2011 10:11:36 AM Mountain Daylight Time			07/28/2011 04:20:39 PM Mountain Daylight Time	ALTIUS HEALTH PLANS, INC. (UTAH)	Altius Health Plans	www.altiusadvantra.com	Altius Advantra Emp MA Only (HMO-POS)	01	02		1			H8649	803	0	2012	State of Utah		1	1	2			2						www.altiusadvantra.com	www.altiusadvantra.com	www.altiusadvantra.com	(866)-784-4918		(866)-784-4918		(888)-256-3561		(888)-256-3561										(711)		(711)		(711)		(711)										1	1	1
H8653	001	0	1	20	08	H8653_001_0	2	1		06/03/2011	2012.02	06/03/2011 08:04:42 AM Eastern Standard Time		06/03/2011 08:00:49 AM Eastern Standard Time		06/03/2011 08:06:21 AM Eastern Standard Time	LIFEPATH HOSPICE, INC.	Chapters Health PACE	www.lifepath-hospice.org	Chapters Health PACE Dual Eligible (PACE)	08	20		1			H8653	001	0	2012	Chapters Health PACE HIllsborough County		2	158	2			2							http://www.lifepath-hospice.org/	http://www.lifepath-hospice.org/									(813)-871-8111	16029	(813)-440-6029		(813)-871-8111	16029	(813)-440-6029										(813)-871-8111	16029	(813)-440-6029		(813)-871-8111	16029	(813)-440-6029				
H8653	002	0	1	20	08	H8653_002_0	2	1		06/03/2011	2012.02	06/03/2011 08:04:51 AM Eastern Standard Time		06/03/2011 08:00:49 AM Eastern Standard Time		06/03/2011 08:06:21 AM Eastern Standard Time	LIFEPATH HOSPICE, INC.	Chapters Health PACE	lifepath-hospice.org	Chapters Health PACE Medicare Only (PACE)	08	20		1			H8653	002	0	2012	Chapters Health PACE Hillsborough County		2	2	2			2							http://www.lifepath-hospice.org/	http://www.lifepath-hospice.org/									(813)-871-8111	16029	(813)-440-6029		(813)-871-8111	18413	(813)-871-8111	18413									(813)-871-8111	16029	(813)-440-6029		(813)-871-8111	18413	(813)-871-8111	18413			
H8655	004	0	1	20	08	H8655_004_0	1	1		05/23/2011	2012.01	05/23/2011 01:14:42 PM Eastern Daylight Time		05/23/2011 07:47:04 AM Eastern Daylight Time		05/23/2011 01:19:30 PM Eastern Daylight Time	RIVERSIDE RETIREMENT SERVICES, INC.	Riverside PACE	www.riversideonline.com	Riverside PACE Dual (PACE)	08	20		1			H8655	004	0	2012	Riverside PACE Dual		2		2			2							N/A - no formulary	www.riversideonline.com									(800)-675-6368		(757)-875-2050		(800)-675-6368		(757)-875-2050										(800)-675-6368		(757)-875-2050		(800)-675-6368		(757)-875-2050				
H8655	005	0	1	20	08	H8655_005_0	1	1		05/23/2011	2012.01	05/23/2011 01:15:12 PM Eastern Daylight Time		05/23/2011 07:47:04 AM Eastern Daylight Time		05/23/2011 01:19:30 PM Eastern Daylight Time	RIVERSIDE RETIREMENT SERVICES, INC.	Riverside PACE	www.riversideonline.com	Riverside PACE Medicare ONLY (PACE)	08	20		1			H8655	005	0	2012	Riverside PACE Medicare ONLY		2		2			2							N/A - no formulary	www.riversideonline.com									(800)-675-6368		(757)-875-2050		(800)-675-6368		(757)-875-2050										(800)-675-6368		(757)-875-2050		(800)-675-6368		(757)-875-2050				
H8684	001	0	1	04	01	H8684_001_0	5	1		07/18/2011	2012.02	07/18/2011 10:14:13 AM Central Daylight Time	08/04/2011 01:38:16 PM Central Daylight Time	08/04/2011 10:14:06 AM Central Daylight Time		08/08/2011 09:51:11 AM Central Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Premier Plan (PPO)	01	04		1			H8684	001	0	2012	New Castle County		2		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		2	2	2
H8684	801	0	1	04	01	H8684_801_0	1	1		05/09/2011	2012.02	05/09/2011 07:38:55 AM Central Daylight Time	06/01/2011 01:11:08 PM Eastern Daylight Time			06/03/2011 10:51:30 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan (PPO)	01	04		1			H8684	801	0	2012	National		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748										1	1	1
H8684	802	0	1	04	01	H8684_802_0	1	1		05/09/2011	2012.02	05/09/2011 07:40:39 AM Central Daylight Time	06/01/2011 01:20:03 PM Eastern Daylight Time			06/03/2011 10:51:30 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Plan w/Rx CY (PPO)	01	04		1			H8684	802	0	2012	National		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		1	1	1
H8684	805	0	2	04	01	H8684_805_0	1	1		04/22/2011	2012.02	04/22/2011 10:16:08 AM Eastern Daylight Time	06/03/2011 08:15:00 AM Eastern Daylight Time			06/03/2011 10:51:30 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Part B Only Plan (PPO)	01	04		2	2		H8684	805	0	2012	National		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748										1	1	1
H8684	806	0	2	04	01	H8684_806_0	1	1		04/22/2011	2012.02	04/22/2011 10:16:28 AM Eastern Daylight Time	06/03/2011 08:25:39 AM Eastern Daylight Time			06/03/2011 10:51:30 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Part B Only Plan w/Rx CY (PPO)	01	04		2	2		H8684	806	0	2012	National		1		2			2						www.AetnaMedicareDocFind.com	www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com	(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(800)-282-5366		(800)-282-5366		(800)-832-2640		(800)-832-2640		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748		1	1	1
H8707	001	0	1	04	01	H8707_001_0	6	1		07/06/2011	2012.02	07/06/2011 03:37:56 PM Eastern Daylight Time	08/05/2011 08:46:19 AM Eastern Daylight Time	08/04/2011 01:12:35 PM Eastern Daylight Time		08/09/2011 09:10:07 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H8707-001 (PPO)	01	04		1			H8707	001	0	2012	Charleston Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8707	003	0	1	04	01	H8707_003_0	7	1		07/08/2011	2012.02	07/08/2011 02:09:48 PM Eastern Daylight Time	05/27/2011 03:06:49 PM Eastern Daylight Time	08/04/2011 01:12:54 PM Eastern Daylight Time		08/09/2011 09:10:07 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H8707-003 (PPO)	01	04		1			H8707	003	0	2012	Spartanburg / Greenville Metro Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8707	005	0	1	04	01	H8707_005_0	7	1		07/08/2011	2012.02	07/08/2011 01:35:38 PM Eastern Daylight Time	05/27/2011 03:09:05 PM Eastern Daylight Time	08/04/2011 01:13:12 PM Eastern Daylight Time		08/09/2011 09:10:07 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H8707-005 (PPO)	01	04		1			H8707	005	0	2012	Richland County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8707	007	0	1	04	01	H8707_007_0	7	1		07/08/2011	2012.02	07/08/2011 02:11:10 PM Eastern Daylight Time	08/05/2011 09:00:07 AM Eastern Daylight Time	08/04/2011 01:13:34 PM Eastern Daylight Time		08/09/2011 09:10:07 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H8707-007 (PPO)	01	04		1			H8707	007	0	2012	Greenville and Spartanburg Counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8748	001	0	1	02	01	H8748_001_0	5	1		08/09/2011	2012.02	08/09/2011 11:12:59 AM Central Daylight Time	08/04/2011 10:25:08 PM Central Daylight Time	08/05/2011 01:46:29 PM Central Daylight Time		08/09/2011 04:41:25 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H8748	001	0	2012	York County		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8748	002	0	1	02	01	H8748_002_0	5	1		08/08/2011	2012.02	08/08/2011 09:50:31 AM Central Daylight Time	08/04/2011 10:25:44 PM Central Daylight Time	08/05/2011 01:46:45 PM Central Daylight Time		08/09/2011 04:41:25 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H8748	002	0	2012	Greenville SC		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8748	003	0	1	02	01	H8748_003_0	5	1		08/08/2011	2012.02	08/08/2011 09:51:52 AM Central Daylight Time	08/04/2011 10:26:31 PM Central Daylight Time	08/05/2011 01:47:01 PM Central Daylight Time		08/09/2011 04:41:25 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H8748	003	0	2012	Beaufort SC		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8748	004	0	1	02	01	H8748_004_0	5	1		08/08/2011	2012.02	08/08/2011 09:52:13 AM Central Daylight Time	08/04/2011 10:27:10 PM Central Daylight Time	08/05/2011 01:47:17 PM Central Daylight Time		08/09/2011 04:53:14 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H8748	004	0	2012	Charleston SC		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8777	001	0	1	20	08	H8777_001_0	1	1		05/23/2011	2012.02	05/23/2011 01:14:19 PM Eastern Daylight Time		05/23/2011 11:43:00 AM Eastern Daylight Time		05/23/2011 01:22:51 PM Eastern Daylight Time	COMPLETE SENIOR CARE	Complete Senior Care	completeseniorcare.org	Complete Senior Care Dual (PACE)	08	20		1			H8777	001	0	2012	Niagara, NY		2		2			2							completeseniorcare.org	completeseniorcare.org									(716)-285-8224	147	(716)-285-8224	147	(716)-285-8224	147	(716)-285-8224	147									(716)-285-8224	147	(716)-285-8224	147	(716)-285-8224	147	(716)-285-8224	147			
H8777	002	0	1	20	08	H8777_002_0	1	1		05/23/2011	2012.02	05/23/2011 01:15:05 PM Eastern Daylight Time		05/23/2011 11:43:00 AM Eastern Daylight Time		05/23/2011 01:22:51 PM Eastern Daylight Time	COMPLETE SENIOR CARE	Complete Senior Care	completeseniorcare.org	Complete Senior Care Medicare Only (PACE)	08	20		1			H8777	002	0	2012	Niagara, NY		2		2			2							completeseniorcare.org	completeseniorcare.org									(716)-285-8224	147	(716)-285-8224	147	(716)-285-8224	147	(716)-285-8224	147									(716)-285-8224	147	(716)-285-8224	147	(716)-285-8224	147	(716)-285-8224	147			
H8800	001	0	1	20	08	H8800_001_0	1	1		05/25/2011	2012.02	05/25/2011 01:10:57 PM Eastern Daylight Time		05/25/2011 10:56:06 AM Eastern Daylight Time		05/25/2011 01:13:47 PM Eastern Daylight Time	TOTAL SENIOR CARE, INC.	Total Senior Care, Inc.	totalseniorcare.org	Total Senior Care - Dual (PACE)	08	20		1			H8800	001	0	2012	Total Senior Care, Inc.		2		2			2							www.totalseniorcare.org	totalseniorcare.org									(866)-939-8613		(716)-379-8474		(866)-939-8613		(716)-379-8474										(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220				
H8800	002	0	1	20	08	H8800_002_0	1	1		05/25/2011	2012.02	05/25/2011 01:11:33 PM Eastern Daylight Time		05/25/2011 10:56:21 AM Eastern Daylight Time		05/25/2011 01:13:47 PM Eastern Daylight Time	TOTAL SENIOR CARE, INC.	Total Senior Care, Inc.	totalseniorcare.org	Total Senior Care - Medicare Small Only (PACE)	08	20		1			H8800	002	0	2012	Total Senior Care, Inc.		2		2			2							www.totalseniorcare.org	totalseniorcare.org									(866)-939-8613		(716)-379-8474		(866)-939-8613		(716)-379-8474										(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220				
H8822	001	0	1	01	01	H8822_001_0	8	1		08/09/2011	2012.02	08/09/2011 01:41:41 PM Eastern Daylight Time	08/09/2011 01:42:46 PM Eastern Daylight Time	08/09/2011 01:42:44 PM Eastern Daylight Time		08/09/2011 02:00:06 PM Eastern Daylight Time	ADVANTAGE HEALTH SOLUTIONS, INC.	ADVANTAGE Health Solutions, Inc.	www.advantageplan.com	Wishard Complete Care Basic (HMO)	01	01		1			H8822	001	0	2012	Marion County		2	515	2			2						www.advantageplan.com	www.advantageplan.com	www.advantageplan.com	(800)-523-7533		(317)-573-7950		(800)-201-8342		(800)-201-8342		(877)-684-0014		(877)-684-0014		(800)-201-8342		(800)-201-8342		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(866)-763-9630		(866)-763-9630		(800)-743-3333		(800)-743-3333		2	2	2
H8822	004	0	1	01	01	H8822_004_0	6	1		08/08/2011	2012.02	08/08/2011 02:04:16 PM Eastern Daylight Time	08/09/2011 12:07:52 PM Eastern Daylight Time	08/09/2011 12:07:32 PM Eastern Daylight Time		08/09/2011 02:00:06 PM Eastern Daylight Time	ADVANTAGE HEALTH SOLUTIONS, INC.	ADVANTAGE Health Solutions, Inc.	www.advantageplan.com	ADVANTAGE Network (HMO)	01	01		1			H8822	004	0	2012	Central Indiana		2	1250	2			2						www.advantageplan.com	www.advantageplan.com	www.advantageplan.com	(800)-523-7533		(317)-573-7950		(800)-201-8342		(800)-201-8342		(877)-684-0014		(877)-684-0014		(800)-201-8342		(800)-201-8342		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(866)-763-9630		(866)-763-9630		(800)-743-3333		(800)-743-3333		2	2	2
H8822	005	0	1	01	01	H8822_005_0	5	1	2	08/09/2011	2012.02	08/09/2011 01:43:28 PM Eastern Daylight Time	08/09/2011 01:42:45 PM Eastern Daylight Time	08/09/2011 01:42:44 PM Eastern Daylight Time		08/09/2011 02:00:06 PM Eastern Daylight Time	ADVANTAGE HEALTH SOLUTIONS, INC.	ADVANTAGE Health Solutions, Inc.	www.advantageplan.com	ADVANTAGE Special Needs Plan (HMO SNP)	01	01		1			H8822	005	0	2012	Central Indiana		2	500	2			1	3		1	2		www.advantageplan.com	www.advantageplan.com	www.advantageplan.com	(800)-523-7533		(317)-573-7950		(800)-201-8342		(800)-201-8342		(877)-684-0014		(877)-684-0014		(800)-201-8342		(800)-201-8342		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(866)-763-9630		(866)-763-9630		(800)-743-3333		(800)-743-3333		2	1	1
H8822	801	0	1	01	01	H8822_801_0	2	1		06/03/2011	2012.02	06/03/2011 08:31:36 AM Eastern Daylight Time	05/27/2011 02:44:47 PM Eastern Daylight Time			06/03/2011 09:20:32 AM Eastern Daylight Time	ADVANTAGE HEALTH SOLUTIONS, INC.	ADVANTAGE Health Solutions, Inc.	www.advantageplan.com	ADVANTAGE Preferred Group (HMO)	01	01		1			H8822	801	0	2012	Indiana		1	1	2			2						www.advantageplan.com	www.advantageplan.com	www.advantageplan.com	(800)-523-7533		(317)-573-7950		(800)-201-8342		(800)-201-8342										(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333										1	1	1
H8822	802	0	1	01	01	H8822_802_0	2	1		06/03/2011	2012.02	06/03/2011 08:31:50 AM Eastern Daylight Time	05/27/2011 02:44:47 PM Eastern Daylight Time			06/03/2011 09:20:32 AM Eastern Daylight Time	ADVANTAGE HEALTH SOLUTIONS, INC.	ADVANTAGE Health Solutions, Inc.	www.advantageplan.com	ADVANTAGE Preferred Plus Group (HMO)	01	01		1			H8822	802	0	2012	Indiana		1	100	2			2						www.advantageplan.com	www.advantageplan.com	www.advantageplan.com	(800)-523-7533		(317)-573-7950		(800)-201-8342		(800)-201-8342		(877)-684-0014		(877)-684-0014		(800)-201-8342		(800)-201-8342		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(866)-763-9630		(866)-763-9630		(800)-743-3333		(800)-743-3333		1	1	1
H8822	803	0	1	01	01	H8822_803_0	2	1		06/03/2011	2012.02	06/03/2011 08:32:03 AM Eastern Daylight Time	05/27/2011 02:44:48 PM Eastern Daylight Time			06/03/2011 09:20:32 AM Eastern Daylight Time	ADVANTAGE HEALTH SOLUTIONS, INC.	ADVANTAGE Health Solutions, Inc.	www.advantageplan.com	ADVANTAGE Select Group (HMO)	01	01		1			H8822	803	0	2012	Indiana		1	1	2			2						www.advantageplan.com	www.advantageplan.com	www.advantageplan.com	(800)-523-7533		(317)-573-7950		(800)-201-8342		(800)-201-8342										(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333										1	1	1
H8822	804	0	1	01	01	H8822_804_0	2	1		06/03/2011	2012.02	06/03/2011 08:35:08 AM Eastern Daylight Time	05/27/2011 02:44:46 PM Eastern Daylight Time			06/03/2011 09:20:32 AM Eastern Daylight Time	ADVANTAGE HEALTH SOLUTIONS, INC.	ADVANTAGE Health Solutions, Inc.	www.advantageplan.com	ADVANTAGE Select Plus Group (HMO)	01	01		1			H8822	804	0	2012	Indiana		1	100	2			2						www.advantageplan.com	www.advantageplan.com	www.advantageplan.com	(800)-523-7533		(317)-573-7950		(800)-201-8342		(800)-201-8342		(877)-684-0014		(877)-684-0014		(800)-201-8342		(800)-201-8342		(800)-743-3333		(800)-743-3333		(800)-743-3333		(800)-743-3333		(866)-763-9630		(866)-763-9630		(800)-743-3333		(800)-743-3333		1	1	1
H8953	001	0	1	01	01	H8953_001_0	4	1		07/08/2011	2012.02	07/08/2011 11:29:27 AM Eastern Daylight Time	08/05/2011 10:42:39 PM Eastern Daylight Time	08/04/2011 01:13:54 PM Eastern Daylight Time		08/08/2011 04:00:01 PM Eastern Daylight Time	HUMANA HEALTH PLAN OF OHIO, INC.	Humana Health Plan of Ohio, Inc.	www.humana-medicare.com	Humana Gold Plus H8953-001 (HMO)	01	01		1			H8953	001	0	2012	Greater Cincinnati Area		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8953	002	0	1	01	01	H8953_002_0	4	1		07/08/2011	2012.02	07/08/2011 11:27:14 AM Eastern Daylight Time	08/05/2011 10:46:24 PM Eastern Daylight Time	08/04/2011 01:14:12 PM Eastern Daylight Time		08/08/2011 04:00:01 PM Eastern Daylight Time	HUMANA HEALTH PLAN OF OHIO, INC.	Humana Health Plan of Ohio, Inc.	www.humana-medicare.com	Humana Gold Plus H8953-002 (HMO)	01	01		1			H8953	002	0	2012	Cuyahoga, Lorain and Medina Counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8953	003	0	1	01	01	H8953_003_0	4	1		07/08/2011	2012.02	07/08/2011 11:26:46 AM Eastern Daylight Time	05/27/2011 02:11:02 PM Eastern Daylight Time	08/04/2011 01:14:35 PM Eastern Daylight Time		08/08/2011 04:00:01 PM Eastern Daylight Time	HUMANA HEALTH PLAN OF OHIO, INC.	Humana Health Plan of Ohio, Inc.	www.humana-medicare.com	Humana Gold Plus H8953-003 (HMO)	01	01		1			H8953	003	0	2012	Greene and Montgomery Counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8953	005	0	1	01	01	H8953_005_0	4	1		07/08/2011	2012.02	07/08/2011 11:26:23 AM Eastern Daylight Time	08/05/2011 10:53:44 PM Eastern Daylight Time	08/04/2011 01:14:53 PM Eastern Daylight Time		08/08/2011 04:00:01 PM Eastern Daylight Time	HUMANA HEALTH PLAN OF OHIO, INC.	Humana Health Plan of Ohio, Inc.	www.humana-medicare.com	Humana Gold Plus H8953-005 (HMO)	01	01		1			H8953	005	0	2012	Delaware and Franklin Counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8953	006	0	1	01	01	H8953_006_0	4	1		07/08/2011	2012.02	07/08/2011 11:26:02 AM Eastern Daylight Time	08/05/2011 10:53:56 PM Eastern Daylight Time	08/04/2011 01:15:12 PM Eastern Daylight Time		08/08/2011 04:00:01 PM Eastern Daylight Time	HUMANA HEALTH PLAN OF OHIO, INC.	Humana Health Plan of Ohio, Inc.	www.humana-medicare.com	Humana Gold Plus H8953-006 (HMO)	01	01		1			H8953	006	0	2012	Stark and Summit Counties		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8953	007	0	1	01	01	H8953_007_0	3	1	2	07/08/2011	2012.02	07/08/2011 11:25:17 AM Eastern Daylight Time	08/05/2011 10:54:18 PM Eastern Daylight Time	08/04/2011 01:15:27 PM Eastern Daylight Time		08/08/2011 04:00:01 PM Eastern Daylight Time	HUMANA HEALTH PLAN OF OHIO, INC.	Humana Health Plan of Ohio, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H8953-007 (HMO SNP)	01	01		1			H8953	007	0	2012	Butler, Clermont, Hamilton and Warren Counties		2		2			1	3		1	4		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8953	008	0	1	01	01	H8953_008_0	4	1	2	08/08/2011	2012.02	08/08/2011 01:14:53 PM Eastern Daylight Time	08/11/2011 10:04:48 AM Eastern Daylight Time	08/04/2011 01:15:50 PM Eastern Daylight Time		08/11/2011 12:10:15 PM Eastern Daylight Time	HUMANA HEALTH PLAN OF OHIO, INC.	Humana Health Plan of Ohio, Inc.	www.humana-medicare.com	Humana Gold Plus SNP-DE H8953-008 (HMO SNP)	01	01		1			H8953	008	0	2012	Delaware and Franklin Counties		2		2			1	3		1	4		www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8953	801	0	1	01	01	H8953_801_0	2	1		07/06/2011	2012.02	07/06/2011 10:57:56 AM Eastern Daylight Time	05/27/2011 03:31:27 PM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA HEALTH PLAN OF OHIO, INC.	Humana Health Plan of Ohio, Inc.	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H8953	801	0	2012	Select counties in Cincinnati metro area		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H8953	802	0	1	01	01	H8953_802_0	2	1		07/06/2011	2012.02	07/06/2011 10:58:03 AM Eastern Daylight Time	05/27/2011 03:42:26 PM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA HEALTH PLAN OF OHIO, INC.	Humana Health Plan of Ohio, Inc.	www.humana-medicare.com	Humana Employer Sponsored (HMO)	01	01		1			H8953	802	0	2012	Select counties in Cincinnati metro area		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
H8953	803	0	1	01	01	H8953_803_0	5	1		07/06/2011	2012.02	07/06/2011 10:58:07 AM Eastern Daylight Time	05/31/2011 08:52:40 AM Eastern Daylight Time			07/06/2011 11:22:46 AM Eastern Daylight Time	HUMANA HEALTH PLAN OF OHIO, INC.	Humana Health Plan of Ohio, Inc.	www.humana-medicare.com	Humana Employer Sponsored Non-CY (HMO)	01	01		1			H8953	803	0	2012	Select counties in Cincinnati metro area		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
H8980	002	0	1	04	01	H8980_002_0	9	1		08/09/2011	2012.02	08/09/2011 10:56:06 AM Eastern Daylight Time	08/08/2011 04:25:22 PM Eastern Daylight Time	08/04/2011 09:51:11 AM Eastern Daylight Time		08/09/2011 01:09:51 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	HealthAmerica	http://www.pa.chcadvantra.com	Advantra Silver (PPO)	01	04		1			H8980	002	0	2012	Columbiana, Mahoning and Trumbull Counties		2		2			2						http://providerdirectory.coventry-medicare.com	http://PAFormulary.coventry-medicare.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator	(800)-290-0190		(800)-290-0190		(877)-887-5787		(877)-887-5787		(877)-300-5135		(877)-300-5135		(877)-887-5787		(877)-887-5787		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8980	003	0	1	04	01	H8980_003_0	10	1		08/09/2011	2012.02	08/09/2011 10:56:18 AM Eastern Daylight Time	08/08/2011 03:23:22 PM Eastern Daylight Time	08/04/2011 09:39:18 AM Eastern Daylight Time		08/09/2011 01:09:51 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	HealthAmerica	http://www.pa.chcadvantra.com	Advantra Elite (PPO)	01	04		1			H8980	003	0	2012	Columbiana, Mahoning and Trumbull Counties		2		2			2						http://providerdirectory.coventry-medicare.com	http://PAFormulary.coventry-medicare.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator	(800)-290-0190		(800)-290-0190		(877)-887-5787		(877)-887-5787		(877)-300-5135		(877)-300-5135		(877)-887-5787		(877)-887-5787		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H8980	801	0	1	04	01	H8980_801_0	5	1		05/25/2011	2012.02	05/25/2011 01:11:39 PM Eastern Daylight Time	07/25/2011 02:06:23 PM Eastern Daylight Time			07/27/2011 02:54:48 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	HealthAmerica	http://www.pa.chcadvantra.com	Advantra MA Only (PPO)	01	04		1			H8980	801	0	2012	Ohio		1		2			2						http://providerdirectory.coventry-medicare.com	http://PAFormulary.coventry-medicare.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator	(800)-290-0190		(800)-290-0190		(800)-470-4272		(800)-470-4272										(711)		(711)		(711)		(711)										1	1	1
H8980	802	0	1	04	01	H8980_802_0	5	1		05/25/2011	2012.02	05/25/2011 01:12:05 PM Eastern Daylight Time	07/25/2011 02:10:51 PM Eastern Daylight Time			07/27/2011 02:54:48 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	HealthAmerica	http://www.pa.chcadvantra.com	Advantra Gold (PPO)	01	04		1			H8980	802	0	2012	Ohio		1		2			2						http://providerdirectory.coventry-medicare.com	http://PAFormulary.coventry-medicare.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator	(800)-290-0190		(800)-290-0190		(800)-470-4272		(800)-470-4272		(877)-300-5135		(877)-300-5135		(800)-470-4272		(800)-470-4272		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H8980	803	0	1	04	01	H8980_803_0	5	1		05/25/2011	2012.02	05/25/2011 01:12:35 PM Eastern Daylight Time	07/25/2011 02:15:45 PM Eastern Daylight Time			07/27/2011 02:54:48 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	HealthAmerica	http://www.pa.chcadvantra.com	Advantra Gold (PPO)	01	04		1			H8980	803	0	2012	Ohio		1		2			2						http://providerdirectory.coventry-medicare.com	http://PAFormulary.coventry-medicare.com	http://coventry-medicare.coventryhealthcare.com/prescription-drug-benefits/pharmacy-locator	(800)-290-0190		(800)-290-0190		(800)-470-4272		(800)-470-4272		(877)-300-5135		(877)-300-5135		(800)-470-4272		(800)-470-4272		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H8991	017	0	1	01	01	H8991_017_0	7	1	2	08/05/2011	2012.02	08/05/2011 10:22:33 AM Eastern Daylight Time	08/05/2011 09:54:00 AM Eastern Daylight Time	08/04/2011 05:28:00 PM Eastern Daylight Time		08/09/2011 05:31:53 PM Eastern Daylight Time	AMERIGROUP FLORIDA, INC.	Amerigroup Community Care	www.myamerigroup.com/medicare	Amerivantage Specialty + Rx (HMO SNP)	01	01		1			H8991	017	0	2012	South and Central Florida		2	2020	2			1	3		1	1		www.myamerigroup.com/medicare	http://www.amerigroupcorp.com/Members/amerivantage/_documents	http://www.amerigroupcorp.com/Members/amerivantage	(866)-805-4589		(866)-805-4589		(877)-470-4131		(877)-470-4131		(866)-805-4589		(866)-805-4589		(877)-470-4131		(877)-470-4131		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		(800)-855-2880		2	2	2
H9001	001	0	1	01	01	H9001_001_0	5	1		07/26/2011	2012.02	07/26/2011 02:59:25 PM Eastern Daylight Time	07/21/2011 11:50:50 AM Eastern Daylight Time			07/26/2011 03:24:43 PM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.fchp.org	Fallon Senior Plan Standard (HMO)	01	01		1			H9001	001	0	2012	WORC county, and parts of FRK,HPS,MSEX,NOFcounties		2	1430	2			2						http://www.fchp.org/FindPhysician/	http://www.fchp.org/Extranet/Seniors/Formulary/	http://www.fchp.org/Extranet/Seniors/PharmacyFinder/	(800)-325-5669		(800)-325-5669		(888)-377-1980		(888)-377-1980										(711)		(711)		(711)		(711)										2	2	2
H9001	010	0	1	01	01	H9001_010_0	6	1		07/26/2011	2012.02	07/26/2011 02:59:43 PM Eastern Daylight Time	07/21/2011 11:51:06 AM Eastern Daylight Time			07/26/2011 03:24:43 PM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.fchp.org	Fallon Senior Plan Saver (HMO)	01	01		1			H9001	010	0	2012	WORC county, and parts of FRK,HPS,MSEX,NOFcounties		2	1025	2			2						http://www.fchp.org/FindPhysician/	http://www.fchp.org/Extranet/Seniors/Formulary/	http://www.fchp.org/Extranet/Seniors/PharmacyFinder/	(800)-325-5669		(800)-325-5669		(888)-377-1980		(888)-377-1980										(711)		(711)		(711)		(711)										2	2	2
H9001	011	0	1	01	01	H9001_011_0	10	1		08/09/2011	2012.02	08/09/2011 08:23:17 AM Eastern Daylight Time	08/09/2011 08:17:19 AM Eastern Daylight Time	08/09/2011 08:17:24 AM Eastern Daylight Time		08/09/2011 08:40:57 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.fchp.org	Fallon Senior Plan Saver Rx (HMO)	01	01		1			H9001	011	0	2012	WORC county, and parts of FRK,HPS,MSEX,NOFcounties		2	2272	2			2						http://www.fchp.org/FindPhysician/	http://www.fchp.org/Extranet/Seniors/Formulary/	http://www.fchp.org/Extranet/Seniors/PharmacyFinder/	(800)-325-5669		(800)-325-5669		(888)-377-1980		(888)-377-1980		(800)-325-5669		(800)-325-5669		(888)-377-1980		(888)-377-1980		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H9001	013	0	1	01	01	H9001_013_0	10	1		08/09/2011	2012.02	08/09/2011 08:23:23 AM Eastern Daylight Time	08/09/2011 08:17:33 AM Eastern Daylight Time	08/09/2011 08:17:38 AM Eastern Daylight Time		08/09/2011 08:40:57 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.fchp.org	Fallon Senior Plan Saver Enhanced Rx (HMO)	01	01		1			H9001	013	0	2012	WORC county, and parts of FRK,HPS,MSEX,NOFcounties		2	6218	2			2						http://www.fchp.org/FindPhysician/	http://www.fchp.org/Extranet/Seniors/Formulary/	http://www.fchp.org/Extranet/Seniors/PharmacyFinder/	(800)-325-5669		(800)-325-5669		(888)-377-1980		(888)-377-1980		(800)-325-5669		(800)-325-5669		(888)-377-1980		(888)-377-1980		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H9001	015	0	1	01	01	H9001_015_0	10	1		08/09/2011	2012.02	08/09/2011 08:23:30 AM Eastern Daylight Time	08/09/2011 08:17:45 AM Eastern Daylight Time	08/09/2011 08:17:51 AM Eastern Daylight Time		08/09/2011 08:40:57 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.fchp.org	Fallon Senior Plan Standard Enhanced Rx (HMO)	01	01		1			H9001	015	0	2012	WORC county, and parts of FRK,HPS,MSEX,NOFcounties		2	5468	2			2						http://www.fchp.org/FindPhysician/	http://www.fchp.org/Extranet/Seniors/Formulary/	http://www.fchp.org/Extranet/Seniors/PharmacyFinder/	(800)-325-5669		(800)-325-5669		(888)-377-1980		(888)-377-1980		(800)-325-5669		(800)-325-5669		(888)-377-1980		(888)-377-1980		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H9001	017	0	1	01	01	H9001_017_0	10	1		08/09/2011	2012.02	08/09/2011 08:23:37 AM Eastern Daylight Time	08/09/2011 08:18:00 AM Eastern Daylight Time	08/09/2011 08:18:05 AM Eastern Daylight Time		08/09/2011 08:40:57 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.fchp.org	Fallon Senior Plan Plus Enhanced Rx (HMO)	01	01		1			H9001	017	0	2012	WORC county, and parts of FRK,HPS,MSEX,NOFcounties		2	4657	2			2						http://www.fchp.org/FindPhysician/	http://www.fchp.org/Extranet/Seniors/Formulary/	http://www.fchp.org/Extranet/Seniors/PharmacyFinder/	(800)-325-5669		(800)-325-5669		(888)-377-1980		(888)-377-1980		(800)-325-5669		(800)-325-5669		(888)-377-1980		(888)-377-1980		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H9001	019	0	1	01	01	H9001_019_0	7	1	2	07/28/2011	2012.02	07/28/2011 09:32:35 PM Eastern Daylight Time	07/28/2011 09:18:49 PM Eastern Daylight Time	07/28/2011 06:04:22 PM Eastern Daylight Time		07/28/2011 09:33:59 PM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.navicare.org	NaviCare (HMO SNP)	01	01		1			H9001	019	0	2012	WORC,HAMD counties, parts FRK,HPS,MSEX,NOFcounties		2	1520	2			1	3		1	5		http://www.fchp.org/FindPhysician/	http://www.fchp.org/Extranet/Seniors/Formulary/	http://www.fchp.org/Extranet/Seniors/PharmacyFinder/	(877)-700-6996		(877)-700-6996		(877)-255-7108		(877)-255-7108		(877)-700-6996		(877)-700-6996		(877)-255-7108		(877)-255-7108		(877)-795-6526		(877)-795-6526		(877)-795-6526		(877)-795-6526		(877)-795-6526		(877)-795-6526		(877)-795-6526		(877)-795-6526		2	2	2
H9001	020	0	1	01	01	H9001_020_0	11	1		08/09/2011	2012.02	08/09/2011 08:23:46 AM Eastern Daylight Time	08/09/2011 08:18:13 AM Eastern Daylight Time	08/09/2011 08:18:26 AM Eastern Daylight Time		08/09/2011 08:40:57 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.fchp.org	Fallon Senior Plan Saver Rx (HMO)	01	01		1			H9001	020	0	2012	Hampden County		2	115	2			2						http://www.fchp.org/FindPhysician/	http://www.fchp.org/Extranet/Seniors/Formulary/	http://www.fchp.org/Extranet/Seniors/PharmacyFinder/	(800)-325-5669		(800)-325-5669		(888)-377-1980		(888)-377-1980		(800)-325-5669		(800)-325-5669		(888)-377-1980		(888)-377-1980		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H9001	021	0	1	01	01	H9001_021_0	10	1		07/28/2011	2012.02	07/28/2011 07:42:38 PM Eastern Daylight Time	07/21/2011 11:56:10 AM Eastern Daylight Time	07/28/2011 05:40:36 PM Eastern Daylight Time		07/28/2011 07:58:03 PM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.fchp.org	Fallon Senior Plan Saver Enhanced Rx (HMO)	01	01		1			H9001	021	0	2012	Hampden County		2	501	2			2						http://www.fchp.org/FindPhysician/	http://www.fchp.org/Extranet/Seniors/Formulary/	http://www.fchp.org/Extranet/Seniors/PharmacyFinder/	(800)-325-5669		(800)-325-5669		(888)-377-1980		(888)-377-1980		(800)-325-5669		(800)-325-5669		(888)-377-1980		(888)-377-1980		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H9001	022	0	1	01	01	H9001_022_0	6	1		07/26/2011	2012.02	07/26/2011 03:02:09 PM Eastern Daylight Time	07/21/2011 11:56:30 AM Eastern Daylight Time			07/26/2011 03:24:43 PM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.fchp.org	Fallon Senior Plan Standard (HMO)	01	01		1			H9001	022	0	2012	Hampden County		2	25	2			2						http://www.fchp.org/FindPhysician/	http://www.fchp.org/Extranet/Seniors/Formulary/	http://www.fchp.org/Extranet/Seniors/PharmacyFinder/	(800)-325-5669		(800)-325-5669		(888)-377-1980		(888)-377-1980										(711)		(711)		(711)		(711)										2	2	2
H9001	024	0	1	01	01	H9001_024_0	11	1		08/09/2011	2012.02	08/09/2011 08:23:59 AM Eastern Daylight Time	08/09/2011 08:18:34 AM Eastern Daylight Time	08/09/2011 08:18:40 AM Eastern Daylight Time		08/09/2011 08:40:57 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.fchp.org	Fallon Senior Plan Standard Enhanced Rx (HMO)	01	01		1			H9001	024	0	2012	Hampden County		2	153	2			2						http://www.fchp.org/FindPhysician/	http://www.fchp.org/Extranet/Seniors/Formulary/	http://www.fchp.org/Extranet/Seniors/PharmacyFinder/	(800)-325-5669		(800)-325-5669		(888)-377-1980		(888)-377-1980		(800)-325-5669		(800)-325-5669		(888)-377-1980		(888)-377-1980		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H9001	025	0	1	01	01	H9001_025_0	11	1		08/09/2011	2012.02	08/09/2011 08:24:05 AM Eastern Daylight Time	08/09/2011 08:18:47 AM Eastern Daylight Time	08/09/2011 08:18:53 AM Eastern Daylight Time		08/09/2011 08:40:57 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.fchp.org	Fallon Senior Plan Plus Enhanced Rx (HMO)	01	01		1			H9001	025	0	2012	Hampden County		2	509	2			2						http://www.fchp.org/FindPhysician/	http://www.fchp.org/Extranet/Seniors/Formulary/	http://www.fchp.org/Extranet/Seniors/PharmacyFinder/	(800)-325-5669		(800)-325-5669		(888)-377-1980		(888)-377-1980		(800)-325-5669		(800)-325-5669		(888)-377-1980		(888)-377-1980		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H9001	026	0	1	01	01	H9001_026_0	6	1		07/26/2011	2012.02	07/26/2011 03:02:49 PM Eastern Daylight Time	07/21/2011 11:58:56 AM Eastern Daylight Time			07/26/2011 03:24:43 PM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.fchp.org	Fallon Senior Plan Saver (HMO)	01	01		1			H9001	026	0	2012	Hampden County		2	50	2			2						http://www.fchp.org/FindPhysician/	http://www.fchp.org/Extranet/Seniors/Formulary/	http://www.fchp.org/Extranet/Seniors/PharmacyFinder/	(800)-325-5669		(800)-325-5669		(888)-377-1980		(888)-377-1980										(711)		(711)		(711)		(711)										2	2	2
H9001	027	0	1	01	01	H9001_027_0	10	1		08/09/2011	2012.02	08/09/2011 08:24:14 AM Eastern Daylight Time	08/09/2011 08:19:00 AM Eastern Daylight Time	08/09/2011 08:19:14 AM Eastern Daylight Time		08/09/2011 08:40:57 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.fchp.org	Fallon Senior Plan Super Saver Rx (HMO)	01	01		1			H9001	027	0	2012	WORC county, and parts of FRK,HPS,MSEX,NOFcounties		2	300	2			2						http://www.fchp.org/FindPhysician/	http://www.fchp.org/Extranet/Seniors/Formulary/	http://www.fchp.org/Extranet/Seniors/PharmacyFinder/	(800)-325-5669		(800)-325-5669		(888)-377-1980		(888)-377-1980		(800)-325-5669		(800)-325-5669		(888)-377-1980		(888)-377-1980		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H9001	028	0	1	01	01	H9001_028_0	10	1		08/09/2011	2012.02	08/09/2011 08:24:21 AM Eastern Daylight Time	08/09/2011 08:19:20 AM Eastern Daylight Time	08/09/2011 08:19:27 AM Eastern Daylight Time		08/09/2011 08:40:57 AM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.fchp.org	Fallon Senior Plan Super Saver Rx (HMO)	01	01		1			H9001	028	0	2012	Hampden County		2	50	2			2						http://www.fchp.org/FindPhysician/	http://www.fchp.org/Extranet/Seniors/Formulary/	http://www.fchp.org/Extranet/Seniors/PharmacyFinder/	(800)-325-5669		(800)-325-5669		(888)-377-1980		(888)-377-1980		(800)-325-5669		(800)-325-5669		(888)-377-1980		(888)-377-1980		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H9001	801	0	1	01	01	H9001_801_0	2	1		06/06/2011	2012.02	06/06/2011 06:36:35 PM Eastern Daylight Time	06/06/2011 09:25:04 PM Eastern Daylight Time			06/06/2011 11:48:29 PM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.fchp.org	HMO MA Only (HMO)	01	01		1			H9001	801	0	2012	Full Service Area - Employer Groups		1	1099	2			2						http://www.fchp.org/FindPhysician/	http://www.fchp.org/Extranet/Seniors/Formulary/	http://www.fchp.org/Extranet/Seniors/PharmacyFinder/	(800)-325-5669		(800)-325-5669		(888)-377-1980		(888)-377-1980										(711)		(711)		(711)		(711)										1	1	1
H9001	803	0	1	01	01	H9001_803_0	2	1		06/06/2011	2012.02	06/06/2011 06:36:41 PM Eastern Daylight Time	06/06/2011 09:26:10 PM Eastern Daylight Time			06/06/2011 11:48:29 PM Eastern Daylight Time	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.fchp.org	HMO MA RX Coinsurance - Calendar Year (HMO)	01	01		1			H9001	803	0	2012	Full Service Area - Employer Groups		1	6021	2			2						http://www.fchp.org/FindPhysician/	http://www.fchp.org/Extranet/Seniors/Formulary/	http://www.fchp.org/Extranet/Seniors/PharmacyFinder/	(800)-325-5669		(800)-325-5669		(888)-377-1980		(888)-377-1980		(800)-325-5669		(800)-325-5669		(888)-377-1980		(888)-377-1980		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H9003	001	0	1	01	01	H9003_001_0	9	1		07/25/2011	2012.02	07/25/2011 04:15:03 PM Pacific Daylight Time	08/04/2011 03:47:05 PM Pacific Daylight Time	08/04/2011 12:20:49 PM Pacific Daylight Time		08/05/2011 10:24:59 AM Pacific Daylight Time	KAISER FOUNDATION HP OF THE N W	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage (HMO)	01	01		1			H9003	001	0	2012	Portland-Vancouver Metro, Salem OR, Longview WA		2		2			2						kp.org/medicare	kp.org/seniorrx	kp.org/seniorrx	(877)-221-8221		(877)-221-8221		(877)-408-3496		(877)-408-3496		(877)-221-8221		(877)-221-8221		(877)-408-3496		(877)-408-3496		(800)-735-2900		(800)-735-2900		(888)-758-6054		(888)-758-6054		(800)-735-2900		(800)-735-2900		(888)-758-6054		(888)-758-6054		2	2	2
H9003	006	0	1	01	01	H9003_006_0	8	1		07/25/2011	2012.02	07/25/2011 04:15:17 PM Pacific Daylight Time	08/04/2011 03:44:01 PM Pacific Daylight Time	08/04/2011 12:21:35 PM Pacific Daylight Time		08/05/2011 10:24:59 AM Pacific Daylight Time	KAISER FOUNDATION HP OF THE N W	Kaiser Permanente	kp.org/medicare	Kaiser Permanente Senior Advantage Basic (HMO)	01	01		1			H9003	006	0	2012	Portland-Vancouver Metro, Salem OR, Longview WA		2		2			2						kp.org/medicare	kp.org/seniorrx	kp.org/seniorrx	(877)-221-8221		(877)-221-8221		(877)-408-3496		(877)-408-3496		(877)-221-8221		(877)-221-8221		(877)-408-3496		(877)-408-3496		(800)-735-2900		(800)-735-2900		(888)-758-6054		(888)-758-6054		(800)-735-2900		(800)-735-2900		(888)-758-6054		(888)-758-6054		2	2	2
H9003	801	0	1	01	01	H9003_801_0	5	1		07/25/2011	2012.02	07/25/2011 04:15:39 PM Pacific Daylight Time	06/03/2011 09:07:13 AM Pacific Daylight Time			07/25/2011 04:29:36 PM Pacific Daylight Time	KAISER FOUNDATION HP OF THE N W	Kaiser Permanente	kp.org/medicare	Employer Group Only with Part D (HMO)	01	01		1			H9003	801	0	2012	Portland-Vancouver Metro, Salem OR, Longview WA		1		2			2						kp.org/medicare	kp.org/seniorrx	kp.org/seniorrx	(877)-221-8221		(877)-221-8221		(877)-221-8221		(877)-221-8221		(877)-221-8221		(877)-221-8221		(877)-221-8221		(877)-221-8221		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		2	2	2
H9003	802	0	1	01	01	H9003_802_0	5	1		07/25/2011	2012.02	07/25/2011 04:15:54 PM Pacific Daylight Time	06/03/2011 09:09:27 AM Pacific Daylight Time			07/25/2011 04:29:36 PM Pacific Daylight Time	KAISER FOUNDATION HP OF THE N W	Kaiser Permanente	kp.org/medicare	Employer Group Only without Part D (HMO)	01	01		1			H9003	802	0	2012	Portland-Vancouver Metro, Salem OR, Longview WA		1		2			2						kp.org/medicare	kp.org/seniorrx	kp.org/seniorrx	(877)-221-8221		(877)-221-8221		(877)-221-8221		(877)-221-8221										(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900										2	2	2
H9003	805	0	1	01	01	H9003_805_0	4	1		07/25/2011	2012.02	07/25/2011 04:16:10 PM Pacific Daylight Time	06/03/2011 09:11:28 AM Pacific Daylight Time			07/25/2011 04:29:36 PM Pacific Daylight Time	KAISER FOUNDATION HP OF THE N W	Kaiser Permanente	kp.org/medicare	FEHB AB with D (HMO)	01	01		1			H9003	805	0	2012	Portland-Vancouver Metro, Salem OR, Longview WA		1		2			2						kp.org/medicare	kp.org/seniorrx	kp.org/seniorrx	(877)-221-8221		(877)-221-8221		(877)-221-8221		(877)-221-8221		(877)-221-8221		(877)-221-8221		(877)-221-8221		(877)-221-8221		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		(800)-735-2900		2	2	2
H9011	003	0	1	01	01	H9011_003_0	5	1		08/04/2011	2012.02	08/04/2011 08:16:46 PM Central Daylight Time	08/05/2011 04:47:42 PM Central Daylight Time	08/05/2011 01:47:32 PM Central Daylight Time		08/09/2011 11:07:45 AM Central Daylight Time	UNITEDHEALTHCARE OF FLORIDA, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H9011	003	0	2012	Miami-Dade County		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H9011	011	0	1	01	01	H9011_011_0	3	1	2	08/08/2011	2012.02	08/08/2011 02:42:57 PM Central Daylight Time	08/08/2011 10:28:10 AM Central Daylight Time	08/05/2011 01:16:12 PM Central Daylight Time		08/09/2011 11:07:45 AM Central Daylight Time	UNITEDHEALTHCARE OF FLORIDA, INC.	SecureHorizons by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Dual Complete (HMO SNP)	01	01		1			H9011	011	0	2012	Miami-Dade County		2		2			1	3		1	2		www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(866)-480-2064		(866)-480-2064		(888)-565-8170		(888)-565-8170		(866)-480-2064		(866)-480-2064		(888)-565-8170		(888)-565-8170		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H9011	016	0	1	02	01	H9011_016_0	5	1		08/04/2011	2012.02	08/04/2011 08:24:10 PM Central Daylight Time	08/05/2011 04:48:39 PM Central Daylight Time	08/05/2011 01:47:48 PM Central Daylight Time		08/09/2011 11:07:45 AM Central Daylight Time	UNITEDHEALTHCARE OF FLORIDA, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H9011	016	0	2012	Miami-Dade FL		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H9011	018	0	1	01	01	H9011_018_0	4	1		08/04/2011	2012.02	08/04/2011 08:25:08 PM Central Daylight Time	08/05/2011 04:49:35 PM Central Daylight Time	08/05/2011 01:48:04 PM Central Daylight Time		08/09/2011 11:07:45 AM Central Daylight Time	UNITEDHEALTHCARE OF FLORIDA, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H9011	018	0	2012	Broward County		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H9011	019	0	1	02	01	H9011_019_0	4	1		08/04/2011	2012.02	08/04/2011 08:26:32 PM Central Daylight Time	08/05/2011 04:50:24 PM Central Daylight Time	08/05/2011 01:48:19 PM Central Daylight Time		08/09/2011 11:07:45 AM Central Daylight Time	UNITEDHEALTHCARE OF FLORIDA, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H9011	019	0	2012	Broward County		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H9011	020	0	1	01	01	H9011_020_0	4	1		08/04/2011	2012.02	08/04/2011 08:27:15 PM Central Daylight Time	08/05/2011 04:51:23 PM Central Daylight Time	08/05/2011 01:48:35 PM Central Daylight Time		08/09/2011 11:07:45 AM Central Daylight Time	UNITEDHEALTHCARE OF FLORIDA, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plan 1 (HMO)	01	01		1			H9011	020	0	2012	Palm Beach County		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H9011	021	0	1	02	01	H9011_021_0	4	1		08/04/2011	2012.02	08/04/2011 08:28:37 PM Central Daylight Time	08/05/2011 04:52:13 PM Central Daylight Time	08/05/2011 01:48:51 PM Central Daylight Time		08/09/2011 11:07:45 AM Central Daylight Time	UNITEDHEALTHCARE OF FLORIDA, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Plus (HMO-POS)	01	02		1			H9011	021	0	2012	Palm Beach County		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H9011	801	0	1	01	01	H9011_801_0	2	1		07/06/2011	2012.02	07/06/2011 04:50:43 PM Central Daylight Time	06/05/2011 09:55:45 AM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF FLORIDA, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H9011	801	0	2012	Broward, Dade and Palm Beach Counties		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H9011	802	0	1	01	01	H9011_802_0	2	1		07/06/2011	2012.02	07/06/2011 04:50:48 PM Central Daylight Time	06/05/2011 09:57:03 AM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF FLORIDA, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H9011	802	0	2012	Broward, Dade and Palm Beach Counties		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548										(711)		(711)		(711)		(711)										2	2	2
H9011	803	0	1	01	01	H9011_803_0	2	1		07/06/2011	2012.02	07/06/2011 04:50:51 PM Central Daylight Time	06/05/2011 09:58:21 AM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF FLORIDA, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		1			H9011	803	0	2012	Select Counties in FL		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H9011	805	0	2	01	01	H9011_805_0	2	1		07/06/2011	2012.02	07/06/2011 04:50:54 PM Central Daylight Time	06/05/2011 09:59:38 AM Central Daylight Time			07/14/2011 09:37:05 AM Central Daylight Time	UNITEDHEALTHCARE OF FLORIDA, INC.	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (HMO)	01	01		2	2		H9011	805	0	2012	Select counties in FL		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H9047	001	0	1	01	01	H9047_001_0	7	1		07/22/2011	2012.02	07/22/2011 10:48:39 AM Pacific Daylight Time	08/08/2011 08:16:05 PM Pacific Daylight Time	08/08/2011 08:29:36 PM Pacific Daylight Time		08/09/2011 04:13:04 PM Pacific Daylight Time	PROVIDENCE HEALTH PLAN	Providence Health Plans	www.providence.org/healthplans	Providence Medicare Extra + RX (HMO)	01	01		1			H9047	001	0	2012	Portland Metro, Willamette Valley, Clark County		2		2			2						www.providence.org/Health Plans	www.providence.org/healthplans	www.providence.org/healthplans	(800)-603-2340		(503)-574-8000		(800)-457-6064		(503)-574-5551		(800)-603-2340		(503)-574-8000		(800)-457-6064		(503)-574-5551		(888)-244-6642		(503)-574-8702		(888)-244-6642		(503)-574-8702		(888)-244-6642		(503)-574-8702		(888)-244-6642		(503)-574-8702		2	2	2
H9047	013	0	2	01	01	H9047_013_0	7	1		07/22/2011	2012.02	07/22/2011 10:58:18 AM Pacific Daylight Time	08/08/2011 08:16:51 PM Pacific Daylight Time	08/08/2011 08:32:52 PM Pacific Daylight Time		08/09/2011 04:13:04 PM Pacific Daylight Time	PROVIDENCE HEALTH PLAN	Providence Health Plans	www.providence.org/healthplans	Providence Medicare Extra Part B Only + RX (HMO)	01	01		2	2		H9047	013	0	2012	Portland Metro and Willamette Valley		2		2			2						www.providence.org/Health Plans	www.providence.org/healthplans	www.providence.org/healthplans	(800)-603-2340		(503)-574-8000		(800)-457-6064		(503)-574-5551		(800)-603-2340		(503)-574-8000		(800)-457-6064		(503)-574-5551		(888)-244-6642		(503)-574-8702		(888)-244-6642		(503)-574-8702		(888)-244-6642		(503)-574-8702		(888)-244-6642		(503)-574-8702		2	2	2
H9047	024	0	1	02	01	H9047_024_0	8	1		08/17/2011	2012.02	08/17/2011 03:44:06 PM Pacific Daylight Time	08/17/2011 10:16:31 PM Pacific Daylight Time	08/08/2011 08:33:22 PM Pacific Daylight Time		08/18/2011 03:04:47 PM Pacific Daylight Time	PROVIDENCE HEALTH PLAN	Providence Health Plans	www.providence.org/healthplans	Providence Medicare Choice + RX (HMO-POS)	01	02		1			H9047	024	0	2012	Portland Metro, Willamette Valley, Clark County		2		2			2						www.providence.org/Health Plans	www.providence.org/healthplans	www.providence.org/healthplans	(800)-603-2340		(503)-574-8000		(800)-457-6064		(503)-574-5551		(800)-603-2340		(503)-574-8000		(800)-457-6064		(503)-574-5551		(888)-244-6642		(503)-574-8702		(888)-244-6642		(503)-574-8702		(888)-244-6642		(503)-574-8702		(888)-244-6642		(503)-574-8702		2	2	2
H9047	033	0	1	01	01	H9047_033_0	7	1		07/21/2011	2012.02	07/21/2011 11:13:12 AM Pacific Daylight Time	07/15/2011 09:36:40 AM Pacific Daylight Time			07/21/2011 11:45:47 AM Pacific Daylight Time	PROVIDENCE HEALTH PLAN	Providence Health Plans	www.providence.org/healthplans	Providence Medicare Extra (HMO)	01	01		1			H9047	033	0	2012	Portland Metro, Willamette Valley, Clark County		2		2			2						www.providence.org/Health Plans	www.providence.org/healthplans	www.providence.org/healthplans	(800)-603-2340		(503)-574-8000		(800)-457-6064		(503)-574-5551										(888)-244-6642		(503)-574-8702		(888)-244-6642		(503)-574-8702										2	2	2
H9047	035	0	1	02	01	H9047_035_0	9	1		08/18/2011	2012.02	08/18/2011 10:52:42 AM Pacific Daylight Time	08/18/2011 02:56:15 PM Pacific Daylight Time			08/18/2011 03:04:47 PM Pacific Daylight Time	PROVIDENCE HEALTH PLAN	Providence Health Plans	www.providence.org/healthplans	Providence Medicare Choice (HMO-POS)	01	02		1			H9047	035	0	2012	Portland Metro, Willamette Valley, Clark County		2		2			2						www.providence.org/Health Plans	www.providence.org/healthplans	www.providence.org/healthplans	(800)-603-2340		(503)-574-8000		(800)-457-6064		(503)-574-5551										(888)-244-6642		(503)-574-8702		(888)-244-6642		(503)-574-8702										2	2	2
H9047	801	0	1	01	01	H9047_801_0	8	1		07/21/2011	2012.02	07/21/2011 10:55:46 AM Pacific Daylight Time	07/15/2011 09:38:41 AM Pacific Daylight Time			07/21/2011 11:45:47 AM Pacific Daylight Time	PROVIDENCE HEALTH PLAN	Providence Health Plans	www.providence.org/healthplans	Providence Medicare Extra Group Plan (HMO)	01	01		1			H9047	801	0	2012	Portland Metro, Willamette Valley, Clark County		1		2			2						www.providence.org/Health Plans	www.providence.org/healthplans	www.providence.org/healthplans	(800)-603-2340		(503)-574-8000		(800)-457-6064		(503)-574-5551										(888)-244-6642		(503)-574-8702		(888)-244-6642		(503)-574-8702										2	2	2
H9047	804	0	1	01	01	H9047_804_0	8	1		07/21/2011	2012.02	07/21/2011 11:05:12 AM Pacific Daylight Time	07/15/2011 09:39:45 AM Pacific Daylight Time			07/21/2011 11:45:47 AM Pacific Daylight Time	PROVIDENCE HEALTH PLAN	Providence Health Plans	www.providence.org/healthplans	Providence Medicare Extra Group Plan + RX (HMO)	01	01		1			H9047	804	0	2012	Portland Metro, Willamette Valley, Clark County		1		2			2						www.providence.org/Health Plans	www.providence.org/healthplans	www.providence.org/healthplans	(800)-603-2340		(503)-574-8000		(800)-457-6064		(503)-574-5551		(800)-603-2340		(503)-574-8000		(800)-457-6064		(503)-574-5551		(888)-244-6642		(503)-574-8702		(888)-244-6642		(503)-574-8702		(888)-244-6642		(503)-574-8702		(888)-244-6642		(503)-574-8702		2	2	2
H9047	805	0	1	02	01	H9047_805_0	8	1		07/21/2011	2012.02	07/21/2011 10:57:12 AM Pacific Daylight Time	07/18/2011 03:44:08 PM Pacific Daylight Time			07/21/2011 11:45:47 AM Pacific Daylight Time	PROVIDENCE HEALTH PLAN	Providence Health Plans	www.providence.org/healthplans	Providence Medicare Choice Group Plan + RX (HMO-POS)	01	02		1			H9047	805	0	2012	Portland Metro, Willamette Valley, Clark County		1		2			2						www.providence.org/Health Plans	www.providence.org/healthplans	www.providence.org/healthplans	(800)-603-2340		(503)-574-8000		(800)-457-6064		(503)-574-5551		(800)-603-2340		(503)-574-8000		(800)-457-6064		(503)-574-5551		(888)-244-6642		(503)-574-8702		(888)-244-6642		(503)-574-8702		(888)-244-6642		(503)-574-8702		(888)-244-6642		(503)-574-8702		2	2	2
H9047	806	0	1	02	01	H9047_806_0	8	1		07/21/2011	2012.02	07/21/2011 10:59:36 AM Pacific Daylight Time	07/18/2011 03:44:01 PM Pacific Daylight Time			07/21/2011 11:45:47 AM Pacific Daylight Time	PROVIDENCE HEALTH PLAN	Providence Health Plans	www.providence.org/healthplans	Providence Medicare Choice Group Plan (HMO-POS)	01	02		1			H9047	806	0	2012	Portland Metro, Willamette Valley, Clark County		1		2			2						www.providence.org/Health Plans	www.providence.org/healthplans	www.providence.org/healthplans	(800)-603-2340		(503)-574-8000		(800)-457-6064		(503)-574-5551										(888)-244-6642		(503)-574-8702		(888)-244-6642		(503)-574-8702										2	2	2
H9068	001	0	1	20	08	H9068_001_0	1	1		10/31/2011	2012.02	10/31/2011 05:40:49 PM Eastern Daylight Time		10/26/2011 09:40:16 AM Eastern Daylight Time		10/31/2011 05:42:06 PM Eastern Daylight Time	ALBRIGHT CARE SERVICES	ALBRIGHT CARE SERVICES	www.albrightlife.org	Albright LIFE (PACE)	08	20		1			H9068	001	0	2012	Albright LIFE		2		2			2							www.albrightcare.org	www.albrightcare.org									(570)-522-3880		(570)-522-3880		(570)-522-3880		(570)-522-3880										(570)-522-3880		(570)-522-3880		(570)-522-3880		(570)-522-3880				
H9068	002	0	1	20	08	H9068_002_0	1	1		10/31/2011	2012.02	10/31/2011 05:41:13 PM Eastern Daylight Time		10/26/2011 09:40:16 AM Eastern Daylight Time		10/31/2011 05:42:06 PM Eastern Daylight Time	ALBRIGHT CARE SERVICES	ALBRIGHT CARE SERVICES	www.albrightlife.org	Albright LIFE Medicare Only (PACE)	08	20		1			H9068	002	0	2012	Albright LIFE		2		2			2							www.albrightcare.org	www.albrightcare.org									(570)-522-3880		(570)-522-3880		(570)-522-3880		(570)-522-3880										(570)-522-3880		(570)-522-3880		(570)-522-3880		(570)-522-3880				
H9082	002	0	1	01	01	H9082_002_0	4	1		08/01/2011	2012.02	08/01/2011 10:52:20 AM Pacific Daylight Time	08/05/2011 09:54:00 AM Pacific Daylight Time	08/04/2011 02:10:00 PM Pacific Daylight Time		08/05/2011 02:51:40 PM Pacific Daylight Time	MOLINA HEALTHCARE OF NEW MEXICO, INC.	Molina Healthcare of New Mexico, Inc.	www.molinamedicare.com	Molina Medicare Options (HMO)	01	01		1			H9082	002	0	2012	Northwest/Central/Southern New Mexico		2		2			2						www.molinamedicare.com	www.molinamedicare.com	www.molinamedicare.com	(866)-440-0127		(866)-440-0127		(866)-403-8293		(866)-403-8293		(866)-440-0127		(866)-440-0127		(866)-403-8293		(866)-403-8293		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		(800)-346-4128		2	2	2
H9104	006	0	1	01	01	H9104_006_0	8	1		09/09/2011	2012.02	09/09/2011 03:18:58 PM Pacific Daylight Time	08/06/2011 04:47:12 PM Pacific Daylight Time	08/03/2011 03:26:00 PM Pacific Daylight Time		09/16/2011 10:40:44 AM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Healthy at Home (HMO SNP)	01	01		1			H9104	006	0	2012	Los Angeles County		2		2			1	1	2	1			http://www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H9104	007	0	1	01	01	H9104_007_0	8	1		09/09/2011	2012.02	09/09/2011 03:22:01 PM Pacific Daylight Time	08/06/2011 04:57:29 PM Pacific Daylight Time	08/03/2011 03:26:00 PM Pacific Daylight Time		09/16/2011 10:40:44 AM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Healthy at Home (HMO SNP)	01	01		1			H9104	007	0	2012	Orange County		2		2			1	1	2	1			http://www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H9104	008	0	1	01	01	H9104_008_0	8	1		09/09/2011	2012.02	09/09/2011 03:22:40 PM Pacific Daylight Time	08/06/2011 05:07:27 PM Pacific Daylight Time	08/03/2011 03:27:00 PM Pacific Daylight Time		09/16/2011 10:40:44 AM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Healthy at Home (HMO SNP)	01	01		1			H9104	008	0	2012	Riverside County		2		2			1	1	2	1			http://www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H9104	009	0	1	01	01	H9104_009_0	8	1		09/09/2011	2012.02	09/09/2011 03:23:06 PM Pacific Daylight Time	08/06/2011 05:18:02 PM Pacific Daylight Time	08/03/2011 03:28:00 PM Pacific Daylight Time		09/16/2011 10:40:44 AM Pacific Daylight Time	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	SCAN Healthy at Home (HMO SNP)	01	01		1			H9104	009	0	2012	San Bernardino County		2		2			1	1	2	1			http://www.scanhealthplan.com	http://www.scanhealthplan.com	http://www.scanhealthplan.com	(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-559-3500		(800)-559-3500		(800)-915-7226		(800)-915-7226		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		(800)-735-2929		2	2	2
H9184	002	0	1	04	01	H9184_002_0	7	1		07/18/2011	2012.02	07/18/2011 09:26:54 AM Eastern Daylight Time	08/08/2011 09:16:23 AM Central Daylight Time	08/04/2011 05:05:02 PM Central Daylight Time		08/09/2011 04:46:11 PM Central Daylight Time	BRAVO HEALTH MID-ATLANTIC, INC.	Bravo Health	www.mybravohealth.com	Bravo Freedom (PPO)	01	04		1			H9184	002	0	2012	Baltimore and District of Columbia Metro Areas		2		2			2						www.mybravohealth.com	www.mybravohealth.com/formulary	www.mybravohealth.com	(800)-291-0396		(800)-291-0396		(888)-311-4483		(888)-311-4483		(800)-291-0396		(800)-291-0396		(888)-311-4483		(888)-311-4483		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H9266	001	0	1	20	08	H9266_001_0	1	1		05/23/2011	2012.02	05/23/2011 09:22:36 AM Eastern Daylight Time		05/20/2011 04:49:28 PM Eastern Daylight Time		05/23/2011 09:24:56 AM Eastern Daylight Time	PIEDMONT HEALTH SERVICES, INC.	Piedmont Health SeniorCare	http://www.piedmonthealthseniorcare.org/	Piedmont Health SeniorCare - Dual (PACE)	08	20		1			H9266	001	0	2012	Piedmont Region of NC		2	1612	1	1		2							www.piedmonthealth.org	www.piedmonthealth.org									(877)-714-2100		(336)-532-0000		(877)-714-2100		(336)-532-0000										(877)-714-2100		(336)-532-0000		(877)-714-2100		(336)-532-0000				
H9266	003	0	1	20	08	H9266_003_0	1	1		05/23/2011	2012.02	05/23/2011 09:22:56 AM Eastern Daylight Time		05/20/2011 04:49:29 PM Eastern Daylight Time		05/23/2011 09:24:56 AM Eastern Daylight Time	PIEDMONT HEALTH SERVICES, INC.	Piedmont Health SeniorCare	http://www.piedmonthealthseniorcare.org/	Piedmont Health SeniorCare - Medicare only (PACE)	08	20		1			H9266	003	0	2012	Piedmont Region of NC		2	24	1	1		2							www.piedmonthealth.org	www.piedmonthealth.org									(877)-714-2100		(336)-532-0000		(877)-714-2100		(336)-532-0000										(877)-714-2100		(336)-532-0000		(877)-714-2100		(336)-532-0000				
H9285	001	0	1	01	01	H9285_001_0	6	1		08/01/2011	2012.02	08/01/2011 04:45:38 PM Eastern Daylight Time	08/08/2011 11:27:12 AM Eastern Daylight Time	08/08/2011 11:18:32 AM Eastern Daylight Time		08/08/2011 12:46:49 PM Eastern Daylight Time	ATLANTIS HEALTH PLAN	EASY CHOICE HEALTH PLAN OF NEW YORK	www,EasyChoiceNY.com	Easy Choice Rewards (HMO)	01	01		1			H9285	001	0	2012	Select Counties in New York		2	1	2			2						www.EasyChoiceNY.com	www.EasyChoiceNY.com	www.EasyChoiceNY.com	(888)-300-9320		(888)-300-9320		(888)-300-9320		(888)-300-9320		(888)-300-9320		(888)-300-9320		(888)-300-9320		(888)-300-9320		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		2	2	2
H9285	002	0	1	01	01	H9285_002_0	6	1		07/19/2011	2012.02	07/19/2011 03:17:11 PM Eastern Daylight Time	08/08/2011 11:25:00 AM Eastern Daylight Time	08/08/2011 11:20:22 AM Eastern Daylight Time		08/08/2011 12:46:49 PM Eastern Daylight Time	ATLANTIS HEALTH PLAN	EASY CHOICE HEALTH PLAN OF NEW YORK	www,EasyChoiceNY.com	Easy Choice Value (HMO)	01	01		1			H9285	002	0	2012	Select Counties in New York		2	1	2			2						www.EasyChoiceNY.com	www.EasyChoiceNY.com	www.EasyChoiceNY.com	(888)-300-9320		(888)-300-9320		(888)-300-9320		(888)-300-9320		(888)-300-9320		(888)-300-9320		(888)-300-9320		(888)-300-9320		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		2	2	2
H9302	001	0	1	01	01	H9302_001_0	9	1		07/12/2011	2012.02	07/12/2011 02:47:01 PM Pacific Daylight Time	08/09/2011 03:41:46 PM Pacific Daylight Time	08/09/2011 03:39:44 PM Pacific Daylight Time		08/09/2011 03:57:10 PM Pacific Daylight Time	SOUNDPATH HEALTH, INC.	Soundpath Health	www.soundpathhealth.com	Soundpath Health Apex + Rx (HMO)	01	01		1			H9302	001	0	2012	Western and Central Washington areas		2	2716	2			2						http://www.soundpathhealth.com	www.soundpathhealth.com	www.soundpathhealth.com	(866)-789-7747		(253)-345-5555		(866)-789-7747		(253)-345-5555		(866)-789-7747		(253)-345-5555		(866)-789-7747		(253)-345-5555		(866)-264-4141		(253)-284-3900		(866)-264-4141		(253)-284-3900		(866)-264-4141		(253)-284-3900		(866)-264-4141		(253)-284-3900		2	2	2
H9302	003	0	1	01	01	H9302_003_0	10	1		08/08/2011	2012.02	08/08/2011 03:42:46 PM Pacific Daylight Time	08/09/2011 03:42:13 PM Pacific Daylight Time	08/09/2011 03:42:13 PM Pacific Daylight Time		08/09/2011 03:57:10 PM Pacific Daylight Time	SOUNDPATH HEALTH, INC.	Soundpath Health	www.soundpathhealth.com	Soundpath Health Charter + Rx (HMO)	01	01		1			H9302	003	0	2012	Western and Central Washington areas		2	3724	2			2						http://www.soundpathhealth.com	www.soundpathhealth.com	www.soundpathhealth.com	(866)-789-7747		(253)-345-5555		(866)-789-7747		(253)-345-5555		(866)-789-7747		(253)-345-5555		(866)-789-7747		(253)-345-5555		(866)-264-4141		(253)-284-3900		(866)-264-4141		(253)-284-3900		(866)-264-4141		(253)-284-3900		(866)-264-4141		(253)-284-3900		2	2	2
H9302	004	0	1	01	01	H9302_004_0	4	1		07/12/2011	2012.02	07/12/2011 04:29:14 PM Pacific Daylight Time	06/30/2011 05:45:16 PM Pacific Daylight Time			07/13/2011 01:46:38 PM Pacific Daylight Time	SOUNDPATH HEALTH, INC.	Soundpath Health	www.soundpathhealth.com	Soundpath Health Alpine (HMO)	01	01		1			H9302	004	0	2012	Western and Central Washington areas		2	654	2			2						http://www.soundpathhealth.com	www.soundpathhealth.com	www.soundpathhealth.com	(866)-789-7747		(253)-345-5555		(866)-789-7747		(253)-345-5555										(866)-264-4141		(253)-284-3900		(866)-264-4141		(253)-284-3900										2	2	2
H9302	007	0	1	01	01	H9302_007_0	9	1		08/08/2011	2012.02	08/08/2011 03:43:39 PM Pacific Daylight Time	08/09/2011 03:45:23 PM Pacific Daylight Time	08/09/2011 03:45:23 PM Pacific Daylight Time		08/09/2011 03:57:10 PM Pacific Daylight Time	SOUNDPATH HEALTH, INC.	Soundpath Health	www.soundpathhealth.com	Soundpath Health Sound + Rx (HMO)	01	01		1			H9302	007	0	2012	King, Lewis, Pierce, Snohomish, Thurston counties		2	6419	2			2						http://www.soundpathhealth.com	www.soundpathhealth.com	www.soundpathhealth.com	(866)-789-7747		(253)-345-5555		(866)-789-7747		(253)-345-5555		(866)-789-7747		(253)-345-5555		(866)-789-7747		(253)-345-5555		(866)-264-4141		(253)-284-3900		(866)-264-4141		(253)-284-3900		(866)-264-4141		(253)-284-3900		(866)-264-4141		(253)-284-3900		2	2	2
H9302	009	0	1	01	01	H9302_009_0	6	1		07/12/2011	2012.02	07/12/2011 02:48:21 PM Pacific Daylight Time	06/30/2011 05:46:15 PM Pacific Daylight Time			07/13/2011 01:46:38 PM Pacific Daylight Time	SOUNDPATH HEALTH, INC.	Soundpath Health	www.soundpathhealth.com	Soundpath Health Ascent (HMO)	01	01		1			H9302	009	0	2012	Western and Central Washington areas		2	414	2			2						http://www.soundpathhealth.com	www.soundpathhealth.com	www.soundpathhealth.com	(866)-789-7747		(253)-345-5555		(866)-789-7747		(253)-345-5555										(866)-264-4141		(253)-284-3900		(866)-264-4141		(253)-284-3900										2	2	2
H9302	010	0	1	01	01	H9302_010_0	9	1		08/08/2011	2012.02	08/08/2011 03:44:26 PM Pacific Daylight Time	08/09/2011 03:39:44 PM Pacific Daylight Time	08/09/2011 03:45:23 PM Pacific Daylight Time		08/09/2011 03:57:10 PM Pacific Daylight Time	SOUNDPATH HEALTH, INC.	Soundpath Health	www.soundpathhealth.com	Soundpath Health Pinnacle + Rx (HMO)	01	01		1			H9302	010	0	2012	Chelan, Douglas, Grant, Whatcom counties		2	1133	2			2						http://www.soundpathhealth.com	www.soundpathhealth.com	www.soundpathhealth.com	(866)-789-7747		(253)-345-5555		(866)-789-7747		(253)-345-5555		(866)-789-7747		(253)-345-5555		(866)-789-7747		(253)-345-5555		(866)-264-4141		(253)-284-3900		(866)-264-4141		(253)-284-3900		(866)-264-4141		(253)-284-3900		(866)-264-4141		(253)-284-3900		2	2	2
H9302	801	0	1	01	01	H9302_801_0	3	1		06/03/2011	2012.02	06/03/2011 08:53:57 AM Pacific Daylight Time	06/06/2011 02:44:09 PM Pacific Daylight Time			06/07/2011 09:19:27 AM Pacific Daylight Time	SOUNDPATH HEALTH, INC.	Soundpath Health	www.soundpathhealth.com.	Soundpath Health + Rx (HMO)	01	01		1			H9302	801	0	2012	Western and Central Washington areas		1	9	2			2						http://www.soundpathhealth.com	www.soundpathhealth.com	www.soundpathhealth.com	(866)-789-7747		(253)-345-5555		(866)-789-7747		(253)-345-5555		(866)-789-7747		(253)-345-5555		(866)-789-7747		(253)-345-5555		(866)-264-4141		(253)-284-3900		(866)-264-4141		(253)-284-3900		(866)-264-4141		(253)-284-3900		(866)-264-4141		(253)-284-3900		1	1	1
H9385	001	0	1	01	01	H9385_001_0	5	1	2	07/18/2011	2012.02	07/18/2011 01:40:40 PM Pacific Daylight Time	08/12/2011 08:42:37 AM Pacific Daylight Time	08/03/2011 03:28:00 PM Pacific Daylight Time		08/12/2011 09:23:19 AM Pacific Daylight Time	SCAN HEALTH PLAN OF ARIZONA	SCAN Health Plan Arizona	www.scanhealthplan.com	SCAN Connections (HMO SNP)	01	01		1			H9385	001	0	2012	Maricopa County		2		2			1	3		1	5		www.scanhealthplan.com	http://www.scanhealthplan.com/Arizona/Medicare	http://www.scanhealthplan.com	(888)-540-7226		(602)-778-3300		(866)-490-7226		(602)-778-3300		(888)-540-7226		(602)-778-3300		(866)-490-7226		(602)-778-3300		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		2	2	2
H9385	002	0	1	01	01	H9385_002_0	6	1		08/08/2011	2012.02	08/08/2011 11:33:37 AM Pacific Daylight Time	08/08/2011 05:35:40 PM Pacific Daylight Time	08/03/2011 03:29:00 PM Pacific Daylight Time		08/09/2011 11:19:50 AM Pacific Daylight Time	SCAN HEALTH PLAN OF ARIZONA	SCAN Health Plan Arizona	www.scanhealthplan.com	SCAN Classic (HMO)	01	01		1			H9385	002	0	2012	Maricopa and Pima County		2		2			2						www.scanhealthplan.com	http://www.scanhealthplan.com/Arizona/Medicare	http://www.scanhealthplan.com	(888)-540-7226		(602)-778-3300		(866)-490-7226		(602)-778-3300		(888)-540-7226		(602)-778-3300		(866)-490-7226		(602)-778-3300		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		2	2	2
H9385	805	0	1	01	01	H9385_805_0	5	1		07/18/2011	2012.02	07/18/2011 01:40:55 PM Pacific Daylight Time	08/18/2011 01:52:43 PM Pacific Daylight Time			08/19/2011 09:34:33 AM Pacific Daylight Time	SCAN HEALTH PLAN OF ARIZONA	SCAN Health Plan Arizona	www.scanhealthplan.com	SCAN Arizona Employer Group (HMO)	01	01		1			H9385	805	0	2012	Maricopa and Pima County		1		2			2						www.scanhealthplan.com	http://www.scanhealthplan.com/Arizona/Medicare	http://www.scanhealthplan.com	(888)-540-7226		(602)-778-3300		(866)-490-7226		(602)-778-3300										(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939										2	2	2
H9385	807	0	1	01	01	H9385_807_0	5	1		07/18/2011	2012.02	07/18/2011 01:41:03 PM Pacific Daylight Time	08/18/2011 02:11:43 PM Pacific Daylight Time			08/19/2011 09:34:33 AM Pacific Daylight Time	SCAN HEALTH PLAN OF ARIZONA	SCAN Health Plan Arizona	www.scanhealthplan.com	SCAN Arizona Employer Group (HMO)	01	01		1			H9385	807	0	2012	Maricopa and Pima County		1		2			2						www.scanhealthplan.com	http://www.scanhealthplan.com/Arizona/Medicare	http://www.scanhealthplan.com	(888)-540-7226		(602)-778-3300		(866)-490-7226		(602)-778-3300		(888)-540-7226		(602)-778-3300		(866)-490-7226		(602)-778-3300		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		2	2	2
H9385	808	0	1	01	01	H9385_808_0	5	1		07/18/2011	2012.02	07/18/2011 01:41:13 PM Pacific Daylight Time	08/18/2011 02:26:12 PM Pacific Daylight Time			08/19/2011 09:34:33 AM Pacific Daylight Time	SCAN HEALTH PLAN OF ARIZONA	SCAN Health Plan Arizona	www.scanhealthplan.com	SCAN Arizona Employer Group (HMO)	01	01		1			H9385	808	0	2012	Maricopa and Pima County		1		2			2						www.scanhealthplan.com	http://www.scanhealthplan.com/Arizona/Medicare	http://www.scanhealthplan.com	(888)-540-7226		(602)-778-3300		(866)-490-7226		(602)-778-3300		(888)-540-7226		(602)-778-3300		(866)-490-7226		(602)-778-3300		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		(800)-367-8939		2	2	2
H9503	001	0	1	04	01	H9503_001_0	7	1		07/08/2011	2012.02	07/08/2011 10:21:12 AM Eastern Daylight Time	08/04/2011 03:15:00 PM Eastern Daylight Time	08/04/2011 01:16:09 PM Eastern Daylight Time		08/08/2011 04:33:34 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H9503-001 (PPO)	01	04		1			H9503	001	0	2012	Clark County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H9503	003	0	1	04	01	H9503_003_0	6	1		07/08/2011	2012.02	07/08/2011 10:25:26 AM Eastern Daylight Time	08/04/2011 03:16:18 PM Eastern Daylight Time	08/04/2011 01:16:29 PM Eastern Daylight Time		08/08/2011 04:33:34 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H9503-003 (PPO)	01	04		1			H9503	003	0	2012	Washoe County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H9503	005	0	1	04	01	H9503_005_0	4	1		07/08/2011	2012.02	07/08/2011 10:16:56 AM Eastern Daylight Time	06/04/2011 03:24:07 PM Eastern Daylight Time			07/11/2011 01:48:58 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H9503-005 (PPO)	01	04		1			H9503	005	0	2012	Washoe County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
H9503	006	0	1	04	01	H9503_006_0	6	1		07/08/2011	2012.02	07/08/2011 10:17:26 AM Eastern Daylight Time	08/04/2011 03:32:58 PM Eastern Daylight Time	08/04/2011 01:16:48 PM Eastern Daylight Time		08/08/2011 04:37:22 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice H9503-006 (PPO)	01	04		1			H9503	006	0	2012	Washoe County		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H9572	001	1	1	04	01	H9572_001_1	9	1		07/14/2011	2012.02	07/14/2011 10:13:12 AM Eastern Daylight Time	08/04/2011 05:55:05 PM Eastern Daylight Time	08/05/2011 11:02:06 AM Eastern Daylight Time		08/08/2011 04:59:48 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Signature (PPO)	01	04		1			H9572	001	1	2012	State of Michigan	Grand Rapids and Muskegon Area	2	7440	2			2						www.bcbsm.com/medicare/search.shtml	www.bcbsm.com/medicare/formulary.shtml	www.bcbsm.com/medicare/rxdirectory.shtml	(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		2	2	2
H9572	001	2	1	04	01	H9572_001_2	8	1		07/14/2011	2012.02	07/14/2011 10:13:48 AM Eastern Daylight Time	08/04/2011 05:55:13 PM Eastern Daylight Time	08/05/2011 11:02:10 AM Eastern Daylight Time		08/08/2011 04:59:48 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Signature (PPO)	01	04		1			H9572	001	2	2012	State of Michigan	Lansing and Southwesy Michigan	2	7440	2			2						www.bcbsm.com/medicare/search.shtml	www.bcbsm.com/medicare/formulary.shtml	www.bcbsm.com/medicare/rxdirectory.shtml	(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		2	2	2
H9572	001	3	1	04	01	H9572_001_3	8	1		07/14/2011	2012.02	07/14/2011 10:13:57 AM Eastern Daylight Time	08/04/2011 05:55:21 PM Eastern Daylight Time	08/05/2011 11:02:14 AM Eastern Daylight Time		08/08/2011 04:59:48 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Signature (PPO)	01	04		1			H9572	001	3	2012	State of Michigan	UP + Northern Lower Michigan	2	7440	2			2						www.bcbsm.com/medicare/search.shtml	www.bcbsm.com/medicare/formulary.shtml	www.bcbsm.com/medicare/rxdirectory.shtml	(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		2	2	2
H9572	001	4	1	04	01	H9572_001_4	8	1		07/14/2011	2012.02	07/14/2011 10:14:05 AM Eastern Daylight Time	08/04/2011 05:55:29 PM Eastern Daylight Time	08/05/2011 11:02:18 AM Eastern Daylight Time		08/08/2011 04:59:48 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Signature (PPO)	01	04		1			H9572	001	4	2012	State of Michigan	Ann Arbor-Jackson-Monroe Area	2	7440	2			2						www.bcbsm.com/medicare/search.shtml	www.bcbsm.com/medicare/formulary.shtml	www.bcbsm.com/medicare/rxdirectory.shtml	(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		2	2	2
H9572	001	5	1	04	01	H9572_001_5	8	1		07/14/2011	2012.02	07/14/2011 10:14:13 AM Eastern Daylight Time	08/04/2011 05:55:37 PM Eastern Daylight Time	08/05/2011 11:02:22 AM Eastern Daylight Time		08/08/2011 04:59:48 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Signature (PPO)	01	04		1			H9572	001	5	2012	State of Michigan	Central Lower Michigan and Thumb Area	2	7440	2			2						www.bcbsm.com/medicare/search.shtml	www.bcbsm.com/medicare/formulary.shtml	www.bcbsm.com/medicare/rxdirectory.shtml	(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		2	2	2
H9572	001	6	1	04	01	H9572_001_6	8	1		07/14/2011	2012.02	07/14/2011 10:14:20 AM Eastern Daylight Time	08/04/2011 05:55:45 PM Eastern Daylight Time	08/05/2011 11:02:26 AM Eastern Daylight Time		08/08/2011 04:59:48 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Signature (PPO)	01	04		1			H9572	001	6	2012	State of Michigan	Macomb, Oakland and Wayne Counties	2	7440	2			2						www.bcbsm.com/medicare/search.shtml	www.bcbsm.com/medicare/formulary.shtml	www.bcbsm.com/medicare/rxdirectory.shtml	(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		2	2	2
H9572	002	1	1	04	01	H9572_002_1	7	1		07/28/2011	2012.02	07/28/2011 05:00:13 PM Eastern Daylight Time	08/04/2011 05:55:52 PM Eastern Daylight Time	08/05/2011 11:02:31 AM Eastern Daylight Time		08/08/2011 04:59:48 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Vitality (PPO)	01	04		1			H9572	002	1	2012	State of Michigan	Grand Rapids and Muskegon Area	2	913	2			2						www.bcbsm.com/medicare/search.shtml	www.bcbsm.com/medicare/formulary.shtml	www.bcbsm.com/medicare/rxdirectory.shtml	(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		2	2	2
H9572	002	2	1	04	01	H9572_002_2	7	1		07/14/2011	2012.02	07/14/2011 10:19:40 AM Eastern Daylight Time	08/04/2011 05:56:00 PM Eastern Daylight Time	08/05/2011 11:02:36 AM Eastern Daylight Time		08/08/2011 04:59:48 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Vitality (PPO)	01	04		1			H9572	002	2	2012	State of Michigan	Lansing and Southwest Michigan	2	913	2			2						www.bcbsm.com/medicare/search.shtml	www.bcbsm.com/medicare/formulary.shtml	www.bcbsm.com/medicare/rxdirectory.shtml	(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		2	2	2
H9572	002	3	1	04	01	H9572_002_3	7	1		07/14/2011	2012.02	07/14/2011 10:19:46 AM Eastern Daylight Time	08/04/2011 05:56:09 PM Eastern Daylight Time	08/05/2011 11:02:41 AM Eastern Daylight Time		08/08/2011 04:59:48 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Vitality (PPO)	01	04		1			H9572	002	3	2012	State of Michigan	UP + Northern Lower Michigan	2	913	2			2						www.bcbsm.com/medicare/search.shtml	www.bcbsm.com/medicare/formulary.shtml	www.bcbsm.com/medicare/rxdirectory.shtml	(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		2	2	2
H9572	002	4	1	04	01	H9572_002_4	7	1		07/14/2011	2012.02	07/14/2011 10:19:53 AM Eastern Daylight Time	08/04/2011 05:56:17 PM Eastern Daylight Time	08/05/2011 11:02:46 AM Eastern Daylight Time		08/08/2011 04:59:48 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Vitality (PPO)	01	04		1			H9572	002	4	2012	State of Michigan	Ann Arbor - Jackson - Monroe Area	2	913	2			2						www.bcbsm.com/medicare/search.shtml	www.bcbsm.com/medicare/formulary.shtml	www.bcbsm.com/medicare/rxdirectory.shtml	(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		2	2	2
H9572	002	5	1	04	01	H9572_002_5	7	1		07/14/2011	2012.02	07/14/2011 10:20:00 AM Eastern Daylight Time	08/04/2011 05:56:25 PM Eastern Daylight Time	08/05/2011 11:02:50 AM Eastern Daylight Time		08/08/2011 04:59:48 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Vitality (PPO)	01	04		1			H9572	002	5	2012	State of Michigan	Central Lower Michigan and Thumb Area	2	913	2			2						www.bcbsm.com/medicare/search.shtml	www.bcbsm.com/medicare/formulary.shtml	www.bcbsm.com/medicare/rxdirectory.shtml	(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		2	2	2
H9572	002	6	1	04	01	H9572_002_6	7	1		07/14/2011	2012.02	07/14/2011 10:20:06 AM Eastern Daylight Time	08/04/2011 05:56:33 PM Eastern Daylight Time	08/05/2011 11:02:55 AM Eastern Daylight Time		08/08/2011 04:59:48 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Vitality (PPO)	01	04		1			H9572	002	6	2012	State of Michigan	Macomb, Oakland and Wayne Counties	2	913	2			2						www.bcbsm.com/medicare/search.shtml	www.bcbsm.com/medicare/formulary.shtml	www.bcbsm.com/medicare/rxdirectory.shtml	(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		2	2	2
H9572	003	1	1	04	01	H9572_003_1	8	1		07/14/2011	2012.02	07/14/2011 10:20:15 AM Eastern Daylight Time	08/04/2011 05:56:42 PM Eastern Daylight Time	08/05/2011 11:03:00 AM Eastern Daylight Time		08/08/2011 04:59:48 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Assure (PPO)	01	04		1			H9572	003	1	2012	State of Michigan	Grand Rapids and Muskegon Area	2	4780	2			2						www.bcbsm.com/medicare/search.shtml	www.bcbsm.com/medicare/formulary.shtml	www.bcbsm.com/medicare/rxdirectory.shtml	(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		2	2	2
H9572	003	2	1	04	01	H9572_003_2	8	1		07/14/2011	2012.02	07/14/2011 10:20:24 AM Eastern Daylight Time	08/04/2011 05:56:53 PM Eastern Daylight Time	08/05/2011 11:03:04 AM Eastern Daylight Time		08/08/2011 04:59:48 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Assure (PPO)	01	04		1			H9572	003	2	2012	State of Michigan	Lansing and Southwest Michigan	2	4780	2			2						www.bcbsm.com/medicare/search.shtml	www.bcbsm.com/medicare/formulary.shtml	www.bcbsm.com/medicare/rxdirectory.shtml	(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		2	2	2
H9572	003	3	1	04	01	H9572_003_3	8	1		07/14/2011	2012.02	07/14/2011 10:20:31 AM Eastern Daylight Time	08/04/2011 05:57:02 PM Eastern Daylight Time	08/05/2011 11:03:08 AM Eastern Daylight Time		08/08/2011 04:59:48 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Assure (PPO)	01	04		1			H9572	003	3	2012	State of Michigan	UP + Northern Lower Michigan	2	4780	2			2						www.bcbsm.com/medicare/search.shtml	www.bcbsm.com/medicare/formulary.shtml	www.bcbsm.com/medicare/rxdirectory.shtml	(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		2	2	2
H9572	003	4	1	04	01	H9572_003_4	8	1		07/14/2011	2012.02	07/14/2011 10:20:39 AM Eastern Daylight Time	08/04/2011 05:57:10 PM Eastern Daylight Time	08/05/2011 11:03:12 AM Eastern Daylight Time		08/08/2011 04:59:48 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Assure (PPO)	01	04		1			H9572	003	4	2012	State of Michigan	Ann Arbor - Jackson - Monroe Area	2	4780	2			2						www.bcbsm.com/medicare/search.shtml	www.bcbsm.com/medicare/formulary.shtml	www.bcbsm.com/medicare/rxdirectory.shtml	(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		2	2	2
H9572	003	5	1	04	01	H9572_003_5	8	1		07/14/2011	2012.02	07/14/2011 10:20:47 AM Eastern Daylight Time	08/04/2011 05:57:18 PM Eastern Daylight Time	08/05/2011 11:03:16 AM Eastern Daylight Time		08/08/2011 04:59:48 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Assure (PPO)	01	04		1			H9572	003	5	2012	State of Michigan	Central Lower Michigan and Thumb Area	2	4780	2			2						www.bcbsm.com/medicare/search.shtml	www.bcbsm.com/medicare/formulary.shtml	www.bcbsm.com/medicare/rxdirectory.shtml	(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		2	2	2
H9572	003	6	1	04	01	H9572_003_6	9	1		07/14/2011	2012.02	07/14/2011 10:20:55 AM Eastern Daylight Time	08/04/2011 05:57:26 PM Eastern Daylight Time	08/05/2011 11:03:21 AM Eastern Daylight Time		08/08/2011 04:59:48 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Assure (PPO)	01	04		1			H9572	003	6	2012	State of Michigan	Macomb, Oakland and Wayne Counties	2	4780	2			2						www.bcbsm.com/medicare/search.shtml	www.bcbsm.com/medicare/formulary.shtml	www.bcbsm.com/medicare/rxdirectory.shtml	(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		2	2	2
H9572	801	0	1	04	01	H9572_801_0	7	1		07/13/2011	2012.02	07/13/2011 10:02:55 AM Eastern Daylight Time	06/05/2011 07:31:02 PM Eastern Daylight Time			07/13/2011 11:36:08 AM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Employer Rx CY (PPO)	01	04		1			H9572	801	0	2012	State of Michigan		1	12000	2			2						www.bcbsm.com/medicare/search.shtml	www.bcbsm.com/medicare/formulary.shtml	www.bcbsm.com/medicare/rxdirectory.shtml	(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		2	2	2
H9572	802	0	1	04	01	H9572_802_0	8	1		07/13/2011	2012.02	07/13/2011 10:03:29 AM Eastern Daylight Time	06/06/2011 07:38:24 PM Eastern Daylight Time			07/13/2011 11:36:08 AM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Employer CY (PPO)	01	04		1			H9572	802	0	2012	State of Michigan		1	12000	2			2						www.bcbsm.com/medicare/search.shtml	www.bcbsm.com/medicare/formulary.shtml	www.bcbsm.com/medicare/rxdirectory.shtml	(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583										(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704										2	2	2
H9572	803	0	1	04	01	H9572_803_0	5	1		07/13/2011	2012.02	07/13/2011 10:04:20 AM Eastern Daylight Time	06/06/2011 07:51:08 PM Eastern Daylight Time			07/13/2011 11:36:08 AM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Employer Rx non-CY (PPO)	01	04		1			H9572	803	0	2012	State of Michigan		1	12000	2			2						www.bcbsm.com/medicare/search.shtml	www.bcbsm.com/medicare/formulary.shtml	www.bcbsm.com/medicare/rxdirectory.shtml	(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704		2	2	2
H9572	804	0	1	04	01	H9572_804_0	5	1		07/13/2011	2012.02	07/13/2011 10:04:56 AM Eastern Daylight Time	06/06/2011 08:00:08 PM Eastern Daylight Time			07/13/2011 11:36:08 AM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Medicare Plus Blue PPO Employer non-CY (PPO)	01	04		1			H9572	804	0	2012	State of Michigan		1	12000	2			2						www.bcbsm.com/medicare/search.shtml	www.bcbsm.com/medicare/formulary.shtml	www.bcbsm.com/medicare/rxdirectory.shtml	(877)-241-2583		(877)-241-2583		(877)-469-2583		(877)-469-2583										(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704										2	2	2
H9615	002	0	1	04	01	H9615_002_0	6	1		07/15/2011	2012.02	07/15/2011 10:58:42 AM Eastern Daylight Time	08/05/2011 02:53:10 PM Eastern Daylight Time	08/05/2011 01:16:23 PM Eastern Daylight Time		08/09/2011 08:36:14 AM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.joinMVPmedicare.com	GoldAnywhere Rx (PPO)	01	04		1			H9615	002	0	2012	Eastern NY/Central NY		2	2483	2			2						www.mvphealthcare.com	https://www.mvphealthcare.com/medicare/documents/2011_Comprehensive_Formulary_roc.pdf	www.mvphealthcare.com	(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205		(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		2	2	2
H9615	802	0	1	04	01	H9615_802_0	2	1		05/26/2011	2012.02	05/26/2011 12:27:18 PM Eastern Daylight Time	07/12/2011 09:55:39 AM Eastern Daylight Time			07/14/2011 09:41:36 AM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.mvphealthcare.com	GoldAnywhere Rx - Employer Group (PPO)	01	04		1			H9615	802	0	2012	Eastern NY/Central NY/Vermont		1	2148	2			2						www.mvphealthcare.com	https://www.mvphealthcare.com/medicare/documents/2011_Comprehensive_Formulary_roc.pdf	www.mvphealthcare.com	(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205		(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		1	1	1
H9615	804	0	1	04	01	H9615_804_0	2	1		05/26/2011	2012.02	05/26/2011 12:27:43 PM Eastern Daylight Time	07/12/2011 09:56:00 AM Eastern Daylight Time			07/14/2011 09:41:36 AM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.mvphealthcare.com	GoldAnywhere Rx - Employer Group (PPO)	01	04		1			H9615	804	0	2012	Mid-Hudson NY		1	540	2			2						www.mvphealthcare.com	https://www.mvphealthcare.com/medicare/documents/2011_Comprehensive_Formulary_roc.pdf	www.mvphealthcare.com	(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205		(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		1	1	1
H9615	807	0	1	04	01	H9615_807_0	2	1		05/27/2011	2012.02	05/27/2011 03:48:07 PM Eastern Daylight Time	07/12/2011 09:55:06 AM Eastern Daylight Time			07/14/2011 09:41:36 AM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.mvphealthcare.com	USA Care Rx - Employer Group (PPO)	01	04		1			H9615	807	0	2012	United States and Puerto Rico		1	299	2			2						www.mvphealthcare.com	https://www.mvphealthcare.com/medicare/documents/2011_Comprehensive_Formulary_roc.pdf	www.mvphealthcare.com	(888)-597-4419		(888)-597-4419		(888)-280-6205		(888)-280-6205		(888)-597-4419		(888)-597-4419		(888)-280-6205		(888)-280-6205		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		1	1	1
H9670	003	0	1	04	01	H9670_003_0	6	1		06/07/2011	2012.02	06/07/2011 06:59:17 AM Eastern Daylight Time	08/11/2011 10:59:45 AM Eastern Daylight Time	08/09/2011 06:58:42 AM Eastern Daylight Time		08/11/2011 11:11:30 AM Eastern Daylight Time	UPMC HEALTH BENEFITS, INC.	UPMC Health Plan	http://www.upmchealthplan.com/medicare/	UPMC for Life PPO High Deductible with Rx OH (PPO)	01	04		1			H9670	003	0	2012	Ohio Counties		2	100	2			2						http://www.upmchealthplan.com/medicare/	http://www.upmchealthplan.com/medicare/partd.html	http://www.upmchealthplan.com/medicare/partd.html	(877)-539-3080		(877)-539-3080		(877)-381-3765		(877)-381-3765		(877)-539-3080		(877)-539-3080		(877)-381-3765		(877)-381-3765		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		2	2	2
H9670	004	0	1	04	01	H9670_004_0	6	1		06/07/2011	2012.02	06/07/2011 07:01:46 AM Eastern Daylight Time	08/11/2011 11:00:35 AM Eastern Daylight Time	08/09/2011 06:59:27 AM Eastern Daylight Time		08/11/2011 11:11:30 AM Eastern Daylight Time	UPMC HEALTH BENEFITS, INC.	UPMC Health Plan	http://www.upmchealthplan.com/medicare/	UPMC for Life PPO High Deductible with Rx WV (PPO)	01	04		1			H9670	004	0	2012	West Virginia Counties		2	100	2			2						http://www.upmchealthplan.com/medicare/	http://www.upmchealthplan.com/medicare/partd.html	http://www.upmchealthplan.com/medicare/partd.html	(877)-539-3080		(877)-539-3080		(877)-381-3765		(877)-381-3765		(877)-539-3080		(877)-539-3080		(877)-381-3765		(877)-381-3765		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		2	2	2
H9670	801	0	1	04	01	H9670_801_0	1	1		05/25/2011	2012.02	05/25/2011 11:01:11 AM Eastern Daylight Time	06/01/2011 12:46:41 PM Eastern Daylight Time			06/01/2011 01:15:34 PM Eastern Daylight Time	UPMC HEALTH BENEFITS, INC.	UPMC Health Plan	http://www.upmchealthplan.com/medicare/	UPMC Employer Group (PPO)	01	04		1			H9670	801	0	2012	Ohio and West Virginia		1	300	2			2						http://www.upmchealthplan.com/medicare/	http://www.upmchealthplan.com/medicare/partd.html	http://www.upmchealthplan.com/medicare/partd.html	(877)-539-3080		(877)-539-3080		(877)-381-3765		(877)-381-3765										(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629										2	2	2
H9670	802	0	1	04	01	H9670_802_0	1	1		05/25/2011	2012.02	05/25/2011 11:01:30 AM Eastern Daylight Time	06/01/2011 12:35:04 PM Eastern Daylight Time			06/01/2011 01:15:34 PM Eastern Daylight Time	UPMC HEALTH BENEFITS, INC.	UPMC Health Plan	http://www.upmchealthplan.com/medicare/	UPMC Employer Group Rx (PPO)	01	04		1			H9670	802	0	2012	Ohio and West Virginia		1	900	2			2						http://www.upmchealthplan.com/medicare/	http://www.upmchealthplan.com/medicare/partd.html	http://www.upmchealthplan.com/medicare/partd.html	(877)-539-3080		(877)-539-3080		(877)-381-3765		(877)-381-3765		(877)-539-3080		(877)-539-3080		(877)-381-3765		(877)-381-3765		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		2	2	2
H9670	803	0	1	04	01	H9670_803_0	1	1		05/25/2011	2012.02	05/25/2011 11:01:53 AM Eastern Daylight Time	06/01/2011 12:36:12 PM Eastern Daylight Time			06/01/2011 01:15:34 PM Eastern Daylight Time	UPMC HEALTH BENEFITS, INC.	UPMC Health Plan	http://www.upmchealthplan.com/medicare/	UPMC Employer Group Rx (PPO)	01	04		1			H9670	803	0	2012	Ohio and West Virginia		1	100	2			2						http://www.upmchealthplan.com/medicare/	http://www.upmchealthplan.com/medicare/partd.html	http://www.upmchealthplan.com/medicare/partd.html	(877)-539-3080		(877)-539-3080		(877)-381-3765		(877)-381-3765		(877)-539-3080		(877)-539-3080		(877)-381-3765		(877)-381-3765		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629		2	2	2
H9720	038	0	1	09	04	H9720_038_0	5	1		07/15/2011	2012.02	07/15/2011 02:46:10 PM Eastern Daylight Time	07/08/2011 02:10:12 PM Eastern Daylight Time			07/15/2011 02:49:36 PM Eastern Daylight Time	AMERICA'S 1ST CHOICE HEALTH PLANS, INC.	AMERICA'S 1ST CHOICE HEALTH PLANS, INC.	www.Americas1stChoice.com	Presidential (PFFS)	04	09	2	1			H9720	038	0	2012	Select Counties in Georgia		2	1	2			2							www.americas1stchoice.com	www.americas1stchoice.com	(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947										(800)-735-8583		(800)-735-8583		(800)-735-8583		(800)-735-8583										2		2
H9720	039	0	1	09	04	H9720_039_0	6	1		07/15/2011	2012.02	07/15/2011 02:46:23 PM Eastern Daylight Time	08/05/2011 03:00:21 PM Eastern Daylight Time	08/05/2011 03:00:21 PM Eastern Daylight Time		08/05/2011 04:51:31 PM Eastern Daylight Time	AMERICA'S 1ST CHOICE HEALTH PLANS, INC.	AMERICA'S 1ST CHOICE HEALTH PLANS, INC.	www.Americas1stChoice.com	Presidential Plus (PFFS)	04	09	2	1			H9720	039	0	2012	Select Counties in Georgia		2	1	2			2							www.americas1stchoice.com	www.americas1stchoice.com	(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947		(866)-321-3947		(800)-735-8583		(800)-735-8583		(800)-735-8583		(800)-735-8583		(800)-735-8583		(800)-735-8583		(800)-735-8583		(800)-735-8583		2		2
H9788	001	0	1	07	02	H9788_001_0	3	2		06/03/2011	2012.02	06/03/2011 09:56:23 AM Eastern Daylight Time			06/05/2011 09:22:51 PM Eastern Daylight Time	06/05/2011 09:54:26 PM Eastern Daylight Time	HEALTHNOW NEW YORK INC.	ActiveSaver MSA and BlueSaver MSA	www.bcbswny.com	BlueSaver MSA (MSA)	02	07	2	1			H9788	001	0	2012	Western New York		2	500	2			2									(866)-346-6134		(866)-346-6134		(888)-587-2583		(888)-587-2583										(866)-346-6135		(866)-346-6135		(877)-286-5710		(877)-286-5710												
H9788	002	0	1	07	02	H9788_002_0	2	2		06/03/2011	2012.02	06/03/2011 09:56:33 AM Eastern Daylight Time			06/05/2011 09:22:58 PM Eastern Daylight Time	06/05/2011 09:54:26 PM Eastern Daylight Time	HEALTHNOW NEW YORK INC.	ActiveSaver MSA and BlueSaver MSA	www.bsneny.com	BlueSaver MSA (MSA)	02	07	2	1			H9788	002	0	2012	NorthEastern New York		2	500	2			2									(866)-346-6134		(866)-346-6134		(877)-258-7453		(877)-258-7453										(866)-346-6135		(866)-346-6135		(877)-513-1470		(877)-513-1470												
H9788	003	0	1	07	02	H9788_003_0	2	2		06/03/2011	2012.02	06/03/2011 09:56:42 AM Eastern Daylight Time			06/05/2011 09:23:06 PM Eastern Daylight Time	06/05/2011 09:54:26 PM Eastern Daylight Time	HEALTHNOW NEW YORK INC.	ActiveSaver MSA and BlueSaver MSA	www.healthnowny.com	ActiveSaver MSA (MSA)	02	07	2	1			H9788	003	0	2012	HealthNow New York Inc. of CNY		2	500	2			2									(866)-346-6134		(866)-346-6134		(888)-989-9905		(888)-989-9905										(866)-346-6135		(866)-346-6135		(877)-513-1470		(877)-513-1470												
H9788	004	0	1	07	02	H9788_004_0	2	2		06/03/2011	2012.02	06/03/2011 09:56:52 AM Eastern Daylight Time			06/05/2011 09:23:12 PM Eastern Daylight Time	06/05/2011 09:54:26 PM Eastern Daylight Time	HEALTHNOW NEW YORK INC.	ActiveSaver MSA and BlueSaver MSA	www.healthnowny.com	ActiveSaver MSA (MSA)	02	07	2	1			H9788	004	0	2012	HealthNow New York Inc. Downstate NY		2	500	2			2									(866)-346-6134		(866)-346-6134		(888)-989-9905		(888)-989-9905										(866)-346-6135		(866)-346-6135		(877)-513-1470		(877)-513-1470												
H9788	801	0	1	07	02	H9788_801_0	2	2		06/03/2011	2012.02	06/03/2011 09:57:04 AM Eastern Daylight Time			06/05/2011 09:23:19 PM Eastern Daylight Time	06/05/2011 09:54:26 PM Eastern Daylight Time	HEALTHNOW NEW YORK INC.	ActiveSaver MSA and BlueSaver MSA	www.bcbswny.com,www.bsneny.com,www.healthnowny.com	BlueSaver MSA (MSA)	02	07	2	1			H9788	801	0	2012	New York State		1	500	2			2									(866)-346-6134		(866)-346-6134		(888)-587-2583		(888)-587-2583										(866)-346-6135		(866)-346-6135		(877)-286-5710		(877)-286-5710												
H9788	802	0	1	07	02	H9788_802_0	2	2		06/03/2011	2012.02	06/03/2011 09:57:12 AM Eastern Daylight Time			06/05/2011 09:23:26 PM Eastern Daylight Time	06/05/2011 09:54:26 PM Eastern Daylight Time	HEALTHNOW NEW YORK INC.	ActiveSaver MSA and BlueSaver MSA	www.bcbswny.com,www.bsneny.com,www.healthnowny.com	ActiveSaver MSA (MSA)	02	07	2	1			H9788	802	0	2012	New York State		1	500	2			2									(866)-346-6134		(866)-346-6134		(888)-989-9905		(888)-989-9905										(866)-346-6135		(866)-346-6135		(877)-513-1470		(877)-513-1470												
H9830	001	0	1	20	08	H9830_001_0	1	1		05/31/2011	2012.02	05/31/2011 02:27:00 PM Eastern Daylight Time		05/31/2011 11:15:57 AM Eastern Daylight Time		05/31/2011 02:54:28 PM Eastern Daylight Time	NEWCOURTLAND LIFE PROGRAM	NewCourtland LIFE Program	www.newcourtlandlife.org	NewCourtland LIFE  - Dual (PACE)	08	20		1			H9830	001	0	2012	NewCourtland LIFE - Dual		2		2			2							N/A	http://www.medicineshoppe.com/FranchiseeLocations/1024/SpecialServices.aspx									(888)-625-4334		(267)-335-1500		(888)-625-4334		(267)-335-1500										(888)-625-4334		(267)-335-1500		(888)-625-4334		(267)-335-1500				
H9830	002	0	1	20	08	H9830_002_0	1	1		05/31/2011	2012.02	05/31/2011 02:27:30 PM Eastern Daylight Time		05/31/2011 11:15:57 AM Eastern Daylight Time		05/31/2011 02:54:28 PM Eastern Daylight Time	NEWCOURTLAND LIFE PROGRAM	NewCourtland LIFE Program	www.newcourtlandlife.org	NewCourland LIFE - Medicare only (PACE)	08	20		1			H9830	002	0	2012	NewCourtland LIFE - Medicare only		2		2			2							N/A	http://www.medicineshoppe.com/FranchiseeLocations/1024/SpecialServices.aspx									(888)-625-4334		(267)-335-1500		(888)-625-4334		(267)-335-1500										(888)-625-4334		(267)-335-1500		(888)-625-4334		(267)-335-1500				
H9847	001	0	1	04	01	H9847_001_0	10	1		08/09/2011	2012.02	08/09/2011 07:34:15 AM Eastern Daylight Time	08/08/2011 02:52:07 PM Eastern Daylight Time	08/08/2011 02:50:31 PM Eastern Daylight Time		08/09/2011 07:41:47 AM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.nc.chcadvantra.com	Advantra Gold (PPO)	01	04		1			H9847	001	0	2012	North Carolina		2	9615	2			2						www.nc.chcadvantra.com	www.chcadvantra.com	www.chcadvantra.com	(866)-731-9574		(866)-731-9574		(877)-886-7567		(877)-886-7567		(877)-300-5134		(877)-300-5134		(877)-984-5110		(877)-984-5110		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
H9847	801	0	1	04	01	H9847_801_0	5	1		05/27/2011	2012.02	05/27/2011 01:29:41 PM Eastern Daylight Time	08/02/2011 11:31:11 AM Eastern Daylight Time			08/02/2011 11:38:36 AM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.nc.chcadvantra.com	Coventry Advantra (PPO)	01	04		1			H9847	801	0	2012	North Carolina		1	500	2			2						www.nc.chcadvantra.com	www.chcadvantra.com	www.chcadvantra.com	(866)-731-9574		(866)-731-9574		(877)-886-7567		(877)-886-7567										(711)		(711)		(711)		(711)										1	1	1
H9847	802	0	1	04	01	H9847_802_0	5	1		05/27/2011	2012.02	05/27/2011 01:30:20 PM Eastern Daylight Time	08/02/2011 11:31:20 AM Eastern Daylight Time			08/02/2011 11:42:45 AM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.nc.chcadvantra.com	Coventry Advantra (PPO)	01	04		1			H9847	802	0	2012	North Carolina		1	500	2			2						www.nc.chcadvantra.com	www.chcadvantra.com	www.chcadvantra.com	(866)-731-9574		(866)-731-9574		(877)-886-7567		(877)-886-7567		(877)-300-5134		(877)-300-5134		(877)-984-5110		(877)-984-5110		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H9847	803	0	1	04	01	H9847_803_0	4	1		05/27/2011	2012.02	05/27/2011 09:51:36 AM Eastern Daylight Time	08/02/2011 11:30:57 AM Eastern Daylight Time			08/02/2011 11:49:25 AM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Health Care	www.nc.chcadvantra.com	Coventry Advantra (PPO)	01	04		1			H9847	803	0	2012	North Carolina		1	500	2			2						www.nc.chcadvantra.com	www.chcadvantra.com	www.chcadvantra.com	(866)-731-9574		(866)-731-9574		(877)-886-7567		(877)-886-7567		(877)-300-5134		(877)-300-5134		(877)-984-5110		(877)-984-5110		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		1	1	1
H9859	001	0	1	02	01	H9859_001_0	4	1		07/15/2011	2012.02	07/15/2011 10:55:43 AM Eastern Daylight Time	07/06/2011 10:11:14 AM Eastern Daylight Time			08/10/2011 07:37:14 AM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.joinMVPmedicare.com	Preferred Gold (HMO-POS)	01	02		1			H9859	001	0	2012	Eastern NY/Central NY		2	102	2			2						www.mvphealthcare.com	https://www.mvphealthcare.com/medicare/documents/2011_Comprehensive_Formulary_roc.pdf	www.mvphealthcare.com	(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205										(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220										2	2	2
H9859	002	0	1	02	01	H9859_002_0	5	1		07/15/2011	2012.02	07/15/2011 10:55:50 AM Eastern Daylight Time	08/05/2011 05:17:40 PM Eastern Daylight Time	08/05/2011 01:27:14 PM Eastern Daylight Time		08/09/2011 08:36:14 AM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.joinMVPmedicare.com	Preferred Gold Rx (HMO-POS)	01	02		1			H9859	002	0	2012	Eastern NY/Central NY		2	3554	2			2						www.mvphealthcare.com	https://www.mvphealthcare.com/medicare/documents/2011_Comprehensive_Formulary_roc.pdf	www.mvphealthcare.com	(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205		(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		2	2	2
H9859	004	0	1	02	01	H9859_004_0	6	1		07/15/2011	2012.02	07/15/2011 10:55:57 AM Eastern Daylight Time	08/05/2011 05:18:54 PM Eastern Daylight Time	08/05/2011 01:18:44 PM Eastern Daylight Time		08/09/2011 08:36:14 AM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.joinMVPmedicare.com	Preferred Gold Rx (HMO-POS)	01	02		1			H9859	004	0	2012	Mid-Hudson NY		2	507	2			2						www.mvphealthcare.com	https://www.mvphealthcare.com/medicare/documents/2011_Comprehensive_Formulary_roc.pdf	www.mvphealthcare.com	(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205		(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		2	2	2
H9859	013	0	1	02	01	H9859_013_0	6	1		07/15/2011	2012.02	07/15/2011 10:56:04 AM Eastern Daylight Time	08/05/2011 02:56:12 PM Eastern Daylight Time	08/05/2011 01:28:27 PM Eastern Daylight Time		08/09/2011 08:36:14 AM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.joinMVPmedicare.com	GoldValue Rx (HMO-POS)	01	02		1			H9859	013	0	2012	Eastern NY/Central NY		2	806	2			2						www.mvphealthcare.com	https://www.mvphealthcare.com/medicare/documents/2011_Comprehensive_Formulary_roc.pdf	www.mvphealthcare.com	(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205		(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		2	2	2
H9859	802	0	1	02	01	H9859_802_0	1	1		04/25/2011	2012.02	04/25/2011 02:24:55 PM Eastern Daylight Time	06/03/2011 07:47:16 PM Eastern Daylight Time			06/04/2011 08:10:42 AM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.mvphealthcare.com	Preferred Gold Rx - Employer Group (HMO-POS)	01	02		1			H9859	802	0	2012	Eastern NY/Central NY/Vermont		1	4207	2			2						www.mvphealthcare.com	https://www.mvphealthcare.com/medicare/documents/2011_Comprehensive_Formulary_roc.pdf	www.mvphealthcare.com	(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205		(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		1	1	1
H9859	804	0	1	02	01	H9859_804_0	1	1		04/25/2011	2012.02	04/25/2011 02:25:10 PM Eastern Daylight Time	06/03/2011 07:47:16 PM Eastern Daylight Time			06/04/2011 08:22:56 AM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP HEALTH CARE	www.mvphealthcare.com	Preferred Gold Rx - Employer Group (HMO-POS)	01	02		1			H9859	804	0	2012	Mid-Hudson NY		1	800	2			2						www.mvphealthcare.com	https://www.mvphealthcare.com/medicare/documents/2011_Comprehensive_Formulary_roc.pdf	www.mvphealthcare.com	(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205		(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220		1	1	1
H9947	001	0	1	04	01	H9947_001_0	8	1		08/04/2011	2012.02	08/04/2011 08:59:45 AM Pacific Daylight Time	08/08/2011 03:08:48 PM Pacific Daylight Time	08/04/2011 12:42:36 PM Pacific Daylight Time		08/08/2011 11:55:40 PM Pacific Daylight Time	BLUE CROSS BLUE SHIELD OF GEORGIA	Blue Cross Blue Shield of Georgia	www.bcbsga.com/medicare	Medicare Preferred Core (PPO)	01	04		1			H9947	001	0	2012	Georgia Metro Area		2	3364	2			2						www.bcbsga.com/medicare	www.anthem.com	www.anthem.com	(866)-438-9968		(866)-438-9968		(800)-797-1769		(800)-797-1769		(866)-438-9968		(866)-438-9968		(800)-797-1769		(800)-797-1769		(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894		(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894		2	2	2
H9947	002	0	1	04	01	H9947_002_0	8	1		08/04/2011	2012.02	08/04/2011 08:59:56 AM Pacific Daylight Time	08/08/2011 03:08:49 PM Pacific Daylight Time	08/04/2011 12:42:36 PM Pacific Daylight Time		08/08/2011 11:55:40 PM Pacific Daylight Time	BLUE CROSS BLUE SHIELD OF GEORGIA	Blue Cross Blue Shield of Georgia	www.bcbsga.com/medicare	Medicare Preferred Premier (PPO)	01	04		1			H9947	002	0	2012	Georgia Metro Area		2	1559	2			2						www.bcbsga.com/medicare	www.anthem.com	www.anthem.com	(866)-438-9968		(866)-438-9968		(800)-797-1769		(800)-797-1769		(866)-438-9968		(866)-438-9968		(800)-797-1769		(800)-797-1769		(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894		(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894		2	2	2
H9947	003	0	1	04	01	H9947_003_0	10	1		08/04/2011	2012.02	08/04/2011 09:00:30 AM Pacific Daylight Time	08/08/2011 03:08:50 PM Pacific Daylight Time	08/04/2011 12:42:36 PM Pacific Daylight Time		08/08/2011 11:55:40 PM Pacific Daylight Time	BLUE CROSS BLUE SHIELD OF GEORGIA	Blue Cross Blue Shield of Georgia	www.bcbsga.com/medicare	Medicare Preferred Online (PPO)	01	04		1			H9947	003	0	2012	Georgia Metro Area		2	237	2			2						www.bcbsga.com/medicare	www.anthem.com	www.anthem.com	(866)-438-9968		(866)-438-9968		(800)-797-1769		(800)-797-1769		(866)-438-9968		(866)-438-9968		(800)-797-1769		(800)-797-1769		(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894		(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894		2	2	2
H9947	801	0	1	04	01	H9947_801_0	6	1		07/07/2011	2012.02	07/07/2011 03:47:21 PM Eastern Daylight Time	07/22/2011 11:46:04 AM Eastern Daylight Time			07/22/2011 01:57:05 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF GEORGIA	Blue Cross Blue Shield of Georgia	www.bcbsga.com/medicare	Medicare Preferred (PPO)	01	04		1			H9947	801	0	2012	Georgia		1	5615	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(877)-411-1640		(877)-411-1640		(877)-411-1647		(877)-411-1647		(877)-411-1640		(877)-411-1640		(877)-411-1647		(877)-411-1647		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		2	2	2
H9947	802	0	1	04	01	H9947_802_0	5	1		07/07/2011	2012.02	07/07/2011 03:47:35 PM Eastern Daylight Time	07/22/2011 11:46:05 AM Eastern Daylight Time			07/22/2011 01:57:05 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF GEORGIA	Blue Cross Blue Shield of Georgia	www.bcbsga.com/medicare	Medicare Preferred (PPO)	01	04		1			H9947	802	0	2012	Georgia		1	50	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(877)-411-1640		(877)-411-1640		(877)-411-1647		(877)-411-1647										(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657										2	2	2
H9947	803	0	1	04	01	H9947_803_0	5	1		07/07/2011	2012.02	07/07/2011 03:47:51 PM Eastern Daylight Time	07/22/2011 11:46:06 AM Eastern Daylight Time			07/22/2011 01:57:05 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF GEORGIA	Blue Cross Blue Shield of Georgia	www.bcbsga.com/medicare	Medicare Preferred (PPO)	01	04		1			H9947	803	0	2012	Georgia		1	50	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(877)-411-1640		(877)-411-1640		(877)-411-1647		(877)-411-1647		(877)-411-1640		(877)-411-1640		(877)-411-1647		(877)-411-1647		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657		2	2	2
H9947	804	0	1	04	01	H9947_804_0	5	1		07/07/2011	2012.02	07/07/2011 03:48:05 PM Eastern Daylight Time	07/22/2011 11:46:06 AM Eastern Daylight Time			07/22/2011 01:57:05 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF GEORGIA	Blue Cross Blue Shield of Georgia	www.bcbsga.com/medicare	Medicare Preferred (PPO)	01	04		1			H9947	804	0	2012	Georgia		1	50	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(877)-411-1640		(877)-411-1640		(877)-411-1647		(877)-411-1647										(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657										2	2	2
H9988	002	0	1	04	01	H9988_002_0	7	1		08/05/2011	2012.02	08/05/2011 10:29:11 AM Central Daylight Time	08/04/2011 02:12:59 PM Central Daylight Time	08/04/2011 10:31:05 AM Central Daylight Time		08/07/2011 07:53:12 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Plus Plan (PPO)	01	04		1			H9988	002	0	2012	Georgia		2	39	2			2						http://www.sterlinghealth.com	http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-839-9079		(888)-839-9079		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H9988	004	0	1	04	01	H9988_004_0	8	1		08/05/2011	2012.02	08/05/2011 10:29:11 AM Central Daylight Time	08/04/2011 02:14:13 PM Central Daylight Time	08/04/2011 10:31:27 AM Central Daylight Time		08/07/2011 07:53:12 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	WindsorSterling Gold Plus Plan (PPO)	01	04		1			H9988	004	0	2012	North Carolina		2	127	2			2						http://www.sterlinghealth.com	http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-839-9079		(888)-839-9079		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H9988	014	0	1	04	01	H9988_014_0	7	1		08/05/2011	2012.02	08/05/2011 10:29:12 AM Central Daylight Time	08/04/2011 02:15:52 PM Central Daylight Time	08/04/2011 10:31:48 AM Central Daylight Time		08/07/2011 07:53:12 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	http://www.sterlinghealth.com	WindsorSterling Gold Plus Plan (PPO)	01	04		1			H9988	014	0	2012	Ohio		2	9	2			2						http://www.sterlinghealth.com	http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-839-9079		(888)-839-9079		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H9988	015	0	1	04	01	H9988_015_0	7	1		08/05/2011	2012.02	08/05/2011 10:29:12 AM Central Daylight Time	08/04/2011 02:17:06 PM Central Daylight Time	08/04/2011 10:32:10 AM Central Daylight Time		08/07/2011 07:53:12 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	http://www.sterlinghealth.com	WindsorSterling Gold Plus Plan (PPO)	01	04		1			H9988	015	0	2012	South Carolina		2	8	2			2						http://www.sterlinghealth.com	http://www.sterlinghealth.com	http://www.sterlinghealth.com	(888)-839-9079		(888)-839-9079		(888)-858-8572		(888)-858-8572		(866)-454-7141		(866)-454-7141		(888)-909-1713		(888)-909-1713		(711)		(711)		(711)		(711)		(800)-899-2114		(800)-899-2114		(711)		(711)		2	2	2
H9988	017	0	1	04	01	H9988_017_0	5	1		08/09/2011	2012.02	08/09/2011 10:52:48 AM Central Daylight Time		08/09/2011 10:53:52 AM Central Daylight Time		08/09/2011 11:12:47 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.FMCHP.com	Fresenius Health Partners PPO SNP (PPO SNP)	01	04		1			H9988	017	0	2012	Georgia		2	206	2			1	4		1		00000000100000000000	http://www.sterlinghealth.com	http://www.sterlinghealth.com	http://www.sterlinghealth.com	(866)-307-3625		(866)-307-3625		(866)-307-3625		(866)-307-3625		(866)-307-3625		(866)-307-3625		(866)-307-3625		(866)-307-3625		(877)-736-2535		(877)-736-2535		(877)-736-2535		(877)-736-2535		(877)-736-2535		(877)-736-2535		(877)-736-2535		(877)-736-2535		2	2	2
H9988	018	0	1	04	01	H9988_018_0	5	1		08/09/2011	2012.02	08/09/2011 10:53:02 AM Central Daylight Time		08/09/2011 10:50:40 AM Central Daylight Time		08/09/2011 11:12:47 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.FMCHP.com	Fresenius Health Partners PPO SNP (PPO SNP)	01	04		1			H9988	018	0	2012	North Carolina		2	274	2			1	4		1		00000000100000000000	http://www.sterlinghealth.com	http://www.sterlinghealth.com	http://www.sterlinghealth.com	(866)-307-3625		(866)-307-3625		(866)-307-3625		(866)-307-3625		(866)-307-3625		(866)-307-3625		(866)-307-3625		(866)-307-3625		(877)-736-2535		(877)-736-2535		(877)-736-2535		(877)-736-2535		(877)-736-2535		(877)-736-2535		(877)-736-2535		(877)-736-2535		2	2	2
H9988	019	0	1	04	01	H9988_019_0	5	1		08/09/2011	2012.02	08/09/2011 10:53:14 AM Central Daylight Time		08/09/2011 10:51:03 AM Central Daylight Time		08/09/2011 11:12:47 AM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.FMCHP.com	Fresenius Health Partners PPO SNP (PPO SNP)	01	04		1			H9988	019	0	2012	Tennessee		2	170	2			1	4		1		00000000100000000000	http://www.sterlinghealth.com	http://www.sterlinghealth.com	http://www.sterlinghealth.com	(866)-307-3625		(866)-307-3625		(866)-307-3625		(866)-307-3625		(866)-307-3625		(866)-307-3625		(866)-307-3625		(866)-307-3625		(877)-736-2535		(877)-736-2535		(877)-736-2535		(877)-736-2535		(877)-736-2535		(877)-736-2535		(877)-736-2535		(877)-736-2535		2	2	2
H9998	001	0	1	20	08	H9998_001_0	1	1		06/02/2011	2012.02	06/02/2011 10:07:32 AM Central Daylight Time		06/02/2011 10:05:59 AM Central Daylight Time		06/02/2011 10:08:42 AM Central Daylight Time	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	La Paloma	www.lubbockmhmr.org	La Paloma - Dual (PACE)	08	20		1			H9998	001	0	2012	La Paloma - Dual		2		2			2							www.lubbockmhmr.org	http://www.seniorscript.com/									(806)-766-0360		(806)-766-0360		(806)-766-0360		(806)-766-0360										(806)-766-0360		(806)-766-0360		(806)-766-0360		(806)-766-0360				
H9998	002	0	1	20	08	H9998_002_0	1	1		06/02/2011	2012.02	06/02/2011 09:59:34 AM Central Daylight Time		06/02/2011 10:06:02 AM Central Daylight Time		06/02/2011 10:08:42 AM Central Daylight Time	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	La Paloma	www.lubbockmhmr.org	La Paloma - Medicare only (PACE)	08	20		1			H9998	002	0	2012	La Paloma - Medicare only		2		2			2							www.lubbockmhmr.org	http://www.seniorscript.com/									(806)-766-0360		(806)-766-0360		(806)-766-0360		(806)-766-0360										(806)-766-0360		(806)-766-0360		(806)-766-0360		(806)-766-0360				
R3175	001	0	1	31	11	R3175_001_0	3	1		08/09/2011	2012.02	08/09/2011 10:14:23 AM Central Daylight Time	08/08/2011 03:01:18 PM Central Daylight Time	08/05/2011 01:49:06 PM Central Daylight Time		08/09/2011 02:44:43 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	UnitedHealthcare MedicareComplete Choice (Regional PPO)	11	31		1			R3175	001	0	2012	State of Hawaii		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-711-6088		(800)-711-6088		(800)-555-5757		(800)-555-5757		(800)-711-6088		(800)-711-6088		(800)-555-5757		(800)-555-5757		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R3175	002	0	1	31	11	R3175_002_0	3	1		08/09/2011	2012.02	08/09/2011 10:04:35 AM Central Daylight Time	08/08/2011 03:01:51 PM Central Daylight Time			08/09/2011 02:44:43 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	UnitedHealthcare MedicareComplete Choice Essential (Regional PPO)	11	31		1			R3175	002	0	2012	State of Hawaii		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-711-6088		(800)-711-6088		(800)-555-5757		(800)-555-5757										(711)		(711)		(711)		(711)										2	2	2
R3175	003	0	1	31	11	R3175_003_0	4	1	2	08/08/2011	2012.02	08/08/2011 03:07:58 PM Central Daylight Time	08/08/2011 03:02:26 PM Central Daylight Time	08/05/2011 01:16:34 PM Central Daylight Time		08/09/2011 01:10:13 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Dual Complete RP (Regional PPO SNP)	11	31		1			R3175	003	0	2012	State of Hawaii		2		2			1	3		1	2		www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(866)-622-8054		(866)-622-8054		(888)-834-3721		(888)-834-3721		(866)-622-8054		(866)-622-8054		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R3175	801	0	1	31	11	R3175_801_0	3	1		07/06/2011	2012.02	07/06/2011 04:42:45 PM Central Daylight Time	08/08/2011 03:02:58 PM Central Daylight Time			08/09/2011 03:57:48 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (Regional PPO)	11	31		1			R3175	801	0	2012	State of Hawaii		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R3175	802	0	1	31	11	R3175_802_0	3	1		07/06/2011	2012.02	07/06/2011 03:47:23 PM Central Daylight Time	08/08/2011 03:03:31 PM Central Daylight Time			08/09/2011 03:57:48 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (Regional PPO)	11	31		1			R3175	802	0	2012	State of Hawaii		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548										(711)		(711)		(711)		(711)										2	2	2
R3332	001	0	1	31	11	R3332_001_0	12	1		08/09/2011	2012.02	08/09/2011 02:23:11 PM Eastern Daylight Time	08/09/2011 12:36:56 PM Eastern Daylight Time	08/04/2011 09:57:56 AM Eastern Daylight Time		08/09/2011 03:53:54 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF FL, INC.	Blue Cross and Blue Shield of Florida, Inc.	www.BlueMedicareFL.com	BlueMedicare Regional PPO (Regional PPO)	11	31		1			R3332	001	0	2012	State of Florida		2		2			2						www.BlueMedicareFL.com	www.myprime.com	www.myprime.com	(800)-926-6565		(800)-926-6565		(800)-876-2227		(800)-876-2227		(800)-926-6565		(800)-926-6565		(800)-876-2227		(800)-876-2227		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771		2	2	2
R3444	008	0	1	31	11	R3444_008_0	8	1		08/08/2011	2012.02	08/08/2011 12:59:16 PM Eastern Daylight Time	08/08/2011 06:41:00 PM Eastern Daylight Time	08/09/2011 10:07:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Silver Rx (Regional PPO SNP)	11	31		1			R3444	008	0	2012	Arkansas and Missouri		2	5792	2			1	4		1		00000000000000000100	www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-711-1656		(800)-711-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R3444	009	0	1	31	11	R3444_009_0	8	1		08/08/2011	2012.02	08/08/2011 01:00:55 PM Eastern Daylight Time	08/06/2011 04:28:00 PM Eastern Daylight Time	08/09/2011 10:07:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Gold Rx (Regional PPO SNP)	11	31		1			R3444	009	0	2012	Arkansas and Missouri		2	13876	2			1	4		1		00000000000000000100	www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-711-1656		(800)-711-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R3444	011	0	1	31	11	R3444_011_0	7	1	2	08/08/2011	2012.02	08/08/2011 01:01:58 PM Eastern Daylight Time	08/06/2011 04:28:00 PM Eastern Daylight Time	08/09/2011 10:07:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Dual Advantage (Regional PPO SNP)	11	31		1			R3444	011	0	2012	Arkansas and Missouri		2	3088	2			1	3		1	5		www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-711-1656		(800)-711-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R3444	012	0	1	31	11	R3444_012_0	7	1		06/22/2011	2012.02	06/22/2011 03:04:30 PM Eastern Daylight Time	08/06/2011 04:28:00 PM Eastern Daylight Time	08/09/2011 10:07:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Medicare Advantage (Regional PPO)	11	31		1			R3444	012	0	2012	Arkansas and Missouri		2	4160	2			2						www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-711-1656		(800)-711-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R5287	001	0	1	31	11	R5287_001_0	4	1		08/08/2011	2012.02	08/08/2011 06:18:35 PM Central Daylight Time	08/05/2011 06:27:22 PM Central Daylight Time	08/05/2011 01:49:22 PM Central Daylight Time		08/09/2011 11:07:45 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice Plan 2 (Regional PPO)	11	31		1			R5287	001	0	2012	State of Florida		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R5287	002	0	1	31	11	R5287_002_0	4	1		08/07/2011	2012.02	08/07/2011 01:07:14 PM Central Daylight Time	08/05/2011 06:28:42 PM Central Daylight Time			08/09/2011 11:07:45 AM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice Essential (Regional PPO)	11	31		1			R5287	002	0	2012	State of Florida		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514										(711)		(711)		(711)		(711)										2	2	2
R5287	003	0	1	31	11	R5287_003_0	4	1	2	08/08/2011	2012.02	08/08/2011 01:27:20 PM Central Daylight Time	08/08/2011 07:40:33 AM Central Daylight Time	08/05/2011 01:16:56 PM Central Daylight Time		08/09/2011 01:10:13 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Dual Complete RP (Regional PPO SNP)	11	31		1			R5287	003	0	2012	State of Florida		2		2			1	3		1	2		www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R5342	001	0	1	31	11	R5342_001_0	5	1		09/13/2011	2012.02	09/13/2011 01:40:34 PM Central Daylight Time	08/04/2011 07:33:27 PM Central Daylight Time	08/05/2011 01:49:37 PM Central Daylight Time		09/13/2011 01:48:30 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.UHCMedicareSolutions.com	UnitedHealthcare MedicareComplete Choice (Regional PPO)	11	31		1			R5342	001	0	2012	State of New York		2		2			2						www.UHCMedicareSolutions.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-711-6088		(800)-711-6088		(800)-555-5757		(800)-555-5757		(800)-711-6088		(800)-711-6088		(800)-555-5757		(800)-555-5757		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R5342	002	0	1	31	11	R5342_002_0	4	1		07/20/2011	2012.02	07/20/2011 05:08:10 PM Central Daylight Time	08/04/2011 07:32:49 PM Central Daylight Time			08/09/2011 04:53:14 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	UnitedHealthcare MedicareComplete Choice Essential (Regional PPO)	11	31		1			R5342	002	0	2012	State of New York		2		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(800)-711-6088		(800)-711-6088		(800)-555-5757		(800)-555-5757										(711)		(711)		(711)		(711)										2	2	2
R5342	003	0	1	31	11	R5342_003_0	4	1	2	07/22/2011	2012.02	07/22/2011 12:21:12 PM Central Daylight Time	08/04/2011 07:32:11 PM Central Daylight Time	08/05/2011 01:17:19 PM Central Daylight Time		08/09/2011 01:10:13 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	SecureHorizons by UnitedHealthcare	www.UHCDualComplete.com	UnitedHealthcare Dual Complete RP (Regional PPO SNP)	11	31		1			R5342	003	0	2012	State of New York		2		2			1	3		1	2		www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(877)-702-5110		(877)-702-5110		(888)-834-3721		(888)-834-3721		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R5342	801	0	1	31	11	R5342_801_0	3	1		07/06/2011	2012.02	07/06/2011 03:47:33 PM Central Daylight Time	08/05/2011 11:45:31 AM Central Daylight Time			08/09/2011 03:57:48 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (Regional PPO)	11	31		1			R5342	801	0	2012	State of New York		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R5342	802	0	1	31	11	R5342_802_0	3	1		07/06/2011	2012.02	07/06/2011 03:47:40 PM Central Daylight Time	08/05/2011 11:46:10 AM Central Daylight Time			08/09/2011 03:57:48 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (Regional PPO)	11	31		1			R5342	802	0	2012	State of New York		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548										(711)		(711)		(711)		(711)										2	2	2
R5342	803	0	1	31	11	R5342_803_0	3	1		07/06/2011	2012.02	07/06/2011 03:47:45 PM Central Daylight Time	08/05/2011 11:46:50 AM Central Daylight Time			08/09/2011 03:57:48 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	SecureHorizons by UnitedHealthcare	www.UHCretiree.com	UnitedHealthcare Group Medicare Advantage (Regional PPO)	11	31		1			R5342	803	0	2012	New York		1		2			2						www.SecureHorizons.com/ourplans/findaphysician.html	www.SecureHorizons.com/ourplans/searchformulary.html	www.PrescriptionSolutions.com	(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(888)-867-5548		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R5566	005	0	1	31	11	R5566_005_0	9	1		07/20/2011	2012.02	07/20/2011 02:10:25 PM Central Daylight Time	08/09/2011 10:47:44 AM Central Daylight Time	08/08/2011 08:46:56 AM Central Daylight Time		08/09/2011 04:56:31 PM Central Daylight Time	BCBS MN, MT, NE, ND, WY, WELLMARK IA AND SD	MedicareBlue PPO	www.YourMedicareSolutions.com	MedicareBlue PPO (Regional PPO)	11	31		1			R5566	005	0	2012	States of IA, MN, MT, NE, ND, SD, WY		2		2			2						www.YourMedicareSolutions.com	www.YourMedicareSolutions.com	www.YourMedicareSolutions.com	(888)-457-3009		(888)-457-3009		(866)-434-2038		(866)-434-2038		(888)-457-3009		(888)-457-3009		(866)-434-2038		(866)-434-2038		(888)-457-3005		(888)-457-3005		(866)-456-1550		(866)-456-1550		(888)-457-3005		(888)-457-3005		(866)-456-1550		(866)-456-1550		2	2	2
R5566	805	0	1	31	11	R5566_805_0	6	1		07/06/2011	2012.02	07/06/2011 08:58:59 AM Central Daylight Time	08/09/2011 10:48:58 AM Central Daylight Time			08/09/2011 04:56:31 PM Central Daylight Time	BCBS MN, MT, NE, ND, WY, WELLMARK IA AND SD	MedicareBlue PPO	www.YourMedicareSolutions.com	Group MedicareBlue PPO (Regional PPO)	11	31		1			R5566	805	0	2012	States of IA,MN,MT,ND,NE,SD,WY		1		2			2						www.YourMedicareSolutions.com	www.YourMedicareSolutions.com	www.YourMedicareSolutions.com	(888)-457-3009		(888)-457-3009		(866)-434-2038		(866)-434-2038		(888)-457-3009		(888)-457-3009		(866)-434-2038		(866)-434-2038		(888)-457-3005		(888)-457-3005		(866)-456-1550		(866)-456-1550		(888)-457-3005		(888)-457-3005		(866)-456-1550		(866)-456-1550		2	2	2
R5674	001	0	1	31	11	R5674_001_0	5	1		08/08/2011	2012.02	08/08/2011 09:37:45 AM Central Daylight Time	08/05/2011 02:40:20 PM Central Daylight Time	08/05/2011 01:17:41 PM Central Daylight Time		08/09/2011 01:10:07 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierranevadaspectrum.com	Sierra Nevada Spectrum (Regional PPO)	11	31		1			R5674	001	0	2012	Nevada		2		2			2						http://www.sierranevadaspectrum.com	http://www.sierranevadaspectrum.com	http://www.sierranevadaspectrum.com	(877)-559-4512		(877)-559-4512		(877)-271-8591		(877)-271-8591		(877)-559-4512		(877)-559-4512		(877)-271-8591		(877)-271-8591		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R5674	801	0	1	31	11	R5674_801_0	3	1		07/06/2011	2012.02	07/06/2011 03:47:56 PM Central Daylight Time	08/05/2011 12:34:00 PM Central Daylight Time			08/09/2011 03:57:48 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	http://www.sierranevadaspectrum.com	Basic Group (with Drug) Coverage (Regional PPO)	11	31		1			R5674	801	0	2012	Nevada		1		2			2						http://www.sierranevadaspectrum.com	http://www.sierranevadaspectrum.com	http://www.sierranevadaspectrum.com	(877)-559-4512		(702)-562-8021		(877)-271-8591		(877)-271-8591		(877)-559-4512		(702)-562-8021		(877)-271-8591		(877)-271-8591		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R5674	802	0	1	31	11	R5674_802_0	3	1		07/06/2011	2012.02	07/06/2011 03:48:00 PM Central Daylight Time	08/05/2011 12:34:35 PM Central Daylight Time			08/09/2011 03:57:48 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	http://www.sierranevadaspectrum.com	Basic Group MA Only Coverage (Regional PPO)	11	31		1			R5674	802	0	2012	Nevada		1		2			2						http://www.sierranevadaspectrum.com	http://www.sierranevadaspectrum.com	http://www.sierranevadaspectrum.com	(877)-559-4512		(702)-562-8021		(877)-271-8591		(877)-271-8591										(711)		(711)		(711)		(711)										2	2	2
R5674	803	0	1	31	11	R5674_803_0	3	1		07/06/2011	2012.02	07/06/2011 03:48:06 PM Central Daylight Time	08/05/2011 12:35:10 PM Central Daylight Time			08/09/2011 03:57:48 PM Central Daylight Time	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	http://www.sierranevadaspectrum.com	(NCY) Basic Group (With Drug) Coverage (Regional PPO)	11	31		1			R5674	803	0	2012	Nevada		1		2			2						http://www.sierranevadaspectrum.com	http://www.sierranevadaspectrum.com	http://www.sierranevadaspectrum.com	(877)-559-4512		(702)-562-8021		(877)-271-8591		(877)-271-8591		(877)-559-4512		(702)-562-8021		(877)-271-8591		(877)-271-8591		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R5826	001	0	1	31	11	R5826_001_0	8	1		07/11/2011	2012.02	07/11/2011 01:31:24 PM Eastern Daylight Time	08/05/2011 04:07:28 PM Eastern Daylight Time	08/04/2011 01:17:08 PM Eastern Daylight Time		08/09/2011 09:25:58 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice R5826-001 (Regional PPO)	11	31		1			R5826	001	0	2012	States of Alabama and Tennessee		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R5826	002	0	1	31	11	R5826_002_0	5	1		08/05/2011	2012.02	08/05/2011 06:05:38 PM Eastern Daylight Time	08/05/2011 10:56:04 PM Eastern Daylight Time	08/04/2011 01:17:28 PM Eastern Daylight Time		08/08/2011 05:03:57 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice R5826-002 (Regional PPO)	11	31		1			R5826	002	0	2012	States of Pennsylvania and West Virginia		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R5826	003	0	1	31	11	R5826_003_0	4	1		07/11/2011	2012.02	07/11/2011 01:34:21 PM Eastern Daylight Time	08/05/2011 04:28:59 PM Eastern Daylight Time	08/04/2011 01:17:48 PM Eastern Daylight Time		08/08/2011 03:57:47 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice R5826-003 (Regional PPO)	11	31		1			R5826	003	0	2012	States of North Carolina and Virginia		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R5826	005	0	1	31	11	R5826_005_0	7	1		08/08/2011	2012.02	08/08/2011 04:44:00 PM Eastern Daylight Time	08/05/2011 10:43:44 PM Eastern Daylight Time	08/04/2011 01:18:08 PM Eastern Daylight Time		08/09/2011 09:42:55 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice R5826-005 (Regional PPO)	11	31		1			R5826	005	0	2012	State of Florida		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R5826	006	0	1	31	11	R5826_006_0	5	1		08/11/2011	2012.02	08/11/2011 03:22:17 PM Eastern Daylight Time	08/08/2011 11:22:00 AM Eastern Daylight Time	08/04/2011 01:18:28 PM Eastern Daylight Time		08/11/2011 04:47:09 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice R5826-006 (Regional PPO)	11	31		1			R5826	006	0	2012	State of Michigan		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R5826	007	0	1	31	11	R5826_007_0	3	1		07/08/2011	2012.02	07/08/2011 01:45:45 PM Eastern Daylight Time	08/05/2011 10:56:29 PM Eastern Daylight Time	08/04/2011 01:18:48 PM Eastern Daylight Time		08/08/2011 03:50:34 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice R5826-007 (Regional PPO)	11	31		1			R5826	007	0	2012	State of Ohio		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R5826	008	0	1	31	11	R5826_008_0	6	1		08/08/2011	2012.02	08/08/2011 08:42:14 AM Eastern Daylight Time	08/09/2011 05:51:19 PM Eastern Daylight Time	08/04/2011 01:19:07 PM Eastern Daylight Time		08/10/2011 10:12:27 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice R5826-008 (Regional PPO)	11	31		1			R5826	008	0	2012	States of Indiana and Kentucky		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R5826	009	0	1	31	11	R5826_009_0	4	1		08/11/2011	2012.02	08/11/2011 03:17:36 PM Eastern Daylight Time	08/05/2011 02:37:00 PM Eastern Daylight Time	08/04/2011 01:19:26 PM Eastern Daylight Time		08/11/2011 04:47:09 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice R5826-009 (Regional PPO)	11	31		1			R5826	009	0	2012	States of Illinois and Wisconsin		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R5826	010	0	1	31	11	R5826_010_0	5	1		08/17/2011	2012.02	08/17/2011 12:30:23 PM Eastern Daylight Time	08/16/2011 01:04:34 PM Eastern Daylight Time	08/04/2011 01:19:46 PM Eastern Daylight Time		08/17/2011 01:24:05 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice R5826-010 (Regional PPO)	11	31		1			R5826	010	0	2012	States of Arkansas and Missouri		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R5826	011	0	1	31	11	R5826_011_0	6	1		07/11/2011	2012.02	07/11/2011 02:02:06 PM Eastern Daylight Time	08/05/2011 04:04:41 PM Eastern Daylight Time	08/04/2011 01:20:08 PM Eastern Daylight Time		08/08/2011 04:05:26 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice R5826-011 (Regional PPO)	11	31		1			R5826	011	0	2012	States of Louisiana and Mississippi		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R5826	012	0	1	31	11	R5826_012_0	6	1		07/11/2011	2012.02	07/11/2011 02:08:13 PM Eastern Daylight Time	08/07/2011 04:05:22 PM Eastern Daylight Time	08/04/2011 01:20:28 PM Eastern Daylight Time		08/08/2011 03:49:43 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice R5826-012 (Regional PPO)	11	31		1			R5826	012	0	2012	State of Texas		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R5826	013	0	1	31	11	R5826_013_0	3	1		08/08/2011	2012.02	08/08/2011 11:56:01 AM Eastern Daylight Time	08/05/2011 05:46:52 PM Eastern Daylight Time	08/04/2011 01:20:48 PM Eastern Daylight Time		08/08/2011 04:32:56 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice R5826-013 (Regional PPO)	11	31		1			R5826	013	0	2012	States of Kansas and Oklahoma		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R5826	014	0	1	31	11	R5826_014_0	8	1		08/08/2011	2012.02	08/08/2011 03:18:22 PM Eastern Daylight Time	08/05/2011 04:36:36 PM Eastern Daylight Time	08/04/2011 01:21:08 PM Eastern Daylight Time		08/08/2011 04:06:31 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Reader's Digest Healthy Living Plan (Regional PPO)	11	31		1			R5826	014	0	2012	State of Arizona		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R5826	018	0	1	31	11	R5826_018_0	6	1		08/08/2011	2012.02	08/08/2011 05:53:40 PM Eastern Daylight Time	08/05/2011 10:38:50 PM Eastern Daylight Time			08/09/2011 10:37:35 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice R5826-018 (Regional PPO)	11	31		1			R5826	018	0	2012	State of Florida		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
R5826	021	0	1	31	11	R5826_021_0	4	1		08/09/2011	2012.02	08/09/2011 03:24:34 PM Eastern Daylight Time	08/05/2011 10:38:43 PM Eastern Daylight Time			08/09/2011 03:42:06 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice R5826-021 (Regional PPO)	11	31		1			R5826	021	0	2012	State of Ohio		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
R5826	023	0	1	31	11	R5826_023_0	5	1		08/11/2011	2012.02	08/11/2011 04:06:37 PM Eastern Daylight Time	08/09/2011 01:26:01 PM Eastern Daylight Time			08/11/2011 04:51:03 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice R5826-023 (Regional PPO)	11	31		1			R5826	023	0	2012	States of Illinois and Wisconsin		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
R5826	026	0	1	31	11	R5826_026_0	7	1		08/08/2011	2012.02	08/08/2011 03:41:52 PM Eastern Daylight Time	08/07/2011 04:06:57 PM Eastern Daylight Time			08/08/2011 03:49:43 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice R5826-026 (Regional PPO)	11	31		1			R5826	026	0	2012	State of Texas		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
R5826	053	0	1	31	11	R5826_053_0	5	1		08/11/2011	2012.02	08/11/2011 03:25:56 PM Eastern Daylight Time	08/05/2011 04:04:18 PM Eastern Daylight Time			08/11/2011 04:51:03 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice R5826-053 (Regional PPO)	11	31		1			R5826	053	0	2012	State of Michigan		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
R5826	062	0	1	31	11	R5826_062_0	4	1		08/05/2011	2012.02	08/05/2011 05:42:05 PM Eastern Daylight Time	08/05/2011 10:42:00 PM Eastern Daylight Time			08/09/2011 09:47:49 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice R5826-062 (Regional PPO)	11	31		1			R5826	062	0	2012	States of Pennsylvania and West Virginia		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
R5826	063	0	1	31	11	R5826_063_0	3	1		07/11/2011	2012.02	07/11/2011 03:31:33 PM Eastern Daylight Time	08/05/2011 08:48:23 AM Eastern Daylight Time			08/09/2011 02:59:36 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice R5826-063 (Regional PPO)	11	31		1			R5826	063	0	2012	States of North Carolina and Virginia		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
R5826	064	0	1	31	11	R5826_064_0	6	1		08/11/2011	2012.02	08/11/2011 10:20:50 AM Eastern Daylight Time	08/05/2011 04:23:50 PM Eastern Daylight Time			08/11/2011 03:31:06 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice R5826-064 (Regional PPO)	11	31		1			R5826	064	0	2012	States of Georgia and South Carolina		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
R5826	065	0	1	31	11	R5826_065_0	9	1		07/11/2011	2012.02	07/11/2011 01:34:59 PM Eastern Daylight Time	08/05/2011 04:06:28 PM Eastern Daylight Time			08/09/2011 09:25:58 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice R5826-065 (Regional PPO)	11	31		1			R5826	065	0	2012	States of Alabama and Tennessee		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
R5826	066	0	1	31	11	R5826_066_0	6	1		08/11/2011	2012.02	08/11/2011 03:23:05 PM Eastern Daylight Time	08/05/2011 10:42:23 PM Eastern Daylight Time			08/11/2011 04:14:44 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice R5826-066 (Regional PPO)	11	31		1			R5826	066	0	2012	States of Indiana and Kentucky		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
R5826	067	0	1	31	11	R5826_067_0	5	1		08/11/2011	2012.02	08/11/2011 03:34:51 PM Eastern Daylight Time	08/05/2011 05:41:36 PM Eastern Daylight Time			08/11/2011 04:40:38 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice R5826-067 (Regional PPO)	11	31		1			R5826	067	0	2012	States of Arkansas and Missouri		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
R5826	068	0	1	31	11	R5826_068_0	5	1		07/18/2011	2012.02	07/18/2011 02:54:59 PM Eastern Daylight Time	08/05/2011 03:55:42 PM Eastern Daylight Time			08/08/2011 04:05:26 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice R5826-068 (Regional PPO)	11	31		1			R5826	068	0	2012	States of Louisiana and Mississippi		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
R5826	069	0	1	31	11	R5826_069_0	3	1		08/08/2011	2012.02	08/08/2011 12:00:43 PM Eastern Daylight Time	08/05/2011 05:41:49 PM Eastern Daylight Time			08/08/2011 04:32:56 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice R5826-069 (Regional PPO)	11	31		1			R5826	069	0	2012	States of Kansas and Oklahoma		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
R5826	070	0	1	31	11	R5826_070_0	5	1		08/08/2011	2012.02	08/08/2011 03:16:56 PM Eastern Daylight Time	08/05/2011 04:46:43 PM Eastern Daylight Time			08/08/2011 04:06:31 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Reader's Digest Healthy Living Plan (Regional PPO)	11	31		1			R5826	070	0	2012	State of Arizona		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	2	2
R5826	072	0	1	31	11	R5826_072_0	4	1		08/11/2011	2012.02	08/11/2011 03:30:04 PM Eastern Daylight Time	08/08/2011 11:23:25 AM Eastern Daylight Time	08/04/2011 01:21:29 PM Eastern Daylight Time		08/11/2011 04:54:32 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice R5826-072 (Regional PPO)	11	31		1			R5826	072	0	2012	State of Michigan		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R5826	074	0	1	31	11	R5826_074_0	7	1		08/09/2011	2012.02	08/09/2011 10:15:13 AM Eastern Daylight Time	08/05/2011 10:39:38 PM Eastern Daylight Time	08/04/2011 01:21:56 PM Eastern Daylight Time		08/09/2011 11:00:11 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Reader's Digest Healthy Living Plan (Regional PPO)	11	31		1			R5826	074	0	2012	State of Florida		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R5826	076	0	1	31	11	R5826_076_0	4	1		08/08/2011	2012.02	08/08/2011 03:17:52 PM Eastern Daylight Time	08/05/2011 04:38:17 PM Eastern Daylight Time	08/04/2011 01:22:21 PM Eastern Daylight Time		08/08/2011 04:06:31 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Reader's Digest Healthy Living Plan (Regional PPO)	11	31		1			R5826	076	0	2012	State of Arizona		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R5826	077	0	1	31	11	R5826_077_0	7	1		08/09/2011	2012.02	08/09/2011 04:57:26 PM Eastern Daylight Time	08/09/2011 03:53:20 PM Eastern Daylight Time	08/04/2011 01:22:42 PM Eastern Daylight Time		08/09/2011 05:20:32 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice R5826-077 (Regional PPO)	11	31		1			R5826	077	0	2012	States of Georgia and South Carolina		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R5826	078	0	1	31	11	R5826_078_0	5	1		07/11/2011	2012.02	07/11/2011 12:40:20 PM Eastern Daylight Time	08/05/2011 03:56:34 PM Eastern Daylight Time	08/04/2011 01:23:01 PM Eastern Daylight Time		08/08/2011 04:05:26 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice R5826-078 (Regional PPO)	11	31		1			R5826	078	0	2012	States of Louisiana and Mississippi		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R5826	079	0	1	31	11	R5826_079_0	3	1		07/11/2011	2012.02	07/11/2011 10:45:53 AM Eastern Daylight Time	08/05/2011 09:01:27 AM Eastern Daylight Time	08/04/2011 01:23:20 PM Eastern Daylight Time		08/08/2011 03:57:47 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice R5826-079 (Regional PPO)	11	31		1			R5826	079	0	2012	States of North Carolina and Virginia		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R5826	081	0	1	31	11	R5826_081_0	6	1		07/08/2011	2012.02	07/08/2011 12:11:15 PM Eastern Daylight Time	08/07/2011 05:37:39 PM Eastern Daylight Time	08/04/2011 01:23:39 PM Eastern Daylight Time		08/08/2011 06:26:19 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	HumanaChoice R5826-081 (Regional PPO)	11	31		1			R5826	081	0	2012	States of Pennsylvania and West Virginia		2		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R5826	801	0	1	31	11	R5826_801_0	8	1		06/20/2011	2012.02	06/20/2011 03:40:56 PM Eastern Daylight Time	08/08/2011 02:17:34 PM Eastern Daylight Time			08/09/2011 08:56:24 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (Regional PPO)	11	31		1			R5826	801	0	2012	States of Alabama and Tennessee		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
R5826	802	0	1	31	11	R5826_802_0	8	1		06/20/2011	2012.02	06/20/2011 03:42:49 PM Eastern Daylight Time	08/08/2011 02:18:52 PM Eastern Daylight Time			08/09/2011 08:56:24 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (Regional PPO)	11	31		1			R5826	802	0	2012	States of Pennsylvania and West Virginia		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
R5826	803	0	1	31	11	R5826_803_0	8	1		06/20/2011	2012.02	06/20/2011 03:43:07 PM Eastern Daylight Time	08/08/2011 02:20:30 PM Eastern Daylight Time			08/09/2011 08:56:24 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (Regional PPO)	11	31		1			R5826	803	0	2012	States of North Carolina and Virginia		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
R5826	804	0	1	31	11	R5826_804_0	8	1		06/20/2011	2012.02	06/20/2011 03:43:26 PM Eastern Daylight Time	08/08/2011 02:21:38 PM Eastern Daylight Time			08/09/2011 08:56:24 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (Regional PPO)	11	31		1			R5826	804	0	2012	States of Georgia and South Carolina		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
R5826	805	0	1	31	11	R5826_805_0	8	1		06/20/2011	2012.02	06/20/2011 03:43:45 PM Eastern Daylight Time	08/08/2011 02:22:37 PM Eastern Daylight Time			08/09/2011 08:56:24 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (Regional PPO)	11	31		1			R5826	805	0	2012	State of Florida		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
R5826	806	0	1	31	11	R5826_806_0	8	1		06/20/2011	2012.02	06/20/2011 03:44:04 PM Eastern Daylight Time	08/08/2011 02:23:33 PM Eastern Daylight Time			08/09/2011 08:56:24 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (Regional PPO)	11	31		1			R5826	806	0	2012	State of Michigan		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
R5826	807	0	1	31	11	R5826_807_0	8	1		06/20/2011	2012.02	06/20/2011 03:44:23 PM Eastern Daylight Time	08/08/2011 02:24:41 PM Eastern Daylight Time			08/09/2011 08:56:24 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (Regional PPO)	11	31		1			R5826	807	0	2012	State of Ohio		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
R5826	808	0	1	31	11	R5826_808_0	8	1		06/20/2011	2012.02	06/20/2011 03:44:41 PM Eastern Daylight Time	08/08/2011 02:25:51 PM Eastern Daylight Time			08/09/2011 08:56:24 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (Regional PPO)	11	31		1			R5826	808	0	2012	States of Indiana and Kentucky		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
R5826	809	0	1	31	11	R5826_809_0	8	1		06/20/2011	2012.02	06/20/2011 03:45:00 PM Eastern Daylight Time	08/08/2011 02:29:23 PM Eastern Daylight Time			08/09/2011 08:56:24 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (Regional PPO)	11	31		1			R5826	809	0	2012	States of Illinois and Wisconsin		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
R5826	810	0	1	31	11	R5826_810_0	8	1		06/20/2011	2012.02	06/20/2011 03:45:19 PM Eastern Daylight Time	08/08/2011 02:26:56 PM Eastern Daylight Time			08/09/2011 08:56:24 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (Regional PPO)	11	31		1			R5826	810	0	2012	States of Arkansas and Missouri		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
R5826	811	0	1	31	11	R5826_811_0	8	1		06/20/2011	2012.02	06/20/2011 03:45:38 PM Eastern Daylight Time	08/08/2011 02:28:09 PM Eastern Daylight Time			08/09/2011 08:56:24 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (Regional PPO)	11	31		1			R5826	811	0	2012	States of Louisiana and Mississippi		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
R5826	812	0	1	31	11	R5826_812_0	9	1		06/20/2011	2012.02	06/20/2011 03:45:57 PM Eastern Daylight Time	08/12/2011 12:39:43 PM Eastern Daylight Time			08/12/2011 03:28:25 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (Regional PPO)	11	31		1			R5826	812	0	2012	State of Texas		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
R5826	813	0	1	31	11	R5826_813_0	8	1		06/20/2011	2012.02	06/20/2011 03:46:16 PM Eastern Daylight Time	08/08/2011 02:31:40 PM Eastern Daylight Time			08/09/2011 08:56:24 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (Regional PPO)	11	31		1			R5826	813	0	2012	States of Kansas and Oklahoma		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
R5826	814	0	1	31	11	R5826_814_0	8	1		06/20/2011	2012.02	06/20/2011 03:46:35 PM Eastern Daylight Time	08/08/2011 02:32:57 PM Eastern Daylight Time			08/09/2011 08:56:24 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (Regional PPO)	11	31		1			R5826	814	0	2012	State of Arizona		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
R5826	815	0	1	31	11	R5826_815_0	8	1		06/20/2011	2012.02	06/20/2011 03:46:56 PM Eastern Daylight Time	08/08/2011 02:34:06 PM Eastern Daylight Time			08/09/2011 08:56:24 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (Regional PPO)	11	31		1			R5826	815	0	2012	States of Alabama and Tennessee		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
R5826	816	0	1	31	11	R5826_816_0	7	1		06/20/2011	2012.02	06/20/2011 03:47:18 PM Eastern Daylight Time	08/08/2011 02:36:18 PM Eastern Daylight Time			08/09/2011 08:56:24 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (Regional PPO)	11	31		1			R5826	816	0	2012	States of Pennsylvania and West Virginia		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
R5826	817	0	1	31	11	R5826_817_0	7	1		06/20/2011	2012.02	06/20/2011 03:47:39 PM Eastern Daylight Time	08/08/2011 02:38:07 PM Eastern Daylight Time			08/09/2011 08:56:24 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (Regional PPO)	11	31		1			R5826	817	0	2012	States of North Carolina and Virginia		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
R5826	818	0	1	31	11	R5826_818_0	7	1		06/20/2011	2012.02	06/20/2011 03:48:01 PM Eastern Daylight Time	08/08/2011 02:40:24 PM Eastern Daylight Time			08/09/2011 08:56:24 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (Regional PPO)	11	31		1			R5826	818	0	2012	States of Georgia and South Carolina		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
R5826	819	0	1	31	11	R5826_819_0	7	1		06/20/2011	2012.02	06/20/2011 03:48:23 PM Eastern Daylight Time	08/08/2011 02:42:38 PM Eastern Daylight Time			08/09/2011 09:00:48 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (Regional PPO)	11	31		1			R5826	819	0	2012	State of Florida		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
R5826	820	0	1	31	11	R5826_820_0	7	1		06/20/2011	2012.02	06/20/2011 03:48:45 PM Eastern Daylight Time	08/08/2011 02:44:46 PM Eastern Daylight Time			08/09/2011 09:00:48 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (Regional PPO)	11	31		1			R5826	820	0	2012	State of Michigan		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
R5826	821	0	1	31	11	R5826_821_0	7	1		06/20/2011	2012.02	06/20/2011 03:49:06 PM Eastern Daylight Time	08/08/2011 02:48:03 PM Eastern Daylight Time			08/09/2011 09:00:48 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (Regional PPO)	11	31		1			R5826	821	0	2012	State of Ohio		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
R5826	822	0	1	31	11	R5826_822_0	7	1		06/20/2011	2012.02	06/20/2011 03:49:28 PM Eastern Daylight Time	08/08/2011 02:50:04 PM Eastern Daylight Time			08/09/2011 09:00:48 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (Regional PPO)	11	31		1			R5826	822	0	2012	States of Indiana and Kentucky		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
R5826	823	0	1	31	11	R5826_823_0	7	1		06/20/2011	2012.02	06/20/2011 03:49:50 PM Eastern Daylight Time	08/08/2011 02:52:07 PM Eastern Daylight Time			08/09/2011 09:00:48 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (Regional PPO)	11	31		1			R5826	823	0	2012	States of Illinois and Wisconsin		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
R5826	824	0	1	31	11	R5826_824_0	7	1		06/20/2011	2012.02	06/20/2011 03:50:11 PM Eastern Daylight Time	08/08/2011 02:54:18 PM Eastern Daylight Time			08/09/2011 09:00:48 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (Regional PPO)	11	31		1			R5826	824	0	2012	States of Arkansas and Missouri		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
R5826	825	0	1	31	11	R5826_825_0	7	1		06/20/2011	2012.02	06/20/2011 03:50:33 PM Eastern Daylight Time	08/08/2011 02:56:31 PM Eastern Daylight Time			08/09/2011 09:00:48 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (Regional PPO)	11	31		1			R5826	825	0	2012	States of Louisiana and Mississippi		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
R5826	826	0	1	31	11	R5826_826_0	7	1		06/20/2011	2012.02	06/20/2011 03:50:55 PM Eastern Daylight Time	08/08/2011 02:58:53 PM Eastern Daylight Time			08/09/2011 09:00:48 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (Regional PPO)	11	31		1			R5826	826	0	2012	State of Texas		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
R5826	827	0	1	31	11	R5826_827_0	7	1		06/20/2011	2012.02	06/20/2011 03:51:16 PM Eastern Daylight Time	08/08/2011 03:01:15 PM Eastern Daylight Time			08/09/2011 09:00:48 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (Regional PPO)	11	31		1			R5826	827	0	2012	States of Kansas and Oklahoma		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
R5826	828	0	1	31	11	R5826_828_0	7	1		06/20/2011	2012.02	06/20/2011 03:51:39 PM Eastern Daylight Time	08/08/2011 03:03:35 PM Eastern Daylight Time			08/09/2011 09:00:48 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (Regional PPO)	11	31		1			R5826	828	0	2012	State of Arizona		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364										(711)		(711)		(711)		(711)										2	1	1
R5826	831	0	1	31	11	R5826_831_0	7	1		06/20/2011	2012.02	06/20/2011 03:51:58 PM Eastern Daylight Time	08/08/2011 02:37:15 PM Eastern Daylight Time			08/09/2011 09:00:48 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored Non-CY (Regional PPO)	11	31		1			R5826	831	0	2012	States of Pennsylvania and West Virginia		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
R5826	832	0	1	31	11	R5826_832_0	7	1		06/20/2011	2012.02	06/20/2011 03:52:17 PM Eastern Daylight Time	08/08/2011 02:39:20 PM Eastern Daylight Time			08/09/2011 09:00:48 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored Non-CY (Regional PPO)	11	31		1			R5826	832	0	2012	States of North Carolina and Virginia		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
R5826	833	0	1	31	11	R5826_833_0	7	1		06/20/2011	2012.02	06/20/2011 03:52:36 PM Eastern Daylight Time	08/08/2011 02:41:36 PM Eastern Daylight Time			08/09/2011 09:00:48 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored Non-CY (Regional PPO)	11	31		1			R5826	833	0	2012	States of Georgia and South Carolina		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
R5826	834	0	1	31	11	R5826_834_0	7	1		06/20/2011	2012.02	06/20/2011 03:52:55 PM Eastern Daylight Time	08/08/2011 02:43:49 PM Eastern Daylight Time			08/09/2011 09:00:48 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored Non-CY (Regional PPO)	11	31		1			R5826	834	0	2012	State of Florida		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
R5826	835	0	1	31	11	R5826_835_0	7	1		06/20/2011	2012.02	06/20/2011 03:53:15 PM Eastern Daylight Time	08/08/2011 02:35:16 PM Eastern Daylight Time			08/09/2011 09:00:48 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored Non-CY (Regional PPO)	11	31		1			R5826	835	0	2012	States of Alabama and Tennessee		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
R5826	836	0	1	31	11	R5826_836_0	7	1		06/20/2011	2012.02	06/20/2011 03:53:34 PM Eastern Daylight Time	08/08/2011 02:46:26 PM Eastern Daylight Time			08/09/2011 09:00:48 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored Non-CY (Regional PPO)	11	31		1			R5826	836	0	2012	State of Michigan		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
R5826	837	0	1	31	11	R5826_837_0	7	1		06/20/2011	2012.02	06/20/2011 03:53:55 PM Eastern Daylight Time	08/08/2011 02:49:03 PM Eastern Daylight Time			08/09/2011 09:00:48 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored Non-CY (Regional PPO)	11	31		1			R5826	837	0	2012	State of Ohio		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
R5826	838	0	1	31	11	R5826_838_0	7	1		06/20/2011	2012.02	06/20/2011 03:54:15 PM Eastern Daylight Time	08/08/2011 02:51:06 PM Eastern Daylight Time			08/09/2011 09:00:48 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored Non-CY (Regional PPO)	11	31		1			R5826	838	0	2012	States of Indiana and Kentucky		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
R5826	839	0	1	31	11	R5826_839_0	7	1		06/20/2011	2012.02	06/20/2011 03:54:34 PM Eastern Daylight Time	08/08/2011 02:53:06 PM Eastern Daylight Time			08/09/2011 09:00:48 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored Non-CY (Regional PPO)	11	31		1			R5826	839	0	2012	States of Illinois and Wisconsin		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
R5826	840	0	1	31	11	R5826_840_0	7	1		06/20/2011	2012.02	06/20/2011 03:54:54 PM Eastern Daylight Time	08/08/2011 02:55:24 PM Eastern Daylight Time			08/09/2011 09:00:48 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored Non-CY (Regional PPO)	11	31		1			R5826	840	0	2012	States of Arkansas and Missouri		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
R5826	841	0	1	31	11	R5826_841_0	7	1		06/20/2011	2012.02	06/20/2011 03:55:13 PM Eastern Daylight Time	08/08/2011 02:57:45 PM Eastern Daylight Time			08/09/2011 09:00:48 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored Non-CY (Regional PPO)	11	31		1			R5826	841	0	2012	States of Louisiana and Mississippi		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
R5826	842	0	1	31	11	R5826_842_0	7	1		06/20/2011	2012.02	06/20/2011 03:55:32 PM Eastern Daylight Time	08/08/2011 02:59:56 PM Eastern Daylight Time			08/09/2011 09:00:48 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored Non-CY (Regional PPO)	11	31		1			R5826	842	0	2012	State of Texas		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
R5826	843	0	1	31	11	R5826_843_0	7	1		06/20/2011	2012.02	06/20/2011 03:55:51 PM Eastern Daylight Time	08/08/2011 03:02:32 PM Eastern Daylight Time			08/09/2011 09:00:48 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored Non-CY (Regional PPO)	11	31		1			R5826	843	0	2012	States of Kansas and Oklahoma		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
R5826	844	0	1	31	11	R5826_844_0	7	1		06/20/2011	2012.02	06/20/2011 03:56:10 PM Eastern Daylight Time	08/08/2011 03:04:48 PM Eastern Daylight Time			08/09/2011 09:00:48 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored Non-CY (Regional PPO)	11	31		1			R5826	844	0	2012	State of Arizona		1		2			2						www.humana.com/members/tools	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs	(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(800)-457-4708		(800)-457-4708		(800)-833-2364		(800)-833-2364		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	1	1
R5941	003	0	1	31	11	R5941_003_0	8	1		08/05/2011	2012.02	08/05/2011 03:18:12 PM Eastern Daylight Time	08/08/2011 07:08:56 PM Eastern Daylight Time	08/08/2011 07:11:06 PM Eastern Daylight Time		08/08/2011 07:18:07 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Blue Medicare Access Standard (Regional PPO)	11	31		1			R5941	003	0	2012	Indiana and Kentucky		2	23365	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(800)-467-1199		(800)-467-1199		(800)-797-0529		(800)-797-0529		(800)-467-1199		(800)-467-1199		(800)-797-0560		(800)-797-0560		(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894		(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894		2	2	2
R5941	007	0	1	31	11	R5941_007_0	6	1		08/08/2011	2012.02	08/08/2011 05:49:27 PM Eastern Daylight Time	08/08/2011 07:09:05 PM Eastern Daylight Time			08/08/2011 07:18:07 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Blue Medicare Access Classic (Regional PPO)	11	31		1			R5941	007	0	2012	Ohio		2	2187	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(800)-467-1199		(800)-467-1199		(800)-797-0560		(800)-797-0560										(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894										2	2	2
R5941	008	0	1	31	11	R5941_008_0	8	1		08/05/2011	2012.02	08/05/2011 03:14:31 PM Eastern Daylight Time	08/08/2011 07:09:12 PM Eastern Daylight Time	08/08/2011 07:11:12 PM Eastern Daylight Time		08/08/2011 07:18:07 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Blue Medicare Access Value (Regional PPO)	11	31		1			R5941	008	0	2012	Ohio		2	63176	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(800)-467-1199		(800)-467-1199		(800)-797-0560		(800)-797-0560		(800)-467-1199		(800)-467-1199		(800)-797-0560		(800)-797-0560		(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894		(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894		2	2	2
R5941	009	0	1	31	11	R5941_009_0	9	1		08/05/2011	2012.02	08/05/2011 03:16:18 PM Eastern Daylight Time	08/08/2011 07:09:19 PM Eastern Daylight Time	08/08/2011 07:11:18 PM Eastern Daylight Time		08/08/2011 07:18:07 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Blue Medicare Access Value (Regional PPO)	11	31		1			R5941	009	0	2012	Indiana and Kentucky		2	60144	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(800)-467-1199		(800)-467-1199		(800)-797-0529		(800)-797-0529		(800)-467-1199		(800)-467-1199		(800)-797-0560		(800)-797-0560		(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894		(888)-853-7754		(888)-853-7754		(800)-241-6894		(800)-241-6894		2	2	2
R5941	801	0	1	31	11	R5941_801_0	8	1		08/08/2011	2012.02	08/08/2011 01:39:38 PM Eastern Daylight Time	08/08/2011 01:19:45 PM Eastern Daylight Time			08/08/2011 01:49:03 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Blue Medicare Access (Regional PPO)	11	31		1			R5941	801	0	2012	Ohio		1	316	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608		(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		2	2	2
R5941	802	0	1	31	11	R5941_802_0	7	1		08/08/2011	2012.02	08/08/2011 01:40:17 PM Eastern Daylight Time	08/08/2011 01:19:46 PM Eastern Daylight Time			08/08/2011 01:49:03 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Blue Medicare Access (Regional PPO)	11	31		1			R5941	802	0	2012	Indiana and Kentucky		1	316	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608		(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754		2	2	2
R5941	805	0	1	31	11	R5941_805_0	7	1		08/08/2011	2012.02	08/08/2011 01:40:23 PM Eastern Daylight Time	08/08/2011 01:19:47 PM Eastern Daylight Time			08/08/2011 01:49:03 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Blue Medicare Access (Regional PPO)	11	31		1			R5941	805	0	2012	Ohio		1	316	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608										(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754										2	2	2
R5941	806	0	1	31	11	R5941_806_0	7	1		08/08/2011	2012.02	08/08/2011 01:40:39 PM Eastern Daylight Time	08/08/2011 01:19:48 PM Eastern Daylight Time			08/08/2011 01:49:03 PM Eastern Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com/medicare	Blue Medicare Access (Regional PPO)	11	31		1			R5941	806	0	2012	Indiana and Kentucky		1	316	2			2						www.anthem.com	www.anthem.com	www.anthem.com	(866)-845-8609		(866)-845-8609		(866)-845-8608		(866)-845-8608										(888)-853-7754		(888)-853-7754		(888)-853-7754		(888)-853-7754										2	2	2
R6801	008	0	1	31	11	R6801_008_0	9	1		08/09/2011	2012.02	08/09/2011 08:54:15 AM Eastern Daylight Time	08/08/2011 06:07:00 PM Eastern Daylight Time	08/09/2011 10:07:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Silver Rx (Regional PPO SNP)	11	31		1			R6801	008	0	2012	Texas		2	5792	2			1	4		1		00000000000000000100	http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-711-1656		(800)-711-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R6801	009	0	1	31	11	R6801_009_0	9	1		08/11/2011	2012.02	08/11/2011 03:28:23 PM Eastern Daylight Time	08/08/2011 06:43:00 PM Eastern Daylight Time	08/09/2011 10:07:00 AM Eastern Daylight Time		08/11/2011 03:29:38 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Gold Rx (Regional PPO SNP)	11	31		1			R6801	009	0	2012	Texas		2	13876	2			1	4		1		00000000000000000100	http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-711-1656		(800)-711-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R6801	011	0	1	31	11	R6801_011_0	7	1	2	08/08/2011	2012.02	08/08/2011 02:08:06 PM Eastern Daylight Time	08/08/2011 06:42:00 PM Eastern Daylight Time	08/09/2011 10:07:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Dual Advantage (Regional PPO SNP)	11	31		1			R6801	011	0	2012	Texas		2	3088	2			1	3		1	5		http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-711-1656		(800)-711-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R6801	012	0	1	31	11	R6801_012_0	7	1		08/08/2011	2012.02	08/08/2011 02:07:47 PM Eastern Daylight Time	08/06/2011 04:39:00 PM Eastern Daylight Time	08/09/2011 10:07:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Medicare Advantage (Regional PPO)	11	31		1			R6801	012	0	2012	Texas		2	4160	2			2						http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-711-1656		(800)-711-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R7439	001	0	1	31	11	R7439_001_0	10	1		08/09/2011	2012.02	08/09/2011 05:46:56 PM Hawaiian Standard Time	08/09/2011 02:07:16 PM Hawaiian Standard Time	08/09/2011 02:07:14 PM Hawaiian Standard Time		08/09/2011 05:50:53 PM Hawaiian Standard Time	HAWAII MEDICAL SERVICE ASSOCIATION	Akamai Advantage by HMSA	www.hmsa.com/advantage	Akamai Advantage Secure (Regional PPO)	11	31		1			R7439	001	0	2012	State of Hawaii		2	5000	2			2						www.hmsa.com/advantage	www.hmsa.com	www.hmsa.com	(800)-776-4672		(808)-948-6000		(800)-620-4672		(808)-948-5555		(800)-776-4672		(808)-948-6000		(800)-620-4672		(808)-948-5555		(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222		2	2	2
R7439	003	0	1	31	11	R7439_003_0	9	1		08/09/2011	2012.02	08/09/2011 03:10:17 PM Hawaiian Standard Time	08/09/2011 02:07:19 PM Hawaiian Standard Time	08/09/2011 02:07:08 PM Hawaiian Standard Time		08/09/2011 04:15:59 PM Hawaiian Standard Time	HAWAII MEDICAL SERVICE ASSOCIATION	Akamai Advantage by HMSA	www.hmsa.com/advantage	Akamai Advantage Preferred (Regional PPO)	11	31		1			R7439	003	0	2012	State of Hawaii		2	10000	2			2						www.hmsa.com/advantage	www.hmsa.com	www.hmsa.com	(800)-776-4672		(808)-948-6000		(800)-620-4672		(808)-948-5555		(800)-776-4672		(808)-948-6000		(800)-620-4672		(808)-948-5555		(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222		2	2	2
R7439	006	0	1	31	11	R7439_006_0	8	1		08/09/2011	2012.02	08/09/2011 03:54:48 PM Hawaiian Standard Time	08/09/2011 02:07:11 PM Hawaiian Standard Time			08/09/2011 04:20:07 PM Hawaiian Standard Time	HAWAII MEDICAL SERVICE ASSOCIATION	Akamai Advantage by HMSA	www.hmsa.com/advantage	Akamai Advantage Assured (Regional PPO)	11	31		1			R7439	006	0	2012	State of Hawaii		2	1000	2			2						www.hmsa.com/advantage	www.hmsa.com	www.hmsa.com	(800)-776-4672		(808)-948-6000		(800)-620-4672		(808)-948-5555										(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222										2	2	2
R7439	801	0	1	31	11	R7439_801_0	2	1		05/30/2011	2012.02	05/30/2011 07:04:39 PM Hawaiian Standard Time	08/09/2011 12:46:32 PM Hawaiian Standard Time			08/09/2011 01:19:05 PM Hawaiian Standard Time	HAWAII MEDICAL SERVICE ASSOCIATION	Akamai Advantage by HMSA	www.hmsa.com/advantage	Akamai Advantage MAPD Region 25 Emp-only CY (Regional PPO)	11	31		1			R7439	801	0	2012	Hawaii		1	1000	2			2						www.hmsa.com/advantage	www.hmsa.com	www.hmsa.com	(800)-776-4672		(808)-948-6000		(800)-620-4672		(808)-948-5555		(800)-776-4672		(808)-948-6000		(800)-620-4672		(808)-948-5555		(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222		1	1	1
R7439	802	0	1	31	11	R7439_802_0	3	1		05/30/2011	2012.02	05/30/2011 07:05:14 PM Hawaiian Standard Time	08/09/2011 12:46:36 PM Hawaiian Standard Time			08/09/2011 01:21:16 PM Hawaiian Standard Time	HAWAII MEDICAL SERVICE ASSOCIATION	Akamai Advantage by HMSA	www.hmsa.com/advantage	Akamai Advantage MAPD Region 25 Emp-only NCY (Regional PPO)	11	31		1			R7439	802	0	2012	Hawaii		1	1000	2			2						www.hmsa.com/advantage	www.hmsa.com	www.hmsa.com	(800)-776-4672		(808)-948-6000		(800)-620-4672		(808)-948-5555		(800)-776-4672		(808)-948-6000		(800)-620-4672		(808)-948-5555		(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222		1	1	1
R7439	805	0	1	31	11	R7439_805_0	2	1		05/30/2011	2012.02	05/30/2011 07:05:45 PM Hawaiian Standard Time	08/09/2011 12:46:43 PM Hawaiian Standard Time			08/09/2011 01:24:18 PM Hawaiian Standard Time	HAWAII MEDICAL SERVICE ASSOCIATION	Akamai Advantage by HMSA	www.hmsa.com/advantage	Akamai Advantage MA Region 25 Emp-only CY (Regional PPO)	11	31		1			R7439	805	0	2012	Hawaii		1	1000	2			2						www.hmsa.com/advantage	www.hmsa.com	www.hmsa.com	(800)-776-4672		(808)-948-6000		(800)-620-4672		(808)-948-5555										(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222										1	1	1
R7439	806	0	1	31	11	R7439_806_0	2	1		05/30/2011	2012.02	05/30/2011 07:06:18 PM Hawaiian Standard Time	08/09/2011 12:46:46 PM Hawaiian Standard Time			08/09/2011 01:26:12 PM Hawaiian Standard Time	HAWAII MEDICAL SERVICE ASSOCIATION	Akamai Advantage by HMSA	www.hmsa.com/advantage	Akamai Advantage MA Region 25 Emp-only NCY (Regional PPO)	11	31		1			R7439	806	0	2012	Hawaii		1	1000	2			2						www.hmsa.com/advantage	www.hmsa.com	www.hmsa.com	(800)-776-4672		(808)-948-6000		(800)-620-4672		(808)-948-5555										(877)-298-4672		(808)-948-6222		(877)-298-4672		(808)-948-6222										1	1	1
R7444	001	0	1	31	11	R7444_001_0	6	1		08/18/2011	2012.02	08/18/2011 03:07:34 PM Central Daylight Time	08/17/2011 04:19:18 PM Central Daylight Time	08/05/2011 01:49:53 PM Central Daylight Time		08/18/2011 04:35:53 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicarePlans.com	AARP MedicareComplete Choice (Regional PPO)	11	31		1			R7444	001	0	2012	New England		2		2			2						www.AARPMedicarePlans.com/tools/find-a-doctor.html?type=MA	www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=MA	www.PrescriptionSolutions.com	(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(800)-643-4845		(800)-643-4845		(800)-547-5514		(800)-547-5514		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R9896	008	0	1	31	11	R9896_008_0	8	1		08/08/2011	2012.02	08/08/2011 01:04:42 PM Eastern Daylight Time	08/08/2011 06:40:00 PM Eastern Daylight Time	08/09/2011 10:08:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Silver Rx (Regional PPO SNP)	11	31		1			R9896	008	0	2012	Georgia and South Carolina		2	20149	2			1	4		1		00000000000000000100	http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-711-1656		(800)-711-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R9896	009	0	1	31	11	R9896_009_0	8	1		08/08/2011	2012.02	08/08/2011 01:07:45 PM Eastern Daylight Time	08/06/2011 04:59:00 PM Eastern Daylight Time	08/09/2011 10:08:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Gold Rx (Regional PPO SNP)	11	31		1			R9896	009	0	2012	Georgia and South Carolina		2	26960	2			1	4		1		00000000000000000100	http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-711-1656		(800)-711-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
R9896	012	0	1	31	11	R9896_012_0	7	1		06/22/2011	2012.02	06/22/2011 03:06:23 PM Eastern Daylight Time	08/06/2011 04:58:00 PM Eastern Daylight Time	08/09/2011 10:08:00 AM Eastern Daylight Time		08/09/2011 07:15:21 PM Eastern Daylight Time	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO	Care Improvement Plus	http://www.careimprovementplus.com/	Care Improvement Plus Medicare Advantage (Regional PPO)	11	31		1			R9896	012	0	2012	Georgia and South Carolina		2	2342	2			2						http://www.careimprovementplus.com	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	http://www.careimprovementplus.com/members/formulary--medicare-drug-plan-coverage.aspx	(800)-204-1002		(800)-204-1002		(800)-711-1656		(800)-711-1656		(866)-673-3561		(866)-673-3561		(800)-711-1656		(800)-711-1656		(711)		(711)		(711)		(711)		(711)		(711)		(711)		(711)		2	2	2
S0043	009	0		29	10	S0043_009_0	1	1		06/02/2011	2012.02	06/02/2011 10:21:01 AM SA Western Standard Time		05/31/2011 05:05:56 PM SA Western Standard Time		06/03/2011 02:22:43 PM SA Western Standard Time	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	MediMax One (PDP)	10	29					S0043	009	0	2012	Puerto Rico		2					2							http://www.pmcpr.org	http://www.pmcpr.org									(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510										(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701				
S0043	010	0		29	10	S0043_010_0	1	1		06/02/2011	2012.02	06/02/2011 10:13:44 AM SA Western Standard Time		05/31/2011 05:05:59 PM SA Western Standard Time		06/03/2011 02:22:43 PM SA Western Standard Time	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	MediMax  Plus (PDP)	10	29					S0043	010	0	2012	Puerto Rico		2					2							http://www.pmcpr.org	http://www.pmcpr.org									(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510										(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701				
S0043	013	0		29	10	S0043_013_0	2	1		06/02/2011	2012.02	06/02/2011 10:13:28 AM SA Western Standard Time		07/08/2011 09:38:50 AM SA Western Standard Time		07/08/2011 05:14:39 PM SA Western Standard Time	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	MediMax Elite (PDP)	10	29					S0043	013	0	2012	Puerto Rico		2					2							http://www.pmcpr.org	http://www.pmcpr.org									(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510										(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701				
S0043	801	0		29	10	S0043_801_0	1	1		05/11/2011	2012.02	05/11/2011 09:01:17 AM SA Western Standard Time				06/03/2011 02:22:43 PM SA Western Standard Time	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	MediMax Employeer Plan I C (PDP)	10	29					S0043	801	0	2012	Puerto Rico		1					2							http://www.pmcpr.org	http://www.pmcpr.org									(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510										(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701				
S0043	802	0		29	10	S0043_802_0	1	1		05/11/2011	2012.02	05/11/2011 09:01:21 AM SA Western Standard Time				06/03/2011 02:22:43 PM SA Western Standard Time	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	MediMax Employeer Plan II NC (PDP)	10	29					S0043	802	0	2012	Puerto Rico		1					2							http://www.pmcpr.org	http://www.pmcpr.org									(866)-516-7700		(787)-625-2126		(877)-568-0808		(787)-622-7510										(866)-516-7701		(866)-516-7701		(866)-516-7701		(866)-516-7701				
S0197	005	0		29	10	S0197_005_0	4	1		06/02/2011	2012.02	06/02/2011 09:59:50 PM Eastern Daylight Time		07/15/2011 12:39:42 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	CAMBRIDGE LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S0197	005	0	2012	First Health Part D Premier Plus New York		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-4646		(866)-823-4646		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S0197	809	0		29	10	S0197_809_0	3	1		06/07/2011	2012.02	06/07/2011 04:02:01 PM Eastern Daylight Time				06/07/2011 04:45:57 PM Eastern Daylight Time	CAMBRIDGE LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Employer Group - 12333 - CY (PDP)	10	29					S0197	809	0	2012	First Health Part D Employer Group - 12333 - CY		1					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-4646		(866)-823-4646		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S0197	810	0		29	10	S0197_810_0	3	1		06/07/2011	2012.02	06/07/2011 04:01:47 PM Eastern Daylight Time				06/07/2011 04:45:57 PM Eastern Daylight Time	CAMBRIDGE LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Employer Group - 12333 - NCY (PDP)	10	29					S0197	810	0	2012	First Health Part D Employer Group - 12333 - NCY		1					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-4646		(866)-823-4646		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S0197	815	0		29	10	S0197_815_0	3	1		06/07/2011	2012.02	06/07/2011 04:02:07 PM Eastern Daylight Time				06/07/2011 04:45:57 PM Eastern Daylight Time	CAMBRIDGE LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Employer Group - 12336 - CY (PDP)	10	29					S0197	815	0	2012	First Health Part D Employer Group - 12336 - CY		1					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-4646		(866)-823-4646		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S0197	816	0		29	10	S0197_816_0	3	1		06/07/2011	2012.02	06/07/2011 04:02:12 PM Eastern Daylight Time				06/07/2011 04:45:57 PM Eastern Daylight Time	CAMBRIDGE LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Employer Group - 12336 - NCY (PDP)	10	29					S0197	816	0	2012	First Health Part D Employer Group - 12336 - NCY		1					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-4646		(866)-823-4646		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S0197	817	0		29	10	S0197_817_0	3	1		06/07/2011	2012.02	06/07/2011 04:02:17 PM Eastern Daylight Time				06/07/2011 04:45:57 PM Eastern Daylight Time	CAMBRIDGE LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Employer Group - 12330 - CY (PDP)	10	29					S0197	817	0	2012	First Health Part D Employer Group - 12330 - CY		1					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-4646		(866)-823-4646		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S0197	818	0		29	10	S0197_818_0	3	1		06/07/2011	2012.02	06/07/2011 04:02:21 PM Eastern Daylight Time				06/07/2011 04:45:57 PM Eastern Daylight Time	CAMBRIDGE LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Employer Group - 12330 - NCY (PDP)	10	29					S0197	818	0	2012	First Health Part D Employer Group - 12330- NCY		1					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-4646		(866)-823-4646		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S0223	001	0		29	10	S0223_001_0	3	1		06/04/2011	2012.02	06/04/2011 08:58:51 PM Eastern Daylight Time		07/21/2011 11:00:04 AM Eastern Daylight Time		07/21/2011 11:04:54 AM Eastern Daylight Time	HEALTH FIRST HEALTH PLANS, INC	Health First Medicare Plans	www.HealthFirstHealthPlans.org	Health First Essential Prescription Drug Plan (PDP)	10	29					S0223	001	0	2012	Health First Essential Prescription Drug Plan		2					2							http://www.health-first.org/health_plans/	www.sxc.com									(800)-716-7737		(321)-434-5665		(800)-716-7737		(321)-434-5665										(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771				
S0223	002	0		29	10	S0223_002_0	2	1		06/02/2011	2012.02	06/02/2011 12:47:01 PM Eastern Daylight Time		07/19/2011 01:04:59 PM Eastern Daylight Time		07/19/2011 01:35:28 PM Eastern Daylight Time	HEALTH FIRST HEALTH PLANS, INC	Health First Medicare Plans	www.HealthFirstHealthPlans.org	Health First Prime Prescription Drug Plan (PDP)	10	29					S0223	002	0	2012	Health First Prime Prescription Drug Plan		2					2							http://www.health-first.org/health_plans/	www.sxc.com									(800)-716-7737		(321)-434-5665		(800)-716-7737		(321)-434-5665										(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771				
S0586	801	0		29	10	S0586_801_0	1	1		06/04/2011	2012.02	06/04/2011 02:56:15 PM Eastern Daylight Time				06/04/2011 02:56:27 PM Eastern Daylight Time	MVP HEALTH PLAN, INC.	MVP Health Care	www.mvphealthcare.com	MVP RxCare - Employer Group (PDP)	10	29					S0586	801	0	2012	United States and Puerto Rico		1					2							https://www.mvphealthcare.com/medicare/documents/2011_Comprehensive_Formulary_roc.pdf	www.mvphealthcare.com									(800)-665-7924		(800)-665-7924		(888)-280-6205		(888)-280-6205										(800)-662-1220		(800)-662-1220		(800)-662-1220		(800)-662-1220				
S0655	801	0		29	10	S0655_801_0	3	1		06/03/2011	2012.02	06/03/2011 06:42:07 PM Eastern Daylight Time				06/06/2011 05:06:24 PM Eastern Daylight Time	TUFTS INSURANCE COMPANY	Tufts Health Plan Medicare Preferred	tuftsmedicarepreferred.org	Tufts Medicare Preferred PDP Group (PDP)	10	29					S0655	801	0	2012	Massachusetts and Nationwide		1					2							tuftsmedicarepreferred.org/druglist.php	tuftsmedicarepreferred.org/druglist.php									(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835										(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977				
S0655	802	0		29	10	S0655_802_0	3	1		06/03/2011	2012.02	06/03/2011 06:42:53 PM Eastern Daylight Time				06/06/2011 05:06:24 PM Eastern Daylight Time	TUFTS INSURANCE COMPANY	Tufts Health Plan Medicare Preferred	tuftsmedicarepreferred.org	Tufts Medicare Preferred PDP Group (PDP)	10	29					S0655	802	0	2012	Massachusetts and Nationwide		1					2							tuftsmedicarepreferred.org/druglist.php	tuftsmedicarepreferred.org/druglist.php									(800)-701-9000		(800)-701-9000		(877)-218-4835		(877)-218-4835										(800)-208-9562		(800)-208-9562		(888)-899-8977		(888)-899-8977				
S1030	001	0		29	10	S1030_001_0	3	1		08/01/2011	2012.02	08/01/2011 03:21:29 PM Central Daylight Time		07/21/2011 10:49:26 AM Central Daylight Time		08/02/2011 11:04:05 AM Central Daylight Time	BCBS OF ALABAMA AND BCBS OF TENNESSEE	BlueRx	www.bluerxalatenn.com	BlueRx Option II (PDP)	10	29					S1030	001	0	2012	State of Alabama, State of Tennessee		2					2							www.bcbsalmedicare.com/medicare/plans/bluerx/tools.cfm	www.bcbsalmedicare.com/medicare/plans/bluerx/tools.cfm									(800)-327-3998		(800)-327-3998		(877)-233-3555		(877)-233-3555										(711)		(711)		(711)		(711)				
S1030	006	0		29	10	S1030_006_0	2	1		08/02/2011	2012.02	08/02/2011 10:42:57 AM Central Daylight Time		06/01/2011 10:51:14 AM Central Daylight Time		08/02/2011 10:47:32 AM Central Daylight Time	BCBS OF ALABAMA AND BCBS OF TENNESSEE	BlueRx	www.bluerxalatenn.com	BlueRx Option I (PDP)	10	29					S1030	006	0	2012	State of Alabama, State of Tennessee		2					2							www.bcbsalmedicare.com/medicare/plans/bluerx/tools.cfm	www.bcbsalmedicare.com/medicare/plans/bluerx/tools.cfm									(800)-327-3998		(800)-327-3998		(877)-233-3555		(877)-233-3555										(711)		(711)		(711)		(711)				
S1030	801	0		29	10	S1030_801_0	1	1		05/24/2011	2012.02	05/24/2011 04:38:08 PM Central Daylight Time				06/01/2011 03:07:37 PM Central Daylight Time	BCBS OF ALABAMA AND BCBS OF TENNESSEE	BlueRx	www.bluerxalatenn.com	BlueRx Employer Group Plan 801 (PDP)	10	29					S1030	801	0	2012	State of Alabama, State of Tennessee		1					2							www.bcbsalmedicare.com/medicare/plans/bluerx/tools.cfm	www.bcbsalmedicare.com/medicare/plans/bluerx/tools.cfm									(800)-327-3998		(800)-327-3998		(877)-233-3555		(877)-233-3555										(711)		(711)		(711)		(711)				
S1030	802	0		29	10	S1030_802_0	1	1		05/26/2011	2012.02	05/26/2011 01:11:43 PM Central Daylight Time				06/01/2011 02:24:04 PM Central Daylight Time	BCBS OF ALABAMA AND BCBS OF TENNESSEE	BlueRx	www.bluerxalatenn.com	BlueRx Employer Group Plan 802 (PDP)	10	29					S1030	802	0	2012	State of Alabama, State of Tennessee		1					2							www.bcbsalmedicare.com/medicare/plans/bluerx/tools.cfm	www.bcbsalmedicare.com/medicare/plans/bluerx/tools.cfm									(800)-327-3998		(800)-327-3998		(877)-233-3555		(877)-233-3555										(711)		(711)		(711)		(711)				
S1480	001	0		29	10	S1480_001_0	4	1		05/26/2011	2012.02	05/26/2011 01:08:37 PM Eastern Daylight Time		07/14/2011 02:15:58 PM Eastern Daylight Time		07/15/2011 04:33:19 PM Eastern Daylight Time	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	www.primetimehealthplan.com	PrimeTime Health Plan Prime PDP Basic (PDP)	10	29					S1480	001	0	2012	State of Ohio		2					2							www.primetimehealthplan.com	www.primetimehealthplan.com									(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407										(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460				
S1480	002	0		29	10	S1480_002_0	5	1		05/26/2011	2012.02	05/26/2011 01:13:14 PM Eastern Daylight Time		07/22/2011 01:38:26 PM Eastern Daylight Time		07/22/2011 01:40:47 PM Eastern Daylight Time	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	www.primetimehealthplan.com	PrimeTime Health Plan Prime PDP Enhanced (PDP)	10	29					S1480	002	0	2012	State of Ohio		2					2							www.primetimehealthplan.com	www.primetimehealthplan.com									(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407										(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460				
S1480	801	0		29	10	S1480_801_0	3	1		05/06/2011	2012.02	05/06/2011 04:43:50 PM Eastern Daylight Time				06/06/2011 09:44:27 AM Eastern Daylight Time	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	www.primetimehealthplan.com	PrimeTime Health Plan Employer Group PDP (PDP)	10	29					S1480	801	0	2012	State of Ohio		1					2							www.primetimehealthplan.com	www.primetimehealthplan.com									(800)-577-5084		(330)-363-7407		(800)-577-5084		(330)-363-7407										(800)-617-7446		(330)-363-7460		(800)-617-7446		(330)-363-7460				
S1822	801	0		29	10	S1822_801_0	1	1		05/20/2011	2012.02	05/20/2011 02:26:01 PM Central Daylight Time				06/03/2011 07:49:36 PM Central Daylight Time	HEALTHPARTNERS, INC.	HealthPartners National PDP	healthpartners.com/medicare	HealthPartners Retiree National Choice CY (PDP)	10	29					S1822	801	0	2012	Nationwide		1					2							healthpartners.com/medicarerx	healthpartners.com/medicare									(877)-816-9539		(952)-883-7373		(866)-993-7428		(952)-883-7428										(800)-443-0156		(952)-883-6060		(800)-443-0156		(952)-883-6060				
S1822	802	0		29	10	S1822_802_0	1	1		05/03/2011	2012.02	05/03/2011 12:07:43 PM Central Daylight Time				06/03/2011 07:54:40 PM Central Daylight Time	HEALTHPARTNERS, INC.	HealthPartners National PDP	healthpartners.com/medicare	HealthPartners Retiree National Choice NCY (PDP)	10	29					S1822	802	0	2012	Nationwide		1					2							healthpartners.com/medicarerx	healthpartners.com/medicare									(877)-816-9539		(952)-883-7373		(866)-993-7428		(952)-883-7428										(800)-443-0156		(952)-883-6060		(800)-443-0156		(952)-883-6060				
S2321	002	0		29	10	S2321_002_0	2	1		05/26/2011	2012.02	05/26/2011 02:04:43 PM Eastern Daylight Time		05/31/2011 03:31:33 PM Eastern Daylight Time		06/03/2011 09:54:35 PM Eastern Daylight Time	QCC INS CO D/B/A AMERIHEALTH INS CO	AmeriHealth Rx	www.amerihealthmedicare.com	AmeriHealth Rx Option II (PDP)	10	29					S2321	002	0	2012	Pennsylvania, West Virginia		2					2							http://www.amerihealthmedicare.com/find_a_drug/index.html	http://www.amerihealthmedicare.com/find_a_provider/index.html									(888)-678-7007		(888)-678-7007		(866)-456-1695		(866)-456-1695										(888)-457-3002		(888)-457-3002		(866)-456-1683		(866)-456-1683				
S2321	005	0		29	10	S2321_005_0	2	1		05/26/2011	2012.02	05/26/2011 01:44:34 PM Eastern Daylight Time		06/01/2011 01:28:38 PM Eastern Daylight Time		06/03/2011 09:54:35 PM Eastern Daylight Time	QCC INS CO D/B/A AMERIHEALTH INS CO	AmeriHealth Rx	www.amerihealthmedicare.com	AmeriHealth Rx Option I (PDP)	10	29					S2321	005	0	2012	Pennsylvania, West Virginia		2					2							http://www.amerihealthmedicare.com/find_a_drug/index.html	http://www.amerihealthmedicare.com/find_a_provider/index.html									(888)-678-7007		(888)-678-7007		(866)-456-1695		(866)-456-1695										(888)-457-3002		(888)-457-3002		(866)-456-1683		(866)-456-1683				
S2468	002	0		29	10	S2468_002_0	4	1		06/27/2011	2012.02	06/27/2011 10:06:59 AM Pacific Daylight Time		06/30/2011 09:54:14 PM Pacific Daylight Time		07/01/2011 05:56:26 AM Pacific Daylight Time	CA PHYSICIANS' SERVICE DBA BLUE SHIELD OF CA	Blue Shield of California	www.blueshieldca.com/findamedicareplan	Blue Shield Medicare Premium Plan (PDP)	10	29					S2468	002	0	2012	State of California		2					2							https://www.blueshieldca.com/medicarepartdplans/formulary/	www.blueshieldca.com									(888)-239-6469		(888)-239-6469		(800)-488-8000		(800)-488-8000										(888)-239-6482		(888)-239-6482		(888)-595-0000		(888)-595-0000				
S2468	003	0		29	10	S2468_003_0	4	1		06/27/2011	2012.02	06/27/2011 10:07:10 AM Pacific Daylight Time		07/11/2011 09:03:58 AM Pacific Daylight Time		07/11/2011 09:38:21 AM Pacific Daylight Time	CA PHYSICIANS' SERVICE DBA BLUE SHIELD OF CA	Blue Shield of California	www.blueshieldca.com/findamedicareplan	Blue Shield Medicare Basic Plan (PDP)	10	29					S2468	003	0	2012	State of California		2					2							https://www.blueshieldca.com/medicarepartdplans/formulary/	www.blueshieldca.com									(888)-239-6469		(888)-239-6469		(800)-488-8000		(800)-488-8000										(888)-239-6482		(888)-239-6482		(888)-595-0000		(888)-595-0000				
S2468	004	0		29	10	S2468_004_0	5	1		06/27/2011	2012.02	06/27/2011 10:07:21 AM Pacific Daylight Time		06/30/2011 10:26:32 PM Pacific Daylight Time		07/01/2011 06:05:44 AM Pacific Daylight Time	CA PHYSICIANS' SERVICE DBA BLUE SHIELD OF CA	Blue Shield of California	www.blueshieldca.com/findamedicareplan	Blue Shield Medicare Enhanced Plan (PDP)	10	29					S2468	004	0	2012	State of California		2					2							https://www.blueshieldca.com/medicarepartdplans/formulary/	www.blueshieldca.com									(888)-239-6469		(888)-239-6469		(800)-488-8000		(800)-488-8000										(888)-239-6482		(888)-239-6482		(888)-595-0000		(888)-595-0000				
S2468	801	0		29	10	S2468_801_0	1	1		05/06/2011	2012.02	05/06/2011 02:08:42 PM Pacific Daylight Time				06/02/2011 02:03:33 PM Pacific Daylight Time	CA PHYSICIANS' SERVICE DBA BLUE SHIELD OF CA	Blue Shield of California	www.blueshieldca.com	Blue Shield of California Medicare Rx Plan (PDP)	10	29					S2468	801	0	2012	PDP Employer Group Plan		1					2							https://www.blueshieldca.com/medicarepartdplans/formulary/	www.blueshieldca.com									(888)-239-6469		(888)-239-6469		(800)-488-8000		(800)-488-8000										(888)-239-6482		(888)-239-6482		(888)-595-0000		(888)-595-0000				
S2468	802	0		29	10	S2468_802_0	1	1		05/06/2011	2012.02	05/06/2011 02:08:55 PM Pacific Daylight Time				06/02/2011 02:07:07 PM Pacific Daylight Time	CA PHYSICIANS' SERVICE DBA BLUE SHIELD OF CA	Blue Shield of California	www.blueshieldca.com	Blue Shield of California Medicare Rx Plan (PDP)	10	29					S2468	802	0	2012	PDP Employer Group Plan		1					2							https://www.blueshieldca.com/medicarepartdplans/formulary/	www.blueshieldca.com									(888)-239-6469		(888)-239-6469		(800)-488-8000		(800)-488-8000										(888)-239-6482		(888)-239-6482		(888)-595-0000		(888)-595-0000				
S2505	001	0		29	10	S2505_001_0	3	1		06/04/2011	2012.02	06/04/2011 04:50:49 PM Central Daylight Time		07/20/2011 01:23:01 PM Central Daylight Time		07/20/2011 06:31:24 PM Central Daylight Time	WINDSOR HEALTH PLAN, INC	Windsor Rx	www.windsorrx.com	Windsor Rx (PDP)	10	29					S2505	001	0	2012	Alabama and Tennessee		2					2							www.windsorrx.com	www.windsorrx.com									(800)-264-1587		(800)-264-1587		(866)-448-8313		(866)-448-8313										(800)-595-8856		(800)-595-8856		(866)-460-7617		(866)-460-7617				
S2505	003	0		29	10	S2505_003_0	3	1		06/04/2011	2012.02	06/04/2011 04:51:07 PM Central Daylight Time		07/20/2011 01:23:23 PM Central Daylight Time		07/20/2011 06:31:24 PM Central Daylight Time	WINDSOR HEALTH PLAN, INC	Windsor Rx	www.windsorrx.com	Windsor Rx (PDP)	10	29					S2505	003	0	2012	Arkansas		2					2							www.windsorrx.com	www.windsorrx.com									(800)-264-1587		(800)-264-1587		(866)-448-8313		(866)-448-8313										(800)-595-8856		(800)-595-8856		(866)-460-7617		(866)-460-7617				
S2505	005	0		29	10	S2505_005_0	3	1		06/04/2011	2012.02	06/04/2011 04:51:08 PM Central Daylight Time		07/20/2011 01:23:46 PM Central Daylight Time		07/20/2011 06:31:24 PM Central Daylight Time	WINDSOR HEALTH PLAN, INC	Windsor Rx	www.windsorrx.com	Windsor Rx (PDP)	10	29					S2505	005	0	2012	Mississippi		2					2							www.windsorrx.com	www.windsorrx.com									(800)-264-1587		(800)-264-1587		(866)-448-8313		(866)-448-8313										(800)-595-8856		(800)-595-8856		(866)-460-7617		(866)-460-7617				
S2505	007	0		29	10	S2505_007_0	3	1		06/04/2011	2012.02	06/04/2011 04:53:02 PM Central Daylight Time		07/20/2011 01:24:09 PM Central Daylight Time		07/20/2011 06:31:24 PM Central Daylight Time	WINDSOR HEALTH PLAN, INC	Windsor Rx	www.windsorrx.com	Windsor Rx (PDP)	10	29					S2505	007	0	2012	South Carolina		2					2							www.windsorrx.com	www.windsorrx.com									(800)-264-1587		(800)-264-1587		(866)-448-8313		(866)-448-8313										(800)-595-8856		(800)-595-8856		(866)-460-7617		(866)-460-7617				
S2874	001	0		29	10	S2874_001_0	3	1		05/25/2011	2012.02	05/25/2011 03:42:32 PM Eastern Daylight Time		07/21/2011 12:26:00 PM Eastern Daylight Time		07/25/2011 11:02:04 AM Eastern Daylight Time	HUMANA INSURANCE OF PUERTO RICO, INC.	Humana Insurance of Puerto Rico, Inc	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S2874	001	0	2012	Puerto Rico - Island Wide		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625										(711)		(711)		(711)		(711)				
S2874	004	0		29	10	S2874_004_0	2	1		07/22/2011	2012.02	07/22/2011 10:13:26 AM Eastern Daylight Time		07/21/2011 05:23:00 PM Eastern Daylight Time		07/22/2011 05:22:24 PM Eastern Daylight Time	HUMANA INSURANCE OF PUERTO RICO, INC.	Humana Insurance of Puerto Rico, Inc	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S2874	004	0	2012	Puerto Rico - Island Wide		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625										(711)		(711)		(711)		(711)				
S2874	801	0		29	10	S2874_801_0	1	1		05/28/2011	2012.02	05/28/2011 06:48:46 PM Eastern Daylight Time				05/28/2011 06:59:21 PM Eastern Daylight Time	HUMANA INSURANCE OF PUERTO RICO, INC.	Humana Insurance of Puerto Rico, Inc	www.humana-medicare.com	Humana Employer Sponsored (PDP)	10	29					S2874	801	0	2012	Puerto Rico - Island Wide		1					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625										(711)		(711)		(711)		(711)				
S2874	802	0		29	10	S2874_802_0	1	1		05/28/2011	2012.02	05/28/2011 06:48:57 PM Eastern Daylight Time				05/28/2011 06:59:21 PM Eastern Daylight Time	HUMANA INSURANCE OF PUERTO RICO, INC.	Humana Insurance of Puerto Rico, Inc	www.humana-medicare.com	Humana Employer Sponsored Non-CY (PDP)	10	29					S2874	802	0	2012	Puerto Rico - Island Wide		1					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625										(711)		(711)		(711)		(711)				
S2874	803	0		29	10	S2874_803_0	1	1		05/28/2011	2012.02	05/28/2011 06:49:16 PM Eastern Daylight Time				05/28/2011 06:59:21 PM Eastern Daylight Time	HUMANA INSURANCE OF PUERTO RICO, INC.	Humana Insurance of Puerto Rico, Inc	www.humana-medicare.com	Humana Employer Sponsored - Walmart (PDP)	10	29					S2874	803	0	2012	Puerto Rico - Island Wide		1					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(866)-773-5959		(866)-773-5959		(800)-681-3625		(800)-681-3625										(711)		(711)		(711)		(711)				
S2893	001	0		29	10	S2893_001_0	2	1		06/01/2011	2012.02	06/01/2011 12:18:31 PM Pacific Daylight Time		06/03/2011 12:06:40 PM Pacific Daylight Time		06/03/2011 01:17:17 PM Pacific Daylight Time	ANTHEM INSURANCE CO.  BCBSMA  BCBSRI  BCBSVT	Blue MedicareRx	www.RxMedicarePlans.com	Blue MedicareRx Value Plus (PDP)	10	29					S2893	001	0	2012	Connecticut, Massachusetts, Rhode Island, Vermont		2					2							www.rxmedicareplans.com	www.rxmedicareplans.com									(888)-543-4917		(888)-543-4917		(877)-479-2227		(877)-479-2227										(866)-236-1069		(866)-236-1069		(866)-236-1069		(866)-236-1069				
S2893	003	0		29	10	S2893_003_0	3	1		06/01/2011	2012.02	06/01/2011 12:12:48 PM Pacific Daylight Time		07/21/2011 07:21:31 PM Pacific Daylight Time		07/21/2011 07:36:33 PM Pacific Daylight Time	ANTHEM INSURANCE CO.  BCBSMA  BCBSRI  BCBSVT	Blue MedicareRx	www.RxMedicarePlans.com	Blue MedicareRx Premier (PDP)	10	29					S2893	003	0	2012	Connecticut, Massachusetts, Rhode Island, Vermont		2					2							www.rxmedicareplans.com	www.rxmedicareplans.com									(888)-543-4917		(888)-543-4917		(877)-479-2227		(877)-479-2227										(866)-236-1069		(866)-236-1069		(866)-236-1069		(866)-236-1069				
S2893	801	0		29	10	S2893_801_0	2	1		05/22/2011	2012.02	05/22/2011 02:53:35 PM Pacific Daylight Time				06/03/2011 01:17:17 PM Pacific Daylight Time	ANTHEM INSURANCE CO.  BCBSMA  BCBSRI  BCBSVT	Blue MedicareRx	www.RxMedicarePlans.com	Blue MedicareRx (PDP)	10	29					S2893	801	0	2012	Connecticut, Massachusetts, Rhode Island, Vermont		1					2							www.rxmedicareplans.com	www.rxmedicareplans.com									(888)-543-4917		(888)-543-4917		(877)-479-2227		(877)-479-2227										(866)-236-1069		(866)-236-1069		(866)-236-1069		(866)-236-1069				
S2893	802	0		29	10	S2893_802_0	2	1		05/22/2011	2012.02	05/22/2011 02:53:40 PM Pacific Daylight Time				06/03/2011 01:17:17 PM Pacific Daylight Time	ANTHEM INSURANCE CO.  BCBSMA  BCBSRI  BCBSVT	Blue MedicareRx	www.RxMedicarePlans.com	Blue MedicareRx (PDP)	10	29					S2893	802	0	2012	Connecticut, Massachusetts, Rhode Island, Vermont		1					2							www.rxmedicareplans.com	www.rxmedicareplans.com									(888)-543-4917		(888)-543-4917		(877)-479-2227		(877)-479-2227										(866)-236-1069		(866)-236-1069		(866)-236-1069		(866)-236-1069				
S3389	802	0		29	10	S3389_802_0	2	1		06/06/2011	2012.02	06/06/2011 08:48:58 AM Eastern Daylight Time				06/06/2011 08:55:37 AM Eastern Daylight Time	UPMC HEALTH BENEFITS, INC	UPMC Health Plan	http://www.upmchealthplan.com/medicare/	UPMC Employer Group (PDP)	10	29					S3389	802	0	2012	States of Pennsylvania and West Virginia		1					2							http://www.upmchealthplan.com/medicare/partd.html	http://www.upmchealthplan.com/medicare/partd.html									(877)-539-3080		(877)-539-3080		(877)-381-3765		(877)-381-3765										(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629				
S3389	803	0		29	10	S3389_803_0	2	1		05/16/2011	2012.02	05/16/2011 11:19:00 AM Eastern Daylight Time				06/06/2011 08:55:37 AM Eastern Daylight Time	UPMC HEALTH BENEFITS, INC	UPMC Health Plan	http://www.upmchealthplan.com/medicare/	UPMC Employer Group (PDP)	10	29					S3389	803	0	2012	States of Pennsylvania and West Virginia		1					2							http://www.upmchealthplan.com/medicare/partd.html	http://www.upmchealthplan.com/medicare/partd.html									(877)-539-3080		(877)-539-3080		(877)-381-3765		(877)-381-3765										(800)-361-2629		(800)-361-2629		(800)-361-2629		(800)-361-2629				
S3440	001	0		29	10	S3440_001_0	4	1		07/15/2011	2012.02	07/15/2011 09:49:00 AM Eastern Daylight Time		07/15/2011 10:26:16 AM Eastern Daylight Time		07/15/2011 10:28:12 AM Eastern Daylight Time	ALLIANCE HEALTH AND LIFE INSURANCE COMPANY	Alliance Medicare Rx	www.hap.org/Medicare	Alliance Medicare RX (PDP)	10	29					S3440	001	0	2012	Alliance Medicare RX - Michigan		2					2							www.hap.org/medicare	www.hap.org/medicare									(800)-765-3436		(313)-664-9064		(800)-868-3153		(800)-868-3153										(800)-956-4325		(313)-664-8000		(800)-956-4325		(313)-664-8000				
S3521	001	0		29	10	S3521_001_0	2	1		05/24/2011	2012.02	05/24/2011 02:39:45 PM Eastern Daylight Time		06/06/2011 07:44:30 AM Eastern Daylight Time		06/06/2011 10:35:03 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC	Simply Prescriptions	www.simplyprescriptions.com	Rx 1 (PDP)	10	29					S3521	001	0	2012	New York State		2					2							www.simplyprescriptions.com/drug_lists.shtml	www.simplyprescriptions.com									(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986										(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220				
S3521	003	0		29	10	S3521_003_0	3	1		05/26/2011	2012.02	05/26/2011 09:08:17 AM Eastern Daylight Time		07/20/2011 07:19:00 PM Eastern Daylight Time		07/22/2011 10:38:48 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC	Simply Prescriptions	www.simplyprescriptions.com	Rx 3 (PDP)	10	29					S3521	003	0	2012	New York State		2					2							www.simplyprescriptions.com/drug_lists.shtml	www.simplyprescriptions.com									(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986										(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220				
S3521	801	0		29	10	S3521_801_0	1	1		05/02/2011	2012.02	05/02/2011 11:19:39 AM Eastern Daylight Time				06/06/2011 10:35:03 AM Eastern Daylight Time	EXCELLUS HEALTH PLAN, INC	Simply Prescriptions	www.simplyprescriptions.com	Part D - Employer Group (PDP)	10	29					S3521	801	0	2012	National and US Territories		1					2							www.simplyprescriptions.com/drug_lists.shtml	www.simplyprescriptions.com									(877)-883-9577		(877)-883-9577		(800)-659-1986		(800)-659-1986										(800)-421-1220		(800)-421-1220		(800)-421-1220		(800)-421-1220				
S3994	801	0		29	10	S3994_801_0	1	1		05/30/2011	2012.02	05/30/2011 05:32:09 PM Hawaiian Standard Time				06/05/2011 03:44:45 PM Hawaiian Standard Time	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	HMSA's Medicare Rx Plan	www.hmsa.com	Medicare Rx EGWP CY (PDP)	10	29					S3994	801	0	2012	State of Hawaii		1					2							www.hmsa.com	www.hmsa.com									(800)-776-4672		(808)-948-6000		(800)-620-4672		(808)-948-5555										(877)-447-5990		(808)-948-6222		(877)-447-5990		(808)-948-6222				
S3994	802	0		29	10	S3994_802_0	1	1		05/30/2011	2012.02	05/30/2011 05:32:25 PM Hawaiian Standard Time				06/05/2011 03:47:42 PM Hawaiian Standard Time	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	HMSA's Medicare Rx Plan	www.hmsa.com	Medicare Rx EGWP NCY (PDP)	10	29					S3994	802	0	2012	State of Hawaii		1					2							www.hmsa.com	www.hmsa.com									(800)-776-4672		(808)-948-6000		(800)-620-4672		(808)-948-5555										(877)-447-5990		(808)-948-6222		(877)-447-5990		(808)-948-6222				
S4219	001	0		29	10	S4219_001_0	3	1		05/23/2011	2012.02	05/23/2011 03:58:04 PM Central Daylight Time		06/01/2011 11:17:30 AM Central Daylight Time		06/04/2011 12:17:50 PM Central Daylight Time	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medicare Prescription Plan	www.healthalliancemedicare.org	Health Alliance Medicare Prescription Plan - Basic (PDP)	10	29					S4219	001	0	2012	State of Illinois		2					2							www.healthalliancemedicare.org	www.healthalliancemedicare.org									(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-965-4022										(866)-883-8551		(866)-883-8551		(866)-883-8551		(866)-883-8551				
S4219	801	0		29	10	S4219_801_0	3	1		05/23/2011	2012.02	05/23/2011 04:14:51 PM Central Daylight Time				06/04/2011 12:17:50 PM Central Daylight Time	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medicare Prescription Plan	www.healthalliancemedicare.org	Health Alliance Group Medicare Prescription Plan (PDP)	10	29					S4219	801	0	2012	United States		1					2							www.healthalliancemedicare.org	www.healthalliancemedicare.org									(800)-965-4022		(800)-965-4022		(800)-965-4022		(800)-965-4022										(866)-883-8551		(866)-883-8551		(866)-883-8551		(866)-883-8551				
S4802	012	0		29	10	S4802_012_0	2	1		06/04/2011	2012.02	06/04/2011 03:05:19 PM Central Daylight Time		07/22/2011 02:42:49 PM Central Daylight Time		07/22/2011 03:59:00 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	Windsor Rx (PDP)	10	29					S4802	012	0	2012	Region 21		2					2							http://www.sterlinghealth.com	http://www.sterlinghealth.com									(866)-454-7141		(866)-454-7114		(888)-909-1713		(888)-909-1713										(800)-899-2114		(800)-899-2114		(888)-858-8567		(888)-858-8567				
S4802	013	0		29	10	S4802_013_0	2	1		06/04/2011	2012.02	06/04/2011 03:06:43 PM Central Daylight Time		07/22/2011 02:45:45 PM Central Daylight Time		07/22/2011 03:59:00 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	Windsor Rx (PDP)	10	29					S4802	013	0	2012	Region 22		2					2							http://www.sterlinghealth.com	http://www.sterlinghealth.com									(866)-454-7141		(866)-454-7114		(888)-909-1713		(888)-909-1713										(800)-899-2114		(800)-899-2114		(888)-858-8567		(888)-858-8567				
S4802	014	0		29	10	S4802_014_0	2	1		06/04/2011	2012.02	06/04/2011 03:07:39 PM Central Daylight Time		07/22/2011 02:46:41 PM Central Daylight Time		07/22/2011 03:59:00 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	Windsor Rx (PDP)	10	29					S4802	014	0	2012	Region 23		2					2							http://www.sterlinghealth.com	http://www.sterlinghealth.com									(866)-454-7141		(866)-454-7114		(888)-909-1713		(888)-909-1713										(800)-899-2114		(800)-899-2114		(888)-858-8567		(888)-858-8567				
S4802	020	0		29	10	S4802_020_0	2	1		06/04/2011	2012.02	06/04/2011 03:08:43 PM Central Daylight Time		07/22/2011 02:47:59 PM Central Daylight Time		07/22/2011 03:59:00 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	Windsor Rx (PDP)	10	29					S4802	020	0	2012	Region 30		2					2							http://www.sterlinghealth.com	http://www.sterlinghealth.com									(866)-454-7141		(866)-454-7114		(888)-909-1713		(888)-909-1713										(800)-899-2114		(800)-899-2114		(888)-858-8567		(888)-858-8567				
S4802	021	0		29	10	S4802_021_0	2	1		06/04/2011	2012.02	06/04/2011 03:09:33 PM Central Daylight Time		07/22/2011 02:50:15 PM Central Daylight Time		07/22/2011 03:59:00 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	Windsor Rx (PDP)	10	29					S4802	021	0	2012	Region 31		2					2							http://www.sterlinghealth.com	http://www.sterlinghealth.com									(866)-454-7141		(866)-454-7114		(888)-909-1713		(888)-909-1713										(800)-899-2114		(800)-899-2114		(888)-858-8567		(888)-858-8567				
S4802	030	0		29	10	S4802_030_0	2	1		06/04/2011	2012.02	06/04/2011 03:10:28 PM Central Daylight Time		07/22/2011 02:51:55 PM Central Daylight Time		07/22/2011 03:59:00 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlinghealth.com	Windsor Rx (PDP)	10	29					S4802	030	0	2012	Region 25		2					2							http://www.sterlinghealth.com	http://www.sterlinghealth.com									(866)-454-7141		(866)-454-7114		(888)-909-1713		(888)-909-1713										(800)-899-2114		(800)-899-2114		(888)-858-8567		(888)-858-8567				
S4802	801	0		29	10	S4802_801_0	1	1		06/06/2011	2012.02	06/06/2011 08:50:12 PM Central Daylight Time				06/06/2011 08:52:05 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingretireescripts.com	Sterling Retiree Rx (PDP)	10	29					S4802	801	0	2012	Nationwide		1					2							http://www.sterlinghealth.com	http://www.sterlinghealth.com									(800)-313-7667		(800)-313-7667		(800)-313-7667		(800)-313-7667										(800)-313-7667		(800)-313-7667		(800)-313-7667		(800)-313-7667				
S4802	805	0		29	10	S4802_805_0	1	1		06/06/2011	2012.02	06/06/2011 08:50:21 PM Central Daylight Time				06/06/2011 08:52:05 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingretireescripts.com	Sterling Retiree Rx (PDP)	10	29					S4802	805	0	2012	Nationwide		1					2							http://www.sterlinghealth.com	http://www.sterlinghealth.com									(800)-313-7667		(800)-313-7667		(800)-313-7667		(800)-313-7667										(800)-313-7667		(800)-313-7667		(800)-313-7667		(800)-313-7667				
S4802	806	0		29	10	S4802_806_0	1	1		06/06/2011	2012.02	06/06/2011 08:50:29 PM Central Daylight Time				06/06/2011 08:52:05 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.medicarerx.navitus.com	Navitus MedicareRx (PDP)	10	29					S4802	806	0	2012	Nationwide		1					2							http://www.sterlinghealth.com	http://www.sterlinghealth.com									(866)-270-3877		(866)-270-3877		(866)-270-3877		(866)-270-3877										(920)-225-7005		(920)-225-7005		(920)-225-7005		(920)-225-7005				
S4802	807	0		29	10	S4802_807_0	1	1		06/06/2011	2012.02	06/06/2011 08:50:36 PM Central Daylight Time				06/06/2011 08:52:05 PM Central Daylight Time	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.medicarerx.navitus.com	Navitus MedicareRx (PDP)	10	29					S4802	807	0	2012	Nationwide		1					2							http://www.sterlinghealth.com	http://www.sterlinghealth.com									(866)-270-3877		(866)-270-3877		(866)-270-3877		(866)-270-3877										(920)-225-7005		(920)-225-7005		(920)-225-7005		(920)-225-7005				
S5540	002	0		29	10	S5540_002_0	1	1		06/06/2011	2012.02	06/06/2011 05:44:19 PM Eastern Daylight Time		06/06/2011 07:11:09 PM Eastern Daylight Time		06/06/2011 07:34:42 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Blue Cross and Blue Shield of North Carolina	www.bcbsnc.com/medicare	Blue Medicare Rx Standard (PDP)	10	29					S5540	002	0	2012	North Carolina		2					2							http://www.bcbsnc.com/medicare/drug-search.cfm	http://www.bcbsnc.com/medicare/pharmacy-search.cfm									(888)-247-4142		(888)-247-4142		(800)-478-0583		(800)-478-0583										(888)-247-4145		(888)-247-4145		(800)-922-3140		(800)-922-3140				
S5540	004	0		29	10	S5540_004_0	3	1		06/05/2011	2012.02	06/05/2011 05:59:14 PM Eastern Daylight Time		07/22/2011 08:32:25 AM Eastern Daylight Time		07/22/2011 01:15:52 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Blue Cross and Blue Shield of North Carolina	www.bcbsnc.com/medicare	Blue Medicare Rx Enhanced (PDP)	10	29					S5540	004	0	2012	North Carolina		2					2							http://www.bcbsnc.com/medicare/drug-search.cfm	http://www.bcbsnc.com/medicare/pharmacy-search.cfm									(888)-247-4142		(888)-247-4142		(800)-478-0583		(800)-478-0583										(888)-247-4145		(888)-247-4145		(800)-922-3140		(800)-922-3140				
S5540	801	0		29	10	S5540_801_0	1	1		06/05/2011	2012.02	06/05/2011 06:41:49 PM Eastern Daylight Time				06/06/2011 07:34:42 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Blue Cross and Blue Shield of North Carolina	www.bcbsnc.com/medicare	Blue Medicare Rx EGWP (PDP)	10	29					S5540	801	0	2012	National Employer Group Retirees		1					2							http://www.bcbsnc.com/medicare/drug-search.cfm	http://www.bcbsnc.com/medicare/pharmacy-search.cfm									(888)-247-4142		(888)-247-4142		(800)-478-0583		(800)-478-0583										(888)-247-4145		(888)-247-4145		(800)-922-3140		(800)-922-3140				
S5552	002	0		29	10	S5552_002_0	2	1		05/27/2011	2012.02	05/27/2011 01:31:14 PM Eastern Daylight Time		07/21/2011 12:26:00 PM Eastern Daylight Time		07/25/2011 09:51:41 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	Humana Complete (PDP)	10	29					S5552	002	0	2012	State of New York		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5552	003	0		29	10	S5552_003_0	3	1		05/25/2011	2012.02	05/25/2011 04:35:08 PM Eastern Daylight Time		07/21/2011 12:26:00 PM Eastern Daylight Time		07/25/2011 10:09:06 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5552	003	0	2012	State of New York		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5552	004	0		29	10	S5552_004_0	3	1		07/22/2011	2012.02	07/22/2011 09:57:11 AM Eastern Daylight Time		07/21/2011 05:23:00 PM Eastern Daylight Time		07/22/2011 09:40:21 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S5552	004	0	2012	State of New York		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5552	801	0		29	10	S5552_801_0	1	1		05/28/2011	2012.02	05/28/2011 06:49:41 PM Eastern Daylight Time				05/28/2011 06:59:21 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	Humana Employer Sponsored (PDP)	10	29					S5552	801	0	2012	State of New York		1					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5552	802	0		29	10	S5552_802_0	1	1		05/28/2011	2012.02	05/28/2011 06:49:55 PM Eastern Daylight Time				05/28/2011 06:59:21 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	Humana Employer Sponsored Non-CY (PDP)	10	29					S5552	802	0	2012	State of New York		1					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5552	803	0		29	10	S5552_803_0	1	1		05/28/2011	2012.02	05/28/2011 06:50:10 PM Eastern Daylight Time				05/28/2011 06:59:21 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	Humana Employer Sponsored - Walmart (PDP)	10	29					S5552	803	0	2012	State of New York		1					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5555	001	0		29	10	S5555_001_0	4	1		05/21/2011	2012.02	05/21/2011 03:45:38 PM SA Western Standard Time		07/21/2011 02:14:02 PM SA Western Standard Time		07/22/2011 09:57:32 AM SA Western Standard Time	MCS ADVANTAGE, INC.	MCS Classicare	www.mcsclassicare.com	MCS Classicare Rx (PDP)	10	29					S5555	001	0	2012	Puerto Rico		2					2							www.mcsclassicare.com	www.mcsclassicare.com									(866)-627-8183		(787)-620-2530		(866)-627-8181		(787)-620-2528										(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182				
S5555	003	0		29	10	S5555_003_0	3	1		06/02/2011	2012.02	06/02/2011 05:20:28 PM SA Western Standard Time		06/05/2011 03:58:52 PM SA Western Standard Time		06/06/2011 11:42:40 AM SA Western Standard Time	MCS ADVANTAGE, INC.	MCS Classicare	www.mcsclassicare.com	MCS Classicare Rx Standard (PDP)	10	29					S5555	003	0	2012	Puerto Rico		2					2							www.mcsclassicare.com	www.mcsclassicare.com									(866)-627-8183		(787)-620-2530		(866)-627-8181		(787)-620-2528										(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182				
S5555	801	0		29	10	S5555_801_0	1	1		06/06/2011	2012.02	06/06/2011 10:56:16 AM SA Western Standard Time				06/07/2011 10:18:49 AM SA Western Standard Time	MCS ADVANTAGE, INC.	MCS Classicare	www.mcsclassicare.com	MCS Classicare PDP Group (C) (PDP)	10	29					S5555	801	0	2012	Puerto Rico		1					2							www.mcsclassicare.com	www.mcsclassicare.com									(866)-627-8183		(787)-620-2530		(866)-627-8181		(787)-620-2528										(866)-627-8182		(866)-627-8182		(866)-627-8182		(866)-627-8182				
S5569	003	0		29	10	S5569_003_0	2	1		06/02/2011	2012.02	06/02/2011 09:26:31 PM Eastern Daylight Time		07/18/2011 12:45:58 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	CAMBRIDGE LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier (PDP)	10	29					S5569	003	0	2012	First Health Part D Premier - New York		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-4701		(866)-823-4701		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5569	006	0		29	10	S5569_006_0	2	1		06/02/2011	2012.02	06/02/2011 05:54:38 PM Eastern Daylight Time		07/18/2011 08:24:39 AM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	CAMBRIDGE LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5569	006	0	2012	First Health Part D Value Plus - New York		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-4701		(866)-823-4701		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5580	003	0		29	10	S5580_003_0	2	1		06/09/2011	2012.02	06/09/2011 01:21:50 PM Central Daylight Time		07/21/2011 08:51:00 AM Central Daylight Time		07/21/2011 06:30:37 PM Central Daylight Time	FIRST UNITED AMERICAN LIFE INSURANCE COMPANY	First United American Life Insurance Company	http://www.firstuamedicarepartd.com	First United American - Preferred (PDP)	10	29					S5580	003	0	2012	State of New York		2					2							http://www.firstuamedicarepartd.com/	http://www.firstuamedicarepartd.com/									(866)-524-4171		(866)-524-4171		(866)-524-4171		(866)-524-4171										(866)-524-4172		(866)-524-4172		(866)-524-4172		(866)-524-4172				
S5580	006	0		29	10	S5580_006_0	1	1		06/03/2011	2012.02	06/03/2011 01:10:41 PM Central Daylight Time		06/05/2011 03:49:43 PM Central Daylight Time		06/05/2011 04:06:56 PM Central Daylight Time	FIRST UNITED AMERICAN LIFE INSURANCE COMPANY	First United American Life Insurance Company	http://www.firstuamedicarepartd.com	First United American - Select (PDP)	10	29					S5580	006	0	2012	State of New York		2					2							http://www.firstuamedicarepartd.com/	http://www.firstuamedicarepartd.com/									(866)-524-4171		(866)-524-4171		(866)-524-4171		(866)-524-4171										(866)-524-4172		(866)-524-4172		(866)-524-4172		(866)-524-4172				
S5580	801	0		29	10	S5580_801_0	1	1		06/03/2011	2012.02	06/03/2011 01:10:51 PM Central Daylight Time				06/05/2011 04:06:56 PM Central Daylight Time	FIRST UNITED AMERICAN LIFE INSURANCE COMPANY	First United American Life Insurance Company	http://www.firstuamedicarepartd.com	First UA Employer Calendar Drug Plan (PDP)	10	29					S5580	801	0	2012	National		1					2							http://www.firstuamedicarepartd.com/	http://www.firstuamedicarepartd.com/									(866)-524-4171		(866)-524-4171		(866)-524-4171		(866)-524-4171										(866)-524-4172		(866)-524-4172		(866)-524-4172		(866)-524-4172				
S5580	802	0		29	10	S5580_802_0	1	1		06/03/2011	2012.02	06/03/2011 01:10:55 PM Central Daylight Time				06/05/2011 04:06:56 PM Central Daylight Time	FIRST UNITED AMERICAN LIFE INSURANCE COMPANY	First United American Life Insurance Company	http://www.firstuamedicarepartd.com	First UA Employer Non-Calendar Drug Plan (PDP)	10	29					S5580	802	0	2012	National		1					2							http://www.firstuamedicarepartd.com/	http://www.firstuamedicarepartd.com/									(866)-524-4171		(866)-524-4171		(866)-524-4171		(866)-524-4171										(866)-524-4172		(866)-524-4172		(866)-524-4172		(866)-524-4172				
S5584	001	0		29	10	S5584_001_0	2	1		06/01/2011	2012.02	06/01/2011 05:50:17 PM Eastern Daylight Time		06/06/2011 01:53:18 PM Eastern Daylight Time		06/06/2011 04:02:23 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Prescription Blue Option A (PDP)	10	29					S5584	001	0	2012	State of Michigan		2					2							www.bcbsm.com/medicare/formulary.shtml	www.bcbsm.com/medicare/rxdirectory.shtml									(800)-565-1770		(800)-565-1770		(877)-469-2583		(877)-469-2583										(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704				
S5584	002	0		29	10	S5584_002_0	4	1		06/01/2011	2012.02	06/01/2011 05:53:34 PM Eastern Daylight Time		07/21/2011 04:11:01 PM Eastern Daylight Time		07/22/2011 12:04:37 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Prescription Blue Option B (PDP)	10	29					S5584	002	0	2012	State of Michigan		2					2							www.bcbsm.com/medicare/formulary.shtml	www.bcbsm.com/medicare/rxdirectory.shtml									(800)-565-1770		(800)-565-1770		(877)-469-2583		(877)-469-2583										(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704				
S5584	801	0		29	10	S5584_801_0	2	1		05/13/2011	2012.02	05/13/2011 05:06:54 PM Eastern Daylight Time				06/06/2011 04:02:23 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Prescription Blue Employer Plan CY (PDP)	10	29					S5584	801	0	2012	State of Michigan		1					2							www.bcbsm.com/medicare/formulary.shtml	www.bcbsm.com/medicare/rxdirectory.shtml									(800)-565-1770		(800)-565-1770		(877)-469-2583		(877)-469-2583										(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704				
S5584	802	0		29	10	S5584_802_0	2	1		05/13/2011	2012.02	05/13/2011 05:07:08 PM Eastern Daylight Time				06/06/2011 04:02:23 PM Eastern Daylight Time	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com/medicare	Prescription Blue Employer Plan non-CY (PDP)	10	29					S5584	802	0	2012	State of Michigan		1					2							www.bcbsm.com/medicare/formulary.shtml	www.bcbsm.com/medicare/rxdirectory.shtml									(800)-565-1770		(800)-565-1770		(877)-469-2583		(877)-469-2583										(800)-579-0235		(800)-579-0235		(800)-481-8704		(800)-481-8704				
S5588	802	0		29	10	S5588_802_0	1	1		06/01/2011	2012.02	06/01/2011 02:21:56 PM Eastern Daylight Time				06/01/2011 03:23:37 PM Eastern Daylight Time	PARAMOUNT INSURANCE COMPANY	Paramount Prescription Drug Plan	www.paramounthealthcare.com	Paramount Std. Prescription Drug Plan Empl (PDP)	10	29					S5588	802	0	2012	Paramount Standard Prescription Drug Plan (Ohio)		1					2							www.paramounthealthcare.com/medicareplans	www.paramounthealthcare.com/medicareplans									(800)-462-3589		(800)-462-3589		(800)-462-3589		(800)-462-3589										(888)-740-5670		(888)-740-5670		(888)-740-5670		(888)-740-5670				
S5588	803	0		29	10	S5588_803_0	1	1		06/01/2011	2012.02	06/01/2011 02:22:12 PM Eastern Daylight Time				06/01/2011 03:23:37 PM Eastern Daylight Time	PARAMOUNT INSURANCE COMPANY	Paramount Prescription Drug Plan	www.paramounthealthcare.com	Paramount Enh. Prescription Drug Plan Empl (PDP)	10	29					S5588	803	0	2012	Paramount Enhanced Prescription Drug Plan (Ohio)		1					2							www.paramounthealthcare.com/medicareplans	www.paramounthealthcare.com/medicareplans									(800)-462-3589		(800)-462-3589		(800)-462-3589		(800)-462-3589										(888)-740-5670		(888)-740-5670		(888)-740-5670		(888)-740-5670				
S5593	002	0		29	10	S5593_002_0	2	1		05/25/2011	2012.02	05/25/2011 01:37:57 PM Eastern Daylight Time		06/02/2011 06:27:11 PM Eastern Daylight Time		06/03/2011 02:57:31 PM Eastern Daylight Time	HIGHMARK SENIOR RESOURCES INC.	Highmark Senior Resources Inc.	www.highmarkblueshield.com	BlueRx Plus (PDP)	10	29					S5593	002	0	2012	Pennsylvania  and West Virginia		2					2							http://highmark.medicare-approvedformularies.com/	www.highmarkblueshield.com									(800)-290-3914		(800)-290-3914		(866)-682-7975		(866)-682-7975										(711)		(711)		(711)		(711)				
S5593	003	0		29	10	S5593_003_0	2	1		05/27/2011	2012.02	05/27/2011 10:31:59 AM Eastern Daylight Time		06/02/2011 06:23:49 PM Eastern Daylight Time		06/03/2011 02:57:31 PM Eastern Daylight Time	HIGHMARK SENIOR RESOURCES INC.	Highmark Senior Resources Inc.	www.highmarkblueshield.com	BlueRx Complete (PDP)	10	29					S5593	003	0	2012	Pennsylvania  and West Virginia		2					2							http://highmark.medicare-approvedformularies.com/	www.highmarkblueshield.com									(800)-290-3914		(800)-290-3914		(866)-682-7975		(866)-682-7975										(711)		(711)		(711)		(711)				
S5593	801	0		29	10	S5593_801_0	2	1		04/14/2011	2012.02	04/14/2011 10:20:33 AM Eastern Daylight Time				06/03/2011 02:57:31 PM Eastern Daylight Time	HIGHMARK SENIOR RESOURCES INC.	Highmark Senior Resources Inc.	www.highmarkblueshield.com	BlueRx Employer Group Calendar (PDP)	10	29					S5593	801	0	2012	National		1					2							http://highmark.medicare-approvedformularies.com/	www.highmarkblueshield.com									(800)-290-3914		(800)-290-3914		(866)-682-7975		(866)-682-7975										(711)		(711)		(711)		(711)				
S5593	802	0		29	10	S5593_802_0	2	1		04/14/2011	2012.02	04/14/2011 10:20:44 AM Eastern Daylight Time				06/03/2011 02:57:31 PM Eastern Daylight Time	HIGHMARK SENIOR RESOURCES INC.	Highmark Senior Resources Inc.	www.highmarkblueshield.com	BlueRx Employer Group Non-Calendar (PDP)	10	29					S5593	802	0	2012	National		1					2							http://highmark.medicare-approvedformularies.com/	www.highmarkblueshield.com									(800)-290-3914		(800)-290-3914		(866)-682-7975		(866)-682-7975										(711)		(711)		(711)		(711)				
S5596	001	0		29	10	S5596_001_0	5	1		06/27/2011	2012.02	06/27/2011 01:25:48 PM Pacific Daylight Time		07/21/2011 04:31:50 PM Pacific Daylight Time		07/22/2011 10:11:11 AM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.partdcoverage.com	Blue MedicareRx Plus (PDP)	10	29					S5596	001	0	2012	Maine and New Hampshire		2					2							www.partdcoverage.com	www.partdcoverage.com									(866)-755-2776		(866)-755-2776		(800)-261-8667		(800)-261-8667										(866)-798-7026		(866)-798-7026		(800)-241-6894		(800)-241-6894				
S5596	003	0		29	10	S5596_003_0	6	1		07/01/2011	2012.02	07/01/2011 11:31:28 AM Pacific Daylight Time		07/21/2011 04:32:03 PM Pacific Daylight Time		07/22/2011 10:11:11 AM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.partdcoverage.com	Blue MedicareRx Premier (PDP)	10	29					S5596	003	0	2012	Maine and New Hampshire		2					2							www.partdcoverage.com	www.partdcoverage.com									(866)-755-2776		(866)-755-2776		(800)-261-8667		(800)-261-8667										(866)-798-7026		(866)-798-7026		(800)-241-6894		(800)-241-6894				
S5596	005	0		29	10	S5596_005_0	5	1		06/27/2011	2012.02	06/27/2011 01:30:54 PM Pacific Daylight Time		07/14/2011 05:04:00 PM Pacific Daylight Time		07/21/2011 07:50:21 PM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.partdcoverage.com	Blue MedicareRx Standard (PDP)	10	29					S5596	005	0	2012	Virginia		2					2							www.partdcoverage.com	www.partdcoverage.com									(866)-755-2776		(866)-755-2776		(800)-261-8667		(800)-261-8667										(866)-798-7026		(866)-798-7026		(800)-241-6894		(800)-241-6894				
S5596	006	0		29	10	S5596_006_0	5	1		06/27/2011	2012.02	06/27/2011 01:26:42 PM Pacific Daylight Time		07/21/2011 04:32:18 PM Pacific Daylight Time		07/22/2011 10:11:11 AM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.partdcoverage.com	Blue MedicareRx Plus (PDP)	10	29					S5596	006	0	2012	Virginia		2					2							www.partdcoverage.com	www.partdcoverage.com									(866)-755-2776		(866)-755-2776		(800)-261-8667		(800)-261-8667										(866)-798-7026		(866)-798-7026		(800)-241-6894		(800)-241-6894				
S5596	007	0		29	10	S5596_007_0	6	1		07/01/2011	2012.02	07/01/2011 11:36:46 AM Pacific Daylight Time		07/21/2011 04:32:30 PM Pacific Daylight Time		07/22/2011 10:11:11 AM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.partdcoverage.com	Blue MedicareRx Premier (PDP)	10	29					S5596	007	0	2012	Virginia		2					2							www.partdcoverage.com	www.partdcoverage.com									(866)-755-2776		(866)-755-2776		(800)-261-8667		(800)-261-8667										(866)-798-7026		(866)-798-7026		(800)-241-6894		(800)-241-6894				
S5596	009	0		29	10	S5596_009_0	5	1		06/27/2011	2012.02	06/27/2011 01:31:04 PM Pacific Daylight Time		07/14/2011 05:04:00 PM Pacific Daylight Time		07/21/2011 07:50:21 PM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.partdcoverage.com	Blue MedicareRx Standard (PDP)	10	29					S5596	009	0	2012	Georgia		2					2							www.partdcoverage.com	www.partdcoverage.com									(800)-928-6201		(800)-928-6201		(800)-261-8667		(800)-261-8667										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5596	010	0		29	10	S5596_010_0	5	1		06/27/2011	2012.02	06/27/2011 01:26:42 PM Pacific Daylight Time		07/21/2011 04:32:42 PM Pacific Daylight Time		07/22/2011 10:11:11 AM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.partdcoverage.com	Blue MedicareRx Plus (PDP)	10	29					S5596	010	0	2012	Georgia		2					2							www.partdcoverage.com	www.partdcoverage.com									(800)-928-6201		(800)-928-6201		(800)-261-8667		(800)-261-8667										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5596	011	0		29	10	S5596_011_0	6	1		07/01/2011	2012.02	07/01/2011 11:36:47 AM Pacific Daylight Time		07/21/2011 04:33:08 PM Pacific Daylight Time		07/22/2011 10:11:11 AM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.partdcoverage.com	Blue MedicareRx Premier (PDP)	10	29					S5596	011	0	2012	Georgia		2					2							www.partdcoverage.com	www.partdcoverage.com									(800)-928-6201		(800)-928-6201		(800)-261-8667		(800)-261-8667										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5596	013	0		29	10	S5596_013_0	5	1		06/27/2011	2012.02	06/27/2011 01:31:15 PM Pacific Daylight Time		07/14/2011 05:05:00 PM Pacific Daylight Time		07/21/2011 07:50:21 PM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.partdcoverage.com	Blue MedicareRx Standard (PDP)	10	29					S5596	013	0	2012	Ohio		2					2							www.partdcoverage.com	www.partdcoverage.com									(866)-755-2776		(866)-755-2776		(800)-261-8667		(800)-261-8667										(866)-798-7026		(866)-798-7026		(800)-241-6894		(800)-241-6894				
S5596	014	0		29	10	S5596_014_0	5	1		06/27/2011	2012.02	06/27/2011 01:26:43 PM Pacific Daylight Time		07/21/2011 04:33:38 PM Pacific Daylight Time		07/22/2011 10:11:11 AM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.partdcoverage.com	Blue MedicareRx Plus (PDP)	10	29					S5596	014	0	2012	Ohio		2					2							www.partdcoverage.com	www.partdcoverage.com									(866)-755-2776		(866)-755-2776		(800)-261-8667		(800)-261-8667										(866)-798-7026		(866)-798-7026		(800)-241-6894		(800)-241-6894				
S5596	015	0		29	10	S5596_015_0	6	1		07/01/2011	2012.02	07/01/2011 11:36:47 AM Pacific Daylight Time		07/21/2011 04:33:54 PM Pacific Daylight Time		07/22/2011 10:11:11 AM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.partdcoverage.com	Blue MedicareRx Premier (PDP)	10	29					S5596	015	0	2012	Ohio		2					2							www.partdcoverage.com	www.partdcoverage.com									(866)-755-2776		(866)-755-2776		(800)-261-8667		(800)-261-8667										(866)-798-7026		(866)-798-7026		(800)-241-6894		(800)-241-6894				
S5596	017	0		29	10	S5596_017_0	5	1		06/27/2011	2012.02	06/27/2011 01:31:26 PM Pacific Daylight Time		07/14/2011 05:05:00 PM Pacific Daylight Time		07/21/2011 07:50:21 PM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.partdcoverage.com	Blue MedicareRx Standard (PDP)	10	29					S5596	017	0	2012	Indiana and Kentucky		2					2							www.partdcoverage.com	www.partdcoverage.com									(866)-755-2776		(866)-755-2776		(800)-261-8667		(800)-261-8667										(866)-798-7026		(866)-798-7026		(800)-241-6894		(800)-241-6894				
S5596	018	0		29	10	S5596_018_0	5	1		06/27/2011	2012.02	06/27/2011 01:26:43 PM Pacific Daylight Time		07/21/2011 04:34:06 PM Pacific Daylight Time		07/22/2011 10:11:11 AM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.partdcoverage.com	Blue MedicareRx Plus (PDP)	10	29					S5596	018	0	2012	Indiana and Kentucky		2					2							www.partdcoverage.com	www.partdcoverage.com									(866)-755-2776		(866)-755-2776		(800)-261-8667		(800)-261-8667										(866)-798-7026		(866)-798-7026		(800)-241-6894		(800)-241-6894				
S5596	019	0		29	10	S5596_019_0	6	1		07/01/2011	2012.02	07/01/2011 11:36:47 AM Pacific Daylight Time		07/21/2011 04:34:19 PM Pacific Daylight Time		07/22/2011 10:11:11 AM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.partdcoverage.com	Blue MedicareRx Premier (PDP)	10	29					S5596	019	0	2012	Indiana and Kentucky		2					2							www.partdcoverage.com	www.partdcoverage.com									(866)-755-2776		(866)-755-2776		(800)-261-8667		(800)-261-8667										(866)-798-7026		(866)-798-7026		(800)-241-6894		(800)-241-6894				
S5596	033	0		29	10	S5596_033_0	6	1		06/27/2011	2012.02	06/27/2011 01:31:38 PM Pacific Daylight Time		07/14/2011 05:05:00 PM Pacific Daylight Time		07/21/2011 07:50:21 PM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.partdcoverage.com	Blue Cross MedicareRx Standard (PDP)	10	29					S5596	033	0	2012	California		2					2							www.partdcoverage.com	www.partdcoverage.com									(800)-928-6201		(800)-928-6201		(800)-261-8667		(800)-261-8667										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5596	034	0		29	10	S5596_034_0	5	1		06/27/2011	2012.02	06/27/2011 01:26:43 PM Pacific Daylight Time		07/21/2011 04:34:33 PM Pacific Daylight Time		07/22/2011 10:11:11 AM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.partdcoverage.com	Blue Cross MedicareRx Plus (PDP)	10	29					S5596	034	0	2012	California		2					2							www.partdcoverage.com	www.partdcoverage.com									(800)-928-6201		(800)-928-6201		(800)-261-8667		(800)-261-8667										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5596	035	0		29	10	S5596_035_0	7	1		07/01/2011	2012.02	07/01/2011 11:36:47 AM Pacific Daylight Time		07/21/2011 04:34:50 PM Pacific Daylight Time		07/22/2011 10:11:11 AM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.partdcoverage.com	Blue Cross MedicareRx Gold (PDP)	10	29					S5596	035	0	2012	California		2					2							www.partdcoverage.com	www.partdcoverage.com									(800)-928-6201		(800)-928-6201		(800)-261-8667		(800)-261-8667										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5596	043	0		29	10	S5596_043_0	5	1		06/27/2011	2012.02	06/27/2011 01:31:51 PM Pacific Daylight Time		07/14/2011 05:05:00 PM Pacific Daylight Time		07/21/2011 07:50:21 PM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.partdcoverage.com	Blue MedicareRx Value (PDP)	10	29					S5596	043	0	2012	Missouri		2					2							www.partdcoverage.com	www.partdcoverage.com									(866)-755-2776		(866)-755-2776		(800)-261-8667		(800)-261-8667										(866)-798-7026		(866)-798-7026		(800)-241-6894		(800)-241-6894				
S5596	044	0		29	10	S5596_044_0	5	1		06/27/2011	2012.02	06/27/2011 01:26:43 PM Pacific Daylight Time		07/21/2011 04:35:04 PM Pacific Daylight Time		07/22/2011 10:11:11 AM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.partdcoverage.com	Blue MedicareRx Plus (PDP)	10	29					S5596	044	0	2012	Missouri		2					2							www.partdcoverage.com	www.partdcoverage.com									(866)-755-2776		(866)-755-2776		(800)-261-8667		(800)-261-8667										(866)-798-7026		(866)-798-7026		(800)-241-6894		(800)-241-6894				
S5596	045	0		29	10	S5596_045_0	6	1		07/01/2011	2012.02	07/01/2011 11:36:48 AM Pacific Daylight Time		07/21/2011 04:35:17 PM Pacific Daylight Time		07/22/2011 10:11:11 AM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.partdcoverage.com	Blue MedicareRx Premier (PDP)	10	29					S5596	045	0	2012	Missouri		2					2							www.partdcoverage.com	www.partdcoverage.com									(866)-755-2776		(866)-755-2776		(800)-261-8667		(800)-261-8667										(866)-798-7026		(866)-798-7026		(800)-241-6894		(800)-241-6894				
S5596	046	0		29	10	S5596_046_0	5	1		06/27/2011	2012.02	06/27/2011 01:32:04 PM Pacific Daylight Time		07/14/2011 05:06:00 PM Pacific Daylight Time		07/21/2011 07:50:21 PM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.partdcoverage.com	Blue MedicareRx Standard (PDP)	10	29					S5596	046	0	2012	Maine and New Hampshire		2					2							www.partdcoverage.com	www.partdcoverage.com									(866)-755-2776		(866)-755-2776		(800)-261-8667		(800)-261-8667										(866)-798-7026		(866)-798-7026		(800)-241-6894		(800)-241-6894				
S5596	056	0		29	10	S5596_056_0	4	1		06/27/2011	2012.02	06/27/2011 01:32:15 PM Pacific Daylight Time		07/14/2011 05:06:00 PM Pacific Daylight Time		07/21/2011 07:50:21 PM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.partdcoverage.com	Blue MedicareRx Standard (PDP)	10	29					S5596	056	0	2012	Wisconsin		2					2							www.partdcoverage.com	www.partdcoverage.com									(866)-755-2776		(866)-755-2776		(800)-261-8667		(800)-261-8667										(866)-798-7026		(866)-798-7026		(800)-241-6894		(800)-241-6894				
S5596	057	0		29	10	S5596_057_0	4	1		06/27/2011	2012.02	06/27/2011 01:26:43 PM Pacific Daylight Time		07/21/2011 04:35:30 PM Pacific Daylight Time		07/22/2011 10:11:11 AM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.partdcoverage.com	Blue MedicareRx Plus (PDP)	10	29					S5596	057	0	2012	Wisconsin		2					2							www.partdcoverage.com	www.partdcoverage.com									(866)-755-2776		(866)-755-2776		(800)-261-8667		(800)-261-8667										(866)-798-7026		(866)-798-7026		(800)-241-6894		(800)-241-6894				
S5596	058	0		29	10	S5596_058_0	5	1		07/01/2011	2012.02	07/01/2011 11:36:48 AM Pacific Daylight Time		07/21/2011 04:35:45 PM Pacific Daylight Time		07/22/2011 10:11:11 AM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.partdcoverage.com	Blue MedicareRx Premier (PDP)	10	29					S5596	058	0	2012	Wisconsin		2					2							www.partdcoverage.com	www.partdcoverage.com									(866)-755-2776		(866)-755-2776		(800)-261-8667		(800)-261-8667										(866)-798-7026		(866)-798-7026		(800)-241-6894		(800)-241-6894				
S5596	059	0		29	10	S5596_059_0	4	1		06/27/2011	2012.02	06/27/2011 01:32:26 PM Pacific Daylight Time		07/22/2011 11:09:00 AM Pacific Daylight Time		07/22/2011 03:39:32 PM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.partdcoverage.com	Blue MedicareRx Standard (PDP)	10	29					S5596	059	0	2012	Colorado		2					2							www.partdcoverage.com	www.partdcoverage.com									(866)-755-2776		(866)-755-2776		(800)-261-8667		(800)-261-8667										(866)-798-7026		(866)-798-7026		(800)-241-6894		(800)-241-6894				
S5596	060	0		29	10	S5596_060_0	4	1		06/27/2011	2012.02	06/27/2011 01:26:44 PM Pacific Daylight Time		07/21/2011 04:35:58 PM Pacific Daylight Time		07/22/2011 10:11:11 AM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.partdcoverage.com	Blue MedicareRx Plus (PDP)	10	29					S5596	060	0	2012	Colorado		2					2							www.partdcoverage.com	www.partdcoverage.com									(866)-755-2776		(866)-755-2776		(800)-261-8667		(800)-261-8667										(866)-798-7026		(866)-798-7026		(800)-241-6894		(800)-241-6894				
S5596	061	0		29	10	S5596_061_0	5	1		07/01/2011	2012.02	07/01/2011 11:36:48 AM Pacific Daylight Time		07/21/2011 04:36:11 PM Pacific Daylight Time		07/22/2011 10:11:11 AM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.partdcoverage.com	Blue MedicareRx Premier (PDP)	10	29					S5596	061	0	2012	Colorado		2					2							www.partdcoverage.com	www.partdcoverage.com									(866)-755-2776		(866)-755-2776		(800)-261-8667		(800)-261-8667										(866)-798-7026		(866)-798-7026		(800)-241-6894		(800)-241-6894				
S5596	062	0		29	10	S5596_062_0	4	1		06/27/2011	2012.02	06/27/2011 01:32:36 PM Pacific Daylight Time		07/14/2011 05:06:00 PM Pacific Daylight Time		07/21/2011 07:50:21 PM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.partdcoverage.com	Blue MedicareRx Standard (PDP)	10	29					S5596	062	0	2012	Nevada		2					2							www.partdcoverage.com	www.partdcoverage.com									(866)-755-2776		(866)-755-2776		(800)-261-8667		(800)-261-8667										(866)-798-7026		(866)-798-7026		(800)-241-6894		(800)-241-6894				
S5596	063	0		29	10	S5596_063_0	4	1		06/27/2011	2012.02	06/27/2011 01:26:44 PM Pacific Daylight Time		07/21/2011 04:36:26 PM Pacific Daylight Time		07/22/2011 10:11:11 AM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.partdcoverage.com	Blue MedicareRx Plus (PDP)	10	29					S5596	063	0	2012	Nevada		2					2							www.partdcoverage.com	www.partdcoverage.com									(866)-755-2776		(866)-755-2776		(800)-261-8667		(800)-261-8667										(866)-798-7026		(866)-798-7026		(800)-241-6894		(800)-241-6894				
S5596	064	0		29	10	S5596_064_0	5	1		07/01/2011	2012.02	07/01/2011 11:36:48 AM Pacific Daylight Time		07/21/2011 04:36:39 PM Pacific Daylight Time		07/22/2011 10:11:11 AM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.partdcoverage.com	Blue MedicareRx Premier (PDP)	10	29					S5596	064	0	2012	Nevada		2					2							www.partdcoverage.com	www.partdcoverage.com									(866)-755-2776		(866)-755-2776		(800)-261-8667		(800)-261-8667										(866)-798-7026		(866)-798-7026		(800)-241-6894		(800)-241-6894				
S5596	803	0		29	10	S5596_803_0	3	1		04/21/2011	2012.02	04/21/2011 10:17:58 AM Pacific Daylight Time				06/06/2011 12:14:56 PM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.partdcoverage.com	Blue MedicareRx (PDP)	10	29					S5596	803	0	2012	VA GA OH IN KY WI CO NV CA MO ME NH (Nationwide)		1					2							www.partdcoverage.com	www.partdcoverage.com									(866)-470-6265		(866)-470-6265		(866)-646-2436		(866)-646-2436										(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657				
S5596	804	0		29	10	S5596_804_0	3	1		04/21/2011	2012.02	04/21/2011 10:17:55 AM Pacific Daylight Time				06/06/2011 12:14:56 PM Pacific Daylight Time	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.partdcoverage.com	Blue MedicareRx (PDP)	10	29					S5596	804	0	2012	VA GA OH IN KY WI CO NV CA MO ME NH (Nationwide)		1					2							www.partdcoverage.com	www.partdcoverage.com									(866)-470-6265		(866)-470-6265		(866)-646-2436		(866)-646-2436										(877)-247-1657		(877)-247-1657		(877)-247-1657		(877)-247-1657				
S5601	002	0		29	10	S5601_002_0	3	1		06/13/2011	2012.02	06/13/2011 05:37:02 PM US Mountain Standard Time		07/08/2011 12:39:16 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Value (PDP)	10	29					S5601	002	0	2012	Northern New England CVS Caremark Value		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	003	0		29	10	S5601_003_0	4	1		07/08/2011	2012.02	07/08/2011 08:50:07 AM US Mountain Standard Time		07/08/2011 01:14:23 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Plus (PDP)	10	29					S5601	003	0	2012	Northern New England CVS Caremark Plus		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	004	0		29	10	S5601_004_0	2	1		06/02/2011	2012.02	06/02/2011 01:24:39 PM US Mountain Standard Time		07/08/2011 12:39:32 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Value (PDP)	10	29					S5601	004	0	2012	Central New England CVS Caremark Value		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	005	0		29	10	S5601_005_0	3	1		07/08/2011	2012.02	07/08/2011 09:43:48 AM US Mountain Standard Time		07/08/2011 01:16:23 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Plus (PDP)	10	29					S5601	005	0	2012	Central New England CVS Caremark Plus		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	006	0		29	10	S5601_006_0	2	1		06/02/2011	2012.02	06/02/2011 01:25:14 PM US Mountain Standard Time		07/08/2011 01:08:36 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Value (PDP)	10	29					S5601	006	0	2012	New York CVS Caremark Value		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	007	0		29	10	S5601_007_0	3	1		07/08/2011	2012.02	07/08/2011 09:43:50 AM US Mountain Standard Time		07/08/2011 01:17:50 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Plus (PDP)	10	29					S5601	007	0	2012	New York CVS Caremark Plus		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	008	0		29	10	S5601_008_0	2	1		06/02/2011	2012.02	06/02/2011 01:32:14 PM US Mountain Standard Time		07/08/2011 12:42:00 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Value (PDP)	10	29					S5601	008	0	2012	New Jersey CVS Caremark Value		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	009	0		29	10	S5601_009_0	3	1		07/08/2011	2012.02	07/08/2011 09:43:51 AM US Mountain Standard Time		07/08/2011 01:18:44 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Plus (PDP)	10	29					S5601	009	0	2012	New Jersey CVS Caremark Plus		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	010	0		29	10	S5601_010_0	2	1		06/02/2011	2012.02	06/02/2011 01:32:24 PM US Mountain Standard Time		07/08/2011 12:45:27 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Value (PDP)	10	29					S5601	010	0	2012	Mid-Atlantic CVS Caremark Value		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	011	0		29	10	S5601_011_0	3	1		07/08/2011	2012.02	07/08/2011 09:43:52 AM US Mountain Standard Time		07/08/2011 01:19:37 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Plus (PDP)	10	29					S5601	011	0	2012	Mid-Atlantic CVS Caremark Plus		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	012	0		29	10	S5601_012_0	2	1		06/02/2011	2012.02	06/02/2011 01:26:47 PM US Mountain Standard Time		07/08/2011 12:47:18 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Value (PDP)	10	29					S5601	012	0	2012	Pennsylvania, West Virginia CVS Caremark Value		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	013	0		29	10	S5601_013_0	3	1		07/08/2011	2012.02	07/08/2011 09:43:53 AM US Mountain Standard Time		07/08/2011 01:20:25 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Plus (PDP)	10	29					S5601	013	0	2012	Pennsylvania, West Virginia CVS Caremark Plus		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	014	0		29	10	S5601_014_0	2	1		06/02/2011	2012.02	06/02/2011 01:28:06 PM US Mountain Standard Time		07/08/2011 12:48:48 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Value (PDP)	10	29					S5601	014	0	2012	Virginia CVS Caremark Value		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	015	0		29	10	S5601_015_0	3	1		07/08/2011	2012.02	07/08/2011 09:43:54 AM US Mountain Standard Time		07/08/2011 01:21:13 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Plus (PDP)	10	29					S5601	015	0	2012	Virginia CVS Caremark Plus		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	016	0		29	10	S5601_016_0	2	1		06/02/2011	2012.02	06/02/2011 01:27:23 PM US Mountain Standard Time		07/08/2011 12:49:22 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Value (PDP)	10	29					S5601	016	0	2012	North Carolina CVS Caremark Value		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	017	0		29	10	S5601_017_0	3	1		07/08/2011	2012.02	07/08/2011 09:43:55 AM US Mountain Standard Time		07/08/2011 01:22:10 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Plus (PDP)	10	29					S5601	017	0	2012	North Carolina CVS Caremark Plus		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	018	0		29	10	S5601_018_0	2	1		06/02/2011	2012.02	06/02/2011 01:29:50 PM US Mountain Standard Time		07/08/2011 12:49:38 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Value (PDP)	10	29					S5601	018	0	2012	South Carolina CVS Caremark Value		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	019	0		29	10	S5601_019_0	3	1		07/08/2011	2012.02	07/08/2011 09:43:56 AM US Mountain Standard Time		07/08/2011 01:22:58 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Plus (PDP)	10	29					S5601	019	0	2012	South Carolina CVS Caremark Plus		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	020	0		29	10	S5601_020_0	2	1		06/02/2011	2012.02	06/02/2011 01:28:31 PM US Mountain Standard Time		07/08/2011 12:51:39 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Value (PDP)	10	29					S5601	020	0	2012	Georgia CVS Caremark Value		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	021	0		29	10	S5601_021_0	3	1		07/08/2011	2012.02	07/08/2011 09:43:57 AM US Mountain Standard Time		07/08/2011 01:23:43 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Plus (PDP)	10	29					S5601	021	0	2012	Georgia CVS Caremark Plus		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	022	0		29	10	S5601_022_0	2	1		06/02/2011	2012.02	06/02/2011 01:30:19 PM US Mountain Standard Time		07/08/2011 12:52:05 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Value (PDP)	10	29					S5601	022	0	2012	Florida CVS Caremark Value		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	023	0		29	10	S5601_023_0	3	1		07/08/2011	2012.02	07/08/2011 09:43:58 AM US Mountain Standard Time		07/08/2011 01:24:30 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Plus (PDP)	10	29					S5601	023	0	2012	Florida CVS Caremark Plus		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	024	0		29	10	S5601_024_0	2	1		06/02/2011	2012.02	06/02/2011 01:26:00 PM US Mountain Standard Time		07/08/2011 12:52:22 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Value (PDP)	10	29					S5601	024	0	2012	Alabama, Tennessee CVS Caremark Value		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	025	0		29	10	S5601_025_0	3	1		07/08/2011	2012.02	07/08/2011 09:44:00 AM US Mountain Standard Time		07/08/2011 01:25:25 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Plus (PDP)	10	29					S5601	025	0	2012	Alabama, Tennessee CVS Caremark Plus		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	026	0		29	10	S5601_026_0	2	1		06/02/2011	2012.02	06/02/2011 01:30:48 PM US Mountain Standard Time		07/08/2011 12:52:38 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Value (PDP)	10	29					S5601	026	0	2012	Michigan CVS Caremark Value		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	027	0		29	10	S5601_027_0	3	1		07/08/2011	2012.02	07/08/2011 09:44:01 AM US Mountain Standard Time		07/08/2011 01:26:14 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Plus (PDP)	10	29					S5601	027	0	2012	Michigan CVS Caremark Plus		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	028	0		29	10	S5601_028_0	2	1		06/02/2011	2012.02	06/02/2011 01:28:32 PM US Mountain Standard Time		07/08/2011 12:53:05 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Value (PDP)	10	29					S5601	028	0	2012	Ohio CVS Caremark Value		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	029	0		29	10	S5601_029_0	3	1		07/08/2011	2012.02	07/08/2011 09:44:03 AM US Mountain Standard Time		07/08/2011 01:26:59 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Plus (PDP)	10	29					S5601	029	0	2012	Ohio CVS Caremark Plus		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	030	0		29	10	S5601_030_0	2	1		06/02/2011	2012.02	06/02/2011 01:30:20 PM US Mountain Standard Time		07/08/2011 12:53:27 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Value (PDP)	10	29					S5601	030	0	2012	Indiana, Kentucky CVS Caremark Value		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	031	0		29	10	S5601_031_0	3	1		07/08/2011	2012.02	07/08/2011 09:44:04 AM US Mountain Standard Time		07/08/2011 01:27:39 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Plus (PDP)	10	29					S5601	031	0	2012	Indiana, Kentucky CVS Caremark Plus		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	032	0		29	10	S5601_032_0	2	1		06/02/2011	2012.02	06/02/2011 01:28:33 PM US Mountain Standard Time		07/08/2011 12:54:24 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Value (PDP)	10	29					S5601	032	0	2012	Wisconsin CVS Caremark Value		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	033	0		29	10	S5601_033_0	3	1		07/08/2011	2012.02	07/08/2011 09:44:05 AM US Mountain Standard Time		07/08/2011 01:28:36 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Plus (PDP)	10	29					S5601	033	0	2012	Wisconsin CVS Caremark Plus		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	034	0		29	10	S5601_034_0	2	1		06/02/2011	2012.02	06/02/2011 01:26:31 PM US Mountain Standard Time		07/08/2011 12:54:40 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Value (PDP)	10	29					S5601	034	0	2012	Illinois CVS Caremark Value		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	035	0		29	10	S5601_035_0	3	1		07/08/2011	2012.02	07/08/2011 09:44:06 AM US Mountain Standard Time		07/08/2011 01:29:39 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Plus (PDP)	10	29					S5601	035	0	2012	Illinois CVS Caremark Plus		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	036	0		29	10	S5601_036_0	2	1		06/02/2011	2012.02	06/02/2011 01:26:32 PM US Mountain Standard Time		07/08/2011 12:54:57 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Value (PDP)	10	29					S5601	036	0	2012	Missouri CVS Caremark Value		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	037	0		29	10	S5601_037_0	3	1		07/08/2011	2012.02	07/08/2011 09:44:07 AM US Mountain Standard Time		07/08/2011 01:30:23 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Plus (PDP)	10	29					S5601	037	0	2012	Missouri CVS Caremark Plus		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	038	0		29	10	S5601_038_0	2	1		06/02/2011	2012.02	06/02/2011 01:27:08 PM US Mountain Standard Time		07/08/2011 12:55:11 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Value (PDP)	10	29					S5601	038	0	2012	Arkansas CVS Caremark Value		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	040	0		29	10	S5601_040_0	2	1		06/02/2011	2012.02	06/02/2011 01:25:48 PM US Mountain Standard Time		07/08/2011 12:56:24 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Value (PDP)	10	29					S5601	040	0	2012	Mississippi CVS Caremark Value		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	041	0		29	10	S5601_041_0	3	1		07/08/2011	2012.02	07/08/2011 09:44:08 AM US Mountain Standard Time		07/08/2011 01:31:21 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Plus (PDP)	10	29					S5601	041	0	2012	Mississippi CVS Caremark Plus		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	042	0		29	10	S5601_042_0	2	1		06/02/2011	2012.02	06/02/2011 01:27:51 PM US Mountain Standard Time		07/08/2011 12:56:38 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Value (PDP)	10	29					S5601	042	0	2012	Louisiana CVS Caremark Value		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	044	0		29	10	S5601_044_0	2	1		06/02/2011	2012.02	06/02/2011 01:31:30 PM US Mountain Standard Time		07/08/2011 12:56:54 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Value (PDP)	10	29					S5601	044	0	2012	Texas CVS Caremark Value		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	045	0		29	10	S5601_045_0	3	1		07/08/2011	2012.02	07/08/2011 09:44:09 AM US Mountain Standard Time		07/08/2011 01:32:42 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Plus (PDP)	10	29					S5601	045	0	2012	Texas CVS Caremark Plus		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	046	0		29	10	S5601_046_0	2	1		06/02/2011	2012.02	06/02/2011 01:30:21 PM US Mountain Standard Time		07/08/2011 12:57:10 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Value (PDP)	10	29					S5601	046	0	2012	Oklahoma CVS Caremark Value		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	048	0		29	10	S5601_048_0	2	1		06/02/2011	2012.02	06/02/2011 01:27:52 PM US Mountain Standard Time		07/08/2011 12:57:27 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Value (PDP)	10	29					S5601	048	0	2012	Kansas CVS Caremark Value		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	049	0		29	10	S5601_049_0	3	1		07/08/2011	2012.02	07/08/2011 09:44:11 AM US Mountain Standard Time		07/08/2011 01:33:30 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Plus (PDP)	10	29					S5601	049	0	2012	Kansas CVS Caremark Plus		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	050	0		29	10	S5601_050_0	2	1		06/02/2011	2012.02	06/02/2011 01:28:59 PM US Mountain Standard Time		07/08/2011 12:57:43 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Value (PDP)	10	29					S5601	050	0	2012	Upper Midwest and N. Plains CVS Caremark Value		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	051	0		29	10	S5601_051_0	3	1		07/08/2011	2012.02	07/08/2011 09:44:12 AM US Mountain Standard Time		07/08/2011 01:34:15 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Plus (PDP)	10	29					S5601	051	0	2012	Upper Midwest and N. Plains CVS Caremark Plus		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	052	0		29	10	S5601_052_0	2	1		06/02/2011	2012.02	06/02/2011 01:26:33 PM US Mountain Standard Time		07/08/2011 12:57:59 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Value (PDP)	10	29					S5601	052	0	2012	New Mexico CVS Caremark Value		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	053	0		29	10	S5601_053_0	3	1		07/08/2011	2012.02	07/08/2011 09:44:13 AM US Mountain Standard Time		07/08/2011 01:34:57 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Plus (PDP)	10	29					S5601	053	0	2012	New Mexico CVS Caremark Plus		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	054	0		29	10	S5601_054_0	2	1		06/02/2011	2012.02	06/02/2011 03:28:12 PM US Mountain Standard Time		07/08/2011 12:58:19 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Value (PDP)	10	29					S5601	054	0	2012	Colorado CVS Caremark Value		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	055	0		29	10	S5601_055_0	3	1		07/08/2011	2012.02	07/08/2011 09:44:14 AM US Mountain Standard Time		07/08/2011 01:35:53 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Plus (PDP)	10	29					S5601	055	0	2012	Colorado CVS Caremark Plus		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	056	0		29	10	S5601_056_0	2	1		06/02/2011	2012.02	06/02/2011 01:31:51 PM US Mountain Standard Time		07/08/2011 12:58:41 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Value (PDP)	10	29					S5601	056	0	2012	Arizona CVS Caremark Value		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	057	0		29	10	S5601_057_0	3	1		07/08/2011	2012.02	07/08/2011 09:44:15 AM US Mountain Standard Time		07/08/2011 01:36:48 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Plus (PDP)	10	29					S5601	057	0	2012	Arizona CVS Caremark Plus		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	058	0		29	10	S5601_058_0	2	1		06/02/2011	2012.02	06/02/2011 01:29:21 PM US Mountain Standard Time		07/08/2011 12:58:55 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Value (PDP)	10	29					S5601	058	0	2012	Nevada CVS Caremark Value		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	059	0		29	10	S5601_059_0	3	1		07/08/2011	2012.02	07/08/2011 09:44:16 AM US Mountain Standard Time		07/08/2011 01:37:35 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Plus (PDP)	10	29					S5601	059	0	2012	Nevada CVS Caremark Plus		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	060	0		29	10	S5601_060_0	2	1		06/02/2011	2012.02	06/02/2011 01:27:53 PM US Mountain Standard Time		07/08/2011 12:59:14 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Value (PDP)	10	29					S5601	060	0	2012	Oregon, Washington CVS Caremark Value		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	061	0		29	10	S5601_061_0	3	1		07/08/2011	2012.02	07/08/2011 09:44:18 AM US Mountain Standard Time		07/08/2011 01:38:26 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Plus (PDP)	10	29					S5601	061	0	2012	Oregon, Washington CVS Caremark Plus		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	062	0		29	10	S5601_062_0	2	1		06/02/2011	2012.02	06/02/2011 01:29:22 PM US Mountain Standard Time		07/08/2011 12:59:31 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Value (PDP)	10	29					S5601	062	0	2012	Idaho, Utah CVS Caremark Value		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	063	0		29	10	S5601_063_0	3	1		07/08/2011	2012.02	07/08/2011 09:44:19 AM US Mountain Standard Time		07/08/2011 01:39:08 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Plus (PDP)	10	29					S5601	063	0	2012	Idaho, Utah CVS Caremark Plus		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	064	0		29	10	S5601_064_0	2	1		06/02/2011	2012.02	06/02/2011 01:30:33 PM US Mountain Standard Time		07/08/2011 01:00:37 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Value (PDP)	10	29					S5601	064	0	2012	California CVS Caremark Value		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	065	0		29	10	S5601_065_0	3	1		07/08/2011	2012.02	07/08/2011 09:44:20 AM US Mountain Standard Time		07/08/2011 01:39:55 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Plus (PDP)	10	29					S5601	065	0	2012	California CVS Caremark Plus		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	066	0		29	10	S5601_066_0	2	1		06/02/2011	2012.02	06/02/2011 01:31:16 PM US Mountain Standard Time		07/08/2011 01:00:58 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Value (PDP)	10	29					S5601	066	0	2012	Hawaii CVS Caremark Value		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	067	0		29	10	S5601_067_0	3	1		07/08/2011	2012.02	07/08/2011 09:44:21 AM US Mountain Standard Time		07/08/2011 01:40:54 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Plus (PDP)	10	29					S5601	067	0	2012	Hawaii CVS Caremark Plus		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	068	0		29	10	S5601_068_0	2	1		06/02/2011	2012.02	06/02/2011 01:25:34 PM US Mountain Standard Time		07/08/2011 12:35:35 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Value (PDP)	10	29					S5601	068	0	2012	Alaska CVS Caremark Value		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	069	0		29	10	S5601_069_0	3	1		07/08/2011	2012.02	07/08/2011 09:44:22 AM US Mountain Standard Time		07/08/2011 01:42:36 PM US Mountain Standard Time		07/11/2011 09:49:48 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	CVS Caremark Plus (PDP)	10	29					S5601	069	0	2012	Alaska CVS Caremark Plus		2					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	801	0		29	10	S5601_801_0	1	1		06/01/2011	2012.02	06/01/2011 05:41:54 PM US Mountain Standard Time				06/02/2011 10:01:47 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	SilverScript Group - Calendar (PDP)	10	29					S5601	801	0	2012	National SilverScript Group		1					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5601	802	0		29	10	S5601_802_0	1	1		06/01/2011	2012.02	06/01/2011 05:42:06 PM US Mountain Standard Time				06/02/2011 10:01:47 AM US Mountain Standard Time	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	SilverScript Group - Non-Calendar (PDP)	10	29					S5601	802	0	2012	National SilverScript Group - Non-Calendar		1					2							www.SilverScript.com	www.SilverScript.com									(866)-235-5660		(866)-235-5660		(866)-552-6106		(866)-552-6106										(866)-236-1069		(866)-236-1069		(866)-552-6288		(866)-552-6288				
S5609	001	0		29	10	S5609_001_0	4	1		07/07/2011	2012.02	07/07/2011 01:47:41 PM Mountain Daylight Time		07/05/2011 01:53:16 PM Pacific Daylight Time		07/19/2011 02:07:51 PM Pacific Daylight Time	ASURIS NORTHWEST HEALTH	Asuris Northwest Health	www.asuris.com/medicareScript	Asuris Medicare Script Basic (PDP)	10	29					S5609	001	0	2012	Region of Oregon and Washington		2					2							www.asuris.com/medicareScript	www.asuris.com/medicareScript									(800)-541-8981		(800)-541-8981		(866)-704-2708		(866)-704-2708										(711)		(711)		(711)		(711)				
S5609	002	0		29	10	S5609_002_0	4	1		07/07/2011	2012.02	07/07/2011 01:49:16 PM Mountain Daylight Time		07/07/2011 02:47:54 PM Pacific Daylight Time		07/19/2011 02:11:28 PM Pacific Daylight Time	ASURIS NORTHWEST HEALTH	Asuris Northwest Health	www.asuris.com/medicareScript	Asuris Medicare Script Enhanced (PDP)	10	29					S5609	002	0	2012	Region of Oregon and Washington		2					2							www.asuris.com/medicareScript	www.asuris.com/medicareScript									(800)-541-8981		(800)-541-8981		(866)-704-2708		(866)-704-2708										(711)		(711)		(711)		(711)				
S5609	802	0		29	10	S5609_802_0	1	1		06/03/2011	2012.02	06/03/2011 10:54:21 AM Mountain Daylight Time				06/06/2011 09:48:20 AM Pacific Daylight Time	ASURIS NORTHWEST HEALTH	Asuris Northwest Health	www.asuris.com/medicareScript	Asuris Medicare Script (PDP)	10	29					S5609	802	0	2012	Nationwide except territories		1					2							www.asuris.com/medicareScript	www.asuris.com/medicareScript									(888)-319-8904		(888)-319-8904		(866)-704-2708		(866)-704-2708										(711)		(711)		(711)		(711)				
S5617	003	0		29	10	S5617_003_0	1	1		05/27/2011	2012.02	05/27/2011 04:05:40 PM Eastern Daylight Time		05/31/2011 11:12:50 PM Eastern Daylight Time		06/01/2011 03:33:45 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan One (PDP)	10	29					S5617	003	0	2012	New Hampshire and Maine		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	008	0		29	10	S5617_008_0	1	1		05/27/2011	2012.02	05/27/2011 04:15:40 PM Eastern Daylight Time		05/31/2011 11:13:16 PM Eastern Daylight Time		06/01/2011 03:33:45 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan One (PDP)	10	29					S5617	008	0	2012	Connecticut, Massachusetts, Rhode Island, Vermont		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	013	0		29	10	S5617_013_0	1	1		05/27/2011	2012.02	05/27/2011 04:18:40 PM Eastern Daylight Time		05/31/2011 11:13:53 PM Eastern Daylight Time		06/01/2011 03:33:45 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan One (PDP)	10	29					S5617	013	0	2012	New York		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	018	0		29	10	S5617_018_0	1	1		05/27/2011	2012.02	05/27/2011 04:25:20 PM Eastern Daylight Time		05/31/2011 11:14:30 PM Eastern Daylight Time		06/01/2011 03:33:45 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan One (PDP)	10	29					S5617	018	0	2012	New Jersey		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	053	0		29	10	S5617_053_0	1	1		05/27/2011	2012.02	05/27/2011 04:35:43 PM Eastern Daylight Time		05/31/2011 11:14:59 PM Eastern Daylight Time		06/01/2011 03:33:45 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan One (PDP)	10	29					S5617	053	0	2012	Florida		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	068	0		29	10	S5617_068_0	1	1		05/27/2011	2012.02	05/27/2011 04:37:14 PM Eastern Daylight Time		05/31/2011 11:15:26 PM Eastern Daylight Time		06/01/2011 03:33:45 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan One (PDP)	10	29					S5617	068	0	2012	Ohio		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	088	0		29	10	S5617_088_0	1	1		05/27/2011	2012.02	05/27/2011 04:43:38 PM Eastern Daylight Time		05/31/2011 11:15:55 PM Eastern Daylight Time		06/01/2011 03:33:45 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan One (PDP)	10	29					S5617	088	0	2012	Missouri		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	103	0		29	10	S5617_103_0	1	1		05/27/2011	2012.02	05/27/2011 04:46:05 PM Eastern Daylight Time		05/31/2011 11:16:23 PM Eastern Daylight Time		06/01/2011 03:33:45 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan One (PDP)	10	29					S5617	103	0	2012	Louisiana		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	108	0		29	10	S5617_108_0	1	1		05/27/2011	2012.02	05/27/2011 04:46:45 PM Eastern Daylight Time		05/31/2011 11:16:56 PM Eastern Daylight Time		06/01/2011 03:33:45 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan One (PDP)	10	29					S5617	108	0	2012	Texas		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	113	0		29	10	S5617_113_0	1	1		05/27/2011	2012.02	05/27/2011 04:47:35 PM Eastern Daylight Time		05/31/2011 11:17:24 PM Eastern Daylight Time		06/01/2011 03:33:45 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan One (PDP)	10	29					S5617	113	0	2012	Oklahoma		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	118	0		29	10	S5617_118_0	1	1		05/27/2011	2012.02	05/27/2011 04:48:13 PM Eastern Daylight Time		05/31/2011 11:17:50 PM Eastern Daylight Time		06/01/2011 03:33:45 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan One (PDP)	10	29					S5617	118	0	2012	Kansas		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	123	0		29	10	S5617_123_0	1	1		05/27/2011	2012.02	05/27/2011 04:49:32 PM Eastern Daylight Time		05/31/2011 11:18:19 PM Eastern Daylight Time		06/01/2011 03:33:45 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan One (PDP)	10	29					S5617	123	0	2012	IA, MN, MT, ND, NE, SD, WY		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	128	0		29	10	S5617_128_0	1	1		05/27/2011	2012.02	05/27/2011 04:50:40 PM Eastern Daylight Time		05/31/2011 11:18:46 PM Eastern Daylight Time		06/01/2011 03:33:45 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan One (PDP)	10	29					S5617	128	0	2012	New Mexico		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	133	0		29	10	S5617_133_0	1	1		05/27/2011	2012.02	05/27/2011 04:51:50 PM Eastern Daylight Time		05/31/2011 11:19:20 PM Eastern Daylight Time		06/01/2011 03:33:45 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan One (PDP)	10	29					S5617	133	0	2012	Colorado		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	138	0		29	10	S5617_138_0	1	1		05/27/2011	2012.02	05/27/2011 04:53:24 PM Eastern Daylight Time		05/31/2011 11:20:37 PM Eastern Daylight Time		06/01/2011 03:33:45 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan One (PDP)	10	29					S5617	138	0	2012	Arizona		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	143	0		29	10	S5617_143_0	1	1		05/27/2011	2012.02	05/27/2011 04:54:28 PM Eastern Daylight Time		05/31/2011 11:21:03 PM Eastern Daylight Time		06/01/2011 03:33:45 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan One (PDP)	10	29					S5617	143	0	2012	Nevada		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	148	0		29	10	S5617_148_0	1	1		05/27/2011	2012.02	05/27/2011 04:55:34 PM Eastern Daylight Time		05/31/2011 11:21:30 PM Eastern Daylight Time		06/01/2011 03:33:45 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan One (PDP)	10	29					S5617	148	0	2012	Oregon and Washington		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	153	0		29	10	S5617_153_0	1	1		05/27/2011	2012.02	05/27/2011 04:56:11 PM Eastern Daylight Time		05/31/2011 11:21:57 PM Eastern Daylight Time		06/01/2011 03:33:45 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan One (PDP)	10	29					S5617	153	0	2012	Idaho and Utah		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	158	0		29	10	S5617_158_0	1	1		05/27/2011	2012.02	05/27/2011 04:57:16 PM Eastern Daylight Time		05/31/2011 11:22:28 PM Eastern Daylight Time		06/01/2011 03:33:45 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan One (PDP)	10	29					S5617	158	0	2012	California		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	163	0		29	10	S5617_163_0	1	1		05/27/2011	2012.02	05/27/2011 04:58:24 PM Eastern Daylight Time		05/31/2011 11:22:54 PM Eastern Daylight Time		06/01/2011 03:33:45 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan One (PDP)	10	29					S5617	163	0	2012	Hawaii		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	172	0		29	10	S5617_172_0	4	1		05/26/2011	2012.02	05/26/2011 06:20:41 PM Eastern Daylight Time		07/21/2011 10:08:00 AM Eastern Daylight Time		07/27/2011 10:34:47 AM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan Two (PDP)	10	29					S5617	172	0	2012	Connecticut, Massachusetts, Rhode Island, Vermont		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	176	0		29	10	S5617_176_0	3	1		05/26/2011	2012.02	05/26/2011 06:21:15 PM Eastern Daylight Time		07/21/2011 10:08:00 AM Eastern Daylight Time		07/27/2011 10:34:47 AM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan Two (PDP)	10	29					S5617	176	0	2012	Pennsylvania and West Virginia		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	177	0		29	10	S5617_177_0	3	1		05/26/2011	2012.02	05/26/2011 06:21:15 PM Eastern Daylight Time		07/21/2011 10:09:00 AM Eastern Daylight Time		07/27/2011 10:34:47 AM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan Two (PDP)	10	29					S5617	177	0	2012	Virginia		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	178	0		29	10	S5617_178_0	3	1		05/26/2011	2012.02	05/26/2011 06:21:16 PM Eastern Daylight Time		07/21/2011 10:09:00 AM Eastern Daylight Time		07/27/2011 10:34:47 AM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan Two (PDP)	10	29					S5617	178	0	2012	North Carolina		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	179	0		29	10	S5617_179_0	3	1		05/26/2011	2012.02	05/26/2011 06:21:16 PM Eastern Daylight Time		07/21/2011 10:10:00 AM Eastern Daylight Time		07/27/2011 10:34:47 AM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan Two (PDP)	10	29					S5617	179	0	2012	South Carolina		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	181	0		29	10	S5617_181_0	3	1		05/26/2011	2012.02	05/26/2011 06:21:17 PM Eastern Daylight Time		07/21/2011 10:10:00 AM Eastern Daylight Time		07/27/2011 10:34:47 AM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan Two (PDP)	10	29					S5617	181	0	2012	Florida		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	182	0		29	10	S5617_182_0	3	1		05/26/2011	2012.02	05/26/2011 06:21:17 PM Eastern Daylight Time		07/21/2011 10:10:00 AM Eastern Daylight Time		07/27/2011 10:34:47 AM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan Two (PDP)	10	29					S5617	182	0	2012	Alabama and Tennessee		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	183	0		29	10	S5617_183_0	3	1		05/26/2011	2012.02	05/26/2011 06:21:17 PM Eastern Daylight Time		07/21/2011 10:11:00 AM Eastern Daylight Time		07/27/2011 10:34:47 AM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan Two (PDP)	10	29					S5617	183	0	2012	Michigan		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	184	0		29	10	S5617_184_0	3	1		05/26/2011	2012.02	05/26/2011 06:21:18 PM Eastern Daylight Time		07/21/2011 10:11:00 AM Eastern Daylight Time		07/27/2011 10:34:47 AM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan Two (PDP)	10	29					S5617	184	0	2012	Ohio		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	185	0		29	10	S5617_185_0	3	1		05/26/2011	2012.02	05/26/2011 06:21:18 PM Eastern Daylight Time		07/21/2011 10:11:00 AM Eastern Daylight Time		07/27/2011 10:34:47 AM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan Two (PDP)	10	29					S5617	185	0	2012	Indiana and Kentucky		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	187	0		29	10	S5617_187_0	3	1		05/26/2011	2012.02	05/26/2011 06:21:19 PM Eastern Daylight Time		07/21/2011 10:12:00 AM Eastern Daylight Time		07/27/2011 10:34:47 AM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan Two (PDP)	10	29					S5617	187	0	2012	Illinois		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	188	0		29	10	S5617_188_0	3	1		05/26/2011	2012.02	05/26/2011 06:21:19 PM Eastern Daylight Time		07/21/2011 10:12:00 AM Eastern Daylight Time		07/27/2011 10:34:47 AM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan Two (PDP)	10	29					S5617	188	0	2012	Missouri		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	189	0		29	10	S5617_189_0	3	1		05/26/2011	2012.02	05/26/2011 06:21:20 PM Eastern Daylight Time		07/21/2011 10:13:00 AM Eastern Daylight Time		07/27/2011 10:34:47 AM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan Two (PDP)	10	29					S5617	189	0	2012	Arkansas		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	192	0		29	10	S5617_192_0	3	1		05/26/2011	2012.02	05/26/2011 06:21:20 PM Eastern Daylight Time		07/21/2011 10:13:00 AM Eastern Daylight Time		07/27/2011 10:34:47 AM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan Two (PDP)	10	29					S5617	192	0	2012	Texas		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	195	0		29	10	S5617_195_0	3	1		05/26/2011	2012.02	05/26/2011 06:21:20 PM Eastern Daylight Time		07/21/2011 10:14:00 AM Eastern Daylight Time		07/27/2011 10:34:47 AM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan Two (PDP)	10	29					S5617	195	0	2012	IA, MN, MT, ND, NE, SD, WY		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	198	0		29	10	S5617_198_0	3	1		05/26/2011	2012.02	05/26/2011 06:21:21 PM Eastern Daylight Time		07/21/2011 10:14:00 AM Eastern Daylight Time		07/27/2011 10:34:47 AM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan Two (PDP)	10	29					S5617	198	0	2012	Arizona		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	214	0		29	10	S5617_214_0	1	1		05/27/2011	2012.02	05/27/2011 04:28:19 PM Eastern Daylight Time		05/31/2011 11:33:44 PM Eastern Daylight Time		06/01/2011 03:33:45 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan One (PDP)	10	29					S5617	214	0	2012	Delaware, Maryland and District of Columbia		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	215	0		29	10	S5617_215_0	1	1		05/27/2011	2012.02	05/27/2011 04:21:55 PM Eastern Daylight Time		05/31/2011 11:34:28 PM Eastern Daylight Time		06/01/2011 03:33:45 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan One (PDP)	10	29					S5617	215	0	2012	Pennsylvania and West Virginia		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	216	0		29	10	S5617_216_0	1	1		05/27/2011	2012.02	05/27/2011 04:29:32 PM Eastern Daylight Time		05/31/2011 11:35:02 PM Eastern Daylight Time		06/01/2011 03:33:45 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan One (PDP)	10	29					S5617	216	0	2012	Virginia		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	217	0		29	10	S5617_217_0	1	1		05/27/2011	2012.02	05/27/2011 04:32:31 PM Eastern Daylight Time		05/31/2011 11:35:43 PM Eastern Daylight Time		06/01/2011 03:33:45 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan One (PDP)	10	29					S5617	217	0	2012	North Carolina		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	218	0		29	10	S5617_218_0	1	1		05/27/2011	2012.02	05/27/2011 04:30:07 PM Eastern Daylight Time		05/31/2011 11:43:26 PM Eastern Daylight Time		06/01/2011 03:33:45 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan One (PDP)	10	29					S5617	218	0	2012	South Carolina		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	219	0		29	10	S5617_219_0	1	1		05/27/2011	2012.02	05/27/2011 04:33:22 PM Eastern Daylight Time		05/31/2011 11:37:42 PM Eastern Daylight Time		06/01/2011 03:33:45 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan One (PDP)	10	29					S5617	219	0	2012	Georgia		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	220	0		29	10	S5617_220_0	1	1		05/27/2011	2012.02	05/27/2011 04:34:24 PM Eastern Daylight Time		05/31/2011 11:38:14 PM Eastern Daylight Time		06/01/2011 03:33:45 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan One (PDP)	10	29					S5617	220	0	2012	Alabama and Tennessee		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	221	0		29	10	S5617_221_0	1	1		05/27/2011	2012.02	05/27/2011 04:39:52 PM Eastern Daylight Time		05/31/2011 11:38:39 PM Eastern Daylight Time		06/01/2011 03:33:45 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan One (PDP)	10	29					S5617	221	0	2012	Michigan		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	222	0		29	10	S5617_222_0	1	1		05/27/2011	2012.02	05/27/2011 04:40:45 PM Eastern Daylight Time		05/31/2011 11:39:11 PM Eastern Daylight Time		06/01/2011 03:33:45 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan One (PDP)	10	29					S5617	222	0	2012	Indiana and Kentucky		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	223	0		29	10	S5617_223_0	1	1		05/27/2011	2012.02	05/27/2011 04:41:36 PM Eastern Daylight Time		05/31/2011 11:39:43 PM Eastern Daylight Time		06/01/2011 03:33:45 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan One (PDP)	10	29					S5617	223	0	2012	Wisconsin		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	224	0		29	10	S5617_224_0	1	1		05/27/2011	2012.02	05/27/2011 04:42:16 PM Eastern Daylight Time		05/31/2011 11:40:13 PM Eastern Daylight Time		06/01/2011 03:33:45 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan One (PDP)	10	29					S5617	224	0	2012	Illinois		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	225	0		29	10	S5617_225_0	1	1		05/27/2011	2012.02	05/27/2011 04:44:24 PM Eastern Daylight Time		05/31/2011 11:40:40 PM Eastern Daylight Time		06/01/2011 03:33:45 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan One (PDP)	10	29					S5617	225	0	2012	Arkansas		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	226	0		29	10	S5617_226_0	1	1		05/27/2011	2012.02	05/27/2011 04:45:10 PM Eastern Daylight Time		05/31/2011 11:41:14 PM Eastern Daylight Time		06/01/2011 03:33:45 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan One (PDP)	10	29					S5617	226	0	2012	Mississippi		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	227	0		29	10	S5617_227_0	1	1		05/27/2011	2012.02	05/27/2011 04:59:41 PM Eastern Daylight Time		05/31/2011 11:41:43 PM Eastern Daylight Time		06/01/2011 03:33:45 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	CIGNA Medicare Rx Plan One (PDP)	10	29					S5617	227	0	2012	Alaska		2					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-222-6700		(800)-222-6700		(800)-735-1459		(800)-735-1459										(800)-322-1451		(800)-322-1451		(800)-322-1451		(800)-322-1451				
S5617	801	0		29	10	S5617_801_0	3	1		04/25/2011	2012.02	04/25/2011 05:04:15 PM Eastern Daylight Time				06/01/2011 03:55:00 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	Employer Plan CY (PDP)	10	29					S5617	801	0	2012	Nationwide		1					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-558-9562		(800)-558-9562		(800)-558-9562		(800)-558-9562										(800)-987-8816		(800)-987-8816		(800)-987-8816		(800)-987-8816				
S5617	802	0		29	10	S5617_802_0	3	1		04/25/2011	2012.02	04/25/2011 05:04:42 PM Eastern Daylight Time				06/01/2011 03:55:00 PM Eastern Daylight Time	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	Employer Plan NCY (PDP)	10	29					S5617	802	0	2012	Nationwide		1					2							http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	http://www.cigna.com/sites/cignamedicare/your_cigna_choices/medicarerx/pharmacy.html									(800)-558-9562		(800)-558-9562		(800)-558-9562		(800)-558-9562										(800)-987-8816		(800)-987-8816		(800)-987-8816		(800)-987-8816				
S5660	104	0		29	10	S5660_104_0	2	1		06/04/2011	2012.02	06/04/2011 03:16:44 PM Eastern Daylight Time		06/05/2011 01:17:46 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5660	104	0	2012	Northern New England		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	105	0		29	10	S5660_105_0	2	1		06/04/2011	2012.02	06/04/2011 03:17:03 PM Eastern Daylight Time		06/05/2011 01:18:24 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5660	105	0	2012	Central New England		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	106	0		29	10	S5660_106_0	2	1		06/04/2011	2012.02	06/04/2011 03:17:50 PM Eastern Daylight Time		06/05/2011 01:22:10 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5660	106	0	2012	State of New Jersey		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	107	0		29	10	S5660_107_0	2	1		06/04/2011	2012.02	06/04/2011 03:18:18 PM Eastern Daylight Time		06/05/2011 02:14:52 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5660	107	0	2012	Mid-Atlantic		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	108	0		29	10	S5660_108_0	2	1		06/04/2011	2012.02	06/04/2011 03:18:33 PM Eastern Daylight Time		06/05/2011 02:10:38 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5660	108	0	2012	States of Pennsylvania and West Virginia		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	109	0		29	10	S5660_109_0	2	1		06/04/2011	2012.02	06/04/2011 03:18:58 PM Eastern Daylight Time		06/05/2011 01:26:14 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5660	109	0	2012	State of Virginia		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	110	0		29	10	S5660_110_0	2	1		06/04/2011	2012.02	06/04/2011 03:19:14 PM Eastern Daylight Time		06/05/2011 01:33:14 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5660	110	0	2012	State of North Carolina		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	111	0		29	10	S5660_111_0	2	1		06/04/2011	2012.02	06/04/2011 03:19:43 PM Eastern Daylight Time		06/05/2011 01:36:36 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5660	111	0	2012	State of South Carolina		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	112	0		29	10	S5660_112_0	2	1		06/04/2011	2012.02	06/04/2011 03:20:09 PM Eastern Daylight Time		06/05/2011 02:35:06 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5660	112	0	2012	State of Georgia		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	113	0		29	10	S5660_113_0	2	1		06/04/2011	2012.02	06/04/2011 03:20:31 PM Eastern Daylight Time		06/05/2011 02:41:30 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5660	113	0	2012	State of Florida		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	114	0		29	10	S5660_114_0	2	1		06/04/2011	2012.02	06/04/2011 03:20:45 PM Eastern Daylight Time		06/05/2011 02:45:48 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5660	114	0	2012	States of Alabama and Tennessee		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	115	0		29	10	S5660_115_0	2	1		06/04/2011	2012.02	06/04/2011 03:21:03 PM Eastern Daylight Time		06/05/2011 02:51:52 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5660	115	0	2012	State of Michigan		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	116	0		29	10	S5660_116_0	2	1		06/05/2011	2012.02	06/05/2011 12:00:49 PM Eastern Daylight Time		06/05/2011 02:57:32 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5660	116	0	2012	State of Ohio		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	117	0		29	10	S5660_117_0	2	1		06/04/2011	2012.02	06/04/2011 03:21:44 PM Eastern Daylight Time		06/05/2011 03:02:44 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5660	117	0	2012	States of Indiana and Kentucky		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	118	0		29	10	S5660_118_0	2	1		06/05/2011	2012.02	06/05/2011 10:24:11 AM Eastern Daylight Time		06/05/2011 01:52:16 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5660	118	0	2012	State of Wisconsin		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	119	0		29	10	S5660_119_0	2	1		06/04/2011	2012.02	06/04/2011 03:22:49 PM Eastern Daylight Time		06/05/2011 03:07:16 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5660	119	0	2012	State of Illinois		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	120	0		29	10	S5660_120_0	2	1		06/04/2011	2012.02	06/04/2011 03:23:04 PM Eastern Daylight Time		06/05/2011 01:40:08 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5660	120	0	2012	State of Missouri		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	121	0		29	10	S5660_121_0	2	1		06/04/2011	2012.02	06/04/2011 03:23:23 PM Eastern Daylight Time		06/05/2011 01:44:08 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5660	121	0	2012	State of Arkansas		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	122	0		29	10	S5660_122_0	2	1		06/05/2011	2012.02	06/05/2011 03:04:11 PM Eastern Daylight Time		06/05/2011 03:21:16 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5660	122	0	2012	State of Mississippi		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	123	0		29	10	S5660_123_0	2	1		06/04/2011	2012.02	06/04/2011 03:24:30 PM Eastern Daylight Time		06/05/2011 01:51:36 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5660	123	0	2012	State of Louisiana		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	124	0		29	10	S5660_124_0	2	1		06/04/2011	2012.02	06/04/2011 03:25:22 PM Eastern Daylight Time		06/05/2011 03:30:40 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5660	124	0	2012	State of Texas		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	125	0		29	10	S5660_125_0	2	1		06/04/2011	2012.02	06/04/2011 03:25:48 PM Eastern Daylight Time		06/05/2011 01:56:50 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5660	125	0	2012	State of Oklahoma		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	126	0		29	10	S5660_126_0	2	1		06/04/2011	2012.02	06/04/2011 03:26:13 PM Eastern Daylight Time		06/05/2011 03:41:14 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5660	126	0	2012	State of Kansas		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	127	0		29	10	S5660_127_0	2	1		06/04/2011	2012.02	06/04/2011 03:26:27 PM Eastern Daylight Time		06/05/2011 03:50:14 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5660	127	0	2012	Upper Midwest and Northern Plains		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	128	0		29	10	S5660_128_0	2	1		06/04/2011	2012.02	06/04/2011 03:26:45 PM Eastern Daylight Time		06/05/2011 01:57:24 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5660	128	0	2012	State of New Mexico		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	129	0		29	10	S5660_129_0	2	1		06/04/2011	2012.02	06/04/2011 03:26:58 PM Eastern Daylight Time		06/05/2011 02:16:26 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5660	129	0	2012	State of Colorado		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	130	0		29	10	S5660_130_0	2	1		06/04/2011	2012.02	06/04/2011 03:27:57 PM Eastern Daylight Time		06/05/2011 02:09:08 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5660	130	0	2012	State of Arizona		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	131	0		29	10	S5660_131_0	2	1		06/04/2011	2012.02	06/04/2011 03:28:17 PM Eastern Daylight Time		06/05/2011 02:21:24 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5660	131	0	2012	State of Nevada		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	132	0		29	10	S5660_132_0	2	1		06/04/2011	2012.02	06/04/2011 03:28:34 PM Eastern Daylight Time		06/05/2011 02:00:34 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5660	132	0	2012	States of Oregon and Washington		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	133	0		29	10	S5660_133_0	2	1		06/04/2011	2012.02	06/04/2011 03:29:30 PM Eastern Daylight Time		06/05/2011 02:03:54 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5660	133	0	2012	States of Idaho and Utah		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	134	0		29	10	S5660_134_0	2	1		06/04/2011	2012.02	06/04/2011 03:29:57 PM Eastern Daylight Time		06/05/2011 03:32:06 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5660	134	0	2012	State of California		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	135	0		29	10	S5660_135_0	2	1		06/04/2011	2012.02	06/04/2011 03:30:17 PM Eastern Daylight Time		06/05/2011 02:26:26 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5660	135	0	2012	State of Hawaii		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	136	0		29	10	S5660_136_0	2	1		06/04/2011	2012.02	06/04/2011 03:30:38 PM Eastern Daylight Time		06/05/2011 02:31:08 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5660	136	0	2012	State of Alaska		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	137	0		29	10	S5660_137_0	1	1		06/05/2011	2012.02	06/05/2011 03:11:53 PM Eastern Daylight Time		06/05/2011 03:00:28 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5660	137	0	2012	Puerto Rico		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	172	0		29	10	S5660_172_0	3	1		06/05/2011	2012.02	06/05/2011 12:01:30 PM Eastern Daylight Time		06/05/2011 03:25:46 PM Eastern Daylight Time		06/06/2011 10:17:21 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Choice (PDP)	10	29					S5660	172	0	2012	Northern New England		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	175	0		29	10	S5660_175_0	2	1		06/05/2011	2012.02	06/05/2011 12:01:41 PM Eastern Daylight Time		06/05/2011 02:43:26 PM Eastern Daylight Time		06/06/2011 10:17:21 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Choice (PDP)	10	29					S5660	175	0	2012	Mid-Atlantic		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	176	0		29	10	S5660_176_0	2	1		06/05/2011	2012.02	06/05/2011 12:01:53 PM Eastern Daylight Time		06/05/2011 03:19:46 PM Eastern Daylight Time		06/06/2011 10:17:21 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Choice (PDP)	10	29					S5660	176	0	2012	States of Pennsylvania and West Virginia		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	180	0		29	10	S5660_180_0	2	1		06/05/2011	2012.02	06/05/2011 12:02:05 PM Eastern Daylight Time		06/05/2011 01:55:14 PM Eastern Daylight Time		06/06/2011 10:17:21 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Choice (PDP)	10	29					S5660	180	0	2012	State of Georgia		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	181	0		29	10	S5660_181_0	2	1		06/05/2011	2012.02	06/05/2011 12:02:14 PM Eastern Daylight Time		06/05/2011 01:58:30 PM Eastern Daylight Time		06/06/2011 10:17:21 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Choice (PDP)	10	29					S5660	181	0	2012	State of Florida		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	182	0		29	10	S5660_182_0	2	1		06/05/2011	2012.02	06/05/2011 12:02:28 PM Eastern Daylight Time		06/05/2011 02:00:46 PM Eastern Daylight Time		06/06/2011 10:17:21 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Choice (PDP)	10	29					S5660	182	0	2012	States of Alabama and Tennessee		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	183	0		29	10	S5660_183_0	2	1		06/05/2011	2012.02	06/05/2011 12:02:44 PM Eastern Daylight Time		06/05/2011 02:07:50 PM Eastern Daylight Time		06/06/2011 10:17:21 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Choice (PDP)	10	29					S5660	183	0	2012	State of Michigan		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	184	0		29	10	S5660_184_0	2	1		06/05/2011	2012.02	06/05/2011 12:02:53 PM Eastern Daylight Time		06/05/2011 02:09:14 PM Eastern Daylight Time		06/06/2011 10:17:21 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Choice (PDP)	10	29					S5660	184	0	2012	State of Ohio		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	185	0		29	10	S5660_185_0	2	1		06/05/2011	2012.02	06/05/2011 12:03:19 PM Eastern Daylight Time		06/05/2011 02:12:12 PM Eastern Daylight Time		06/06/2011 10:17:21 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Choice (PDP)	10	29					S5660	185	0	2012	States of Indiana and Kentucky		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	186	0		29	10	S5660_186_0	2	1		06/05/2011	2012.02	06/05/2011 12:03:32 PM Eastern Daylight Time		06/05/2011 02:13:48 PM Eastern Daylight Time		06/06/2011 10:17:21 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Choice (PDP)	10	29					S5660	186	0	2012	State of Wisconsin		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	187	0		29	10	S5660_187_0	2	1		06/05/2011	2012.02	06/05/2011 12:03:43 PM Eastern Daylight Time		06/05/2011 02:15:36 PM Eastern Daylight Time		06/06/2011 10:17:21 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Choice (PDP)	10	29					S5660	187	0	2012	State of Illinois		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	190	0		29	10	S5660_190_0	2	1		06/05/2011	2012.02	06/05/2011 12:03:54 PM Eastern Daylight Time		06/05/2011 02:17:10 PM Eastern Daylight Time		06/06/2011 10:17:21 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Choice (PDP)	10	29					S5660	190	0	2012	State of Mississippi		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	192	0		29	10	S5660_192_0	2	1		06/05/2011	2012.02	06/05/2011 12:04:04 PM Eastern Daylight Time		06/05/2011 02:19:28 PM Eastern Daylight Time		06/06/2011 10:17:21 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Choice (PDP)	10	29					S5660	192	0	2012	State of Texas		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	194	0		29	10	S5660_194_0	2	1		06/05/2011	2012.02	06/05/2011 12:04:15 PM Eastern Daylight Time		06/05/2011 02:21:46 PM Eastern Daylight Time		06/06/2011 10:17:21 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Choice (PDP)	10	29					S5660	194	0	2012	State of Kansas		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	195	0		29	10	S5660_195_0	2	1		06/05/2011	2012.02	06/05/2011 12:04:51 PM Eastern Daylight Time		06/05/2011 02:23:14 PM Eastern Daylight Time		06/06/2011 10:17:21 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Choice (PDP)	10	29					S5660	195	0	2012	Upper Midwest and Northern Plains		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	196	0		29	10	S5660_196_0	2	1		06/05/2011	2012.02	06/05/2011 12:05:33 PM Eastern Daylight Time		06/05/2011 02:32:14 PM Eastern Daylight Time		06/06/2011 10:17:21 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Choice (PDP)	10	29					S5660	196	0	2012	State of New Mexico		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	197	0		29	10	S5660_197_0	2	1		06/05/2011	2012.02	06/05/2011 12:05:51 PM Eastern Daylight Time		06/05/2011 02:28:50 PM Eastern Daylight Time		06/06/2011 10:17:21 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Choice (PDP)	10	29					S5660	197	0	2012	State of Colorado		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	198	0		29	10	S5660_198_0	2	1		06/05/2011	2012.02	06/05/2011 12:06:02 PM Eastern Daylight Time		06/05/2011 02:24:40 PM Eastern Daylight Time		06/06/2011 10:17:21 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Choice (PDP)	10	29					S5660	198	0	2012	State of Arizona		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	199	0		29	10	S5660_199_0	2	1		06/05/2011	2012.02	06/05/2011 12:07:11 PM Eastern Daylight Time		06/05/2011 02:24:52 PM Eastern Daylight Time		06/06/2011 10:17:21 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Choice (PDP)	10	29					S5660	199	0	2012	State of Nevada		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	202	0		29	10	S5660_202_0	2	1		06/05/2011	2012.02	06/05/2011 12:07:35 PM Eastern Daylight Time		06/05/2011 02:25:36 PM Eastern Daylight Time		06/06/2011 10:17:21 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Choice (PDP)	10	29					S5660	202	0	2012	State of California		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	203	0		29	10	S5660_203_0	2	1		06/05/2011	2012.02	06/05/2011 12:07:48 PM Eastern Daylight Time		06/05/2011 02:20:30 PM Eastern Daylight Time		06/06/2011 10:17:21 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Choice (PDP)	10	29					S5660	203	0	2012	State of Hawaii		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	204	0		29	10	S5660_204_0	2	1		06/05/2011	2012.02	06/05/2011 12:08:13 PM Eastern Daylight Time		06/05/2011 02:17:06 PM Eastern Daylight Time		06/06/2011 10:17:21 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Choice (PDP)	10	29					S5660	204	0	2012	State of Alaska		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	205	0		29	10	S5660_205_0	2	1		06/05/2011	2012.02	06/05/2011 12:08:26 PM Eastern Daylight Time		06/05/2011 03:12:22 PM Eastern Daylight Time		06/06/2011 10:17:21 AM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Choice (PDP)	10	29					S5660	205	0	2012	Puerto Rico		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	801	0		29	10	S5660_801_0	1	1		05/31/2011	2012.02	05/31/2011 02:54:40 PM Eastern Daylight Time				06/05/2011 02:34:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan (PDP)	10	29					S5660	801	0	2012	National Plan - Employer, Calendar Year		1					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	802	0		29	10	S5660_802_0	1	1		05/31/2011	2012.02	05/31/2011 02:54:45 PM Eastern Daylight Time				06/05/2011 02:34:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan (PDP)	10	29					S5660	802	0	2012	National Plan - Employer, Non-Calendar Year		1					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	803	0		29	10	S5660_803_0	1	1		05/31/2011	2012.02	05/31/2011 02:54:49 PM Eastern Daylight Time				06/05/2011 02:34:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan (PDP)	10	29					S5660	803	0	2012	National Plan K - Calendar Year		1					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	804	0		29	10	S5660_804_0	1	1		05/31/2011	2012.02	05/31/2011 02:54:54 PM Eastern Daylight Time				06/05/2011 02:34:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan (PDP)	10	29					S5660	804	0	2012	National Plan OF - Calendar Year		1					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	805	0		29	10	S5660_805_0	1	1		05/31/2011	2012.02	05/31/2011 02:54:58 PM Eastern Daylight Time				06/05/2011 02:34:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan (PDP)	10	29					S5660	805	0	2012	National Plan N1 - Calendar Year		1					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	806	0		29	10	S5660_806_0	1	1		05/31/2011	2012.02	05/31/2011 02:55:03 PM Eastern Daylight Time				06/05/2011 02:34:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan (PDP)	10	29					S5660	806	0	2012	National Plan N2 - Calendar Year		1					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5660	807	0		29	10	S5660_807_0	1	1		05/31/2011	2012.02	05/31/2011 02:55:06 PM Eastern Daylight Time				06/05/2011 02:34:19 PM Eastern Daylight Time	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan (PDP)	10	29					S5660	807	0	2012	National Plan K - Non-Calendar Year		1					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4574		(800)-758-4574		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5670	030	0		29	10	S5670_030_0	4	1		06/02/2011	2012.02	06/02/2011 10:02:13 PM Eastern Daylight Time		07/15/2011 01:58:05 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5670	030	0	2012	First Health Part D Premier Plus - Mid-Atlantic		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5177		(866)-823-5177		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5670	036	0		29	10	S5670_036_0	4	1		06/02/2011	2012.02	06/02/2011 10:08:52 PM Eastern Daylight Time		07/15/2011 02:04:06 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5670	036	0	2012	First Health Part D Premier Plus - PA_ WV		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5177		(866)-823-5177		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5670	042	0		29	10	S5670_042_0	4	1		06/02/2011	2012.02	06/02/2011 10:08:29 PM Eastern Daylight Time		07/15/2011 02:11:26 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5670	042	0	2012	First Health Part D Premier Plus - Virginia		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5177		(866)-823-5177		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5670	048	0		29	10	S5670_048_0	4	1		06/02/2011	2012.02	06/02/2011 10:07:53 PM Eastern Daylight Time		07/15/2011 02:18:38 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5670	048	0	2012	First Health Part D Premier Plus - North Carolina		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5177		(866)-823-5177		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5670	054	0		29	10	S5670_054_0	4	1		06/02/2011	2012.02	06/02/2011 10:07:19 PM Eastern Daylight Time		07/15/2011 02:41:32 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5670	054	0	2012	First Health Part D Premier Plus - South Carolina		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5177		(866)-823-5177		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5670	060	0		29	10	S5670_060_0	4	1		06/02/2011	2012.02	06/02/2011 10:06:44 PM Eastern Daylight Time		07/15/2011 02:47:25 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5670	060	0	2012	First Health Part D Premier Plus - Georgia		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5177		(866)-823-5177		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5670	066	0		29	10	S5670_066_0	5	1		06/02/2011	2012.02	06/02/2011 10:10:24 PM Eastern Daylight Time		07/15/2011 02:57:24 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5670	066	0	2012	First Health Part D Premier Plus - AL_TN		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5177		(866)-823-5177		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5670	072	0		29	10	S5670_072_0	4	1		06/02/2011	2012.02	06/02/2011 10:11:10 PM Eastern Daylight Time		07/15/2011 03:03:04 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5670	072	0	2012	First Health Part D Premier Plus - Michigan		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5177		(866)-823-5177		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5670	078	0		29	10	S5670_078_0	4	1		06/02/2011	2012.02	06/02/2011 10:11:42 PM Eastern Daylight Time		07/15/2011 03:06:59 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5670	078	0	2012	First Health Part D Premier Plus - Ohio		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5177		(866)-823-5177		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5670	084	0		29	10	S5670_084_0	4	1		06/02/2011	2012.02	06/02/2011 10:13:00 PM Eastern Daylight Time		07/15/2011 03:15:00 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5670	084	0	2012	First Health Part D Premier Plus - Wisconsin		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5177		(866)-823-5177		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5670	090	0		29	10	S5670_090_0	5	1		06/02/2011	2012.02	06/02/2011 10:13:33 PM Eastern Daylight Time		07/15/2011 03:19:31 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5670	090	0	2012	First Health Part D Premier Plus - Illinois		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5177		(866)-823-5177		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5670	096	0		29	10	S5670_096_0	4	1		06/02/2011	2012.02	06/02/2011 10:14:08 PM Eastern Daylight Time		07/15/2011 03:22:54 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5670	096	0	2012	First Health Part D Premier Plus - Missouri		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5177		(866)-823-5177		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5670	102	0		29	10	S5670_102_0	5	1		06/02/2011	2012.02	06/02/2011 10:14:55 PM Eastern Daylight Time		07/15/2011 03:27:27 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5670	102	0	2012	First Health Part D Premier Plus - Arkansas		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5177		(866)-823-5177		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5670	108	0		29	10	S5670_108_0	4	1		06/02/2011	2012.02	06/02/2011 10:15:41 PM Eastern Daylight Time		07/15/2011 03:31:26 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5670	108	0	2012	First Health Part D Premier Plus - Mississippi		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5177		(866)-823-5177		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5670	114	0		29	10	S5670_114_0	4	1		06/02/2011	2012.02	06/02/2011 10:16:13 PM Eastern Daylight Time		07/15/2011 03:35:56 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5670	114	0	2012	First Health Part D Premier Plus - Louisiana		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5177		(866)-823-5177		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5670	120	0		29	10	S5670_120_0	4	1		06/02/2011	2012.02	06/02/2011 10:16:44 PM Eastern Daylight Time		07/15/2011 03:39:51 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5670	120	0	2012	First Health Part D Premier Plus - Texas		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5177		(866)-823-5177		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5670	126	0		29	10	S5670_126_0	4	1		06/02/2011	2012.02	06/02/2011 10:17:22 PM Eastern Daylight Time		07/15/2011 03:43:18 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5670	126	0	2012	First Health Part D Premier Plus - Oklahoma		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5177		(866)-823-5177		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5670	132	0		29	10	S5670_132_0	4	1		06/02/2011	2012.02	06/02/2011 10:17:53 PM Eastern Daylight Time		07/15/2011 03:46:52 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5670	132	0	2012	First Health Part D Premier Plus -Kansas		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5177		(866)-823-5177		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5670	138	0		29	10	S5670_138_0	4	1		06/02/2011	2012.02	06/02/2011 10:21:19 PM Eastern Daylight Time		07/15/2011 03:58:37 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5670	138	0	2012	First Health Part D Premier Plus -Colorado		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5177		(866)-823-5177		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5670	144	0		29	10	S5670_144_0	4	1		06/02/2011	2012.02	06/02/2011 10:21:51 PM Eastern Daylight Time		07/15/2011 04:01:58 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5670	144	0	2012	First Health Part D Premier Plus  - Arizona		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5177		(866)-823-5177		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5670	150	0		29	10	S5670_150_0	4	1		06/02/2011	2012.02	06/02/2011 10:22:26 PM Eastern Daylight Time		07/15/2011 12:49:17 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5670	150	0	2012	First Health Part D Premier Plus - Nevada		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5177		(866)-823-5177		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5670	801	0		29	10	S5670_801_0	3	1		06/07/2011	2012.02	06/07/2011 04:05:16 PM Eastern Daylight Time				06/07/2011 04:45:57 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Employer Group - 12333 - CY (PDP)	10	29					S5670	801	0	2012	First Health Part D Employer Group - 11233 - CY		1					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5177		(866)-823-5177		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5670	802	0		29	10	S5670_802_0	3	1		06/07/2011	2012.02	06/07/2011 04:05:23 PM Eastern Daylight Time				06/07/2011 04:45:57 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Employer Group -12333 - NCY (PDP)	10	29					S5670	802	0	2012	First Health Part D Employer Group - 12333 - NCY		1					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5177		(866)-823-5177		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5670	809	0		29	10	S5670_809_0	3	1		06/07/2011	2012.02	06/07/2011 04:05:27 PM Eastern Daylight Time				06/07/2011 04:45:57 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Employer Group - 12336- CY (PDP)	10	29					S5670	809	0	2012	First Health Part D Employer Group - 12336 - CY		1					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5177		(866)-823-5177		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5670	810	0		29	10	S5670_810_0	3	1		06/07/2011	2012.02	06/07/2011 04:05:32 PM Eastern Daylight Time				06/07/2011 04:45:57 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Employer Group - 12336 - NCY (PDP)	10	29					S5670	810	0	2012	First Health Part D Employer Group - 12336 - NCY		1					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5177		(866)-823-5177		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5670	811	0		29	10	S5670_811_0	3	1		06/07/2011	2012.02	06/07/2011 04:05:36 PM Eastern Daylight Time				06/07/2011 04:45:57 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Employer Group -12330- CY (PDP)	10	29					S5670	811	0	2012	First Health Part D Employer Group - 12330 - CY		1					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5177		(866)-823-5177		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5670	812	0		29	10	S5670_812_0	3	1		06/07/2011	2012.02	06/07/2011 04:05:41 PM Eastern Daylight Time				06/07/2011 04:45:57 PM Eastern Daylight Time	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Employer Group - 12330 - NCY (PDP)	10	29					S5670	812	0	2012	First Health Part D Employer Group - 12330 - NCY		1					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5177		(866)-823-5177		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5674	005	0		29	10	S5674_005_0	4	1		06/02/2011	2012.02	06/02/2011 10:00:23 PM Eastern Daylight Time		07/15/2011 01:42:52 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5674	005	0	2012	First Health Part D Premier Plus - No. New England		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5178		(866)-823-5178		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5674	011	0		29	10	S5674_011_0	4	1		06/02/2011	2012.02	06/02/2011 10:00:59 PM Eastern Daylight Time		07/15/2011 01:48:00 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5674	011	0	2012	First Health Part D Premier Plus- Cen. New England		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5178		(866)-823-5178		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5674	017	0		29	10	S5674_017_0	4	1		06/02/2011	2012.02	06/02/2011 10:01:39 PM Eastern Daylight Time		07/15/2011 01:52:58 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5674	017	0	2012	First Health Part D Premier Plus -  New Jersey		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5178		(866)-823-5178		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5674	023	0		29	10	S5674_023_0	4	1		06/02/2011	2012.02	06/02/2011 10:09:43 PM Eastern Daylight Time		07/15/2011 02:52:30 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5674	023	0	2012	First Health Part D Premier Plus - Florida		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5178		(866)-823-5178		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5674	029	0		29	10	S5674_029_0	4	1		06/02/2011	2012.02	06/02/2011 10:12:27 PM Eastern Daylight Time		07/15/2011 03:11:30 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5674	029	0	2012	First Health Part D Premier Plus - IN_ KY		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5178		(866)-823-5178		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5674	035	0		29	10	S5674_035_0	4	1		06/02/2011	2012.02	06/02/2011 10:20:06 PM Eastern Daylight Time		07/15/2011 03:50:46 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5674	035	0	2012	First Health Part D Premier Plus UpMidWst_NoPlains		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5178		(866)-823-5178		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5674	041	0		29	10	S5674_041_0	4	1		06/02/2011	2012.02	06/02/2011 10:20:36 PM Eastern Daylight Time		07/15/2011 03:54:07 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5674	041	0	2012	First Health Part D Premier Plus - New Mexico		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5178		(866)-823-5178		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5674	047	0		29	10	S5674_047_0	4	1		06/02/2011	2012.02	06/02/2011 10:23:04 PM Eastern Daylight Time		07/15/2011 04:05:18 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5674	047	0	2012	First Health Part D Premier Plus - OR_WA		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5178		(866)-823-5178		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5674	053	0		29	10	S5674_053_0	5	1		06/02/2011	2012.02	06/02/2011 10:23:31 PM Eastern Daylight Time		07/15/2011 04:08:50 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5674	053	0	2012	First Health Part D  Premier Plus - Idaho_Utah		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5178		(866)-823-5178		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5674	059	0		29	10	S5674_059_0	4	1		06/02/2011	2012.02	06/02/2011 10:23:58 PM Eastern Daylight Time		07/15/2011 04:12:34 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5674	059	0	2012	First Health Part D Premier Plus - California		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5178		(866)-823-5178		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5674	065	0		29	10	S5674_065_0	4	1		07/15/2011	2012.02	07/15/2011 06:48:33 AM Eastern Daylight Time		07/15/2011 12:57:40 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5674	065	0	2012	First Health Part D Premier Plus - Hawaii		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5178		(866)-823-5178		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5674	071	0		29	10	S5674_071_0	6	1		07/15/2011	2012.02	07/15/2011 06:51:34 AM Eastern Daylight Time		07/21/2011 07:18:20 PM Eastern Daylight Time		07/22/2011 04:41:36 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier Plus (PDP)	10	29					S5674	071	0	2012	First Health Part D Premier Plus  -  Alaska		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5178		(866)-823-5178		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5674	801	0		29	10	S5674_801_0	3	1		06/07/2011	2012.02	06/07/2011 04:06:01 PM Eastern Daylight Time				06/07/2011 04:45:57 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Employer Group - 12333 - CY (PDP)	10	29					S5674	801	0	2012	First Health Part D Employer Group - 12333 - CY		1					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5178		(866)-823-5178		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5674	802	0		29	10	S5674_802_0	3	1		06/07/2011	2012.02	06/07/2011 04:06:06 PM Eastern Daylight Time				06/07/2011 04:45:57 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Employer Group - 12333 - NCY (PDP)	10	29					S5674	802	0	2012	First Health Part D Employer Group - 12333- NCY		1					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5178		(866)-823-5178		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5674	809	0		29	10	S5674_809_0	3	1		06/07/2011	2012.02	06/07/2011 04:06:31 PM Eastern Daylight Time				06/07/2011 04:45:57 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Employer Group - 12336- CY (PDP)	10	29					S5674	809	0	2012	First Health Part D Employer Group - 12336 - CY		1					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5178		(866)-823-5178		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5674	810	0		29	10	S5674_810_0	3	1		06/07/2011	2012.02	06/07/2011 04:06:51 PM Eastern Daylight Time				06/07/2011 04:45:57 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Employer Group - 12336 - NCY (PDP)	10	29					S5674	810	0	2012	First Health Part D Employer Group -12336 - NCY		1					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5178		(866)-823-5178		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5674	811	0		29	10	S5674_811_0	3	1		06/07/2011	2012.02	06/07/2011 04:06:55 PM Eastern Daylight Time				06/07/2011 04:45:57 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Employer Group - 12330 - CY (PDP)	10	29					S5674	811	0	2012	First Health Part D Employer Group - 12330 - CY		1					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5178		(866)-823-5178		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5674	812	0		29	10	S5674_812_0	3	1		06/07/2011	2012.02	06/07/2011 04:07:00 PM Eastern Daylight Time				06/07/2011 04:45:57 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Employer Group - 12330 - NCY (PDP)	10	29					S5674	812	0	2012	First Health Part D Employer Group - 12330 - NCY		1					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-823-5178		(866)-823-5178		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5678	001	0		29	10	S5678_001_0	2	1		05/23/2011	2012.02	05/23/2011 04:28:48 PM Pacific Daylight Time		06/04/2011 11:19:52 PM Pacific Daylight Time		06/05/2011 12:13:27 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 1 (PDP)	10	29					S5678	001	0	2012	Arizona		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	002	0		29	10	S5678_002_0	2	1		05/23/2011	2012.02	05/23/2011 02:41:24 PM Pacific Daylight Time		06/04/2011 11:20:06 PM Pacific Daylight Time		06/05/2011 12:13:27 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 1 (PDP)	10	29					S5678	002	0	2012	California		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	004	0		29	10	S5678_004_0	2	1		05/24/2011	2012.02	05/24/2011 06:41:48 AM Pacific Daylight Time		06/04/2011 11:20:20 PM Pacific Daylight Time		06/05/2011 12:13:27 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 1 (PDP)	10	29					S5678	004	0	2012	Central New England		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	005	0		29	10	S5678_005_0	2	1		05/23/2011	2012.02	05/23/2011 04:03:02 PM Pacific Daylight Time		06/04/2011 11:20:34 PM Pacific Daylight Time		06/05/2011 12:13:27 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 1 (PDP)	10	29					S5678	005	0	2012	New Jersey		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	006	0		29	10	S5678_006_0	2	1		05/24/2011	2012.02	05/24/2011 07:11:19 AM Pacific Daylight Time		06/04/2011 11:20:48 PM Pacific Daylight Time		06/05/2011 12:13:27 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 1 (PDP)	10	29					S5678	006	0	2012	Oregon, Washington		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	007	0		29	10	S5678_007_0	3	1		05/24/2011	2012.02	05/24/2011 07:31:35 AM Pacific Daylight Time		07/21/2011 12:03:56 PM Pacific Daylight Time		07/22/2011 09:56:44 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 2 (PDP)	10	29					S5678	007	0	2012	Arizona		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	008	0		29	10	S5678_008_0	3	1		05/24/2011	2012.02	05/24/2011 07:33:57 AM Pacific Daylight Time		07/21/2011 12:04:10 PM Pacific Daylight Time		07/22/2011 09:56:44 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 2 (PDP)	10	29					S5678	008	0	2012	California		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	010	0		29	10	S5678_010_0	3	1		05/24/2011	2012.02	05/24/2011 07:34:21 AM Pacific Daylight Time		07/21/2011 12:04:28 PM Pacific Daylight Time		07/22/2011 09:56:44 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 2 (PDP)	10	29					S5678	010	0	2012	Central New England		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	011	0		29	10	S5678_011_0	3	1		05/25/2011	2012.02	05/25/2011 04:58:26 PM Pacific Daylight Time		07/21/2011 12:04:48 PM Pacific Daylight Time		07/22/2011 09:56:44 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Value Orange Option 2 (PDP)	10	29					S5678	011	0	2012	New Jersey		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	012	0		29	10	S5678_012_0	3	1		05/24/2011	2012.02	05/24/2011 07:34:49 AM Pacific Daylight Time		07/21/2011 12:05:06 PM Pacific Daylight Time		07/22/2011 09:56:44 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 2 (PDP)	10	29					S5678	012	0	2012	Oregon, Washington		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	013	0		29	10	S5678_013_0	3	1		05/24/2011	2012.02	05/24/2011 07:39:04 AM Pacific Daylight Time		07/21/2011 12:05:22 PM Pacific Daylight Time		07/22/2011 09:56:44 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Value Orange Option 2 (PDP)	10	29					S5678	013	0	2012	Northern New England (NH and ME)		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	014	0		29	10	S5678_014_0	2	1		05/23/2011	2012.02	05/23/2011 03:09:24 PM Pacific Daylight Time		06/04/2011 11:22:36 PM Pacific Daylight Time		06/05/2011 12:13:27 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 1 (PDP)	10	29					S5678	014	0	2012	Northern New England (NH and ME)		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	015	0		29	10	S5678_015_0	3	1		05/24/2011	2012.02	05/24/2011 07:43:16 AM Pacific Daylight Time		07/21/2011 12:05:52 PM Pacific Daylight Time		07/22/2011 09:56:44 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Value Orange Option 2 (PDP)	10	29					S5678	015	0	2012	Mid-Atlantic (DE, DC and MD)		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	016	0		29	10	S5678_016_0	2	1		05/24/2011	2012.02	05/24/2011 07:14:04 AM Pacific Daylight Time		06/04/2011 11:23:16 PM Pacific Daylight Time		06/05/2011 12:13:27 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 1 (PDP)	10	29					S5678	016	0	2012	Mid-Atlantic (DE, DC and MD)		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	017	0		29	10	S5678_017_0	3	1		05/24/2011	2012.02	05/24/2011 07:44:08 AM Pacific Daylight Time		07/21/2011 12:06:22 PM Pacific Daylight Time		07/22/2011 09:56:44 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Value Orange Option 2 (PDP)	10	29					S5678	017	0	2012	Pennsylvania (WV)		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	018	0		29	10	S5678_018_0	2	1		05/23/2011	2012.02	05/23/2011 03:50:11 PM Pacific Daylight Time		06/04/2011 11:23:54 PM Pacific Daylight Time		06/05/2011 12:13:27 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 1 (PDP)	10	29					S5678	018	0	2012	Pennsylvania (WV)		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	019	0		29	10	S5678_019_0	3	1		05/24/2011	2012.02	05/24/2011 07:44:34 AM Pacific Daylight Time		07/21/2011 12:06:54 PM Pacific Daylight Time		07/22/2011 09:56:44 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Value Orange Option 2 (PDP)	10	29					S5678	019	0	2012	Virginia		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	020	0		29	10	S5678_020_0	2	1		05/23/2011	2012.02	05/23/2011 03:53:18 PM Pacific Daylight Time		06/04/2011 11:24:32 PM Pacific Daylight Time		06/05/2011 12:13:27 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 1 (PDP)	10	29					S5678	020	0	2012	Virginia		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	021	0		29	10	S5678_021_0	3	1		05/25/2011	2012.02	05/25/2011 02:58:12 PM Pacific Daylight Time		07/21/2011 12:07:26 PM Pacific Daylight Time		07/22/2011 09:56:44 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Value Orange Option 2 (PDP)	10	29					S5678	021	0	2012	North Carolina		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	022	0		29	10	S5678_022_0	2	1		05/23/2011	2012.02	05/23/2011 02:36:14 PM Pacific Daylight Time		06/04/2011 11:25:10 PM Pacific Daylight Time		06/05/2011 12:13:27 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 1 (PDP)	10	29					S5678	022	0	2012	North Carolina		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	023	0		29	10	S5678_023_0	3	1		05/24/2011	2012.02	05/24/2011 07:45:31 AM Pacific Daylight Time		07/21/2011 12:08:06 PM Pacific Daylight Time		07/22/2011 09:56:44 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Value Orange Option 2 (PDP)	10	29					S5678	023	0	2012	South Carolina		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	024	0		29	10	S5678_024_0	2	1		05/23/2011	2012.02	05/23/2011 03:02:07 PM Pacific Daylight Time		06/04/2011 11:25:48 PM Pacific Daylight Time		06/05/2011 12:13:27 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 1 (PDP)	10	29					S5678	024	0	2012	South Carolina		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	025	0		29	10	S5678_025_0	3	1		05/24/2011	2012.02	05/24/2011 07:45:56 AM Pacific Daylight Time		07/21/2011 12:08:46 PM Pacific Daylight Time		07/22/2011 09:56:44 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Value Orange Option 2 (PDP)	10	29					S5678	025	0	2012	Georgia		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	026	0		29	10	S5678_026_0	2	1		05/23/2011	2012.02	05/23/2011 02:11:50 PM Pacific Daylight Time		06/04/2011 11:27:02 PM Pacific Daylight Time		06/05/2011 12:13:27 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 1 (PDP)	10	29					S5678	026	0	2012	Georgia		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	027	0		29	10	S5678_027_0	3	1		05/24/2011	2012.02	05/24/2011 07:46:22 AM Pacific Daylight Time		07/21/2011 12:09:24 PM Pacific Daylight Time		07/22/2011 09:56:44 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Value Orange Option 2 (PDP)	10	29					S5678	027	0	2012	Florida		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	028	0		29	10	S5678_028_0	2	1		05/23/2011	2012.02	05/23/2011 03:55:25 PM Pacific Daylight Time		06/04/2011 11:28:14 PM Pacific Daylight Time		06/05/2011 12:13:27 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 1 (PDP)	10	29					S5678	028	0	2012	Florida		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	029	0		29	10	S5678_029_0	3	1		05/24/2011	2012.02	05/24/2011 07:46:51 AM Pacific Daylight Time		07/21/2011 12:10:00 PM Pacific Daylight Time		07/22/2011 09:56:44 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Value Orange Option 2 (PDP)	10	29					S5678	029	0	2012	Alabama, Tenessee		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	030	0		29	10	S5678_030_0	2	1		05/23/2011	2012.02	05/23/2011 02:44:52 PM Pacific Daylight Time		06/04/2011 11:29:24 PM Pacific Daylight Time		06/05/2011 12:13:27 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 1 (PDP)	10	29					S5678	030	0	2012	Alabama, Tennessee		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	031	0		29	10	S5678_031_0	3	1		05/24/2011	2012.02	05/24/2011 07:47:14 AM Pacific Daylight Time		07/21/2011 12:10:38 PM Pacific Daylight Time		07/22/2011 09:56:44 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Value Orange Option 2 (PDP)	10	29					S5678	031	0	2012	Michigan		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	032	0		29	10	S5678_032_0	2	1		05/24/2011	2012.02	05/24/2011 07:18:53 AM Pacific Daylight Time		06/04/2011 11:30:34 PM Pacific Daylight Time		06/05/2011 12:13:27 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 1 (PDP)	10	29					S5678	032	0	2012	Michigan		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	033	0		29	10	S5678_033_0	3	1		05/24/2011	2012.02	05/24/2011 07:47:32 AM Pacific Daylight Time		07/21/2011 12:11:16 PM Pacific Daylight Time		07/22/2011 09:56:44 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Value Orange Option 2 (PDP)	10	29					S5678	033	0	2012	Ohio		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	034	0		29	10	S5678_034_0	2	1		05/23/2011	2012.02	05/23/2011 04:48:25 PM Pacific Daylight Time		06/04/2011 11:31:20 PM Pacific Daylight Time		06/05/2011 12:13:27 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 1 (PDP)	10	29					S5678	034	0	2012	Ohio		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	035	0		29	10	S5678_035_0	3	1		05/24/2011	2012.02	05/24/2011 07:48:00 AM Pacific Daylight Time		07/21/2011 12:11:54 PM Pacific Daylight Time		07/22/2011 09:56:44 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Value Orange Option 2 (PDP)	10	29					S5678	035	0	2012	Indiana, Kentucky		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	036	0		29	10	S5678_036_0	2	1		05/23/2011	2012.02	05/23/2011 05:15:40 PM Pacific Daylight Time		06/04/2011 11:32:28 PM Pacific Daylight Time		06/05/2011 12:13:27 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 1 (PDP)	10	29					S5678	036	0	2012	Indiana, Kentucky		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	037	0		29	10	S5678_037_0	3	1		05/24/2011	2012.02	05/24/2011 07:48:26 AM Pacific Daylight Time		07/21/2011 12:12:32 PM Pacific Daylight Time		07/22/2011 09:56:44 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Value Orange Option 2 (PDP)	10	29					S5678	037	0	2012	Wisconsin		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	038	0		29	10	S5678_038_0	2	1		05/24/2011	2012.02	05/24/2011 06:38:26 AM Pacific Daylight Time		06/04/2011 11:33:40 PM Pacific Daylight Time		06/05/2011 12:13:27 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 1 (PDP)	10	29					S5678	038	0	2012	Wisconsin		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	039	0		29	10	S5678_039_0	3	1		05/24/2011	2012.02	05/24/2011 07:48:47 AM Pacific Daylight Time		07/21/2011 12:13:08 PM Pacific Daylight Time		07/22/2011 09:56:44 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Value Orange Option 2 (PDP)	10	29					S5678	039	0	2012	Illinois		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	040	0		29	10	S5678_040_0	2	1		05/23/2011	2012.02	05/23/2011 03:56:48 PM Pacific Daylight Time		06/04/2011 11:35:00 PM Pacific Daylight Time		06/05/2011 01:36:13 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 1 (PDP)	10	29					S5678	040	0	2012	Illinois		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	041	0		29	10	S5678_041_0	3	1		05/24/2011	2012.02	05/24/2011 07:49:08 AM Pacific Daylight Time		07/21/2011 12:13:48 PM Pacific Daylight Time		07/22/2011 09:56:44 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Value Orange Option 2 (PDP)	10	29					S5678	041	0	2012	Missouri		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	042	0		29	10	S5678_042_0	2	1		05/23/2011	2012.02	05/23/2011 03:02:44 PM Pacific Daylight Time		06/04/2011 11:36:16 PM Pacific Daylight Time		06/05/2011 01:36:13 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 1 (PDP)	10	29					S5678	042	0	2012	Missouri		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	043	0		29	10	S5678_043_0	3	1		05/24/2011	2012.02	05/24/2011 07:49:35 AM Pacific Daylight Time		07/21/2011 12:14:30 PM Pacific Daylight Time		07/22/2011 09:56:44 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Value Orange Option 2 (PDP)	10	29					S5678	043	0	2012	Arkansas		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	044	0		29	10	S5678_044_0	2	1		05/23/2011	2012.02	05/23/2011 03:57:56 PM Pacific Daylight Time		06/04/2011 11:37:00 PM Pacific Daylight Time		06/05/2011 01:36:13 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 1 (PDP)	10	29					S5678	044	0	2012	Arkansas		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	045	0		29	10	S5678_045_0	3	1		05/24/2011	2012.02	05/24/2011 07:50:06 AM Pacific Daylight Time		07/21/2011 12:15:08 PM Pacific Daylight Time		07/22/2011 09:56:44 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Value Orange Option 2 (PDP)	10	29					S5678	045	0	2012	Mississippi		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	046	0		29	10	S5678_046_0	2	1		05/23/2011	2012.02	05/23/2011 02:22:39 PM Pacific Daylight Time		06/04/2011 11:38:18 PM Pacific Daylight Time		06/05/2011 01:36:13 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 1 (PDP)	10	29					S5678	046	0	2012	Mississippi		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	047	0		29	10	S5678_047_0	3	1		05/24/2011	2012.02	05/24/2011 07:50:24 AM Pacific Daylight Time		07/21/2011 12:15:46 PM Pacific Daylight Time		07/22/2011 09:56:44 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Value Orange Option 2 (PDP)	10	29					S5678	047	0	2012	Louisiana		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	048	0		29	10	S5678_048_0	2	1		05/23/2011	2012.02	05/23/2011 11:29:38 AM Pacific Daylight Time		06/04/2011 11:39:28 PM Pacific Daylight Time		06/05/2011 01:36:13 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 1 (PDP)	10	29					S5678	048	0	2012	Louisiana		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	049	0		29	10	S5678_049_0	3	1		05/24/2011	2012.02	05/24/2011 07:36:05 AM Pacific Daylight Time		07/21/2011 12:16:24 PM Pacific Daylight Time		07/22/2011 09:56:44 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 2 (PDP)	10	29					S5678	049	0	2012	Texas		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	050	0		29	10	S5678_050_0	2	1		05/24/2011	2012.02	05/24/2011 08:03:40 AM Pacific Daylight Time		06/04/2011 11:40:36 PM Pacific Daylight Time		06/05/2011 01:36:13 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 1 (PDP)	10	29					S5678	050	0	2012	Texas		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	051	0		29	10	S5678_051_0	3	1		05/24/2011	2012.02	05/24/2011 07:51:10 AM Pacific Daylight Time		07/21/2011 12:16:58 PM Pacific Daylight Time		07/22/2011 09:56:44 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Value Orange Option 2 (PDP)	10	29					S5678	051	0	2012	Oklahoma		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	052	0		29	10	S5678_052_0	2	1		05/23/2011	2012.02	05/23/2011 05:17:59 PM Pacific Daylight Time		06/04/2011 11:41:48 PM Pacific Daylight Time		06/05/2011 01:36:13 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 1 (PDP)	10	29					S5678	052	0	2012	Oklahoma		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	053	0		29	10	S5678_053_0	3	1		05/24/2011	2012.02	05/24/2011 07:51:46 AM Pacific Daylight Time		07/21/2011 12:17:38 PM Pacific Daylight Time		07/22/2011 09:56:44 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Value Orange Option 2 (PDP)	10	29					S5678	053	0	2012	Kansas		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	054	0		29	10	S5678_054_0	2	1		05/23/2011	2012.02	05/23/2011 02:23:57 PM Pacific Daylight Time		06/04/2011 11:42:30 PM Pacific Daylight Time		06/05/2011 01:36:13 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 1 (PDP)	10	29					S5678	054	0	2012	Kansas		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	055	0		29	10	S5678_055_0	3	1		05/24/2011	2012.02	05/24/2011 07:52:34 AM Pacific Daylight Time		07/21/2011 12:18:20 PM Pacific Daylight Time		07/22/2011 09:56:44 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Value Orange Option 2 (PDP)	10	29					S5678	055	0	2012	IA, MN, MT, NE, ND, SD, WY		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	056	0		29	10	S5678_056_0	2	1		05/23/2011	2012.02	05/23/2011 05:20:12 PM Pacific Daylight Time		06/04/2011 11:43:40 PM Pacific Daylight Time		06/05/2011 01:36:13 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 1 (PDP)	10	29					S5678	056	0	2012	IA, MN, MT, NE, ND, SD, WY		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	057	0		29	10	S5678_057_0	3	1		05/24/2011	2012.02	05/24/2011 07:52:58 AM Pacific Daylight Time		07/21/2011 12:19:00 PM Pacific Daylight Time		07/22/2011 09:56:44 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Value Orange Option 2 (PDP)	10	29					S5678	057	0	2012	New Mexico		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	058	0		29	10	S5678_058_0	2	1		05/24/2011	2012.02	05/24/2011 06:45:12 AM Pacific Daylight Time		06/04/2011 11:44:52 PM Pacific Daylight Time		06/05/2011 01:36:13 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 1 (PDP)	10	29					S5678	058	0	2012	New Mexico		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	059	0		29	10	S5678_059_0	3	1		05/24/2011	2012.02	05/24/2011 07:53:20 AM Pacific Daylight Time		07/21/2011 12:19:38 PM Pacific Daylight Time		07/22/2011 09:56:44 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Value Orange Option 2 (PDP)	10	29					S5678	059	0	2012	Colorado		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	060	0		29	10	S5678_060_0	2	1		05/24/2011	2012.02	05/24/2011 07:18:13 AM Pacific Daylight Time		06/04/2011 11:46:04 PM Pacific Daylight Time		06/05/2011 01:36:13 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 1 (PDP)	10	29					S5678	060	0	2012	Colorado		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	061	0		29	10	S5678_061_0	3	1		05/24/2011	2012.02	05/24/2011 07:53:43 AM Pacific Daylight Time		07/21/2011 12:20:14 PM Pacific Daylight Time		07/22/2011 09:56:44 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Value Orange Option 2 (PDP)	10	29					S5678	061	0	2012	Nevada		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	062	0		29	10	S5678_062_0	2	1		05/23/2011	2012.02	05/23/2011 05:22:17 PM Pacific Daylight Time		06/04/2011 11:47:14 PM Pacific Daylight Time		06/05/2011 01:36:13 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 1 (PDP)	10	29					S5678	062	0	2012	Nevada		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	063	0		29	10	S5678_063_0	3	1		05/24/2011	2012.02	05/24/2011 07:54:11 AM Pacific Daylight Time		07/21/2011 12:20:56 PM Pacific Daylight Time		07/22/2011 09:56:44 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Value Orange Option 2 (PDP)	10	29					S5678	063	0	2012	Idaho, Utah		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	064	0		29	10	S5678_064_0	2	1		05/24/2011	2012.02	05/24/2011 06:33:21 AM Pacific Daylight Time		06/04/2011 11:47:54 PM Pacific Daylight Time		06/05/2011 01:36:13 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 1 (PDP)	10	29					S5678	064	0	2012	Idaho, Utah		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	065	0		29	10	S5678_065_0	3	1		05/24/2011	2012.02	05/24/2011 07:54:38 AM Pacific Daylight Time		07/21/2011 12:21:30 PM Pacific Daylight Time		07/22/2011 09:56:44 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Value Orange Option 2 (PDP)	10	29					S5678	065	0	2012	Hawaii		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	066	0		29	10	S5678_066_0	2	1		05/24/2011	2012.02	05/24/2011 07:22:56 AM Pacific Daylight Time		06/04/2011 11:48:34 PM Pacific Daylight Time		06/05/2011 01:36:13 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 1 (PDP)	10	29					S5678	066	0	2012	Hawaii		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	067	0		29	10	S5678_067_0	3	1		05/24/2011	2012.02	05/24/2011 07:55:13 AM Pacific Daylight Time		07/21/2011 12:22:14 PM Pacific Daylight Time		07/22/2011 09:56:44 AM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Value Orange Option 2 (PDP)	10	29					S5678	067	0	2012	Alaska		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	068	0		29	10	S5678_068_0	2	1		05/23/2011	2012.02	05/23/2011 01:49:08 PM Pacific Daylight Time		06/04/2011 11:49:14 PM Pacific Daylight Time		06/05/2011 01:36:13 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange Option 1 (PDP)	10	29					S5678	068	0	2012	Alaska		2					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	801	0		29	10	S5678_801_0	2	1		05/24/2011	2012.02	05/24/2011 08:05:15 AM Pacific Daylight Time				06/05/2011 01:12:01 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange (PDP)	10	29					S5678	801	0	2012	49 United States and District of Columbia		1					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5678	803	0		29	10	S5678_803_0	2	1		05/24/2011	2012.02	05/24/2011 08:05:19 AM Pacific Daylight Time				06/05/2011 01:12:01 PM Pacific Daylight Time	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	Health Net Orange (PDP)	10	29					S5678	803	0	2012	49 United States and District of Columbia		1					2							https://www.healthnet.com/formulary.htm	https://www.healthnet.com/portal/medicare/content.do?resource=pharmacyDirectory.htm									(800)-806-8811		(800)-806-8811		(800)-606-3604		(800)-606-3604										(800)-929-9955		(800)-929-9955		(800)-929-9955		(800)-929-9955				
S5715	001	0		29	10	S5715_001_0	6	1		07/28/2011	2012.02	07/28/2011 04:45:51 PM Central Daylight Time		07/28/2011 04:07:04 PM Central Daylight Time		07/29/2011 09:49:29 AM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.yourpartd.com	Blue MedicareRx Value (PDP)	10	29					S5715	001	0	2012	State of Illinois		2					2							https://myprime.com	www.yourpartd.com									(888)-285-2249		(888)-285-2249		(877)-213-1817		(877)-213-1817										(711)		(711)		(711)		(711)				
S5715	002	0		29	10	S5715_002_0	6	1		07/06/2011	2012.02	07/06/2011 09:46:49 AM Central Daylight Time		07/28/2011 04:07:22 PM Central Daylight Time		07/29/2011 09:49:29 AM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.yourpartd.com	Blue MedicareRx Plus (PDP)	10	29					S5715	002	0	2012	State of Illinois		2					2							https://myprime.com	www.yourpartd.com									(888)-285-2249		(888)-285-2249		(877)-213-1817		(877)-213-1817										(711)		(711)		(711)		(711)				
S5715	003	0		29	10	S5715_003_0	7	1		07/28/2011	2012.02	07/28/2011 05:05:04 PM Central Daylight Time		07/28/2011 04:07:40 PM Central Daylight Time		07/29/2011 09:49:29 AM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.yourpartd.com	Blue MedicareRx Value (PDP)	10	29					S5715	003	0	2012	State of New Mexico		2					2							https://myprime.com	www.yourpartd.com									(888)-285-2249		(888)-285-2249		(877)-213-1817		(877)-213-1817										(711)		(711)		(711)		(711)				
S5715	004	0		29	10	S5715_004_0	6	1		06/01/2011	2012.02	06/01/2011 02:05:40 PM Central Daylight Time		07/28/2011 04:07:54 PM Central Daylight Time		07/29/2011 09:49:29 AM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.yourpartd.com	Blue MedicareRx Plus (PDP)	10	29					S5715	004	0	2012	State of New Mexico		2					2							https://myprime.com	www.yourpartd.com									(888)-285-2249		(888)-285-2249		(877)-213-1817		(877)-213-1817										(711)		(711)		(711)		(711)				
S5715	005	0		29	10	S5715_005_0	6	1		07/28/2011	2012.02	07/28/2011 05:01:49 PM Central Daylight Time		07/28/2011 04:08:14 PM Central Daylight Time		07/29/2011 09:49:29 AM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.yourpartd.com	Blue MedicareRx Value (PDP)	10	29					S5715	005	0	2012	State of Texas		2					2							https://myprime.com	www.yourpartd.com									(888)-285-2249		(888)-285-2249		(877)-213-1817		(877)-213-1817										(711)		(711)		(711)		(711)				
S5715	006	0		29	10	S5715_006_0	6	1		06/01/2011	2012.02	06/01/2011 02:05:59 PM Central Daylight Time		07/28/2011 04:08:30 PM Central Daylight Time		07/29/2011 09:49:29 AM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.yourpartd.com	Blue MedicareRx Plus (PDP)	10	29					S5715	006	0	2012	State of Texas		2					2							https://myprime.com	www.yourpartd.com									(888)-285-2249		(888)-285-2249		(877)-213-1817		(877)-213-1817										(711)		(711)		(711)		(711)				
S5715	010	0		29	10	S5715_010_0	6	1		07/28/2011	2012.02	07/28/2011 05:30:24 PM Central Daylight Time		07/28/2011 04:08:48 PM Central Daylight Time		07/29/2011 09:49:29 AM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.yourpartd.com	Blue MedicareRx Value (PDP)	10	29					S5715	010	0	2012	State of Oklahoma		2					2							https://myprime.com	www.yourpartd.com									(888)-285-2249		(888)-285-2249		(877)-213-1817		(877)-213-1817										(711)		(711)		(711)		(711)				
S5715	011	0		29	10	S5715_011_0	6	1		06/01/2011	2012.02	06/01/2011 02:06:17 PM Central Daylight Time		07/28/2011 04:09:04 PM Central Daylight Time		07/29/2011 09:49:29 AM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.yourpartd.com	Blue MedicareRx Plus (PDP)	10	29					S5715	011	0	2012	State of Oklahoma		2					2							https://myprime.com	www.yourpartd.com									(888)-285-2249		(888)-285-2249		(877)-213-1817		(877)-213-1817										(711)		(711)		(711)		(711)				
S5715	801	0		29	10	S5715_801_0	2	1		06/01/2011	2012.02	06/01/2011 02:06:32 PM Central Daylight Time				06/01/2011 03:28:51 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.yourpartd.com	Blue MedicareRx (PDP)	10	29					S5715	801	0	2012	State of Illinois		1					2							https://myprime.com	www.yourpartd.com									(877)-838-3833		(877)-838-3833		(877)-838-3833		(877)-838-3833										(711)		(711)		(711)		(711)				
S5715	802	0		29	10	S5715_802_0	2	1		06/01/2011	2012.02	06/01/2011 02:06:41 PM Central Daylight Time				06/01/2011 03:28:51 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.yourpartd.com	Blue MedicareRx (PDP)	10	29					S5715	802	0	2012	State of New Mexico		1					2							https://myprime.com	www.yourpartd.com									(877)-838-3833		(877)-838-3833		(877)-838-3833		(877)-838-3833										(711)		(711)		(711)		(711)				
S5715	803	0		29	10	S5715_803_0	2	1		06/01/2011	2012.02	06/01/2011 02:06:50 PM Central Daylight Time				06/01/2011 03:28:51 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.yourpartd.com	Blue MedicareRx (PDP)	10	29					S5715	803	0	2012	State of Texas		1					2							https://myprime.com	www.yourpartd.com									(877)-838-3833		(877)-838-3833		(877)-838-3833		(877)-838-3833										(711)		(711)		(711)		(711)				
S5715	804	0		29	10	S5715_804_0	2	1		06/01/2011	2012.02	06/01/2011 02:06:58 PM Central Daylight Time				06/01/2011 03:28:51 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.yourpartd.com	Blue MedicareRx (PDP)	10	29					S5715	804	0	2012	State of Illinois		1					2							https://myprime.com	www.yourpartd.com									(877)-838-3833		(877)-838-3833		(877)-838-3833		(877)-838-3833										(711)		(711)		(711)		(711)				
S5715	805	0		29	10	S5715_805_0	2	1		06/01/2011	2012.02	06/01/2011 02:07:06 PM Central Daylight Time				06/01/2011 03:28:51 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.yourpartd.com	Blue MedicareRx (PDP)	10	29					S5715	805	0	2012	State of New Mexico		1					2							https://myprime.com	www.yourpartd.com									(877)-838-3833		(877)-838-3833		(877)-838-3833		(877)-838-3833										(711)		(711)		(711)		(711)				
S5715	806	0		29	10	S5715_806_0	2	1		06/01/2011	2012.02	06/01/2011 02:07:15 PM Central Daylight Time				06/01/2011 03:28:51 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.yourpartd.com	Blue MedicareRx (PDP)	10	29					S5715	806	0	2012	State of Texas		1					2							https://myprime.com	www.yourpartd.com									(877)-838-3833		(877)-838-3833		(877)-838-3833		(877)-838-3833										(711)		(711)		(711)		(711)				
S5715	807	0		29	10	S5715_807_0	2	1		06/01/2011	2012.02	06/01/2011 02:07:24 PM Central Daylight Time				06/01/2011 03:28:51 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.yourpartd.com	Blue MedicareRx (PDP)	10	29					S5715	807	0	2012	State of Oklahoma		1					2							https://myprime.com	www.yourpartd.com									(877)-838-3833		(877)-838-3833		(877)-838-3833		(877)-838-3833										(711)		(711)		(711)		(711)				
S5715	808	0		29	10	S5715_808_0	2	1		06/01/2011	2012.02	06/01/2011 02:09:48 PM Central Daylight Time				06/01/2011 03:28:51 PM Central Daylight Time	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK, TX	www.yourpartd.com	Blue MedicareRx (PDP)	10	29					S5715	808	0	2012	State of Oklahoma		1					2							https://myprime.com	www.yourpartd.com									(877)-838-3833		(877)-838-3833		(877)-838-3833		(877)-838-3833										(711)		(711)		(711)		(711)				
S5726	013	0		29	10	S5726_013_0	6	1		06/27/2011	2012.02	06/27/2011 01:32:50 PM Pacific Daylight Time		07/14/2011 05:06:00 PM Pacific Daylight Time		07/25/2011 09:11:40 AM Pacific Daylight Time	BLUE CROSS BLUE SHIELD OF KANSAS	Blue MedicareRx	www.partdcoverage.com	Blue MedicareRx Value (PDP)	10	29					S5726	013	0	2012	Kansas		2					2							www.PartDCoverage.com	www.PartDCoverage.com									(866)-755-2776		(866)-755-2776		(877)-471-4121		(877)-471-4121										(866)-798-7026		(866)-798-7026		(800)-766-3777		(800)-766-3777				
S5726	014	0		29	10	S5726_014_0	6	1		06/27/2011	2012.02	06/27/2011 01:26:44 PM Pacific Daylight Time		07/22/2011 09:45:00 AM Pacific Daylight Time		07/25/2011 09:11:40 AM Pacific Daylight Time	BLUE CROSS BLUE SHIELD OF KANSAS	Blue MedicareRx	www.partdcoverage.com	Blue MedicareRx Plus (PDP)	10	29					S5726	014	0	2012	Kansas		2					2							www.PartDCoverage.com	www.PartDCoverage.com									(866)-755-2776		(866)-755-2776		(877)-471-4121		(877)-471-4121										(866)-798-7026		(866)-798-7026		(800)-766-3777		(800)-766-3777				
S5726	015	0		29	10	S5726_015_0	6	1		07/01/2011	2012.02	07/01/2011 11:36:49 AM Pacific Daylight Time		07/22/2011 09:47:00 AM Pacific Daylight Time		07/25/2011 09:11:40 AM Pacific Daylight Time	BLUE CROSS BLUE SHIELD OF KANSAS	Blue MedicareRx	www.partdcoverage.com	Blue MedicareRx Premier (PDP)	10	29					S5726	015	0	2012	Kansas		2					2							www.PartDCoverage.com	www.PartDCoverage.com									(866)-755-2776		(866)-755-2776		(877)-471-4121		(877)-471-4121										(866)-798-7026		(866)-798-7026		(800)-766-3777		(800)-766-3777				
S5726	805	0		29	10	S5726_805_0	3	1		04/21/2011	2012.02	04/21/2011 10:18:06 AM Pacific Daylight Time				06/06/2011 12:14:56 PM Pacific Daylight Time	BLUE CROSS BLUE SHIELD OF KANSAS	Blue MedicareRx	www.PartDCoverage.com	Blue MedicareRx (PDP)	10	29					S5726	805	0	2012	Kansas		1					2							www.PartDCoverage.com	www.PartDCoverage.com									(866)-755-2776		(866)-755-2776		(877)-471-4121		(877)-471-4121										(866)-798-7026		(866)-798-7026		(800)-766-3777		(800)-766-3777				
S5743	001	0		29	10	S5743_001_0	2	1		05/18/2011	2012.02	05/18/2011 02:41:24 PM Central Daylight Time		06/01/2011 12:30:00 PM Central Daylight Time		06/03/2011 09:43:27 AM Central Daylight Time	BCBS MN, MT, NE, ND, WY, WELLMARK IA AND SD	MedicareBlue Rx	www.YourMedicareSolutions.com	MedicareBlue Rx Standard (PDP)	10	29					S5743	001	0	2012	States of IA, MN, MT, NE, ND, SD, WY		2					2							www.YourMedicareSolutions.com	www.YourMedicareSolutions.com									(888)-832-0075		(888)-832-0075		(866)-434-2037		(866)-434-2037										(800)-693-3819		(800)-693-3819		(711)		(711)				
S5743	004	0		29	10	S5743_004_0	2	1		05/18/2011	2012.02	05/18/2011 02:37:36 PM Central Daylight Time		06/01/2011 12:32:00 PM Central Daylight Time		06/03/2011 09:43:27 AM Central Daylight Time	BCBS MN, MT, NE, ND, WY, WELLMARK IA AND SD	MedicareBlue Rx	www.YourMedicareSolutions.com	MedicareBlue Rx Premier (PDP)	10	29					S5743	004	0	2012	States of IA, MN, MT, NE, ND, SD, WY		2					2							www.YourMedicareSolutions.com	www.YourMedicareSolutions.com									(888)-832-0075		(888)-832-0075		(866)-434-2037		(866)-434-2037										(800)-693-3819		(800)-693-3819		(711)		(711)				
S5743	802	0		29	10	S5743_802_0	2	1		04/18/2011	2012.02	04/18/2011 03:36:11 PM Central Daylight Time				06/03/2011 09:43:27 AM Central Daylight Time	BCBS MN, MT, NE, ND, WY, WELLMARK IA AND SD	MedicareBlue Rx	www.YourMedicareSolutions.com	Group MedicareBlue Rx (PDP)	10	29					S5743	802	0	2012	Nationwide		1					2							www.YourMedicareSolutions.com	www.YourMedicareSolutions.com									(877)-838-3827		(877)-838-3827		(866)-434-2037		(866)-434-2037										(866)-213-9262		(866)-213-9262		(866)-456-1550		(866)-456-1550				
S5753	006	0		29	10	S5753_006_0	2	1		06/03/2011	2012.02	06/03/2011 01:46:51 PM Central Daylight Time		07/25/2011 02:23:11 PM Central Daylight Time		07/25/2011 02:25:54 PM Central Daylight Time	WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION	WPS Health Insurance	www.wpsmedicaredrugs.com	WPS MedicareRx Plan 1 (PDP)	10	29					S5753	006	0	2012	State of Wisconsin		2					2							www.wpsmedicaredrugs.com	www.wpsmedicaredrugs.com									(800)-688-1604		(800)-688-1604		(800)-731-0459		(800)-731-0459										(800)-716-3231		(800)-716-3231		(711)		(711)				
S5753	007	0		29	10	S5753_007_0	1	1		06/03/2011	2012.02	06/03/2011 01:47:40 PM Central Daylight Time		06/03/2011 06:41:49 PM Central Daylight Time		06/03/2011 07:41:59 PM Central Daylight Time	WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION	WPS Health Insurance	www.wpsmedicaredrugs.com	WPS MedicareRx Plan 2 (PDP)	10	29					S5753	007	0	2012	State of Wisconsin		2					2							www.wpsmedicaredrugs.com	www.wpsmedicaredrugs.com									(800)-688-1604		(800)-688-1604		(800)-731-0459		(800)-731-0459										(800)-716-3231		(800)-716-3231		(711)		(711)				
S5753	801	0		29	10	S5753_801_0	1	1		06/03/2011	2012.02	06/03/2011 07:41:08 PM Central Daylight Time				06/03/2011 07:41:59 PM Central Daylight Time	WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION	WPS Health Insurance	www.wpsmedicaredrugs.com	WPS Employer Plan - Calendar Year (PDP)	10	29					S5753	801	0	2012	National		1					2							www.wpsmedicaredrugs.com	www.wpsmedicaredrugs.com									(800)-688-1604		(800)-688-1604		(800)-731-0459		(800)-731-0459										(800)-716-3231		(800)-716-3231		(711)		(711)				
S5753	803	0		29	10	S5753_803_0	1	1		06/03/2011	2012.02	06/03/2011 07:41:20 PM Central Daylight Time				06/03/2011 07:41:59 PM Central Daylight Time	WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION	WPS Health Insurance	www.wpsmedicaredrugs.com	WPS Employer Plan Non-Calendar Year (PDP)	10	29					S5753	803	0	2012	National		1					2							www.wpsmedicaredrugs.com	www.wpsmedicaredrugs.com									(800)-688-1604		(800)-688-1604		(800)-731-0459		(800)-731-0459										(800)-716-3231		(800)-716-3231		(711)		(711)				
S5755	005	0		29	10	S5755_005_0	3	1		06/03/2011	2012.02	06/03/2011 10:54:19 AM Central Daylight Time		07/27/2011 11:09:13 AM Central Daylight Time		07/27/2011 11:10:10 AM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Preferred (PDP)	10	29					S5755	005	0	2012	States of Maine and New Hampshire		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	006	0		29	10	S5755_006_0	2	1		06/03/2011	2012.02	06/03/2011 10:57:27 AM Central Daylight Time		07/21/2011 08:50:00 AM Central Daylight Time		07/21/2011 06:30:37 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Preferred (PDP)	10	29					S5755	006	0	2012	States of CT, MA, RI and VT		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	007	0		29	10	S5755_007_0	3	1		06/03/2011	2012.02	06/03/2011 10:58:28 AM Central Daylight Time		07/21/2011 08:50:00 AM Central Daylight Time		07/21/2011 06:30:37 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Preferred (PDP)	10	29					S5755	007	0	2012	State of New Jersey		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	008	0		29	10	S5755_008_0	2	1		06/03/2011	2012.02	06/03/2011 10:59:27 AM Central Daylight Time		07/21/2011 08:50:00 AM Central Daylight Time		07/21/2011 06:30:37 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Preferred (PDP)	10	29					S5755	008	0	2012	States of Delaware and Maryland plus DC		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	009	0		29	10	S5755_009_0	2	1		06/03/2011	2012.02	06/03/2011 11:00:29 AM Central Daylight Time		07/21/2011 08:50:00 AM Central Daylight Time		07/21/2011 06:30:37 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Preferred (PDP)	10	29					S5755	009	0	2012	States of Pennsylvania and West Virginia		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	010	0		29	10	S5755_010_0	2	1		06/03/2011	2012.02	06/03/2011 11:01:44 AM Central Daylight Time		07/21/2011 08:49:00 AM Central Daylight Time		07/21/2011 06:30:37 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Preferred (PDP)	10	29					S5755	010	0	2012	State of Virginia		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	011	0		29	10	S5755_011_0	2	1		06/03/2011	2012.02	06/03/2011 11:02:35 AM Central Daylight Time		07/21/2011 08:49:00 AM Central Daylight Time		07/21/2011 06:30:37 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Preferred (PDP)	10	29					S5755	011	0	2012	State of North Carolina		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	012	0		29	10	S5755_012_0	2	1		06/03/2011	2012.02	06/03/2011 11:03:24 AM Central Daylight Time		07/21/2011 08:48:00 AM Central Daylight Time		07/21/2011 06:30:37 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Preferred (PDP)	10	29					S5755	012	0	2012	State of South Carolina		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	013	0		29	10	S5755_013_0	2	1		06/03/2011	2012.02	06/03/2011 11:04:31 AM Central Daylight Time		07/21/2011 08:48:00 AM Central Daylight Time		07/21/2011 06:30:37 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Preferred (PDP)	10	29					S5755	013	0	2012	State of Georgia		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	014	0		29	10	S5755_014_0	3	1		06/03/2011	2012.02	06/03/2011 11:05:26 AM Central Daylight Time		07/21/2011 08:47:00 AM Central Daylight Time		07/21/2011 06:30:37 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Preferred (PDP)	10	29					S5755	014	0	2012	State of Florida		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	015	0		29	10	S5755_015_0	2	1		06/03/2011	2012.02	06/03/2011 11:06:33 AM Central Daylight Time		07/21/2011 08:47:00 AM Central Daylight Time		07/21/2011 06:30:37 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Preferred (PDP)	10	29					S5755	015	0	2012	States of Alabama and Tennessee		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	016	0		29	10	S5755_016_0	2	1		06/03/2011	2012.02	06/03/2011 11:07:06 AM Central Daylight Time		07/21/2011 08:46:00 AM Central Daylight Time		07/21/2011 06:30:37 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Preferred (PDP)	10	29					S5755	016	0	2012	State of Michigan		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	017	0		29	10	S5755_017_0	2	1		06/03/2011	2012.02	06/03/2011 11:07:50 AM Central Daylight Time		07/21/2011 08:46:00 AM Central Daylight Time		07/21/2011 06:30:37 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Preferred (PDP)	10	29					S5755	017	0	2012	State of Ohio		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	018	0		29	10	S5755_018_0	2	1		06/03/2011	2012.02	06/03/2011 11:08:51 AM Central Daylight Time		07/21/2011 08:51:00 AM Central Daylight Time		07/21/2011 06:30:37 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Preferred (PDP)	10	29					S5755	018	0	2012	States of Indiana and Kentucky		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	019	0		29	10	S5755_019_0	2	1		06/03/2011	2012.02	06/03/2011 11:09:41 AM Central Daylight Time		07/21/2011 08:57:00 AM Central Daylight Time		07/21/2011 06:30:37 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Preferred (PDP)	10	29					S5755	019	0	2012	State of Wisconsin		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	020	0		29	10	S5755_020_0	2	1		06/03/2011	2012.02	06/03/2011 11:10:37 AM Central Daylight Time		07/21/2011 08:57:00 AM Central Daylight Time		07/21/2011 06:30:37 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Preferred (PDP)	10	29					S5755	020	0	2012	State of Illinois		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	021	0		29	10	S5755_021_0	2	1		06/03/2011	2012.02	06/03/2011 11:11:28 AM Central Daylight Time		07/21/2011 08:56:00 AM Central Daylight Time		07/21/2011 06:30:37 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Preferred (PDP)	10	29					S5755	021	0	2012	State of Missouri		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	022	0		29	10	S5755_022_0	1	1		06/03/2011	2012.02	06/03/2011 10:36:54 AM Central Daylight Time		06/05/2011 03:49:43 PM Central Daylight Time		06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Preferred (PDP)	10	29					S5755	022	0	2012	State of Arkansas		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	023	0		29	10	S5755_023_0	2	1		06/03/2011	2012.02	06/03/2011 11:12:21 AM Central Daylight Time		07/21/2011 08:56:00 AM Central Daylight Time		07/21/2011 06:30:37 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Preferred (PDP)	10	29					S5755	023	0	2012	State of Mississippi		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	024	0		29	10	S5755_024_0	2	1		06/03/2011	2012.02	06/03/2011 11:13:16 AM Central Daylight Time		07/21/2011 08:56:00 AM Central Daylight Time		07/21/2011 06:30:37 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Preferred (PDP)	10	29					S5755	024	0	2012	State of Louisiana		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	025	0		29	10	S5755_025_0	2	1		06/03/2011	2012.02	06/03/2011 11:14:08 AM Central Daylight Time		07/21/2011 08:55:00 AM Central Daylight Time		07/21/2011 06:30:37 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Preferred (PDP)	10	29					S5755	025	0	2012	State of Texas		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	026	0		29	10	S5755_026_0	3	1		06/03/2011	2012.02	06/03/2011 11:14:59 AM Central Daylight Time		07/21/2011 08:55:00 AM Central Daylight Time		07/21/2011 06:30:37 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Preferred (PDP)	10	29					S5755	026	0	2012	State of Oklahoma		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	027	0		29	10	S5755_027_0	2	1		06/03/2011	2012.02	06/03/2011 11:15:54 AM Central Daylight Time		07/21/2011 08:54:00 AM Central Daylight Time		07/21/2011 06:30:37 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Preferred (PDP)	10	29					S5755	027	0	2012	State of Kansas		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	028	0		29	10	S5755_028_0	2	1		06/03/2011	2012.02	06/03/2011 11:16:51 AM Central Daylight Time		07/21/2011 08:54:00 AM Central Daylight Time		07/21/2011 06:30:37 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Preferred (PDP)	10	29					S5755	028	0	2012	States of IA, MN, MT, NE, ND, SD and WY		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	029	0		29	10	S5755_029_0	2	1		06/03/2011	2012.02	06/03/2011 11:17:43 AM Central Daylight Time		07/21/2011 08:53:00 AM Central Daylight Time		07/21/2011 06:30:37 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Preferred (PDP)	10	29					S5755	029	0	2012	State of New Mexico		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	030	0		29	10	S5755_030_0	2	1		06/03/2011	2012.02	06/03/2011 11:18:18 AM Central Daylight Time		07/21/2011 08:53:00 AM Central Daylight Time		07/21/2011 06:30:37 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Preferred (PDP)	10	29					S5755	030	0	2012	State of Colorado		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	031	0		29	10	S5755_031_0	2	1		06/03/2011	2012.02	06/03/2011 11:19:21 AM Central Daylight Time		07/21/2011 08:53:00 AM Central Daylight Time		07/21/2011 06:30:37 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Preferred (PDP)	10	29					S5755	031	0	2012	State of Arizona		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	032	0		29	10	S5755_032_0	2	1		06/03/2011	2012.02	06/03/2011 11:20:29 AM Central Daylight Time		07/21/2011 08:53:00 AM Central Daylight Time		07/21/2011 06:30:37 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Preferred (PDP)	10	29					S5755	032	0	2012	State of Nevada		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	033	0		29	10	S5755_033_0	2	1		06/03/2011	2012.02	06/03/2011 11:21:12 AM Central Daylight Time		07/21/2011 08:52:00 AM Central Daylight Time		07/21/2011 06:30:37 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Preferred (PDP)	10	29					S5755	033	0	2012	States of Oregon and Washington		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	034	0		29	10	S5755_034_0	2	1		06/03/2011	2012.02	06/03/2011 11:21:53 AM Central Daylight Time		07/21/2011 08:57:00 AM Central Daylight Time		07/21/2011 06:30:37 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Preferred (PDP)	10	29					S5755	034	0	2012	States of Idaho and Utah		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	035	0		29	10	S5755_035_0	2	1		06/03/2011	2012.02	06/03/2011 11:22:36 AM Central Daylight Time		07/21/2011 08:52:00 AM Central Daylight Time		07/21/2011 06:30:37 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Preferred (PDP)	10	29					S5755	035	0	2012	State of California		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	038	0		29	10	S5755_038_0	1	1		06/03/2011	2012.02	06/03/2011 11:29:06 AM Central Daylight Time		06/05/2011 03:49:42 PM Central Daylight Time		06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Select (PDP)	10	29					S5755	038	0	2012	State of Hawaii		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	039	0		29	10	S5755_039_0	1	1		06/03/2011	2012.02	06/03/2011 11:26:14 AM Central Daylight Time		06/05/2011 03:49:42 PM Central Daylight Time		06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Preferred (PDP)	10	29					S5755	039	0	2012	State of Alaska		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	073	0		29	10	S5755_073_0	1	1		06/03/2011	2012.02	06/03/2011 01:14:46 PM Central Daylight Time		06/05/2011 03:49:42 PM Central Daylight Time		06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Select (PDP)	10	29					S5755	073	0	2012	States of Maine and New Hampshire		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	074	0		29	10	S5755_074_0	1	1		06/03/2011	2012.02	06/03/2011 01:16:16 PM Central Daylight Time		06/05/2011 03:49:42 PM Central Daylight Time		06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Select (PDP)	10	29					S5755	074	0	2012	States of CT, MA, RI, and VT		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	075	0		29	10	S5755_075_0	1	1		06/03/2011	2012.02	06/03/2011 01:17:21 PM Central Daylight Time		06/05/2011 03:49:43 PM Central Daylight Time		06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Select (PDP)	10	29					S5755	075	0	2012	State of New Jersey		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	076	0		29	10	S5755_076_0	1	1		06/03/2011	2012.02	06/03/2011 01:18:37 PM Central Daylight Time		06/05/2011 03:49:43 PM Central Daylight Time		06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Select (PDP)	10	29					S5755	076	0	2012	States of Delaware, Maryland and DC		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	077	0		29	10	S5755_077_0	1	1		06/03/2011	2012.02	06/03/2011 01:19:41 PM Central Daylight Time		06/05/2011 03:49:43 PM Central Daylight Time		06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Select (PDP)	10	29					S5755	077	0	2012	States of Pennsylvania and West Virginia		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	078	0		29	10	S5755_078_0	1	1		06/03/2011	2012.02	06/03/2011 01:21:13 PM Central Daylight Time		06/05/2011 03:49:43 PM Central Daylight Time		06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Select (PDP)	10	29					S5755	078	0	2012	State of Virginia		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	079	0		29	10	S5755_079_0	1	1		06/03/2011	2012.02	06/03/2011 01:22:27 PM Central Daylight Time		06/05/2011 03:49:43 PM Central Daylight Time		06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Select (PDP)	10	29					S5755	079	0	2012	State of North Carolina		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	080	0		29	10	S5755_080_0	1	1		06/03/2011	2012.02	06/03/2011 01:23:20 PM Central Daylight Time		06/05/2011 03:49:43 PM Central Daylight Time		06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Select (PDP)	10	29					S5755	080	0	2012	State of South Carolina		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	081	0		29	10	S5755_081_0	1	1		06/03/2011	2012.02	06/03/2011 01:24:06 PM Central Daylight Time		06/05/2011 03:49:43 PM Central Daylight Time		06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Select (PDP)	10	29					S5755	081	0	2012	State of Georgia		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	082	0		29	10	S5755_082_0	2	1		06/03/2011	2012.02	06/03/2011 01:25:02 PM Central Daylight Time		06/05/2011 03:49:42 PM Central Daylight Time		06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Select (PDP)	10	29					S5755	082	0	2012	State of Florida		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	083	0		29	10	S5755_083_0	1	1		06/03/2011	2012.02	06/03/2011 01:26:30 PM Central Daylight Time		06/05/2011 03:49:45 PM Central Daylight Time		06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Select (PDP)	10	29					S5755	083	0	2012	States of Alabama and Tennessee		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	084	0		29	10	S5755_084_0	1	1		06/03/2011	2012.02	06/03/2011 01:27:20 PM Central Daylight Time		06/05/2011 03:49:45 PM Central Daylight Time		06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Select (PDP)	10	29					S5755	084	0	2012	State of Michigan		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	085	0		29	10	S5755_085_0	1	1		06/03/2011	2012.02	06/03/2011 01:28:12 PM Central Daylight Time		06/05/2011 03:49:45 PM Central Daylight Time		06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Select (PDP)	10	29					S5755	085	0	2012	State of Ohio		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	086	0		29	10	S5755_086_0	1	1		06/03/2011	2012.02	06/03/2011 01:29:06 PM Central Daylight Time		06/05/2011 03:49:45 PM Central Daylight Time		06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Select (PDP)	10	29					S5755	086	0	2012	States of Indiana and Kentucky		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	087	0		29	10	S5755_087_0	1	1		06/03/2011	2012.02	06/03/2011 01:30:11 PM Central Daylight Time		06/05/2011 03:49:45 PM Central Daylight Time		06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Select (PDP)	10	29					S5755	087	0	2012	State of Wisconsin		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	088	0		29	10	S5755_088_0	1	1		06/03/2011	2012.02	06/03/2011 01:30:52 PM Central Daylight Time		06/05/2011 03:49:45 PM Central Daylight Time		06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Select (PDP)	10	29					S5755	088	0	2012	State of Illinois		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	089	0		29	10	S5755_089_0	1	1		06/03/2011	2012.02	06/03/2011 01:31:43 PM Central Daylight Time		06/05/2011 03:49:45 PM Central Daylight Time		06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Select (PDP)	10	29					S5755	089	0	2012	State of Missouri		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	091	0		29	10	S5755_091_0	1	1		06/03/2011	2012.02	06/03/2011 01:32:43 PM Central Daylight Time		06/05/2011 03:49:38 PM Central Daylight Time		06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Select (PDP)	10	29					S5755	091	0	2012	State of Mississippi		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	092	0		29	10	S5755_092_0	1	1		06/03/2011	2012.02	06/03/2011 01:36:27 PM Central Daylight Time		06/05/2011 03:49:38 PM Central Daylight Time		06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Select (PDP)	10	29					S5755	092	0	2012	State of Louisiana		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	093	0		29	10	S5755_093_0	1	1		06/03/2011	2012.02	06/03/2011 01:37:25 PM Central Daylight Time		06/05/2011 03:49:38 PM Central Daylight Time		06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Select (PDP)	10	29					S5755	093	0	2012	State of Texas		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	094	0		29	10	S5755_094_0	1	1		06/03/2011	2012.02	06/03/2011 01:38:43 PM Central Daylight Time		06/05/2011 03:49:38 PM Central Daylight Time		06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Select (PDP)	10	29					S5755	094	0	2012	State of Oklahoma		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	095	0		29	10	S5755_095_0	1	1		06/03/2011	2012.02	06/03/2011 01:39:40 PM Central Daylight Time		06/05/2011 03:49:38 PM Central Daylight Time		06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Select (PDP)	10	29					S5755	095	0	2012	State of Kansas		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	096	0		29	10	S5755_096_0	1	1		06/03/2011	2012.02	06/03/2011 01:40:18 PM Central Daylight Time		06/05/2011 03:49:38 PM Central Daylight Time		06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Select (PDP)	10	29					S5755	096	0	2012	States of IA, MN, MT, NE, ND, SD, and WY		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	097	0		29	10	S5755_097_0	1	1		06/03/2011	2012.02	06/03/2011 01:44:23 PM Central Daylight Time		06/05/2011 03:49:38 PM Central Daylight Time		06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Select (PDP)	10	29					S5755	097	0	2012	State of New Mexico		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	098	0		29	10	S5755_098_0	1	1		06/03/2011	2012.02	06/03/2011 01:45:08 PM Central Daylight Time		06/05/2011 03:49:45 PM Central Daylight Time		06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Select (PDP)	10	29					S5755	098	0	2012	State of Colorado		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	099	0		29	10	S5755_099_0	1	1		06/03/2011	2012.02	06/03/2011 01:45:48 PM Central Daylight Time		06/05/2011 03:49:45 PM Central Daylight Time		06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Select (PDP)	10	29					S5755	099	0	2012	State of Arizona		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	100	0		29	10	S5755_100_0	1	1		06/03/2011	2012.02	06/03/2011 01:46:33 PM Central Daylight Time		06/05/2011 03:49:45 PM Central Daylight Time		06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Select (PDP)	10	29					S5755	100	0	2012	State of Nevada		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	101	0		29	10	S5755_101_0	1	1		06/03/2011	2012.02	06/03/2011 01:47:28 PM Central Daylight Time		06/05/2011 03:49:45 PM Central Daylight Time		06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Select (PDP)	10	29					S5755	101	0	2012	States of Oregon and Washington		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	102	0		29	10	S5755_102_0	1	1		06/03/2011	2012.02	06/03/2011 01:48:22 PM Central Daylight Time		06/05/2011 03:49:45 PM Central Daylight Time		06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Select (PDP)	10	29					S5755	102	0	2012	States of Idaho and Utah		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	103	0		29	10	S5755_103_0	1	1		06/03/2011	2012.02	06/03/2011 01:49:07 PM Central Daylight Time		06/05/2011 03:49:45 PM Central Daylight Time		06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American - Select (PDP)	10	29					S5755	103	0	2012	State of California		2					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	801	0		29	10	S5755_801_0	1	1		06/03/2011	2012.02	06/03/2011 01:51:59 PM Central Daylight Time				06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American Employer Calendar Plan (PDP)	10	29					S5755	801	0	2012	National		1					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5755	802	0		29	10	S5755_802_0	1	1		06/03/2011	2012.02	06/03/2011 01:52:03 PM Central Daylight Time				06/05/2011 04:06:56 PM Central Daylight Time	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com	United American Employer Non-Cal Drug Plan (PDP)	10	29					S5755	802	0	2012	National		1					2							http://www.uamedicarepartd.com/	http://www.uamedicarepartd.com/									(866)-524-4169		(866)-524-4169		(866)-524-4169		(866)-524-4169										(866)-524-4170		(866)-524-4170		(866)-524-4170		(866)-524-4170				
S5766	002	0		29	10	S5766_002_0	9	1		06/06/2011	2012.02	06/06/2011 04:18:50 PM Eastern Daylight Time		06/06/2011 12:59:09 PM Eastern Daylight Time		06/06/2011 04:27:06 PM Eastern Daylight Time	FIRST CARE, INC.	Medi-CareFirst BlueCross BlueShield	www.medi-carefirst.com	BlueRx Standard (PDP)	10	29					S5766	002	0	2012	Delaware, District of Columbia and Maryland		2					2							http://www.medi-carefirst.com	www.medi-carefirst.com									(800)-693-1434		(800)-693-1434		(888)-784-0790		(888)-784-0790										(800)-693-0765		(800)-693-0765		(888)-784-0868		(888)-784-0868				
S5766	003	0		29	10	S5766_003_0	12	1		06/06/2011	2012.02	06/06/2011 04:19:04 PM Eastern Daylight Time		06/06/2011 01:03:51 PM Eastern Daylight Time		06/06/2011 04:27:06 PM Eastern Daylight Time	FIRST CARE, INC.	Medi-CareFirst BlueCross BlueShield	www.medi-carefirst.com	BlueRx Enhanced (PDP)	10	29					S5766	003	0	2012	Delaware, District of Columbia and Maryland		2					2							http://www.medi-carefirst.com	www.medi-carefirst.com									(800)-693-1434		(800)-693-1434		(888)-784-0790		(888)-784-0790										(800)-693-0765		(800)-693-0765		(888)-784-0868		(888)-784-0868				
S5768	005	0		29	10	S5768_005_0	2	1		06/04/2011	2012.02	06/04/2011 09:31:09 AM Eastern Daylight Time		07/18/2011 11:58:22 AM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier (PDP)	10	29					S5768	005	0	2012	First Health Part D Premier - ME_NH		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	007	0		29	10	S5768_007_0	3	1		06/02/2011	2012.02	06/02/2011 09:30:53 PM Eastern Daylight Time		07/18/2011 09:57:18 AM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier (PDP)	10	29					S5768	007	0	2012	First Health Part D Premier - New Jersey		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	008	0		29	10	S5768_008_0	2	1		06/02/2011	2012.02	06/02/2011 09:31:15 PM Eastern Daylight Time		07/18/2011 01:00:10 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier (PDP)	10	29					S5768	008	0	2012	First Health Part D Premier - Mid Atlantic		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	009	0		29	10	S5768_009_0	2	1		06/02/2011	2012.02	06/02/2011 09:31:38 PM Eastern Daylight Time		07/18/2011 10:58:38 AM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier (PDP)	10	29					S5768	009	0	2012	First Health Part D Premier - PA_WV		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	010	0		29	10	S5768_010_0	2	1		06/02/2011	2012.02	06/02/2011 09:32:00 PM Eastern Daylight Time		07/18/2011 12:08:54 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier (PDP)	10	29					S5768	010	0	2012	First Health Part D Premier - Virginia		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	012	0		29	10	S5768_012_0	2	1		06/02/2011	2012.02	06/02/2011 09:32:57 PM Eastern Daylight Time		07/18/2011 01:12:00 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier (PDP)	10	29					S5768	012	0	2012	First Health Part D Premier - South Carolina		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	015	0		29	10	S5768_015_0	2	1		06/02/2011	2012.02	06/02/2011 09:34:14 PM Eastern Daylight Time		07/18/2011 01:43:56 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier (PDP)	10	29					S5768	015	0	2012	First Health Part D Premier - AL_TN		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	016	0		29	10	S5768_016_0	3	1		06/02/2011	2012.02	06/02/2011 09:34:35 PM Eastern Daylight Time		07/18/2011 01:57:37 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier (PDP)	10	29					S5768	016	0	2012	First Health Part D Premier - Michigan		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	017	0		29	10	S5768_017_0	2	1		06/02/2011	2012.02	06/02/2011 09:34:55 PM Eastern Daylight Time		07/18/2011 02:09:09 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier (PDP)	10	29					S5768	017	0	2012	First Health Part D Premier - Ohio		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	018	0		29	10	S5768_018_0	3	1		06/02/2011	2012.02	06/02/2011 09:35:16 PM Eastern Daylight Time		07/18/2011 02:21:18 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier (PDP)	10	29					S5768	018	0	2012	First Health Part D Premier - IN_KY		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	021	0		29	10	S5768_021_0	2	1		06/02/2011	2012.02	06/02/2011 09:36:30 PM Eastern Daylight Time		07/18/2011 02:52:37 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier (PDP)	10	29					S5768	021	0	2012	First Health Part D Premier - Missouri		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	031	0		29	10	S5768_031_0	3	1		06/02/2011	2012.02	06/02/2011 09:49:42 PM Eastern Daylight Time		07/18/2011 02:36:11 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier (PDP)	10	29					S5768	031	0	2012	First Health Part D Premier - Nevada		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	038	0		29	10	S5768_038_0	3	1		06/02/2011	2012.02	06/02/2011 09:28:56 PM Eastern Daylight Time		07/18/2011 12:35:18 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier (PDP)	10	29					S5768	038	0	2012	First Health Part D Premier - Central New England		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	039	0		29	10	S5768_039_0	2	1		06/02/2011	2012.02	06/02/2011 09:32:31 PM Eastern Daylight Time		07/18/2011 12:20:26 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier (PDP)	10	29					S5768	039	0	2012	First Health Part D Premier - North Carolina		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	040	0		29	10	S5768_040_0	3	1		06/02/2011	2012.02	06/02/2011 09:33:27 PM Eastern Daylight Time		07/18/2011 01:24:06 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier (PDP)	10	29					S5768	040	0	2012	First Health Part D Premier - Georgia		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	041	0		29	10	S5768_041_0	2	1		06/02/2011	2012.02	06/02/2011 09:33:51 PM Eastern Daylight Time		07/18/2011 01:33:55 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier (PDP)	10	29					S5768	041	0	2012	First Health Part D Premier - Florida		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	042	0		29	10	S5768_042_0	2	1		06/02/2011	2012.02	06/02/2011 09:36:03 PM Eastern Daylight Time		07/18/2011 02:42:16 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier (PDP)	10	29					S5768	042	0	2012	First Health Part D Premier - Illinois		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	043	0		29	10	S5768_043_0	2	1		06/02/2011	2012.02	06/02/2011 09:36:51 PM Eastern Daylight Time		07/18/2011 03:04:53 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier (PDP)	10	29					S5768	043	0	2012	First Health Part D Premier -  Arkansas		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	044	0		29	10	S5768_044_0	2	1		06/02/2011	2012.02	06/02/2011 09:37:41 PM Eastern Daylight Time		07/18/2011 01:04:50 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier (PDP)	10	29					S5768	044	0	2012	First Health Part D Premier - Louisiana		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	045	0		29	10	S5768_045_0	3	1		06/02/2011	2012.02	06/02/2011 09:38:05 PM Eastern Daylight Time		07/18/2011 01:13:36 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier (PDP)	10	29					S5768	045	0	2012	First Health Part D Premier - Texas		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	046	0		29	10	S5768_046_0	2	1		06/02/2011	2012.02	06/02/2011 09:38:32 PM Eastern Daylight Time		07/18/2011 01:21:27 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier (PDP)	10	29					S5768	046	0	2012	First Health Part D Premier - Oklahoma		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	047	0		29	10	S5768_047_0	2	1		06/02/2011	2012.02	06/02/2011 09:38:52 PM Eastern Daylight Time		07/18/2011 01:37:08 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier (PDP)	10	29					S5768	047	0	2012	First Health Part D Premier - Kansas		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	048	0		29	10	S5768_048_0	2	1		06/02/2011	2012.02	06/02/2011 09:39:32 PM Eastern Daylight Time		07/18/2011 01:59:55 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier (PDP)	10	29					S5768	048	0	2012	First Health Part D Premier - New Mexico		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	082	0		29	10	S5768_082_0	3	1		06/02/2011	2012.02	06/02/2011 09:51:46 PM Eastern Daylight Time		07/18/2011 03:15:09 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier (PDP)	10	29					S5768	082	0	2012	First Health Part D Premier - CA		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	083	0		29	10	S5768_083_0	2	1		06/02/2011	2012.02	06/02/2011 09:35:40 PM Eastern Daylight Time		07/18/2011 02:32:00 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier (PDP)	10	29					S5768	083	0	2012	First Health Part D Premier - Wisconsin		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	117	0		29	10	S5768_117_0	2	1		06/02/2011	2012.02	06/02/2011 09:53:03 PM Eastern Daylight Time		07/18/2011 03:25:50 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier (PDP)	10	29					S5768	117	0	2012	First Health Part D Premier - Alaska		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	118	0		29	10	S5768_118_0	2	1		06/02/2011	2012.02	06/02/2011 09:50:58 PM Eastern Daylight Time		07/18/2011 03:04:34 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier (PDP)	10	29					S5768	118	0	2012	First Health Part D Premier - Idaho_Utah		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	119	0		29	10	S5768_119_0	2	1		06/02/2011	2012.02	06/02/2011 09:48:40 PM Eastern Daylight Time		07/18/2011 02:07:18 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier (PDP)	10	29					S5768	119	0	2012	First Health Part D Premier - Colorado		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	120	0		29	10	S5768_120_0	2	1		06/02/2011	2012.02	06/02/2011 09:37:18 PM Eastern Daylight Time		07/18/2011 12:50:25 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier (PDP)	10	29					S5768	120	0	2012	First Health Part D Premier - Mississippi		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	121	0		29	10	S5768_121_0	2	1		06/02/2011	2012.02	06/02/2011 09:49:08 PM Eastern Daylight Time		07/18/2011 02:21:27 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier (PDP)	10	29					S5768	121	0	2012	First Health Part D Premier - Arizona		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	122	0		29	10	S5768_122_0	2	1		06/02/2011	2012.02	06/02/2011 09:39:12 PM Eastern Daylight Time		07/18/2011 01:47:41 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier (PDP)	10	29					S5768	122	0	2012	First Health Part D Premier - Up MW and No Plains		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	123	0		29	10	S5768_123_0	2	1		06/02/2011	2012.02	06/02/2011 09:50:18 PM Eastern Daylight Time		07/18/2011 02:53:07 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier (PDP)	10	29					S5768	123	0	2012	First Health Part D Premier - OR_WA		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	124	0		29	10	S5768_124_0	2	1		06/02/2011	2012.02	06/02/2011 09:52:19 PM Eastern Daylight Time		07/18/2011 03:44:01 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Premier (PDP)	10	29					S5768	124	0	2012	First Health Part D Premier - Hawaii		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	125	0		29	10	S5768_125_0	2	1		06/02/2011	2012.02	06/02/2011 05:45:03 PM Eastern Daylight Time		07/15/2011 02:39:01 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	125	0	2012	First Health Part D Value Plus - ME_NH		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	126	0		29	10	S5768_126_0	2	1		06/02/2011	2012.02	06/02/2011 05:52:02 PM Eastern Daylight Time		07/18/2011 07:35:32 AM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	126	0	2012	First Health Part D Value Plus - Central New Engla		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	127	0		29	10	S5768_127_0	2	1		06/02/2011	2012.02	06/02/2011 05:56:36 PM Eastern Daylight Time		07/18/2011 08:48:42 AM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	127	0	2012	First Health Part D Value Plus - NJ		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	128	0		29	10	S5768_128_0	2	1		06/02/2011	2012.02	06/02/2011 06:14:10 PM Eastern Daylight Time		07/18/2011 07:48:08 AM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	128	0	2012	First Health Part D Value Plus - Mid Atlantic		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	129	0		29	10	S5768_129_0	2	1		06/02/2011	2012.02	06/02/2011 06:15:37 PM Eastern Daylight Time		07/18/2011 09:38:37 AM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	129	0	2012	First Health Part D Value Plus - PA_WV		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	130	0		29	10	S5768_130_0	2	1		06/02/2011	2012.02	06/02/2011 06:17:27 PM Eastern Daylight Time		07/18/2011 09:51:06 AM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	130	0	2012	First Health Part D Value Plus - Virginia		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	131	0		29	10	S5768_131_0	2	1		06/02/2011	2012.02	06/02/2011 06:18:58 PM Eastern Daylight Time		07/18/2011 10:05:11 AM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	131	0	2012	First Health Part D Value Plus - North Carolina		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	132	0		29	10	S5768_132_0	2	1		06/02/2011	2012.02	06/02/2011 06:19:42 PM Eastern Daylight Time		07/18/2011 10:18:09 AM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	132	0	2012	First Health Part D Value Plus - South Carolina		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	133	0		29	10	S5768_133_0	3	1		07/15/2011	2012.02	07/15/2011 06:38:11 AM Eastern Daylight Time		07/19/2011 12:05:44 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	133	0	2012	First Health Part D Value Plus - Georgia		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	134	0		29	10	S5768_134_0	2	1		06/02/2011	2012.02	06/02/2011 06:21:50 PM Eastern Daylight Time		07/18/2011 08:00:26 AM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	134	0	2012	First Health Part D Value Plus - Florida		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	135	0		29	10	S5768_135_0	3	1		07/15/2011	2012.02	07/15/2011 06:40:22 AM Eastern Daylight Time		07/19/2011 12:17:50 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	135	0	2012	First Health Part D Value Plus - AL_TN		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	136	0		29	10	S5768_136_0	2	1		06/02/2011	2012.02	06/02/2011 06:23:46 PM Eastern Daylight Time		07/15/2011 03:47:27 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	136	0	2012	First Health Part D Value Plus - Michigan		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	137	0		29	10	S5768_137_0	2	1		06/03/2011	2012.02	06/03/2011 05:11:38 PM Eastern Daylight Time		07/15/2011 03:54:48 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	137	0	2012	First Health Part D Value Plus - Ohio		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	138	0		29	10	S5768_138_0	2	1		06/03/2011	2012.02	06/03/2011 05:11:57 PM Eastern Daylight Time		07/15/2011 04:00:40 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	138	0	2012	First Health Part D Value Plus - IN_KY		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	139	0		29	10	S5768_139_0	2	1		06/03/2011	2012.02	06/03/2011 05:14:06 PM Eastern Daylight Time		07/15/2011 04:07:43 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	139	0	2012	First Health Part D Value Plus - Wisconsin		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	140	0		29	10	S5768_140_0	2	1		06/02/2011	2012.02	06/02/2011 06:26:40 PM Eastern Daylight Time		07/15/2011 04:13:09 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	140	0	2012	First Health Part D Value Plus - Illinois		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	141	0		29	10	S5768_141_0	2	1		06/02/2011	2012.02	06/02/2011 06:27:24 PM Eastern Daylight Time		07/15/2011 04:18:59 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	141	0	2012	First Health Part D Value Plus - Missouri		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	142	0		29	10	S5768_142_0	2	1		06/02/2011	2012.02	06/02/2011 06:27:51 PM Eastern Daylight Time		07/15/2011 04:25:24 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	142	0	2012	First Health Part D Value Plus - Arkansas		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	143	0		29	10	S5768_143_0	2	1		06/02/2011	2012.02	06/02/2011 06:28:30 PM Eastern Daylight Time		07/15/2011 04:31:13 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	143	0	2012	First Health Part D Value Plus - Mississippi		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	144	0		29	10	S5768_144_0	2	1		06/02/2011	2012.02	06/02/2011 06:28:49 PM Eastern Daylight Time		07/15/2011 04:37:13 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	144	0	2012	First Health Part D Value Plus - Louisiana		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	145	0		29	10	S5768_145_0	2	1		06/02/2011	2012.02	06/02/2011 06:29:09 PM Eastern Daylight Time		07/15/2011 04:43:14 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	145	0	2012	First Health Part D Value Plus - Texas		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	146	0		29	10	S5768_146_0	2	1		06/02/2011	2012.02	06/02/2011 06:29:32 PM Eastern Daylight Time		07/15/2011 04:48:56 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	146	0	2012	First Health Part D Value Plus - Oklahoma		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	147	0		29	10	S5768_147_0	2	1		06/02/2011	2012.02	06/02/2011 06:30:01 PM Eastern Daylight Time		07/15/2011 04:54:34 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	147	0	2012	First Health Part D Value Plus - Kansas		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	148	0		29	10	S5768_148_0	2	1		06/02/2011	2012.02	06/02/2011 06:30:32 PM Eastern Daylight Time		07/15/2011 05:00:23 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	148	0	2012	First Health Part D Value Plus - UpMidW_NoPlains		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	149	0		29	10	S5768_149_0	2	1		06/02/2011	2012.02	06/02/2011 06:30:58 PM Eastern Daylight Time		07/18/2011 07:23:41 AM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	149	0	2012	First Health Part D Value Plus - New Mexico		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	150	0		29	10	S5768_150_0	2	1		06/02/2011	2012.02	06/02/2011 06:31:27 PM Eastern Daylight Time		07/18/2011 08:12:22 AM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	150	0	2012	First Health Part D Value Plus - Colorado		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	151	0		29	10	S5768_151_0	3	1		07/15/2011	2012.02	07/15/2011 06:42:08 AM Eastern Daylight Time		07/19/2011 12:25:54 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	151	0	2012	First Health Part D Value Plus - Arizona		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	152	0		29	10	S5768_152_0	3	1		07/15/2011	2012.02	07/15/2011 06:43:36 AM Eastern Daylight Time		07/19/2011 12:32:34 PM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	152	0	2012	First Health Part D Value Plus - Nevada		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	153	0		29	10	S5768_153_0	2	1		06/02/2011	2012.02	06/02/2011 06:33:24 PM Eastern Daylight Time		07/18/2011 09:25:55 AM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	153	0	2012	First Health Part D Value Plus - OR_WA		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	154	0		29	10	S5768_154_0	2	1		06/02/2011	2012.02	06/02/2011 06:33:55 PM Eastern Daylight Time		07/18/2011 10:31:02 AM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	154	0	2012	First Health Part D Value Plus - Idaho_Utah		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5768	155	0		29	10	S5768_155_0	2	1		06/02/2011	2012.02	06/02/2011 06:34:37 PM Eastern Daylight Time		07/18/2011 10:58:03 AM Eastern Daylight Time		07/20/2011 03:37:04 PM Eastern Daylight Time	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	First Health Part D	http://www.FirstHealthPartD.com	First Health Part D Value Plus (PDP)	10	29					S5768	155	0	2012	First Health Part D Value Plus - California		2					2							http://www.FHDFormulary.coventry-medicare.com	http://www.FHDPharmacy.coventry-medicare.com									(866)-865-0662		(866)-865-0662		(800)-882-3822		(800)-882-3822										(711)		(711)		(711)		(711)				
S5775	001	0		29	10	S5775_001_0	3	1		06/03/2011	2012.02	06/03/2011 04:33:42 PM SA Western Standard Time		07/22/2011 06:33:05 PM SA Western Standard Time		07/22/2011 06:46:01 PM SA Western Standard Time	PHARMACY INSURANCE CORPORATION OF AMERICA	PICA	www.picapr.com	PICA Primero (PDP)	10	29					S5775	001	0	2012	Commonwealth of Puerto Rico		2					2							www.picapr.com	www.picapr.com									(866)-990-7422		(787)-625-4343		(866)-990-7422		(787)-625-4343										(866)-992-7422		(866)-992-7422		(866)-992-7422		(866)-992-7422				
S5775	002	0		29	10	S5775_002_0	2	1		06/03/2011	2012.02	06/03/2011 04:37:20 PM SA Western Standard Time		06/03/2011 06:28:46 PM SA Western Standard Time		06/03/2011 07:52:20 PM SA Western Standard Time	PHARMACY INSURANCE CORPORATION OF AMERICA	PICA	www.picapr.com	PICA Alante (PDP)	10	29					S5775	002	0	2012	Commonwealth of Puerto Rico		2					2							www.picapr.com	www.picapr.com									(866)-990-7422		(787)-625-4343		(866)-990-7422		(787)-625-4343										(866)-992-7422		(866)-992-7422		(866)-992-7422		(866)-992-7422				
S5775	801	0		29	10	S5775_801_0	2	1		06/03/2011	2012.02	06/03/2011 04:19:31 PM SA Western Standard Time				06/03/2011 07:52:20 PM SA Western Standard Time	PHARMACY INSURANCE CORPORATION OF AMERICA	PICA	www.picapr.com	PICA- Employer (PDP)	10	29					S5775	801	0	2012	Commonwealth of Puerto Rico		1					2							www.picapr.com	www.picapr.com									(866)-990-7422		(787)-625-4343		(866)-990-7422		(787)-625-4343										(866)-992-7422		(866)-992-7422		(866)-992-7422		(866)-992-7422				
S5775	802	0		29	10	S5775_802_0	2	1		06/03/2011	2012.02	06/03/2011 04:22:58 PM SA Western Standard Time				06/03/2011 07:52:20 PM SA Western Standard Time	PHARMACY INSURANCE CORPORATION OF AMERICA	PICA	www.picapr.com	PICA Employer Non Calendar (PDP)	10	29					S5775	802	0	2012	Commonwealth of Puerto Rico		1					2							www.picapr.com	www.picapr.com									(866)-990-7422		(787)-625-4343		(866)-990-7422		(787)-625-4343										(866)-992-7422		(866)-992-7422		(866)-992-7422		(866)-992-7422				
S5795	002	0		29	10	S5795_002_0	2	1		06/02/2011	2012.02	06/02/2011 03:34:09 PM Central Daylight Time		06/02/2011 03:55:54 PM Central Daylight Time		06/02/2011 04:33:06 PM Central Daylight Time	USABLE MUTUAL INSURANCE COMPANY	ARKANSAS BLUE CROSS AND BLUE SHIELD	www.arkansasbluecross.com	AR Blue Cross - Medi-Pak Rx Premier (PDP)	10	29					S5795	002	0	2012	State of Arkansas		2					2							http://www.arkansasbluecross.com	http://www.arkansasbluecross.com									(866)-390-3369		(866)-390-3369		(888)-242-5017		(888)-242-5017										(888)-844-5530		(888)-844-5530		(800)-370-5869		(800)-370-5869				
S5795	003	0		29	10	S5795_003_0	2	1		05/24/2011	2012.02	05/24/2011 12:33:22 PM Central Daylight Time		06/02/2011 03:53:53 PM Central Daylight Time		06/02/2011 04:33:06 PM Central Daylight Time	USABLE MUTUAL INSURANCE COMPANY	ARKANSAS BLUE CROSS AND BLUE SHIELD	www.arkansasbluecross.com	AR Blue Cross - Medi-Pak Rx Basic (PDP)	10	29					S5795	003	0	2012	State of Arkansas		2					2							http://www.arkansasbluecross.com	http://www.arkansasbluecross.com									(866)-390-3369		(866)-390-3369		(888)-242-5017		(888)-242-5017										(888)-844-5530		(888)-844-5530		(800)-370-5869		(800)-370-5869				
S5795	804	0		29	10	S5795_804_0	2	1		04/19/2011	2012.02	04/19/2011 03:55:48 PM Central Daylight Time				05/31/2011 05:01:18 PM Central Daylight Time	USABLE MUTUAL INSURANCE COMPANY	ARKANSAS BLUE CROSS AND BLUE SHIELD	www.arkansasbluecross.com	Arkansas BCBS Std Def Employer CY 4 (PDP)	10	29					S5795	804	0	2012	Employer Group Plan		1					2							http://www.arkansasbluecross.com	http://www.arkansasbluecross.com									(866)-390-3369		(866)-390-3369		(888)-242-5017		(888)-242-5017										(888)-844-5530		(888)-844-5530		(800)-370-5869		(800)-370-5869				
S5795	809	0		29	10	S5795_809_0	2	1		04/19/2011	2012.02	04/19/2011 03:55:58 PM Central Daylight Time				05/31/2011 05:01:18 PM Central Daylight Time	USABLE MUTUAL INSURANCE COMPANY	ARKANSAS BLUE CROSS AND BLUE SHIELD	www.arkansasbluecross.com	Arkansas BCBS Std Def Employer NCY 4 (PDP)	10	29					S5795	809	0	2012	Employer Group Plan		1					2							http://www.arkansasbluecross.com	http://www.arkansasbluecross.com									(866)-390-3369		(866)-390-3369		(888)-242-5017		(888)-242-5017										(888)-844-5530		(888)-844-5530		(800)-370-5869		(800)-370-5869				
S5795	811	0		29	10	S5795_811_0	2	1		04/19/2011	2012.02	04/19/2011 03:56:06 PM Central Daylight Time				05/31/2011 05:01:18 PM Central Daylight Time	USABLE MUTUAL INSURANCE COMPANY	ARKANSAS BLUE CROSS AND BLUE SHIELD	www.arkansasbluecross.com	ABCBS Group Basic CY (PDP)	10	29					S5795	811	0	2012	Employer Group Plan		1					2							http://www.arkansasbluecross.com	http://www.arkansasbluecross.com									(866)-390-3369		(866)-390-3369		(888)-242-5017		(888)-242-5017										(888)-844-5530		(888)-844-5530		(800)-370-5869		(800)-370-5869				
S5795	812	0		29	10	S5795_812_0	2	1		04/19/2011	2012.02	04/19/2011 03:56:14 PM Central Daylight Time				05/31/2011 05:01:18 PM Central Daylight Time	USABLE MUTUAL INSURANCE COMPANY	ARKANSAS BLUE CROSS AND BLUE SHIELD	www.arkansasbluecross.com	ABCBS Group Basic PY (PDP)	10	29					S5795	812	0	2012	Employer Group Plan		1					2							http://www.arkansasbluecross.com	http://www.arkansasbluecross.com									(866)-390-3369		(866)-390-3369		(888)-242-5017		(888)-242-5017										(888)-844-5530		(888)-844-5530		(800)-370-5869		(800)-370-5869				
S5803	070	0		29	10	S5803_070_0	1	1		06/02/2011	2012.02	06/02/2011 09:50:41 AM Eastern Daylight Time		06/02/2011 02:25:45 PM Eastern Daylight Time		06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	070	0	2012	State of New Hampshire and State of Maine		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	071	0		29	10	S5803_071_0	2	1		06/02/2011	2012.02	06/02/2011 09:52:25 AM Eastern Daylight Time		06/02/2011 02:49:21 PM Eastern Daylight Time		06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	071	0	2012	States of CT, MA, RI, VT		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	073	0		29	10	S5803_073_0	1	1		06/02/2011	2012.02	06/02/2011 09:54:18 AM Eastern Daylight Time		06/02/2011 02:48:48 PM Eastern Daylight Time		06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	073	0	2012	State of New Jersey		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	074	0		29	10	S5803_074_0	1	1		06/02/2011	2012.02	06/02/2011 09:54:48 AM Eastern Daylight Time		06/02/2011 02:48:11 PM Eastern Daylight Time		06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	074	0	2012	States of Delaware, District of Columbia, Maryland		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	075	0		29	10	S5803_075_0	1	1		06/02/2011	2012.02	06/02/2011 09:55:18 AM Eastern Daylight Time		06/02/2011 02:49:53 PM Eastern Daylight Time		06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	075	0	2012	States of Pennsylvania and State of West Virginia		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	076	0		29	10	S5803_076_0	1	1		06/02/2011	2012.02	06/02/2011 09:55:40 AM Eastern Daylight Time		06/02/2011 02:55:03 PM Eastern Daylight Time		06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	076	0	2012	State of Virginia		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	077	0		29	10	S5803_077_0	1	1		06/02/2011	2012.02	06/02/2011 09:55:59 AM Eastern Daylight Time		06/02/2011 02:54:26 PM Eastern Daylight Time		06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	077	0	2012	State of North Carolina		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	078	0		29	10	S5803_078_0	1	1		06/02/2011	2012.02	06/02/2011 09:56:19 AM Eastern Daylight Time		06/02/2011 02:53:54 PM Eastern Daylight Time		06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	078	0	2012	State of South Carolina		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	079	0		29	10	S5803_079_0	1	1		06/02/2011	2012.02	06/02/2011 09:56:42 AM Eastern Daylight Time		06/02/2011 02:53:20 PM Eastern Daylight Time		06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	079	0	2012	State of Georgia		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	080	0		29	10	S5803_080_0	1	1		06/02/2011	2012.02	06/02/2011 09:56:58 AM Eastern Daylight Time		06/02/2011 02:52:46 PM Eastern Daylight Time		06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	080	0	2012	State of Florida		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	081	0		29	10	S5803_081_0	1	1		06/02/2011	2012.02	06/02/2011 09:57:14 AM Eastern Daylight Time		06/02/2011 02:52:05 PM Eastern Daylight Time		06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	081	0	2012	State of Alabama and State of Tennessee		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	082	0		29	10	S5803_082_0	1	1		06/02/2011	2012.02	06/02/2011 09:57:28 AM Eastern Daylight Time		06/02/2011 02:51:28 PM Eastern Daylight Time		06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	082	0	2012	State of Michigan		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	083	0		29	10	S5803_083_0	1	1		06/02/2011	2012.02	06/02/2011 09:57:42 AM Eastern Daylight Time		06/02/2011 02:50:49 PM Eastern Daylight Time		06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	083	0	2012	State of Ohio		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	084	0		29	10	S5803_084_0	1	1		06/02/2011	2012.02	06/02/2011 09:57:57 AM Eastern Daylight Time		06/02/2011 02:55:34 PM Eastern Daylight Time		06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	084	0	2012	State of Indiana and State of Kentucky		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	085	0		29	10	S5803_085_0	1	1		06/02/2011	2012.02	06/02/2011 09:58:13 AM Eastern Daylight Time		06/02/2011 02:57:59 PM Eastern Daylight Time		06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	085	0	2012	State of Wisconsin		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	086	0		29	10	S5803_086_0	1	1		06/02/2011	2012.02	06/02/2011 09:58:31 AM Eastern Daylight Time		06/02/2011 03:06:08 PM Eastern Daylight Time		06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	086	0	2012	State of Illinois		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	087	0		29	10	S5803_087_0	1	1		06/02/2011	2012.02	06/02/2011 09:58:46 AM Eastern Daylight Time		06/02/2011 03:09:23 PM Eastern Daylight Time		06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	087	0	2012	State of Missouri		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	088	0		29	10	S5803_088_0	1	1		06/02/2011	2012.02	06/02/2011 09:59:01 AM Eastern Daylight Time		06/02/2011 03:08:50 PM Eastern Daylight Time		06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	088	0	2012	State of Arkansas		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	089	0		29	10	S5803_089_0	1	1		06/02/2011	2012.02	06/02/2011 09:59:18 AM Eastern Daylight Time		06/02/2011 03:07:52 PM Eastern Daylight Time		06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	089	0	2012	State of Mississippi		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	090	0		29	10	S5803_090_0	1	1		06/02/2011	2012.02	06/02/2011 09:59:36 AM Eastern Daylight Time		06/02/2011 03:05:37 PM Eastern Daylight Time		06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	090	0	2012	State of Louisiana		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	091	0		29	10	S5803_091_0	1	1		06/02/2011	2012.02	06/02/2011 09:59:51 AM Eastern Daylight Time		06/02/2011 03:05:07 PM Eastern Daylight Time		06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	091	0	2012	State of Texas		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	092	0		29	10	S5803_092_0	1	1		06/02/2011	2012.02	06/02/2011 10:00:14 AM Eastern Daylight Time		06/02/2011 03:04:36 PM Eastern Daylight Time		06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	092	0	2012	State of Oklahoma		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	093	0		29	10	S5803_093_0	1	1		06/02/2011	2012.02	06/02/2011 10:00:33 AM Eastern Daylight Time		06/02/2011 03:04:01 PM Eastern Daylight Time		06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	093	0	2012	State of Kansas		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	094	0		29	10	S5803_094_0	1	1		06/02/2011	2012.02	06/02/2011 10:00:49 AM Eastern Daylight Time		06/02/2011 03:03:32 PM Eastern Daylight Time		06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	094	0	2012	States of IA, MN, MT, NE, ND, SD, WY		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	095	0		29	10	S5803_095_0	1	1		06/02/2011	2012.02	06/02/2011 10:01:07 AM Eastern Daylight Time		06/02/2011 03:03:00 PM Eastern Daylight Time		06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	095	0	2012	State of New Mexico		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	096	0		29	10	S5803_096_0	1	1		06/02/2011	2012.02	06/02/2011 10:01:22 AM Eastern Daylight Time		06/02/2011 03:02:08 PM Eastern Daylight Time		06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	096	0	2012	State of Colorado		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	097	0		29	10	S5803_097_0	1	1		06/02/2011	2012.02	06/02/2011 10:01:39 AM Eastern Daylight Time		06/02/2011 03:01:41 PM Eastern Daylight Time		06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	097	0	2012	State of Arizona		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	098	0		29	10	S5803_098_0	1	1		06/02/2011	2012.02	06/02/2011 10:01:56 AM Eastern Daylight Time		06/02/2011 03:01:10 PM Eastern Daylight Time		06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	098	0	2012	State of Nevada		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	099	0		29	10	S5803_099_0	1	1		06/02/2011	2012.02	06/02/2011 10:02:13 AM Eastern Daylight Time		06/02/2011 03:00:37 PM Eastern Daylight Time		06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	099	0	2012	State of Oregon and State of Washington		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	100	0		29	10	S5803_100_0	1	1		06/02/2011	2012.02	06/02/2011 10:02:32 AM Eastern Daylight Time		06/02/2011 03:00:08 PM Eastern Daylight Time		06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	100	0	2012	State of Idaho and State of Utah		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	101	0		29	10	S5803_101_0	1	1		06/02/2011	2012.02	06/02/2011 10:02:45 AM Eastern Daylight Time		06/02/2011 02:59:40 PM Eastern Daylight Time		06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	101	0	2012	State of California		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	102	0		29	10	S5803_102_0	1	1		06/02/2011	2012.02	06/02/2011 10:02:59 AM Eastern Daylight Time		06/02/2011 01:54:52 PM Eastern Daylight Time		06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	102	0	2012	State of Hawaii		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	103	0		29	10	S5803_103_0	1	1		06/02/2011	2012.02	06/02/2011 10:03:13 AM Eastern Daylight Time		06/02/2011 02:59:06 PM Eastern Daylight Time		06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	103	0	2012	State of Alaska		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	138	0		29	10	S5803_138_0	3	1		06/02/2011	2012.02	06/02/2011 09:46:51 AM Eastern Daylight Time		06/02/2011 02:00:23 PM Eastern Daylight Time		06/03/2011 04:31:09 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5803	138	0	2012	State of New Hampshire and State of Maine		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	139	0		29	10	S5803_139_0	1	1		06/02/2011	2012.02	06/02/2011 09:47:26 AM Eastern Daylight Time		06/02/2011 03:37:03 PM Eastern Daylight Time		06/03/2011 04:31:09 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5803	139	0	2012	States of CT, MA, RI, VT		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	141	0		29	10	S5803_141_0	1	1		06/02/2011	2012.02	06/02/2011 09:47:28 AM Eastern Daylight Time		06/02/2011 03:35:57 PM Eastern Daylight Time		06/03/2011 04:31:09 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5803	141	0	2012	State of New Jersey		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	142	0		29	10	S5803_142_0	1	1		06/02/2011	2012.02	06/02/2011 09:47:30 AM Eastern Daylight Time		06/02/2011 03:35:24 PM Eastern Daylight Time		06/03/2011 04:31:09 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5803	142	0	2012	States of Delaware, District of Columbia, Maryland		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	143	0		29	10	S5803_143_0	1	1		06/02/2011	2012.02	06/02/2011 09:47:31 AM Eastern Daylight Time		06/02/2011 03:34:48 PM Eastern Daylight Time		06/03/2011 04:31:09 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5803	143	0	2012	State of Pennsylvania and State of West Virginia		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	144	0		29	10	S5803_144_0	1	1		06/02/2011	2012.02	06/02/2011 09:47:32 AM Eastern Daylight Time		06/02/2011 03:34:16 PM Eastern Daylight Time		06/03/2011 04:31:09 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5803	144	0	2012	State of Virginia		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	145	0		29	10	S5803_145_0	1	1		06/02/2011	2012.02	06/02/2011 09:47:34 AM Eastern Daylight Time		06/02/2011 03:33:47 PM Eastern Daylight Time		06/03/2011 04:31:09 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5803	145	0	2012	State of North Carolina		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	146	0		29	10	S5803_146_0	1	1		06/02/2011	2012.02	06/02/2011 09:47:36 AM Eastern Daylight Time		06/02/2011 03:32:52 PM Eastern Daylight Time		06/03/2011 04:31:09 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5803	146	0	2012	State of South Carolina		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	147	0		29	10	S5803_147_0	1	1		06/02/2011	2012.02	06/02/2011 09:47:37 AM Eastern Daylight Time		06/02/2011 03:32:08 PM Eastern Daylight Time		06/03/2011 04:31:09 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5803	147	0	2012	State of Georgia		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	148	0		29	10	S5803_148_0	1	1		06/02/2011	2012.02	06/02/2011 09:47:40 AM Eastern Daylight Time		06/02/2011 03:24:28 PM Eastern Daylight Time		06/03/2011 04:31:09 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5803	148	0	2012	State of Florida		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	149	0		29	10	S5803_149_0	1	1		06/02/2011	2012.02	06/02/2011 09:47:42 AM Eastern Daylight Time		06/02/2011 03:31:39 PM Eastern Daylight Time		06/03/2011 04:31:09 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5803	149	0	2012	State of Alabama and State of Tennessee		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	150	0		29	10	S5803_150_0	1	1		06/02/2011	2012.02	06/02/2011 09:47:44 AM Eastern Daylight Time		06/02/2011 03:31:10 PM Eastern Daylight Time		06/03/2011 04:31:09 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5803	150	0	2012	State of Michigan		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	151	0		29	10	S5803_151_0	1	1		06/02/2011	2012.02	06/02/2011 09:47:46 AM Eastern Daylight Time		06/02/2011 03:30:41 PM Eastern Daylight Time		06/03/2011 04:31:09 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5803	151	0	2012	State of Ohio		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	152	0		29	10	S5803_152_0	1	1		06/02/2011	2012.02	06/02/2011 09:47:48 AM Eastern Daylight Time		06/02/2011 03:30:09 PM Eastern Daylight Time		06/03/2011 04:31:09 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5803	152	0	2012	State of Indiana and State of Kentucky		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	153	0		29	10	S5803_153_0	1	1		06/02/2011	2012.02	06/02/2011 09:47:50 AM Eastern Daylight Time		06/02/2011 03:29:37 PM Eastern Daylight Time		06/03/2011 04:31:09 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5803	153	0	2012	State of Wisconsin		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	154	0		29	10	S5803_154_0	1	1		06/02/2011	2012.02	06/02/2011 09:47:52 AM Eastern Daylight Time		06/02/2011 03:29:04 PM Eastern Daylight Time		06/03/2011 04:31:09 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5803	154	0	2012	State of Illinois		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	155	0		29	10	S5803_155_0	1	1		06/02/2011	2012.02	06/02/2011 09:47:54 AM Eastern Daylight Time		06/02/2011 03:28:33 PM Eastern Daylight Time		06/03/2011 04:31:09 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5803	155	0	2012	State of Missouri		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	156	0		29	10	S5803_156_0	1	1		06/02/2011	2012.02	06/02/2011 09:47:56 AM Eastern Daylight Time		06/03/2011 01:27:54 PM Eastern Daylight Time		06/03/2011 04:31:09 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5803	156	0	2012	State of Arkansas		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	157	0		29	10	S5803_157_0	1	1		06/02/2011	2012.02	06/02/2011 09:47:58 AM Eastern Daylight Time		06/02/2011 03:27:56 PM Eastern Daylight Time		06/03/2011 04:31:09 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5803	157	0	2012	State of Mississippi		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	158	0		29	10	S5803_158_0	1	1		06/02/2011	2012.02	06/02/2011 09:48:00 AM Eastern Daylight Time		06/03/2011 01:29:13 PM Eastern Daylight Time		06/03/2011 04:31:09 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5803	158	0	2012	State of Louisiana		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	159	0		29	10	S5803_159_0	1	1		06/02/2011	2012.02	06/02/2011 09:48:02 AM Eastern Daylight Time		06/02/2011 03:27:25 PM Eastern Daylight Time		06/03/2011 04:31:09 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5803	159	0	2012	State of Texas		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	160	0		29	10	S5803_160_0	1	1		06/02/2011	2012.02	06/02/2011 09:48:04 AM Eastern Daylight Time		06/03/2011 01:31:29 PM Eastern Daylight Time		06/03/2011 04:31:09 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5803	160	0	2012	State of Oklahoma		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	161	0		29	10	S5803_161_0	1	1		06/02/2011	2012.02	06/02/2011 09:48:06 AM Eastern Daylight Time		06/02/2011 03:26:53 PM Eastern Daylight Time		06/03/2011 04:31:09 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5803	161	0	2012	State of Kansas		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	162	0		29	10	S5803_162_0	1	1		06/02/2011	2012.02	06/02/2011 09:48:08 AM Eastern Daylight Time		06/02/2011 03:26:22 PM Eastern Daylight Time		06/03/2011 04:31:09 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5803	162	0	2012	States of IA, MN, MT, NE, ND, SD, WY		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	163	0		29	10	S5803_163_0	1	1		06/02/2011	2012.02	06/02/2011 09:48:09 AM Eastern Daylight Time		06/02/2011 03:25:49 PM Eastern Daylight Time		06/03/2011 04:31:09 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5803	163	0	2012	State of New Mexico		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	164	0		29	10	S5803_164_0	1	1		06/02/2011	2012.02	06/02/2011 09:48:11 AM Eastern Daylight Time		06/02/2011 03:25:10 PM Eastern Daylight Time		06/03/2011 04:31:09 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5803	164	0	2012	State of Colorado		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	165	0		29	10	S5803_165_0	1	1		06/02/2011	2012.02	06/02/2011 09:48:12 AM Eastern Daylight Time		06/02/2011 03:37:36 PM Eastern Daylight Time		06/03/2011 04:31:09 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5803	165	0	2012	State of Arizona		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	166	0		29	10	S5803_166_0	1	1		06/02/2011	2012.02	06/02/2011 09:48:14 AM Eastern Daylight Time		06/02/2011 02:05:05 PM Eastern Daylight Time		06/03/2011 04:31:09 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5803	166	0	2012	State of Nevada		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	167	0		29	10	S5803_167_0	1	1		06/02/2011	2012.02	06/02/2011 09:48:15 AM Eastern Daylight Time		06/02/2011 03:17:03 PM Eastern Daylight Time		06/03/2011 04:31:09 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5803	167	0	2012	State of Oregon and State of Washington		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	168	0		29	10	S5803_168_0	1	1		06/02/2011	2012.02	06/02/2011 09:48:16 AM Eastern Daylight Time		06/02/2011 03:15:41 PM Eastern Daylight Time		06/03/2011 04:31:09 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5803	168	0	2012	State of Idaho and State of Utah		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	169	0		29	10	S5803_169_0	1	1		06/02/2011	2012.02	06/02/2011 09:48:18 AM Eastern Daylight Time		06/02/2011 03:21:22 PM Eastern Daylight Time		06/03/2011 04:31:09 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5803	169	0	2012	State of California		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	170	0		29	10	S5803_170_0	2	1		06/02/2011	2012.02	06/02/2011 09:48:20 AM Eastern Daylight Time		07/15/2011 08:40:21 AM Eastern Daylight Time		07/20/2011 02:48:22 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5803	170	0	2012	State of Hawaii		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	171	0		29	10	S5803_171_0	2	1		06/02/2011	2012.02	06/02/2011 09:48:21 AM Eastern Daylight Time		07/15/2011 08:36:57 AM Eastern Daylight Time		07/20/2011 02:48:22 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5803	171	0	2012	State of Alaska		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	211	0		29	10	S5803_211_0	2	1		07/08/2011	2012.02	07/08/2011 09:40:14 AM Eastern Daylight Time		07/08/2011 12:16:23 PM Eastern Daylight Time		07/08/2011 01:12:12 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	211	0	2012	U.S. Virgin Islands		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	215	0		29	10	S5803_215_0	1	1		06/02/2011	2012.02	06/02/2011 09:48:23 AM Eastern Daylight Time		06/02/2011 02:16:49 PM Eastern Daylight Time		06/03/2011 04:31:09 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5803	215	0	2012	U.S. Virgin Islands		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	801	0		29	10	S5803_801_0	1	1		06/02/2011	2012.02	06/02/2011 10:04:52 AM Eastern Daylight Time				06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	801	0	2012	National		1					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	802	0		29	10	S5803_802_0	1	1		06/02/2011	2012.02	06/02/2011 10:04:48 AM Eastern Daylight Time				06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5803	802	0	2012	National		1					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	803	0		29	10	S5803_803_0	1	1		06/02/2011	2012.02	06/02/2011 10:04:43 AM Eastern Daylight Time				06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Group Plan (PDP)	10	29					S5803	803	0	2012	National		1					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5803	804	0		29	10	S5803_804_0	1	1		06/02/2011	2012.02	06/02/2011 10:04:38 AM Eastern Daylight Time				06/02/2011 05:13:55 PM Eastern Daylight Time	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	CVS Caremark	www.CommunityCCRx.com	Community CCRx Group Plan NCY (PDP)	10	29					S5803	804	0	2012	National		1					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5805	001	0		29	10	S5805_001_0	1	1		06/02/2011	2012.02	06/02/2011 11:35:33 AM Central Daylight Time		06/04/2011 02:47:50 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5805	001	0	2012	New York		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5805	803	0		29	10	S5805_803_0	1	1		06/06/2011	2012.02	06/06/2011 12:07:19 PM Central Daylight Time				06/06/2011 12:13:03 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.AARPMedicareRx.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	803	0	2012	National		1					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-556-6648		(888)-556-6648		(888)-556-6648		(888)-556-6648										(711)		(711)		(711)		(711)				
S5805	804	0		29	10	S5805_804_0	1	1		06/06/2011	2012.02	06/06/2011 12:07:36 PM Central Daylight Time				06/06/2011 12:13:03 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.AARPMedicareRx.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	804	0	2012	National		1					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-556-6648		(888)-556-6648		(888)-556-6648		(888)-556-6648										(711)		(711)		(711)		(711)				
S5805	807	0		29	10	S5805_807_0	1	1		06/06/2011	2012.02	06/06/2011 12:07:48 PM Central Daylight Time				06/06/2011 12:13:03 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.AARPMedicareRx.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	807	0	2012	National		1					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-556-6648		(888)-556-6648		(888)-556-6648		(888)-556-6648										(711)		(711)		(711)		(711)				
S5805	808	0		29	10	S5805_808_0	1	1		06/06/2011	2012.02	06/06/2011 12:08:00 PM Central Daylight Time				06/06/2011 12:13:03 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.AARPMedicareRx.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	808	0	2012	National		1					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-556-6648		(888)-556-6648		(888)-556-6648		(888)-556-6648										(711)		(711)		(711)		(711)				
S5805	809	0		29	10	S5805_809_0	1	1		06/06/2011	2012.02	06/06/2011 12:08:20 PM Central Daylight Time				06/06/2011 12:13:03 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.AARPMedicareRx.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	809	0	2012	National		1					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-556-6648		(888)-556-6648		(888)-556-6648		(888)-556-6648										(711)		(711)		(711)		(711)				
S5805	810	0		29	10	S5805_810_0	1	1		06/06/2011	2012.02	06/06/2011 12:08:31 PM Central Daylight Time				06/06/2011 12:13:03 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.AARPMedicareRx.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	810	0	2012	National		1					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-556-6648		(888)-556-6648		(888)-556-6648		(888)-556-6648										(711)		(711)		(711)		(711)				
S5805	811	0		29	10	S5805_811_0	1	1		06/06/2011	2012.02	06/06/2011 12:08:42 PM Central Daylight Time				06/06/2011 12:13:03 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.AARPMedicareRx.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	811	0	2012	National		1					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-556-6648		(888)-556-6648		(888)-556-6648		(888)-556-6648										(711)		(711)		(711)		(711)				
S5805	812	0		29	10	S5805_812_0	1	1		06/06/2011	2012.02	06/06/2011 12:08:52 PM Central Daylight Time				06/06/2011 12:13:03 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.AARPMedicareRx.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	812	0	2012	National		1					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-556-6648		(888)-556-6648		(888)-556-6648		(888)-556-6648										(711)		(711)		(711)		(711)				
S5805	813	0		29	10	S5805_813_0	1	1		06/06/2011	2012.02	06/06/2011 12:09:02 PM Central Daylight Time				06/06/2011 12:13:03 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.AARPMedicareRx.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	813	0	2012	National		1					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-556-6648		(888)-556-6648		(888)-556-6648		(888)-556-6648										(711)		(711)		(711)		(711)				
S5805	814	0		29	10	S5805_814_0	1	1		06/06/2011	2012.02	06/06/2011 12:09:13 PM Central Daylight Time				06/06/2011 12:13:03 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.AARPMedicareRx.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	814	0	2012	National		1					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-556-6648		(888)-556-6648		(888)-556-6648		(888)-556-6648										(711)		(711)		(711)		(711)				
S5805	815	0		29	10	S5805_815_0	1	1		06/06/2011	2012.02	06/06/2011 12:09:25 PM Central Daylight Time				06/06/2011 12:13:03 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.AARPMedicareRx.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	815	0	2012	National		1					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-556-6648		(888)-556-6648		(888)-556-6648		(888)-556-6648										(711)		(711)		(711)		(711)				
S5805	816	0		29	10	S5805_816_0	1	1		06/06/2011	2012.02	06/06/2011 12:09:38 PM Central Daylight Time				06/06/2011 12:13:03 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.AARPMedicareRx.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5805	816	0	2012	National		1					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-556-6648		(888)-556-6648		(888)-556-6648		(888)-556-6648										(711)		(711)		(711)		(711)				
S5810	035	0		29	10	S5810_035_0	2	1		07/12/2011	2012.02	07/12/2011 02:44:45 PM Eastern Daylight Time		07/11/2011 12:58:51 PM Eastern Daylight Time		07/12/2011 07:10:46 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna CVS/pharmacy Prescription Drug Plan (PDP)	10	29					S5810	035	0	2012	Northern New England (NH, ME)		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	036	0		29	10	S5810_036_0	4	1		09/15/2011	2012.02	09/15/2011 09:27:26 AM Eastern Daylight Time		09/15/2011 09:24:12 AM Eastern Daylight Time		09/15/2011 09:30:32 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna CVS/pharmacy Prescription Drug Plan (PDP)	10	29					S5810	036	0	2012	Central New England  (CT,RI, MA,VT)		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	037	0		29	10	S5810_037_0	4	1		09/15/2011	2012.02	09/15/2011 09:27:33 AM Eastern Daylight Time		09/15/2011 09:24:11 AM Eastern Daylight Time		09/15/2011 09:30:32 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna CVS/pharmacy Prescription Drug Plan (PDP)	10	29					S5810	037	0	2012	New  York		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	038	0		29	10	S5810_038_0	2	1		07/12/2011	2012.02	07/12/2011 02:19:34 PM Eastern Daylight Time		07/11/2011 01:01:51 PM Eastern Daylight Time		07/13/2011 12:44:56 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna CVS/pharmacy Prescription Drug Plan (PDP)	10	29					S5810	038	0	2012	New Jersey		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	039	0		29	10	S5810_039_0	2	1		07/12/2011	2012.02	07/12/2011 02:20:04 PM Eastern Daylight Time		07/11/2011 01:02:24 PM Eastern Daylight Time		07/12/2011 07:10:46 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna CVS/pharmacy Prescription Drug Plan (PDP)	10	29					S5810	039	0	2012	Mid-Atlantic (DE,DC,MD)		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	040	0		29	10	S5810_040_0	2	1		07/12/2011	2012.02	07/12/2011 02:20:34 PM Eastern Daylight Time		07/11/2011 01:02:53 PM Eastern Daylight Time		07/12/2011 07:10:46 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna CVS/pharmacy Prescription Drug Plan (PDP)	10	29					S5810	040	0	2012	Pennsylvania, West Virginia		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	041	0		29	10	S5810_041_0	2	1		07/12/2011	2012.02	07/12/2011 02:21:24 PM Eastern Daylight Time		07/11/2011 01:03:25 PM Eastern Daylight Time		07/12/2011 07:10:46 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna CVS/pharmacy Prescription Drug Plan (PDP)	10	29					S5810	041	0	2012	Virginia		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	042	0		29	10	S5810_042_0	2	1		07/12/2011	2012.02	07/12/2011 02:21:54 PM Eastern Daylight Time		07/11/2011 01:03:56 PM Eastern Daylight Time		07/12/2011 07:10:46 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna CVS/pharmacy Prescription Drug Plan (PDP)	10	29					S5810	042	0	2012	North Carolina		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	043	0		29	10	S5810_043_0	2	1		07/12/2011	2012.02	07/12/2011 02:27:09 PM Eastern Daylight Time		07/11/2011 01:04:24 PM Eastern Daylight Time		07/12/2011 07:10:46 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna CVS/pharmacy Prescription Drug Plan (PDP)	10	29					S5810	043	0	2012	South Carolina		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	044	0		29	10	S5810_044_0	2	1		07/12/2011	2012.02	07/12/2011 02:28:03 PM Eastern Daylight Time		07/11/2011 01:04:54 PM Eastern Daylight Time		07/12/2011 07:10:46 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna CVS/pharmacy Prescription Drug Plan (PDP)	10	29					S5810	044	0	2012	Georgia		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	045	0		29	10	S5810_045_0	2	1		07/12/2011	2012.02	07/12/2011 02:28:29 PM Eastern Daylight Time		07/11/2011 01:05:22 PM Eastern Daylight Time		07/12/2011 07:10:46 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna CVS/pharmacy Prescription Drug Plan (PDP)	10	29					S5810	045	0	2012	Florida		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	046	0		29	10	S5810_046_0	2	1		07/12/2011	2012.02	07/12/2011 02:29:12 PM Eastern Daylight Time		07/11/2011 01:05:51 PM Eastern Daylight Time		07/12/2011 08:04:12 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna CVS/pharmacy Prescription Drug Plan (PDP)	10	29					S5810	046	0	2012	Alabama, Tennessee		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	047	0		29	10	S5810_047_0	2	1		07/12/2011	2012.02	07/12/2011 02:29:40 PM Eastern Daylight Time		07/11/2011 01:06:18 PM Eastern Daylight Time		07/12/2011 08:04:12 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna CVS/pharmacy Prescription Drug Plan (PDP)	10	29					S5810	047	0	2012	Michigan		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	048	0		29	10	S5810_048_0	2	1		07/12/2011	2012.02	07/12/2011 02:30:47 PM Eastern Daylight Time		07/11/2011 01:07:56 PM Eastern Daylight Time		07/12/2011 08:04:12 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna CVS/pharmacy Prescription Drug Plan (PDP)	10	29					S5810	048	0	2012	Ohio		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	049	0		29	10	S5810_049_0	2	1		07/12/2011	2012.02	07/12/2011 02:31:09 PM Eastern Daylight Time		07/11/2011 01:08:24 PM Eastern Daylight Time		07/12/2011 08:04:12 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna CVS/pharmacy Prescription Drug Plan (PDP)	10	29					S5810	049	0	2012	Indiana, Kentucky		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	050	0		29	10	S5810_050_0	2	1		07/12/2011	2012.02	07/12/2011 02:32:45 PM Eastern Daylight Time		07/11/2011 01:08:58 PM Eastern Daylight Time		07/12/2011 08:04:12 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna CVS/pharmacy Prescription Drug Plan (PDP)	10	29					S5810	050	0	2012	Wisconsin		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	051	0		29	10	S5810_051_0	2	1		07/12/2011	2012.02	07/12/2011 02:33:13 PM Eastern Daylight Time		07/11/2011 01:09:30 PM Eastern Daylight Time		07/12/2011 08:04:12 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna CVS/pharmacy Prescription Drug Plan (PDP)	10	29					S5810	051	0	2012	Illinois		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	052	0		29	10	S5810_052_0	2	1		07/12/2011	2012.02	07/12/2011 02:35:50 PM Eastern Daylight Time		07/11/2011 01:10:00 PM Eastern Daylight Time		07/12/2011 08:04:12 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna CVS/pharmacy Prescription Drug Plan (PDP)	10	29					S5810	052	0	2012	Missouri		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	053	0		29	10	S5810_053_0	1	1		06/03/2011	2012.02	06/03/2011 01:48:21 PM Eastern Daylight Time		06/02/2011 01:33:12 PM Eastern Daylight Time		06/04/2011 08:44:44 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Essentials (PDP)	10	29					S5810	053	0	2012	Arkansas		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	054	0		29	10	S5810_054_0	2	1		07/12/2011	2012.02	07/12/2011 02:36:20 PM Eastern Daylight Time		07/11/2011 01:17:41 PM Eastern Daylight Time		07/12/2011 08:04:12 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna CVS/pharmacy Prescription Drug Plan (PDP)	10	29					S5810	054	0	2012	Mississippi		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	055	0		29	10	S5810_055_0	2	1		07/12/2011	2012.02	07/12/2011 02:36:47 PM Eastern Daylight Time		07/11/2011 01:18:46 PM Eastern Daylight Time		07/12/2011 08:04:12 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna CVS/pharmacy Prescription Drug Plan (PDP)	10	29					S5810	055	0	2012	Louisiana		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	056	0		29	10	S5810_056_0	2	1		07/12/2011	2012.02	07/12/2011 02:37:09 PM Eastern Daylight Time		07/11/2011 01:19:18 PM Eastern Daylight Time		07/13/2011 12:44:56 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna CVS/pharmacy Prescription Drug Plan (PDP)	10	29					S5810	056	0	2012	Texas		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	057	0		29	10	S5810_057_0	2	1		07/12/2011	2012.02	07/12/2011 02:37:31 PM Eastern Daylight Time		07/11/2011 01:19:48 PM Eastern Daylight Time		07/13/2011 12:44:56 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna CVS/pharmacy Prescription Drug Plan (PDP)	10	29					S5810	057	0	2012	Oklahoma		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	058	0		29	10	S5810_058_0	2	1		07/12/2011	2012.02	07/12/2011 02:38:03 PM Eastern Daylight Time		07/11/2011 01:20:22 PM Eastern Daylight Time		07/12/2011 08:33:32 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna CVS/pharmacy Prescription Drug Plan (PDP)	10	29					S5810	058	0	2012	Kansas		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	059	0		29	10	S5810_059_0	2	1		07/12/2011	2012.02	07/12/2011 02:38:24 PM Eastern Daylight Time		07/11/2011 01:20:50 PM Eastern Daylight Time		07/12/2011 08:33:32 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna CVS/pharmacy Prescription Drug Plan (PDP)	10	29					S5810	059	0	2012	Upper MW and N Plains (IA,MN,NE,SD,ND,WY,MT)		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	060	0		29	10	S5810_060_0	2	1		07/12/2011	2012.02	07/12/2011 02:38:51 PM Eastern Daylight Time		07/11/2011 01:21:16 PM Eastern Daylight Time		07/12/2011 08:33:32 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna CVS/pharmacy Prescription Drug Plan (PDP)	10	29					S5810	060	0	2012	New Mexico		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	061	0		29	10	S5810_061_0	1	1		06/03/2011	2012.02	06/03/2011 01:50:42 PM Eastern Daylight Time		06/02/2011 01:49:20 PM Eastern Daylight Time		06/04/2011 09:00:36 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Essentials (PDP)	10	29					S5810	061	0	2012	Colorado		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	062	0		29	10	S5810_062_0	2	1		07/12/2011	2012.02	07/12/2011 02:39:55 PM Eastern Daylight Time		07/11/2011 01:22:47 PM Eastern Daylight Time		07/12/2011 08:33:32 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna CVS/pharmacy Prescription Drug Plan (PDP)	10	29					S5810	062	0	2012	Arizona		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	063	0		29	10	S5810_063_0	2	1		07/12/2011	2012.02	07/12/2011 02:40:27 PM Eastern Daylight Time		07/11/2011 01:23:28 PM Eastern Daylight Time		07/12/2011 08:33:32 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna CVS/pharmacy Prescription Drug Plan (PDP)	10	29					S5810	063	0	2012	Nevada		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	064	0		29	10	S5810_064_0	1	1		06/03/2011	2012.02	06/03/2011 01:56:30 PM Eastern Daylight Time		06/02/2011 01:44:02 PM Eastern Daylight Time		06/04/2011 09:00:36 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Essentials (PDP)	10	29					S5810	064	0	2012	Oregon, Washington		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	065	0		29	10	S5810_065_0	1	1		06/03/2011	2012.02	06/03/2011 02:04:24 PM Eastern Daylight Time		06/02/2011 01:48:42 PM Eastern Daylight Time		06/04/2011 09:00:36 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Essentials (PDP)	10	29					S5810	065	0	2012	Idaho, Utah		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	066	0		29	10	S5810_066_0	2	1		07/12/2011	2012.02	07/12/2011 02:41:27 PM Eastern Daylight Time		07/11/2011 01:26:28 PM Eastern Daylight Time		07/12/2011 08:33:32 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna CVS/pharmacy Prescription Drug Plan (PDP)	10	29					S5810	066	0	2012	California		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	067	0		29	10	S5810_067_0	2	1		07/12/2011	2012.02	07/12/2011 02:42:10 PM Eastern Daylight Time		07/11/2011 01:26:57 PM Eastern Daylight Time		07/12/2011 08:33:32 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna CVS/pharmacy Prescription Drug Plan (PDP)	10	29					S5810	067	0	2012	Hawaii		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	068	0		29	10	S5810_068_0	1	1		06/03/2011	2012.02	06/03/2011 02:05:12 PM Eastern Daylight Time		06/02/2011 01:50:25 PM Eastern Daylight Time		06/04/2011 09:00:36 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Essentials (PDP)	10	29					S5810	068	0	2012	Alaska		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	171	0		29	10	S5810_171_0	2	1		06/01/2011	2012.02	06/01/2011 03:44:50 PM Eastern Daylight Time		07/21/2011 08:59:23 AM Eastern Daylight Time		07/21/2011 06:10:49 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Premier (PDP)	10	29					S5810	171	0	2012	Northern New England (NH, ME)		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	172	0		29	10	S5810_172_0	2	1		07/18/2011	2012.02	07/18/2011 11:09:08 AM Eastern Daylight Time		07/21/2011 08:59:48 AM Eastern Daylight Time		07/21/2011 06:10:49 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Premier (PDP)	10	29					S5810	172	0	2012	Central New England  (CT,RI, MA,VT)		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	174	0		29	10	S5810_174_0	2	1		06/01/2011	2012.02	06/01/2011 07:40:51 PM Eastern Daylight Time		07/21/2011 09:00:12 AM Eastern Daylight Time		07/21/2011 06:10:49 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Premier (PDP)	10	29					S5810	174	0	2012	New Jersey		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	175	0		29	10	S5810_175_0	2	1		06/01/2011	2012.02	06/01/2011 07:40:51 PM Eastern Daylight Time		07/21/2011 09:01:06 AM Eastern Daylight Time		07/21/2011 06:10:49 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Premier (PDP)	10	29					S5810	175	0	2012	Mid-Atlantic (DE,DC,MD)		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	176	0		29	10	S5810_176_0	2	1		06/01/2011	2012.02	06/01/2011 07:40:51 PM Eastern Daylight Time		07/21/2011 09:01:30 AM Eastern Daylight Time		07/21/2011 06:10:49 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Premier (PDP)	10	29					S5810	176	0	2012	Pennsylvania, West Virginia		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	177	0		29	10	S5810_177_0	2	1		06/01/2011	2012.02	06/01/2011 07:40:51 PM Eastern Daylight Time		07/21/2011 09:02:00 AM Eastern Daylight Time		07/21/2011 06:10:49 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Premier (PDP)	10	29					S5810	177	0	2012	Virginia		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	178	0		29	10	S5810_178_0	2	1		06/01/2011	2012.02	06/01/2011 07:40:52 PM Eastern Daylight Time		07/21/2011 09:03:13 AM Eastern Daylight Time		07/21/2011 06:10:49 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Premier (PDP)	10	29					S5810	178	0	2012	North Carolina		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	179	0		29	10	S5810_179_0	2	1		06/01/2011	2012.02	06/01/2011 07:40:52 PM Eastern Daylight Time		07/21/2011 09:04:07 AM Eastern Daylight Time		07/21/2011 06:10:49 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Premier (PDP)	10	29					S5810	179	0	2012	South Carolina		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	180	0		29	10	S5810_180_0	2	1		06/01/2011	2012.02	06/01/2011 07:40:52 PM Eastern Daylight Time		07/21/2011 09:05:20 AM Eastern Daylight Time		07/21/2011 06:10:49 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Premier (PDP)	10	29					S5810	180	0	2012	Georgia		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	182	0		29	10	S5810_182_0	2	1		06/01/2011	2012.02	06/01/2011 07:40:53 PM Eastern Daylight Time		07/21/2011 09:05:45 AM Eastern Daylight Time		07/21/2011 06:10:49 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Premier (PDP)	10	29					S5810	182	0	2012	Alabama, Tennessee		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	183	0		29	10	S5810_183_0	2	1		06/01/2011	2012.02	06/01/2011 07:40:53 PM Eastern Daylight Time		07/21/2011 09:06:58 AM Eastern Daylight Time		07/21/2011 06:26:24 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Premier (PDP)	10	29					S5810	183	0	2012	Michigan		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	184	0		29	10	S5810_184_0	2	1		06/01/2011	2012.02	06/01/2011 07:40:53 PM Eastern Daylight Time		07/21/2011 09:07:22 AM Eastern Daylight Time		07/21/2011 06:26:24 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Premier (PDP)	10	29					S5810	184	0	2012	Ohio		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	185	0		29	10	S5810_185_0	2	1		06/01/2011	2012.02	06/01/2011 07:40:53 PM Eastern Daylight Time		07/21/2011 09:07:46 AM Eastern Daylight Time		07/21/2011 06:26:24 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Premier (PDP)	10	29					S5810	185	0	2012	Indiana, Kentucky		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	186	0		29	10	S5810_186_0	2	1		06/01/2011	2012.02	06/01/2011 07:40:54 PM Eastern Daylight Time		07/21/2011 09:08:15 AM Eastern Daylight Time		07/21/2011 06:26:24 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Premier (PDP)	10	29					S5810	186	0	2012	Wisconsin		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	187	0		29	10	S5810_187_0	2	1		06/01/2011	2012.02	06/01/2011 07:40:54 PM Eastern Daylight Time		07/21/2011 09:08:38 AM Eastern Daylight Time		07/21/2011 06:26:24 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Premier (PDP)	10	29					S5810	187	0	2012	Illinois		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	188	0		29	10	S5810_188_0	2	1		06/01/2011	2012.02	06/01/2011 07:40:54 PM Eastern Daylight Time		07/21/2011 09:09:01 AM Eastern Daylight Time		07/21/2011 06:26:24 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Premier (PDP)	10	29					S5810	188	0	2012	Missouri		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	189	0		29	10	S5810_189_0	2	1		06/01/2011	2012.02	06/01/2011 07:40:55 PM Eastern Daylight Time		07/21/2011 09:09:43 AM Eastern Daylight Time		07/21/2011 06:26:24 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Premier (PDP)	10	29					S5810	189	0	2012	Arkansas		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	190	0		29	10	S5810_190_0	2	1		06/01/2011	2012.02	06/01/2011 07:40:55 PM Eastern Daylight Time		07/21/2011 09:10:22 AM Eastern Daylight Time		07/21/2011 06:26:24 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Premier (PDP)	10	29					S5810	190	0	2012	Mississippi		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	191	0		29	10	S5810_191_0	2	1		06/01/2011	2012.02	06/01/2011 07:40:55 PM Eastern Daylight Time		07/21/2011 09:10:47 AM Eastern Daylight Time		07/21/2011 06:26:24 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Premier (PDP)	10	29					S5810	191	0	2012	Louisiana		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	192	0		29	10	S5810_192_0	2	1		06/01/2011	2012.02	06/01/2011 07:40:55 PM Eastern Daylight Time		07/21/2011 09:11:11 AM Eastern Daylight Time		07/21/2011 06:26:24 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Premier (PDP)	10	29					S5810	192	0	2012	Texas		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	193	0		29	10	S5810_193_0	3	1		06/01/2011	2012.02	06/01/2011 07:40:56 PM Eastern Daylight Time		07/21/2011 09:11:33 AM Eastern Daylight Time		07/21/2011 09:40:03 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Premier (PDP)	10	29					S5810	193	0	2012	Oklahoma		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	194	0		29	10	S5810_194_0	3	1		06/01/2011	2012.02	06/01/2011 07:40:56 PM Eastern Daylight Time		07/21/2011 09:11:58 AM Eastern Daylight Time		07/21/2011 09:40:03 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Premier (PDP)	10	29					S5810	194	0	2012	Kansas		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	195	0		29	10	S5810_195_0	3	1		06/01/2011	2012.02	06/01/2011 07:40:56 PM Eastern Daylight Time		07/21/2011 09:12:21 AM Eastern Daylight Time		07/21/2011 09:40:03 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Premier (PDP)	10	29					S5810	195	0	2012	Upper MW and N Plains (IA,MN,NE,SD,ND,WY,MT)		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	197	0		29	10	S5810_197_0	3	1		06/01/2011	2012.02	06/01/2011 07:40:57 PM Eastern Daylight Time		07/21/2011 09:12:46 AM Eastern Daylight Time		07/21/2011 09:40:03 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Premier (PDP)	10	29					S5810	197	0	2012	Colorado		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	198	0		29	10	S5810_198_0	3	1		06/01/2011	2012.02	06/01/2011 07:40:57 PM Eastern Daylight Time		07/21/2011 09:13:10 AM Eastern Daylight Time		07/21/2011 09:40:03 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Premier (PDP)	10	29					S5810	198	0	2012	Arizona		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	199	0		29	10	S5810_199_0	4	1		07/21/2011	2012.02	07/21/2011 10:00:41 PM Eastern Daylight Time		07/21/2011 09:13:35 AM Eastern Daylight Time		07/21/2011 10:08:01 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Premier (PDP)	10	29					S5810	199	0	2012	Nevada		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	200	0		29	10	S5810_200_0	4	1		06/01/2011	2012.02	06/01/2011 07:40:58 PM Eastern Daylight Time		07/21/2011 09:13:57 AM Eastern Daylight Time		07/21/2011 10:08:01 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Premier (PDP)	10	29					S5810	200	0	2012	Oregon, Washington		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	201	0		29	10	S5810_201_0	4	1		06/01/2011	2012.02	06/01/2011 07:40:58 PM Eastern Daylight Time		07/21/2011 09:14:21 AM Eastern Daylight Time		07/21/2011 10:08:01 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Premier (PDP)	10	29					S5810	201	0	2012	Idaho, Utah		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	202	0		29	10	S5810_202_0	4	1		06/01/2011	2012.02	06/01/2011 07:40:58 PM Eastern Daylight Time		07/21/2011 09:14:51 AM Eastern Daylight Time		07/21/2011 10:08:01 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Premier (PDP)	10	29					S5810	202	0	2012	California		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	203	0		29	10	S5810_203_0	4	1		06/01/2011	2012.02	06/01/2011 07:40:59 PM Eastern Daylight Time		07/21/2011 09:16:54 AM Eastern Daylight Time		07/21/2011 10:08:01 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Premier (PDP)	10	29					S5810	203	0	2012	Hawaii		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	204	0		29	10	S5810_204_0	4	1		06/01/2011	2012.02	06/01/2011 07:40:59 PM Eastern Daylight Time		07/21/2011 09:17:39 AM Eastern Daylight Time		07/21/2011 10:08:01 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Premier (PDP)	10	29					S5810	204	0	2012	Alaska		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	239	0		29	10	S5810_239_0	4	1		06/01/2011	2012.02	06/01/2011 07:40:59 PM Eastern Daylight Time		07/21/2011 09:18:09 AM Eastern Daylight Time		07/21/2011 10:08:01 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Premier (PDP)	10	29					S5810	239	0	2012	New York		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	240	0		29	10	S5810_240_0	4	1		06/01/2011	2012.02	06/01/2011 07:41:00 PM Eastern Daylight Time		07/21/2011 06:16:10 PM Eastern Daylight Time		07/21/2011 10:08:01 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Premier (PDP)	10	29					S5810	240	0	2012	Florida		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	241	0		29	10	S5810_241_0	3	1		06/01/2011	2012.02	06/01/2011 07:41:00 PM Eastern Daylight Time		07/21/2011 06:16:19 PM Eastern Daylight Time		07/21/2011 09:40:03 PM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Premier (PDP)	10	29					S5810	241	0	2012	New Mexico		2					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5810	801	0		29	10	S5810_801_0	1	1		06/03/2011	2012.02	06/03/2011 03:30:00 PM Eastern Daylight Time				06/04/2011 11:30:51 AM Eastern Daylight Time	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	Aetna Medicare Rx Plan (PDP)	10	29					S5810	801	0	2012	Employer National		1					2							www.aetnamedicare.com/plan_choices/rx_find_prescriptions.jsp	www.aetnapharmacy.com									(877)-238-6211		(877)-238-6211		(800)-832-2640		(800)-832-2640										(888)-760-4748		(888)-760-4748		(888)-760-4748		(888)-760-4748				
S5820	001	0		29	10	S5820_001_0	1	1		06/03/2011	2012.02	06/03/2011 11:20:16 AM Central Daylight Time		06/04/2011 02:48:07 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	001	0	2012	Northern New England (NH, ME)		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	002	0		29	10	S5820_002_0	1	1		06/02/2011	2012.02	06/02/2011 11:37:07 AM Central Daylight Time		06/04/2011 02:48:23 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	002	0	2012	Central New England (CT, MA, RI, VT)		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	003	0		29	10	S5820_003_0	1	1		06/01/2011	2012.02	06/01/2011 08:51:56 PM Central Daylight Time		06/04/2011 02:48:40 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	003	0	2012	New Jersey		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	004	0		29	10	S5820_004_0	1	1		06/01/2011	2012.02	06/01/2011 08:52:56 PM Central Daylight Time		06/04/2011 02:48:58 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	004	0	2012	Mid-Atlantic (DE, DC, MD)		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	005	0		29	10	S5820_005_0	1	1		06/01/2011	2012.02	06/01/2011 08:53:43 PM Central Daylight Time		06/04/2011 02:49:14 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	005	0	2012	Pennsylvania, West Virginia		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	006	0		29	10	S5820_006_0	1	1		06/01/2011	2012.02	06/01/2011 08:56:24 PM Central Daylight Time		06/04/2011 02:49:32 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	006	0	2012	Virginia		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	007	0		29	10	S5820_007_0	1	1		06/01/2011	2012.02	06/01/2011 08:57:32 PM Central Daylight Time		06/04/2011 02:49:51 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	007	0	2012	North Carolina		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	008	0		29	10	S5820_008_0	1	1		06/01/2011	2012.02	06/01/2011 08:58:29 PM Central Daylight Time		06/04/2011 02:50:07 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	008	0	2012	South Carolina		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	009	0		29	10	S5820_009_0	1	1		06/01/2011	2012.02	06/01/2011 08:59:09 PM Central Daylight Time		06/04/2011 02:50:25 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	009	0	2012	Georgia		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	010	0		29	10	S5820_010_0	1	1		06/01/2011	2012.02	06/01/2011 09:00:33 PM Central Daylight Time		06/04/2011 02:50:41 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	010	0	2012	Florida		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	011	0		29	10	S5820_011_0	1	1		06/01/2011	2012.02	06/01/2011 09:01:13 PM Central Daylight Time		06/04/2011 02:50:57 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	011	0	2012	Alabama, Tennessee		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	012	0		29	10	S5820_012_0	1	1		06/01/2011	2012.02	06/01/2011 09:01:47 PM Central Daylight Time		06/04/2011 02:51:13 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	012	0	2012	Michigan		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	013	0		29	10	S5820_013_0	1	1		06/01/2011	2012.02	06/01/2011 09:02:21 PM Central Daylight Time		06/04/2011 02:51:28 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	013	0	2012	Ohio		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	014	0		29	10	S5820_014_0	1	1		06/01/2011	2012.02	06/01/2011 09:02:58 PM Central Daylight Time		06/04/2011 02:49:12 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	014	0	2012	Indiana, Kentucky		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	015	0		29	10	S5820_015_0	1	1		06/01/2011	2012.02	06/01/2011 09:03:42 PM Central Daylight Time		06/04/2011 02:49:37 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	015	0	2012	Wisconsin		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	016	0		29	10	S5820_016_0	1	1		06/01/2011	2012.02	06/01/2011 09:04:21 PM Central Daylight Time		06/04/2011 02:50:02 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	016	0	2012	Illinois		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	017	0		29	10	S5820_017_0	1	1		06/01/2011	2012.02	06/01/2011 09:05:21 PM Central Daylight Time		06/04/2011 02:50:26 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	017	0	2012	Missouri		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	018	0		29	10	S5820_018_0	1	1		06/01/2011	2012.02	06/01/2011 09:07:21 PM Central Daylight Time		06/04/2011 02:50:51 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	018	0	2012	Arkansas		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	019	0		29	10	S5820_019_0	1	1		06/01/2011	2012.02	06/01/2011 09:09:05 PM Central Daylight Time		06/04/2011 02:51:17 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	019	0	2012	Mississippi		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	020	0		29	10	S5820_020_0	1	1		06/01/2011	2012.02	06/01/2011 09:09:42 PM Central Daylight Time		06/04/2011 02:51:42 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	020	0	2012	Louisiana		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	021	0		29	10	S5820_021_0	1	1		06/01/2011	2012.02	06/01/2011 09:10:21 PM Central Daylight Time		06/04/2011 02:52:06 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	021	0	2012	Texas		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	022	0		29	10	S5820_022_0	1	1		06/01/2011	2012.02	06/01/2011 09:11:00 PM Central Daylight Time		06/04/2011 02:52:31 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	022	0	2012	Oklahoma		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	023	0		29	10	S5820_023_0	1	1		06/01/2011	2012.02	06/01/2011 09:11:42 PM Central Daylight Time		06/04/2011 02:52:55 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	023	0	2012	Kansas		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	024	0		29	10	S5820_024_0	1	1		06/01/2011	2012.02	06/01/2011 09:12:19 PM Central Daylight Time		06/04/2011 02:53:19 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	024	0	2012	Upper Midwest and Northern Plains		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	025	0		29	10	S5820_025_0	1	1		06/01/2011	2012.02	06/01/2011 09:13:05 PM Central Daylight Time		06/04/2011 02:53:43 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	025	0	2012	New Mexico		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	026	0		29	10	S5820_026_0	1	1		06/01/2011	2012.02	06/01/2011 09:13:46 PM Central Daylight Time		06/04/2011 02:54:07 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	026	0	2012	Colorado		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	027	0		29	10	S5820_027_0	1	1		06/01/2011	2012.02	06/01/2011 09:14:22 PM Central Daylight Time		06/04/2011 02:54:33 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	027	0	2012	Arizona		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	028	0		29	10	S5820_028_0	1	1		06/01/2011	2012.02	06/01/2011 09:16:09 PM Central Daylight Time		06/04/2011 02:54:56 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	028	0	2012	Nevada		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	029	0		29	10	S5820_029_0	1	1		06/01/2011	2012.02	06/01/2011 09:16:45 PM Central Daylight Time		06/04/2011 02:55:20 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	029	0	2012	Oregon, Washington		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	030	0		29	10	S5820_030_0	1	1		06/01/2011	2012.02	06/01/2011 09:17:23 PM Central Daylight Time		06/04/2011 02:55:44 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	030	0	2012	Idaho, Utah		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	031	0		29	10	S5820_031_0	1	1		06/01/2011	2012.02	06/01/2011 09:18:02 PM Central Daylight Time		06/04/2011 02:56:08 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	031	0	2012	California		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	032	0		29	10	S5820_032_0	1	1		06/01/2011	2012.02	06/01/2011 09:18:46 PM Central Daylight Time		06/04/2011 02:56:33 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	032	0	2012	Hawaii		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	033	0		29	10	S5820_033_0	1	1		06/01/2011	2012.02	06/01/2011 09:19:27 PM Central Daylight Time		06/04/2011 02:56:58 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	033	0	2012	Alaska		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	034	0		29	10	S5820_034_0	1	1		06/01/2011	2012.02	06/01/2011 09:20:05 PM Central Daylight Time		06/04/2011 02:57:22 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	034	0	2012	American Samoa		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	035	0		29	10	S5820_035_0	1	1		06/01/2011	2012.02	06/01/2011 09:20:44 PM Central Daylight Time		06/04/2011 02:57:46 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	035	0	2012	Guam		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	036	0		29	10	S5820_036_0	1	1		06/01/2011	2012.02	06/01/2011 09:21:35 PM Central Daylight Time		06/04/2011 02:58:10 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	036	0	2012	Northern Mariana Islands		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	037	0		29	10	S5820_037_0	1	1		06/01/2011	2012.02	06/01/2011 09:22:15 PM Central Daylight Time		06/04/2011 02:58:36 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	037	0	2012	Puerto Rico		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	038	0		29	10	S5820_038_0	1	1		06/01/2011	2012.02	06/01/2011 09:23:12 PM Central Daylight Time		06/04/2011 02:58:59 PM Central Daylight Time		06/04/2011 07:53:32 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Preferred (PDP)	10	29					S5820	038	0	2012	US Virgin Islands		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5820	803	0		29	10	S5820_803_0	1	1		06/01/2011	2012.02	06/01/2011 01:05:27 PM Central Daylight Time				06/06/2011 12:13:03 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	803	0	2012	National		1					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-556-6648		(888)-556-6648		(888)-556-6648		(888)-556-6648										(711)		(711)		(711)		(711)				
S5820	804	0		29	10	S5820_804_0	1	1		06/01/2011	2012.02	06/01/2011 01:05:40 PM Central Daylight Time				06/06/2011 12:13:03 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	804	0	2012	National		1					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-556-6648		(888)-556-6648		(888)-556-6648		(888)-556-6648										(711)		(711)		(711)		(711)				
S5820	807	0		29	10	S5820_807_0	1	1		06/01/2011	2012.02	06/01/2011 01:14:35 PM Central Daylight Time				06/06/2011 12:13:03 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	807	0	2012	National		1					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-556-6648		(888)-556-6648		(888)-556-6648		(888)-556-6648										(711)		(711)		(711)		(711)				
S5820	808	0		29	10	S5820_808_0	1	1		06/01/2011	2012.02	06/01/2011 01:14:26 PM Central Daylight Time				06/06/2011 12:13:03 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	808	0	2012	National		1					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-556-6648		(888)-556-6648		(888)-556-6648		(888)-556-6648										(711)		(711)		(711)		(711)				
S5820	810	0		29	10	S5820_810_0	1	1		06/06/2011	2012.02	06/06/2011 12:09:57 PM Central Daylight Time				06/06/2011 12:13:03 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	810	0	2012	National		1					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-556-6648		(888)-556-6648		(888)-556-6648		(888)-556-6648										(711)		(711)		(711)		(711)				
S5820	811	0		29	10	S5820_811_0	1	1		06/06/2011	2012.02	06/06/2011 12:10:12 PM Central Daylight Time				06/06/2011 12:13:03 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	811	0	2012	National		1					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-556-6648		(888)-556-6648		(888)-556-6648		(888)-556-6648										(711)		(711)		(711)		(711)				
S5820	812	0		29	10	S5820_812_0	1	1		06/06/2011	2012.02	06/06/2011 12:10:28 PM Central Daylight Time				06/06/2011 12:13:03 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	812	0	2012	National		1					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-556-6648		(888)-556-6648		(888)-556-6648		(888)-556-6648										(711)		(711)		(711)		(711)				
S5820	813	0		29	10	S5820_813_0	1	1		06/06/2011	2012.02	06/06/2011 12:10:42 PM Central Daylight Time				06/06/2011 12:13:03 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	813	0	2012	National		1					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-556-6648		(888)-556-6648		(888)-556-6648		(888)-556-6648										(711)		(711)		(711)		(711)				
S5820	814	0		29	10	S5820_814_0	1	1		06/06/2011	2012.02	06/06/2011 12:10:53 PM Central Daylight Time				06/06/2011 12:13:03 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	814	0	2012	National		1					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-556-6648		(888)-556-6648		(888)-556-6648		(888)-556-6648										(711)		(711)		(711)		(711)				
S5820	815	0		29	10	S5820_815_0	1	1		06/06/2011	2012.02	06/06/2011 12:11:13 PM Central Daylight Time				06/06/2011 12:13:03 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	815	0	2012	National		1					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-556-6648		(888)-556-6648		(888)-556-6648		(888)-556-6648										(711)		(711)		(711)		(711)				
S5820	816	0		29	10	S5820_816_0	1	1		06/06/2011	2012.02	06/06/2011 12:11:32 PM Central Daylight Time				06/06/2011 12:13:03 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	816	0	2012	National		1					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-556-6648		(888)-556-6648		(888)-556-6648		(888)-556-6648										(711)		(711)		(711)		(711)				
S5820	817	0		29	10	S5820_817_0	1	1		06/06/2011	2012.02	06/06/2011 12:11:44 PM Central Daylight Time				06/06/2011 12:13:03 PM Central Daylight Time	UNITEDHEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.AARPMedicareRx.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5820	817	0	2012	National		1					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-556-6648		(888)-556-6648		(888)-556-6648		(888)-556-6648										(711)		(711)		(711)		(711)				
S5825	017	0		29	10	S5825_017_0	2	1		06/02/2011	2012.02	06/02/2011 09:48:25 AM Eastern Daylight Time		06/04/2011 10:14:28 AM Eastern Daylight Time		06/04/2011 12:38:23 PM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	CVS Caremark	www.CommunityCCRx.com	Community CCRx Choice (PDP)	10	29					S5825	017	0	2012	State of New York		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5825	045	0		29	10	S5825_045_0	2	1		06/02/2011	2012.02	06/02/2011 10:04:03 AM Eastern Daylight Time		06/04/2011 10:22:29 AM Eastern Daylight Time		06/04/2011 12:38:23 PM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	CVS Caremark	www.CommunityCCRx.com	Community CCRx Basic (PDP)	10	29					S5825	045	0	2012	State of New York		2					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-423-5040		(866)-423-5040										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5825	802	0		29	10	S5825_802_0	2	1		06/02/2011	2012.02	06/02/2011 10:04:12 AM Eastern Daylight Time				06/04/2011 12:38:23 PM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	CVS Caremark	www.CommunityCCRx.com	Community CCRx Employer Std Def CY2 (PDP)	10	29					S5825	802	0	2012	National Plan		1					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-684-5353		(866)-684-5353										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5825	804	0		29	10	S5825_804_0	2	1		06/02/2011	2012.02	06/02/2011 10:04:17 AM Eastern Daylight Time				06/04/2011 12:38:23 PM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	CVS Caremark	www.CommunityCCRx.com	Community CCRx Employer Std Def CY4 (PDP)	10	29					S5825	804	0	2012	National Plan		1					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-684-5353		(866)-684-5353										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5825	807	0		29	10	S5825_807_0	2	1		06/02/2011	2012.02	06/02/2011 10:04:21 AM Eastern Daylight Time				06/04/2011 12:38:23 PM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	CVS Caremark	www.CommunityCCRx.com	Community CCRx Employer Std Def NCY2 (PDP)	10	29					S5825	807	0	2012	National Plan		1					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-684-5353		(866)-684-5353										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5825	809	0		29	10	S5825_809_0	2	1		06/02/2011	2012.02	06/02/2011 10:04:26 AM Eastern Daylight Time				06/04/2011 12:38:23 PM Eastern Daylight Time	SILVERSCRIPT INSURANCE COMPANY	CVS Caremark	www.CommunityCCRx.com	Community CCRx Employer Std Def NCY4 (PDP)	10	29					S5825	809	0	2012	National Plan		1					2							www.CommunityCCRx.com	www.CommunityCCRx.com									(866)-684-5353		(866)-684-5353		(866)-684-5353		(866)-684-5353										(866)-684-5351		(866)-684-5351		(866)-684-5351		(866)-684-5351				
S5840	001	0		29	10	S5840_001_0	2	1		06/03/2011	2012.02	06/03/2011 10:35:20 AM SA Western Standard Time		06/05/2011 08:30:46 PM SA Western Standard Time		06/06/2011 09:52:09 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC	First Medical Health Plan, Inc.	www.firstpluspr.com	PharmaPlus (PDP)	10	29					S5840	001	0	2012	Entire Island Puerto Rico		2					2							http://www.firstpluspr.com	http://www.firstpluspr.com									(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242										(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242				
S5840	002	0		29	10	S5840_002_0	3	1		05/26/2011	2012.02	05/26/2011 03:38:58 PM SA Western Standard Time		07/21/2011 12:59:00 PM SA Western Standard Time		07/22/2011 11:06:16 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC	First Medical Health Plan, Inc.	www.firstpluspr.com	PharmaPremium (PDP)	10	29					S5840	002	0	2012	Entire Island Puerto Rico		2					2							http://www.firstpluspr.com	http://www.firstpluspr.com									(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242										(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242				
S5840	801	0		29	10	S5840_801_0	2	1		06/01/2011	2012.02	06/01/2011 06:15:29 PM SA Western Standard Time				06/06/2011 09:52:09 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC	First Medical Health Plan, Inc.	www.firstpluspr.com	Employer Group Prescription Drug Plan 1 (PDP)	10	29					S5840	801	0	2012	Entire Island Puerto Rico		1					2							http://www.firstpluspr.com	http://www.firstpluspr.com									(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242										(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242				
S5840	802	0		29	10	S5840_802_0	2	1		05/26/2011	2012.02	05/26/2011 03:19:36 PM SA Western Standard Time				06/06/2011 09:52:09 AM SA Western Standard Time	FIRST MEDICAL HEALTH PLAN, INC	First Medical Health Plan, Inc.	www.firstpluspr.com	Employer Group Prescription Drug Plan 2 (PDP)	10	29					S5840	802	0	2012	Entire Island Puerto Rico		1					2							http://www.firstpluspr.com	http://www.firstpluspr.com									(888)-767-7717		(888)-767-7717		(877)-662-4242		(877)-662-4242										(877)-672-4242		(877)-672-4242		(877)-672-4242		(877)-672-4242				
S5857	001	0		29	10	S5857_001_0	3	1		06/04/2011	2012.02	06/04/2011 05:11:05 PM Eastern Daylight Time		07/19/2011 03:29:17 PM Eastern Daylight Time		07/19/2011 03:36:04 PM Eastern Daylight Time	PRIORITY HEALTH INSURANCE COMPANY	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Rx (PDP)	10	29					S5857	001	0	2012	State of Michigan		2					2							www.prioritymedicare.com	www.prioritymedicare.com									(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850										(711)		(711)		(711)		(711)				
S5857	802	0		29	10	S5857_802_0	1	1		05/31/2011	2012.02	05/31/2011 01:12:30 PM Eastern Daylight Time				06/06/2011 12:15:48 PM Eastern Daylight Time	PRIORITY HEALTH INSURANCE COMPANY	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Rx EG Non-Calendar Year (PDP)	10	29					S5857	802	0	2012	United States		1					2							www.prioritymedicare.com	www.prioritymedicare.com									(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850										(711)		(711)		(711)		(711)				
S5857	803	0		29	10	S5857_803_0	1	1		05/31/2011	2012.02	05/31/2011 01:12:57 PM Eastern Daylight Time				06/06/2011 12:15:48 PM Eastern Daylight Time	PRIORITY HEALTH INSURANCE COMPANY	Priority Health Medicare	www.prioritymedicare.com	PriorityMedicare Rx EG Calendar Year (PDP)	10	29					S5857	803	0	2012	United States		1					2							www.prioritymedicare.com	www.prioritymedicare.com									(888)-389-6648		(616)-464-8820		(888)-389-6676		(616)-464-8850										(711)		(711)		(711)		(711)				
S5877	004	0		29	10	S5877_004_0	2	1		07/14/2011	2012.02	07/14/2011 12:02:47 PM Mountain Daylight Time		07/19/2011 10:50:56 AM Mountain Daylight Time		07/20/2011 08:59:39 AM Mountain Daylight Time	EDUCATORS MUTUAL INSURANCE ASSOCIATION	Educators Mutual Insurance Association	www.educatorsmutual.com	Educators Rx Basic (PDP)	10	29					S5877	004	0	2012	State of Utah and State of Idaho		2					2							http://www.medicare.educatorsmutual.com/medicare/emia_plans.aspx	http://www.medcohealth.com									(800)-572-8734		(801)-262-7475		(888)-236-4823		(801)-262-7475										(800)-716-3231		(800)-716-3231		(888)-236-4823		(801)-262-7475				
S5877	007	0		29	10	S5877_007_0	4	1		07/08/2011	2012.02	07/08/2011 07:45:34 PM Mountain Daylight Time		07/21/2011 07:52:16 AM Mountain Daylight Time		07/21/2011 03:43:20 PM Mountain Daylight Time	EDUCATORS MUTUAL INSURANCE ASSOCIATION	Educators Mutual Insurance Association	www.educatorsmutual.com	Educators Rx Advantage (PDP)	10	29					S5877	007	0	2012	State of Utah and State of Idaho		2					2							http://www.medicare.educatorsmutual.com/medicare/emia_plans.aspx	http://www.medcohealth.com									(800)-572-8734		(801)-262-7475		(888)-236-4823		(801)-262-7475										(800)-716-3231		(800)-716-3231		(888)-236-4823		(801)-262-7475				
S5884	001	0		29	10	S5884_001_0	2	1		05/25/2011	2012.02	05/25/2011 04:48:56 PM Eastern Daylight Time		07/21/2011 12:26:00 PM Eastern Daylight Time		07/25/2011 10:09:06 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	001	0	2012	States of Alabama and Tennessee		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	002	0		29	10	S5884_002_0	2	1		05/25/2011	2012.02	05/25/2011 05:02:25 PM Eastern Daylight Time		07/21/2011 12:26:00 PM Eastern Daylight Time		07/25/2011 10:09:06 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	002	0	2012	States of CT, MA, RI, VT		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	004	0		29	10	S5884_004_0	2	1		05/25/2011	2012.02	05/25/2011 04:38:08 PM Eastern Daylight Time		07/21/2011 12:26:00 PM Eastern Daylight Time		07/25/2011 10:09:06 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	004	0	2012	States of DC, DE, MD		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	005	0		29	10	S5884_005_0	2	1		05/25/2011	2012.02	05/25/2011 04:39:31 PM Eastern Daylight Time		07/21/2011 12:26:00 PM Eastern Daylight Time		07/25/2011 10:09:06 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	005	0	2012	States of Pennsylvania and West Virginia		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	008	0		29	10	S5884_008_0	2	1		05/25/2011	2012.02	05/25/2011 04:43:57 PM Eastern Daylight Time		07/21/2011 12:27:00 PM Eastern Daylight Time		07/25/2011 10:09:06 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	008	0	2012	State of South Carolina		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	009	0		29	10	S5884_009_0	2	1		05/25/2011	2012.02	05/25/2011 04:45:36 PM Eastern Daylight Time		07/21/2011 12:27:00 PM Eastern Daylight Time		07/25/2011 10:09:06 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	009	0	2012	State of Georgia		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	010	0		29	10	S5884_010_0	2	1		05/25/2011	2012.02	05/25/2011 04:47:02 PM Eastern Daylight Time		07/21/2011 12:27:00 PM Eastern Daylight Time		07/25/2011 10:09:06 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	010	0	2012	State of Florida		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	015	0		29	10	S5884_015_0	3	1		05/25/2011	2012.02	05/25/2011 03:52:23 PM Eastern Daylight Time		07/21/2011 12:27:00 PM Eastern Daylight Time		07/25/2011 11:02:04 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	015	0	2012	State of Illinois		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	019	0		29	10	S5884_019_0	3	1		05/25/2011	2012.02	05/25/2011 03:58:38 PM Eastern Daylight Time		07/21/2011 12:27:00 PM Eastern Daylight Time		07/25/2011 11:02:04 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	019	0	2012	State of Louisiana		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	020	0		29	10	S5884_020_0	3	1		05/25/2011	2012.02	05/25/2011 03:59:53 PM Eastern Daylight Time		07/21/2011 12:27:00 PM Eastern Daylight Time		07/25/2011 11:02:04 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	020	0	2012	State of Texas		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	021	0		29	10	S5884_021_0	3	1		05/25/2011	2012.02	05/25/2011 04:01:22 PM Eastern Daylight Time		07/21/2011 12:27:00 PM Eastern Daylight Time		07/25/2011 11:02:04 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	021	0	2012	State of Oklahoma		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	022	0		29	10	S5884_022_0	3	1		05/25/2011	2012.02	05/25/2011 04:02:36 PM Eastern Daylight Time		07/21/2011 12:27:00 PM Eastern Daylight Time		07/25/2011 11:02:04 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	022	0	2012	State of Kansas		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	024	0		29	10	S5884_024_0	3	1		05/25/2011	2012.02	05/25/2011 04:34:07 PM Eastern Daylight Time		07/21/2011 12:27:00 PM Eastern Daylight Time		07/25/2011 11:02:04 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	024	0	2012	State of New Mexico		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	028	0		29	10	S5884_028_0	3	1		05/25/2011	2012.02	05/25/2011 04:39:15 PM Eastern Daylight Time		07/21/2011 12:28:00 PM Eastern Daylight Time		07/25/2011 11:02:04 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	028	0	2012	States of Oregon and Washington		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	030	0		29	10	S5884_030_0	3	1		05/25/2011	2012.02	05/25/2011 04:41:41 PM Eastern Daylight Time		07/21/2011 12:28:00 PM Eastern Daylight Time		07/25/2011 11:02:04 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	030	0	2012	State of California		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	031	0		29	10	S5884_031_0	2	1		05/27/2011	2012.02	05/27/2011 01:28:33 PM Eastern Daylight Time		07/21/2011 12:28:00 PM Eastern Daylight Time		07/25/2011 09:51:41 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Complete (PDP)	10	29					S5884	031	0	2012	States of CT, MA, RI, VT		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	032	0		29	10	S5884_032_0	2	1		05/27/2011	2012.02	05/27/2011 01:32:37 PM Eastern Daylight Time		07/21/2011 12:28:00 PM Eastern Daylight Time		07/25/2011 09:51:41 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Complete (PDP)	10	29					S5884	032	0	2012	State of New Jersey		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	033	0		29	10	S5884_033_0	2	1		05/27/2011	2012.02	05/27/2011 01:34:05 PM Eastern Daylight Time		07/21/2011 12:28:00 PM Eastern Daylight Time		07/25/2011 09:51:41 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Complete (PDP)	10	29					S5884	033	0	2012	States of DC, DE, MD		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	034	0		29	10	S5884_034_0	2	1		05/27/2011	2012.02	05/27/2011 01:35:31 PM Eastern Daylight Time		07/21/2011 12:28:00 PM Eastern Daylight Time		07/25/2011 09:51:41 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Complete (PDP)	10	29					S5884	034	0	2012	States of Pennsylvania and West Virginia		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	035	0		29	10	S5884_035_0	2	1		05/27/2011	2012.02	05/27/2011 01:37:42 PM Eastern Daylight Time		07/21/2011 12:28:00 PM Eastern Daylight Time		07/25/2011 09:51:41 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Complete (PDP)	10	29					S5884	035	0	2012	State of Virginia		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	036	0		29	10	S5884_036_0	2	1		05/27/2011	2012.02	05/27/2011 01:38:45 PM Eastern Daylight Time		07/21/2011 12:28:00 PM Eastern Daylight Time		07/25/2011 09:51:41 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Complete (PDP)	10	29					S5884	036	0	2012	State of North Carolina		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	037	0		29	10	S5884_037_0	2	1		05/27/2011	2012.02	05/27/2011 01:39:46 PM Eastern Daylight Time		07/21/2011 12:29:00 PM Eastern Daylight Time		07/25/2011 09:51:41 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Complete (PDP)	10	29					S5884	037	0	2012	State of South Carolina		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	038	0		29	10	S5884_038_0	2	1		05/27/2011	2012.02	05/27/2011 01:42:30 PM Eastern Daylight Time		07/21/2011 12:29:00 PM Eastern Daylight Time		07/25/2011 09:51:41 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Complete (PDP)	10	29					S5884	038	0	2012	State of Georgia		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	039	0		29	10	S5884_039_0	2	1		05/27/2011	2012.02	05/27/2011 01:43:41 PM Eastern Daylight Time		07/21/2011 12:29:00 PM Eastern Daylight Time		07/25/2011 09:51:41 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Complete (PDP)	10	29					S5884	039	0	2012	State of Florida		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	040	0		29	10	S5884_040_0	2	1		05/27/2011	2012.02	05/27/2011 01:45:06 PM Eastern Daylight Time		07/21/2011 12:29:00 PM Eastern Daylight Time		07/25/2011 09:51:41 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Complete (PDP)	10	29					S5884	040	0	2012	States of Alabama and Tennessee		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	041	0		29	10	S5884_041_0	2	1		05/27/2011	2012.02	05/27/2011 01:49:48 PM Eastern Daylight Time		07/21/2011 12:29:00 PM Eastern Daylight Time		07/25/2011 09:51:41 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Complete (PDP)	10	29					S5884	041	0	2012	State of Michigan		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	042	0		29	10	S5884_042_0	2	1		05/27/2011	2012.02	05/27/2011 01:50:59 PM Eastern Daylight Time		07/21/2011 12:29:00 PM Eastern Daylight Time		07/25/2011 09:51:41 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Complete (PDP)	10	29					S5884	042	0	2012	State of Ohio		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	043	0		29	10	S5884_043_0	2	1		05/27/2011	2012.02	05/27/2011 01:53:24 PM Eastern Daylight Time		07/21/2011 12:29:00 PM Eastern Daylight Time		07/25/2011 09:51:41 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Complete (PDP)	10	29					S5884	043	0	2012	States of Indiana and Kentucky		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	044	0		29	10	S5884_044_0	2	1		05/27/2011	2012.02	05/27/2011 01:54:21 PM Eastern Daylight Time		07/21/2011 12:29:00 PM Eastern Daylight Time		07/25/2011 09:51:41 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Complete (PDP)	10	29					S5884	044	0	2012	State of Wisconsin		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	045	0		29	10	S5884_045_0	4	1		05/27/2011	2012.02	05/27/2011 01:33:16 PM Eastern Daylight Time		07/21/2011 12:29:00 PM Eastern Daylight Time		07/25/2011 10:36:30 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Complete (PDP)	10	29					S5884	045	0	2012	State of Illinois		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	046	0		29	10	S5884_046_0	4	1		05/27/2011	2012.02	05/27/2011 01:34:30 PM Eastern Daylight Time		07/21/2011 12:30:00 PM Eastern Daylight Time		07/25/2011 10:36:30 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Complete (PDP)	10	29					S5884	046	0	2012	State of Missouri		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	047	0		29	10	S5884_047_0	4	1		05/27/2011	2012.02	05/27/2011 01:35:21 PM Eastern Daylight Time		07/21/2011 12:30:00 PM Eastern Daylight Time		07/25/2011 10:36:30 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Complete (PDP)	10	29					S5884	047	0	2012	State of Arkansas		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	048	0		29	10	S5884_048_0	4	1		05/27/2011	2012.02	05/27/2011 01:36:09 PM Eastern Daylight Time		07/21/2011 12:30:00 PM Eastern Daylight Time		07/25/2011 10:36:30 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Complete (PDP)	10	29					S5884	048	0	2012	State of Mississippi		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	049	0		29	10	S5884_049_0	4	1		05/27/2011	2012.02	05/27/2011 01:36:58 PM Eastern Daylight Time		07/21/2011 12:30:00 PM Eastern Daylight Time		07/25/2011 10:36:30 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Complete (PDP)	10	29					S5884	049	0	2012	State of Louisiana		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	050	0		29	10	S5884_050_0	4	1		05/27/2011	2012.02	05/27/2011 01:37:48 PM Eastern Daylight Time		07/21/2011 12:30:00 PM Eastern Daylight Time		07/25/2011 10:36:30 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Complete (PDP)	10	29					S5884	050	0	2012	State of Texas		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	051	0		29	10	S5884_051_0	4	1		05/27/2011	2012.02	05/27/2011 01:38:36 PM Eastern Daylight Time		07/21/2011 12:30:00 PM Eastern Daylight Time		07/25/2011 10:36:30 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Complete (PDP)	10	29					S5884	051	0	2012	State of Oklahoma		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	052	0		29	10	S5884_052_0	4	1		05/27/2011	2012.02	05/27/2011 01:39:28 PM Eastern Daylight Time		07/21/2011 12:30:00 PM Eastern Daylight Time		07/25/2011 10:36:30 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Complete (PDP)	10	29					S5884	052	0	2012	State of Kansas		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	053	0		29	10	S5884_053_0	4	1		05/27/2011	2012.02	05/27/2011 01:41:22 PM Eastern Daylight Time		07/21/2011 12:30:00 PM Eastern Daylight Time		07/25/2011 10:36:30 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Complete (PDP)	10	29					S5884	053	0	2012	States of IA, MN, MT, ND, NE, SD, WY		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	058	0		29	10	S5884_058_0	4	1		05/27/2011	2012.02	05/27/2011 01:42:08 PM Eastern Daylight Time		07/21/2011 12:30:00 PM Eastern Daylight Time		07/25/2011 10:36:30 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Complete (PDP)	10	29					S5884	058	0	2012	States of Oregon and Washington		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	059	0		29	10	S5884_059_0	4	1		05/27/2011	2012.02	05/27/2011 01:43:06 PM Eastern Daylight Time		07/21/2011 12:31:00 PM Eastern Daylight Time		07/25/2011 10:36:30 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Complete (PDP)	10	29					S5884	059	0	2012	States of Idaho and Utah		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	060	0		29	10	S5884_060_0	3	1		05/27/2011	2012.02	05/27/2011 01:43:58 PM Eastern Daylight Time		07/21/2011 12:31:00 PM Eastern Daylight Time		07/25/2011 12:56:32 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Complete (PDP)	10	29					S5884	060	0	2012	State of California		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	062	0		29	10	S5884_062_0	4	1		05/25/2011	2012.02	05/25/2011 04:36:45 PM Eastern Daylight Time		07/21/2011 12:31:00 PM Eastern Daylight Time		07/25/2011 10:09:06 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	062	0	2012	State of New Jersey		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	065	0		29	10	S5884_065_0	2	1		05/25/2011	2012.02	05/25/2011 04:40:46 PM Eastern Daylight Time		07/21/2011 12:31:00 PM Eastern Daylight Time		07/25/2011 10:09:06 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	065	0	2012	State of Virginia		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	066	0		29	10	S5884_066_0	2	1		05/25/2011	2012.02	05/25/2011 04:42:07 PM Eastern Daylight Time		07/21/2011 12:31:00 PM Eastern Daylight Time		07/25/2011 10:09:06 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	066	0	2012	State of North Carolina		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	071	0		29	10	S5884_071_0	2	1		05/25/2011	2012.02	05/25/2011 04:50:29 PM Eastern Daylight Time		07/21/2011 12:31:00 PM Eastern Daylight Time		07/25/2011 10:09:06 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	071	0	2012	State of Michigan		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	072	0		29	10	S5884_072_0	2	1		05/25/2011	2012.02	05/25/2011 04:51:59 PM Eastern Daylight Time		07/21/2011 12:31:00 PM Eastern Daylight Time		07/25/2011 10:09:06 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	072	0	2012	State of Ohio		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	073	0		29	10	S5884_073_0	2	1		05/25/2011	2012.02	05/25/2011 04:53:02 PM Eastern Daylight Time		07/21/2011 12:31:00 PM Eastern Daylight Time		07/25/2011 10:09:06 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	073	0	2012	States of Indiana and Kentucky		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	074	0		29	10	S5884_074_0	2	1		05/25/2011	2012.02	05/25/2011 04:54:07 PM Eastern Daylight Time		07/21/2011 12:32:00 PM Eastern Daylight Time		07/25/2011 10:09:06 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	074	0	2012	State of Wisconsin		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	076	0		29	10	S5884_076_0	3	1		05/25/2011	2012.02	05/25/2011 03:54:14 PM Eastern Daylight Time		07/21/2011 12:32:00 PM Eastern Daylight Time		07/25/2011 11:02:04 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	076	0	2012	State of Missouri		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	077	0		29	10	S5884_077_0	3	1		05/25/2011	2012.02	05/25/2011 03:55:31 PM Eastern Daylight Time		07/21/2011 12:32:00 PM Eastern Daylight Time		07/25/2011 11:02:04 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	077	0	2012	State of Arkansas		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	078	0		29	10	S5884_078_0	3	1		05/25/2011	2012.02	05/25/2011 03:56:53 PM Eastern Daylight Time		07/21/2011 12:32:00 PM Eastern Daylight Time		07/25/2011 11:02:04 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	078	0	2012	State of Mississippi		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	083	0		29	10	S5884_083_0	3	1		05/25/2011	2012.02	05/25/2011 04:32:34 PM Eastern Daylight Time		07/21/2011 12:32:00 PM Eastern Daylight Time		07/25/2011 11:02:04 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	083	0	2012	States of IA, MN, MT, ND, NE, SD, WY		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	085	0		29	10	S5884_085_0	3	1		05/25/2011	2012.02	05/25/2011 04:35:22 PM Eastern Daylight Time		07/21/2011 12:32:00 PM Eastern Daylight Time		07/25/2011 11:02:04 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	085	0	2012	State of Colorado		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	086	0		29	10	S5884_086_0	2	1		05/25/2011	2012.02	05/25/2011 04:36:42 PM Eastern Daylight Time		07/21/2011 12:32:00 PM Eastern Daylight Time		07/25/2011 12:56:32 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	086	0	2012	State of Arizona		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	087	0		29	10	S5884_087_0	3	1		05/25/2011	2012.02	05/25/2011 04:37:54 PM Eastern Daylight Time		07/21/2011 12:32:00 PM Eastern Daylight Time		07/25/2011 11:02:04 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	087	0	2012	State of Nevada		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	089	0		29	10	S5884_089_0	3	1		05/25/2011	2012.02	05/25/2011 04:40:24 PM Eastern Daylight Time		07/21/2011 12:32:00 PM Eastern Daylight Time		07/25/2011 11:02:04 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	089	0	2012	States of Idaho and Utah		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	092	0		29	10	S5884_092_0	2	1		05/25/2011	2012.02	05/25/2011 04:33:45 PM Eastern Daylight Time		07/21/2011 12:33:00 PM Eastern Daylight Time		07/25/2011 10:09:06 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	092	0	2012	States of Maine and New Hampshire		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	093	0		29	10	S5884_093_0	3	1		05/25/2011	2012.02	05/25/2011 04:43:06 PM Eastern Daylight Time		07/21/2011 12:33:00 PM Eastern Daylight Time		07/25/2011 11:02:04 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	093	0	2012	State of Hawaii		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	094	0		29	10	S5884_094_0	3	1		05/25/2011	2012.02	05/25/2011 04:44:15 PM Eastern Daylight Time		07/21/2011 12:33:00 PM Eastern Daylight Time		07/25/2011 11:02:04 AM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Enhanced (PDP)	10	29					S5884	094	0	2012	State of Alaska		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	101	0		29	10	S5884_101_0	3	1		07/22/2011	2012.02	07/22/2011 08:55:53 AM Eastern Daylight Time		07/21/2011 05:23:00 PM Eastern Daylight Time		07/22/2011 10:11:24 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S5884	101	0	2012	States of New Hampshire and Maine		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	102	0		29	10	S5884_102_0	3	1		07/22/2011	2012.02	07/22/2011 09:57:15 AM Eastern Daylight Time		07/21/2011 05:24:00 PM Eastern Daylight Time		07/22/2011 10:16:20 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S5884	102	0	2012	States of CT, MA, RI, VT		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	103	0		29	10	S5884_103_0	3	1		07/22/2011	2012.02	07/22/2011 09:57:19 AM Eastern Daylight Time		07/21/2011 05:24:00 PM Eastern Daylight Time		07/22/2011 10:20:04 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S5884	103	0	2012	States of DC, DE, MD		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	104	0		29	10	S5884_104_0	3	1		07/22/2011	2012.02	07/22/2011 09:57:22 AM Eastern Daylight Time		07/21/2011 05:24:00 PM Eastern Daylight Time		07/22/2011 10:23:52 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S5884	104	0	2012	States of Pennsylvania and West Virginia		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	105	0		29	10	S5884_105_0	3	1		07/22/2011	2012.02	07/22/2011 09:58:38 AM Eastern Daylight Time		07/21/2011 06:04:00 PM Eastern Daylight Time		07/22/2011 10:27:23 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S5884	105	0	2012	State of Florida		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	106	0		29	10	S5884_106_0	3	1		07/22/2011	2012.02	07/22/2011 09:57:25 AM Eastern Daylight Time		07/21/2011 05:24:00 PM Eastern Daylight Time		07/22/2011 10:31:05 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S5884	106	0	2012	States of Alabama and Tennessee		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	107	0		29	10	S5884_107_0	2	1		07/22/2011	2012.02	07/22/2011 09:36:14 AM Eastern Daylight Time		07/21/2011 05:24:00 PM Eastern Daylight Time		07/22/2011 05:22:24 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S5884	107	0	2012	State of Illinois		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	108	0		29	10	S5884_108_0	2	1		07/22/2011	2012.02	07/22/2011 10:13:30 AM Eastern Daylight Time		07/21/2011 05:24:00 PM Eastern Daylight Time		07/22/2011 05:22:24 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S5884	108	0	2012	State of Louisiana		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	109	0		29	10	S5884_109_0	2	1		07/22/2011	2012.02	07/22/2011 10:13:33 AM Eastern Daylight Time		07/21/2011 05:24:00 PM Eastern Daylight Time		07/22/2011 05:22:24 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S5884	109	0	2012	State of Kansas		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	110	0		29	10	S5884_110_0	2	1		07/22/2011	2012.02	07/22/2011 10:13:36 AM Eastern Daylight Time		07/21/2011 05:24:00 PM Eastern Daylight Time		07/22/2011 05:22:24 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S5884	110	0	2012	State of New Mexico		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	111	0		29	10	S5884_111_0	2	1		07/22/2011	2012.02	07/22/2011 10:13:40 AM Eastern Daylight Time		07/21/2011 05:24:00 PM Eastern Daylight Time		07/22/2011 05:22:24 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S5884	111	0	2012	State of Colorado		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	112	0		29	10	S5884_112_0	2	1		07/22/2011	2012.02	07/22/2011 10:13:43 AM Eastern Daylight Time		07/21/2011 05:25:00 PM Eastern Daylight Time		07/22/2011 05:22:24 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S5884	112	0	2012	State of Nevada		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	113	0		29	10	S5884_113_0	2	1		07/22/2011	2012.02	07/22/2011 10:13:46 AM Eastern Daylight Time		07/21/2011 05:25:00 PM Eastern Daylight Time		07/22/2011 05:22:24 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S5884	113	0	2012	States of Oregon and Washington		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	114	0		29	10	S5884_114_0	2	1		07/22/2011	2012.02	07/22/2011 09:45:50 AM Eastern Daylight Time		07/21/2011 05:25:00 PM Eastern Daylight Time		07/22/2011 05:22:24 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S5884	114	0	2012	State of California		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	115	0		29	10	S5884_115_0	2	1		07/22/2011	2012.02	07/22/2011 10:13:50 AM Eastern Daylight Time		07/21/2011 05:25:00 PM Eastern Daylight Time		07/22/2011 05:22:24 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S5884	115	0	2012	State of Hawaii		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	116	0		29	10	S5884_116_0	2	1		07/22/2011	2012.02	07/22/2011 10:13:53 AM Eastern Daylight Time		07/21/2011 05:25:00 PM Eastern Daylight Time		07/22/2011 05:22:24 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S5884	116	0	2012	State of Alaska		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	131	0		29	10	S5884_131_0	3	1		07/22/2011	2012.02	07/22/2011 09:57:29 AM Eastern Daylight Time		07/21/2011 05:25:00 PM Eastern Daylight Time		07/22/2011 10:35:18 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S5884	131	0	2012	State of New Jersey		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	132	0		29	10	S5884_132_0	3	1		07/22/2011	2012.02	07/22/2011 09:57:33 AM Eastern Daylight Time		07/21/2011 05:25:00 PM Eastern Daylight Time		07/22/2011 10:39:10 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S5884	132	0	2012	State of Virginia		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	133	0		29	10	S5884_133_0	3	1		07/22/2011	2012.02	07/22/2011 09:57:37 AM Eastern Daylight Time		07/21/2011 05:25:00 PM Eastern Daylight Time		07/22/2011 10:42:53 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S5884	133	0	2012	State of North Carolina		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	134	0		29	10	S5884_134_0	3	1		07/22/2011	2012.02	07/22/2011 11:05:13 AM Eastern Daylight Time		07/21/2011 05:26:00 PM Eastern Daylight Time		07/22/2011 10:46:37 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S5884	134	0	2012	State of South Carolina		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	135	0		29	10	S5884_135_0	3	1		07/22/2011	2012.02	07/22/2011 09:57:43 AM Eastern Daylight Time		07/21/2011 05:26:00 PM Eastern Daylight Time		07/22/2011 10:50:24 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S5884	135	0	2012	State of Georgia		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	136	0		29	10	S5884_136_0	4	1		07/22/2011	2012.02	07/22/2011 09:57:47 AM Eastern Daylight Time		07/21/2011 05:26:00 PM Eastern Daylight Time		07/22/2011 11:04:33 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S5884	136	0	2012	State of Michigan		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	137	0		29	10	S5884_137_0	3	1		07/22/2011	2012.02	07/22/2011 09:11:10 AM Eastern Daylight Time		07/21/2011 05:26:00 PM Eastern Daylight Time		07/22/2011 11:08:04 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S5884	137	0	2012	State of Ohio		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	138	0		29	10	S5884_138_0	3	1		07/22/2011	2012.02	07/22/2011 09:57:50 AM Eastern Daylight Time		07/21/2011 05:26:00 PM Eastern Daylight Time		07/22/2011 11:12:42 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S5884	138	0	2012	States of Indiana and Kentucky		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	139	0		29	10	S5884_139_0	3	1		07/22/2011	2012.02	07/22/2011 09:57:54 AM Eastern Daylight Time		07/21/2011 05:26:00 PM Eastern Daylight Time		07/22/2011 11:16:13 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S5884	139	0	2012	State of Wisconsin		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	140	0		29	10	S5884_140_0	3	1		07/22/2011	2012.02	07/22/2011 10:13:56 AM Eastern Daylight Time		07/21/2011 05:26:00 PM Eastern Daylight Time		07/22/2011 05:22:24 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S5884	140	0	2012	State of Missouri		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	141	0		29	10	S5884_141_0	2	1		07/22/2011	2012.02	07/22/2011 10:14:00 AM Eastern Daylight Time		07/21/2011 05:26:00 PM Eastern Daylight Time		07/22/2011 05:22:24 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S5884	141	0	2012	State of Arkansas		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	142	0		29	10	S5884_142_0	2	1		07/22/2011	2012.02	07/22/2011 10:14:03 AM Eastern Daylight Time		07/21/2011 05:27:00 PM Eastern Daylight Time		07/22/2011 05:22:24 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S5884	142	0	2012	State of Mississippi		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	143	0		29	10	S5884_143_0	2	1		07/22/2011	2012.02	07/22/2011 10:14:06 AM Eastern Daylight Time		07/21/2011 05:27:00 PM Eastern Daylight Time		07/22/2011 05:22:24 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S5884	143	0	2012	State of Texas		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	144	0		29	10	S5884_144_0	2	1		07/22/2011	2012.02	07/22/2011 10:14:10 AM Eastern Daylight Time		07/21/2011 05:27:00 PM Eastern Daylight Time		07/22/2011 05:22:24 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S5884	144	0	2012	State of Oklahoma		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	145	0		29	10	S5884_145_0	2	1		07/22/2011	2012.02	07/22/2011 10:14:13 AM Eastern Daylight Time		07/21/2011 05:27:00 PM Eastern Daylight Time		07/22/2011 05:22:24 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S5884	145	0	2012	States of IA, MN, MT, ND, NE, SD, WY		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	146	0		29	10	S5884_146_0	2	1		07/22/2011	2012.02	07/22/2011 10:14:16 AM Eastern Daylight Time		07/21/2011 05:27:00 PM Eastern Daylight Time		07/22/2011 05:22:24 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S5884	146	0	2012	State of Arizona		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	147	0		29	10	S5884_147_0	2	1		07/22/2011	2012.02	07/22/2011 10:14:20 AM Eastern Daylight Time		07/21/2011 05:27:00 PM Eastern Daylight Time		07/22/2011 05:22:24 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Walmart-Preferred Rx Plan (PDP)	10	29					S5884	147	0	2012	States of Idaho and Utah		2					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	834	0		29	10	S5884_834_0	1	1		05/28/2011	2012.02	05/28/2011 06:50:25 PM Eastern Daylight Time				05/28/2011 06:59:21 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored (PDP)	10	29					S5884	834	0	2012	All Regions		1					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	835	0		29	10	S5884_835_0	1	1		05/28/2011	2012.02	05/28/2011 06:50:33 PM Eastern Daylight Time				05/28/2011 06:59:21 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored Non-CY (PDP)	10	29					S5884	835	0	2012	All Regions		1					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5884	836	0		29	10	S5884_836_0	1	1		05/28/2011	2012.02	05/28/2011 06:50:43 PM Eastern Daylight Time				05/28/2011 06:59:21 PM Eastern Daylight Time	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	Humana Employer Sponsored - Walmart (PDP)	10	29					S5884	836	0	2012	All Regions		1					2							http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	http://www.humana.com/Medicare/medicare_prescription_drugs									(800)-281-6918		(800)-281-6918		(800)-706-0872		(800)-706-0872										(711)		(711)		(711)		(711)				
S5904	001	0		29	10	S5904_001_0	3	1		07/12/2011	2012.02	07/12/2011 03:26:23 PM Eastern Daylight Time		07/21/2011 11:30:52 AM Eastern Daylight Time		07/21/2011 02:09:24 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Blue Cross and Blue Shield of Florida, Inc.	www.BlueMedicareFL.com	BlueMedicare Rx-Option 1 (PDP)	10	29					S5904	001	0	2012	State of Florida		2					2							www.myprime.com	www.BlueMedicareFL.com									(800)-926-6565		(800)-926-6565		(800)-876-2227		(800)-876-2227										(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771				
S5904	002	0		29	10	S5904_002_0	3	1		05/31/2011	2012.02	05/31/2011 05:42:43 PM Eastern Daylight Time		07/21/2011 11:13:24 AM Eastern Daylight Time		07/21/2011 02:09:24 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Blue Cross and Blue Shield of Florida, Inc.	www.BlueMedicareFL.com	BlueMedicare Rx-Option 2 (PDP)	10	29					S5904	002	0	2012	State of Florida		2					2							www.myprime.com	www.BlueMedicareFL.com									(800)-926-6565		(800)-926-6565		(800)-876-2227		(800)-876-2227										(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771				
S5904	801	0		29	10	S5904_801_0	1	1		06/01/2011	2012.02	06/01/2011 05:06:00 PM Eastern Daylight Time				06/06/2011 08:44:56 AM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Blue Cross and Blue Shield of Florida, Inc.	www.BlueMedicareFL.com	BlueMedicare Group Rx (PDP)	10	29					S5904	801	0	2012	State of Florida with National Coverage		1					2							www.myprime.com	www.BlueMedicareFL.com									(800)-926-6565		(800)-926-6565		(800)-876-2227		(800)-876-2227										(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771				
S5904	802	0		29	10	S5904_802_0	1	1		05/31/2011	2012.02	05/31/2011 11:38:38 AM Eastern Daylight Time				06/06/2011 08:44:56 AM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Blue Cross and Blue Shield of Florida, Inc.	www.BlueMedicareFL.com	BlueMedicare Group Rx (PDP)	10	29					S5904	802	0	2012	State of Florida with National Coverage		1					2							www.myprime.com	www.BlueMedicareFL.com									(800)-926-6565		(800)-926-6565		(800)-876-2227		(800)-876-2227										(800)-955-8771		(800)-955-8771		(800)-955-8771		(800)-955-8771				
S5907	001	0		29	10	S5907_001_0	7	1		08/01/2011	2012.02	08/01/2011 01:32:02 PM SA Western Standard Time		06/06/2011 08:46:54 AM SA Western Standard Time		08/01/2011 01:36:35 PM SA Western Standard Time	TRIPLE-S SALUD, INC.	Triple-S Salud, Inc.	www.sssplanesmedicare.com	Triple-S FarmaMed (PDP)	10	29					S5907	001	0	2012	Island of Puerto Rico		2					2							www.ssspr.com	www.ssspr.com									(800)-510-0722		(787)-774-6083		(877)-207-8777		(877)-207-8777										(800)-383-4457		(787)-749-4059		(800)-383-4457		(787)-749-4059				
S5907	002	0		29	10	S5907_002_0	8	1		08/01/2011	2012.02	08/01/2011 01:32:23 PM SA Western Standard Time		07/22/2011 12:54:07 PM SA Western Standard Time		08/01/2011 01:36:35 PM SA Western Standard Time	TRIPLE-S SALUD, INC.	Triple-S Salud, Inc.	www.sssplanesmedicare.com	Triple-S FarmaMed Plus (PDP)	10	29					S5907	002	0	2012	Island of Puerto Rico		2					2							www.ssspr.com	www.ssspr.com									(800)-510-0722		(787)-774-6083		(877)-207-8777		(877)-207-8777										(800)-383-4457		(787)-749-4059		(800)-383-4457		(787)-749-4059				
S5907	801	0		29	10	S5907_801_0	6	1		06/01/2011	2012.02	06/01/2011 02:08:16 PM SA Western Standard Time				06/06/2011 09:02:53 AM SA Western Standard Time	TRIPLE-S SALUD, INC.	Triple-S Salud, Inc.	www.sssplanesmedicare.com	Triple-S FarmaMed A (PDP)	10	29					S5907	801	0	2012	Island of Puerto Rico		1					2							www.ssspr.com	www.ssspr.com									(800)-510-0722		(787)-774-6083		(877)-207-8777		(877)-207-8777										(800)-383-4457		(787)-749-4059		(800)-383-4457		(787)-749-4059				
S5907	802	0		29	10	S5907_802_0	6	1		06/01/2011	2012.02	06/01/2011 02:07:21 PM SA Western Standard Time				06/06/2011 09:02:53 AM SA Western Standard Time	TRIPLE-S SALUD, INC.	Triple-S Salud, Inc.	www.sssplanesmedicare.com	Triple-S FarmaMed B (PDP)	10	29					S5907	802	0	2012	Island of Puerto Rico		1					2							www.ssspr.com	www.ssspr.com									(800)-510-0722		(787)-774-6083		(877)-207-8777		(877)-207-8777										(800)-383-4457		(787)-749-4059		(800)-383-4457		(787)-749-4059				
S5916	001	0		29	10	S5916_001_0	4	1		07/07/2011	2012.02	07/07/2011 01:53:24 PM Mountain Daylight Time		07/07/2011 02:49:49 PM Pacific Daylight Time		07/19/2011 02:14:37 PM Pacific Daylight Time	REGENCE LIFE AND HEALTH INSURANCE COMPANY	Regence Life and Health	www.regence.com/medicare	Regence Medicare Script Basic (PDP)	10	29					S5916	001	0	2012	Region of Idaho and Utah		2					2							www.regence.com/medicare/script	www.regence.com/medicare/script									(800)-541-8981		(800)-541-8981		(800)-505-6765		(800)-505-6765										(711)		(711)		(711)		(711)				
S5916	002	0		29	10	S5916_002_0	4	1		07/07/2011	2012.02	07/07/2011 01:57:14 PM Mountain Daylight Time		07/07/2011 02:51:43 PM Pacific Daylight Time		07/19/2011 02:16:48 PM Pacific Daylight Time	REGENCE LIFE AND HEALTH INSURANCE COMPANY	Regence Life and Health	www.regence.com/medicare	Regence Medicare Script Enhanced (PDP)	10	29					S5916	002	0	2012	Region of Idaho and Utah		2					2							www.regence.com/medicare/script	www.regence.com/medicare/script									(800)-541-8981		(800)-541-8981		(800)-505-6765		(800)-505-6765										(711)		(711)		(711)		(711)				
S5916	802	0		29	10	S5916_802_0	1	1		06/03/2011	2012.02	06/03/2011 10:58:27 AM Mountain Daylight Time				06/06/2011 09:55:09 AM Pacific Daylight Time	REGENCE LIFE AND HEALTH INSURANCE COMPANY	Regence Life and Health	www.regence.com/medicare	Regence Medicare Script (PDP)	10	29					S5916	802	0	2012	Nationwide except territories		1					2							www.regence.com/medicare/script	www.regence.com/medicare/script									(888)-319-8904		(888)-319-8904		(800)-505-6765		(800)-505-6765										(711)		(711)		(711)		(711)				
S5921	003	0		29	10	S5921_003_0	1	1		06/02/2011	2012.02	06/02/2011 11:37:31 AM Central Daylight Time		06/04/2011 02:51:45 PM Central Daylight Time		06/04/2011 08:03:05 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Enhanced (PDP)	10	29					S5921	003	0	2012	California		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5921	013	0		29	10	S5921_013_0	1	1		06/01/2011	2012.02	06/01/2011 10:00:11 PM Central Daylight Time		06/04/2011 02:52:03 PM Central Daylight Time		06/04/2011 08:03:05 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Enhanced (PDP)	10	29					S5921	013	0	2012	Alaska		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5921	023	0		29	10	S5921_023_0	1	1		06/01/2011	2012.02	06/01/2011 10:00:16 PM Central Daylight Time		06/04/2011 02:52:20 PM Central Daylight Time		06/04/2011 08:03:05 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Enhanced (PDP)	10	29					S5921	023	0	2012	Oregon and Washington		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5921	033	0		29	10	S5921_033_0	1	1		06/01/2011	2012.02	06/01/2011 10:00:20 PM Central Daylight Time		06/04/2011 02:52:37 PM Central Daylight Time		06/04/2011 08:03:05 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Enhanced (PDP)	10	29					S5921	033	0	2012	Idaho and Utah		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5921	043	0		29	10	S5921_043_0	1	1		06/01/2011	2012.02	06/01/2011 10:00:23 PM Central Daylight Time		06/04/2011 02:52:55 PM Central Daylight Time		06/04/2011 08:03:05 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Enhanced (PDP)	10	29					S5921	043	0	2012	Hawaii		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5921	053	0		29	10	S5921_053_0	1	1		06/01/2011	2012.02	06/01/2011 10:00:26 PM Central Daylight Time		06/04/2011 02:55:40 PM Central Daylight Time		06/04/2011 08:03:05 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Enhanced (PDP)	10	29					S5921	053	0	2012	Ohio		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5921	063	0		29	10	S5921_063_0	1	1		06/01/2011	2012.02	06/01/2011 10:00:28 PM Central Daylight Time		06/04/2011 02:56:09 PM Central Daylight Time		06/04/2011 08:03:05 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Enhanced (PDP)	10	29					S5921	063	0	2012	Indiana and Kentucky		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5921	073	0		29	10	S5921_073_0	1	1		06/01/2011	2012.02	06/01/2011 10:00:31 PM Central Daylight Time		06/04/2011 02:56:36 PM Central Daylight Time		06/04/2011 08:03:05 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Enhanced (PDP)	10	29					S5921	073	0	2012	Wisconsin		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5921	083	0		29	10	S5921_083_0	1	1		06/02/2011	2012.02	06/02/2011 11:37:50 AM Central Daylight Time		06/04/2011 02:57:09 PM Central Daylight Time		06/04/2011 08:03:05 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Enhanced (PDP)	10	29					S5921	083	0	2012	Illinois		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5921	093	0		29	10	S5921_093_0	1	1		06/01/2011	2012.02	06/01/2011 10:00:36 PM Central Daylight Time		06/04/2011 02:57:40 PM Central Daylight Time		06/04/2011 08:03:05 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Enhanced (PDP)	10	29					S5921	093	0	2012	Pennsylvania and West Virginia		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5921	103	0		29	10	S5921_103_0	1	1		06/01/2011	2012.02	06/01/2011 10:00:39 PM Central Daylight Time		06/04/2011 02:58:09 PM Central Daylight Time		06/04/2011 08:03:05 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Enhanced (PDP)	10	29					S5921	103	0	2012	Virginia		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5921	113	0		29	10	S5921_113_0	1	1		06/01/2011	2012.02	06/01/2011 10:00:42 PM Central Daylight Time		06/04/2011 02:58:38 PM Central Daylight Time		06/04/2011 08:03:05 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Enhanced (PDP)	10	29					S5921	113	0	2012	North Carolina		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5921	123	0		29	10	S5921_123_0	1	1		06/01/2011	2012.02	06/01/2011 10:00:44 PM Central Daylight Time		06/04/2011 02:59:03 PM Central Daylight Time		06/04/2011 08:03:05 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Enhanced (PDP)	10	29					S5921	123	0	2012	South Carolina		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5921	133	0		29	10	S5921_133_0	1	1		06/01/2011	2012.02	06/01/2011 10:00:47 PM Central Daylight Time		06/04/2011 02:59:29 PM Central Daylight Time		06/04/2011 08:03:05 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Enhanced (PDP)	10	29					S5921	133	0	2012	Georgia		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5921	143	0		29	10	S5921_143_0	1	1		06/01/2011	2012.02	06/01/2011 10:00:49 PM Central Daylight Time		06/04/2011 03:00:06 PM Central Daylight Time		06/04/2011 08:03:05 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Enhanced (PDP)	10	29					S5921	143	0	2012	Florida		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5921	153	0		29	10	S5921_153_0	1	1		06/01/2011	2012.02	06/01/2011 10:00:52 PM Central Daylight Time		06/04/2011 03:00:34 PM Central Daylight Time		06/04/2011 08:03:05 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Enhanced (PDP)	10	29					S5921	153	0	2012	Alabama and Tennessee		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5921	163	0		29	10	S5921_163_0	1	1		06/01/2011	2012.02	06/01/2011 10:00:55 PM Central Daylight Time		06/04/2011 03:01:04 PM Central Daylight Time		06/04/2011 08:03:05 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Enhanced (PDP)	10	29					S5921	163	0	2012	Michigan		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5921	173	0		29	10	S5921_173_0	1	1		06/01/2011	2012.02	06/01/2011 10:00:57 PM Central Daylight Time		06/04/2011 03:01:33 PM Central Daylight Time		06/04/2011 08:03:05 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Enhanced (PDP)	10	29					S5921	173	0	2012	New Hampshire and Maine		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5921	183	0		29	10	S5921_183_0	1	1		06/01/2011	2012.02	06/01/2011 10:01:01 PM Central Daylight Time		06/04/2011 03:02:00 PM Central Daylight Time		06/04/2011 08:03:05 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Enhanced (PDP)	10	29					S5921	183	0	2012	Connecticut, Massachusetts, Rhode Island, Vermont		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5921	193	0		29	10	S5921_193_0	1	1		06/01/2011	2012.02	06/01/2011 10:01:07 PM Central Daylight Time		06/04/2011 03:02:27 PM Central Daylight Time		06/04/2011 08:03:05 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Enhanced (PDP)	10	29					S5921	193	0	2012	Texas		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5921	213	0		29	10	S5921_213_0	1	1		06/01/2011	2012.02	06/01/2011 10:03:36 PM Central Daylight Time		06/04/2011 03:02:54 PM Central Daylight Time		06/04/2011 08:03:05 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Enhanced (PDP)	10	29					S5921	213	0	2012	New York		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5921	223	0		29	10	S5921_223_0	1	1		06/01/2011	2012.02	06/01/2011 10:01:13 PM Central Daylight Time		06/04/2011 02:53:11 PM Central Daylight Time		06/04/2011 08:03:05 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Enhanced (PDP)	10	29					S5921	223	0	2012	Colorado		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5921	233	0		29	10	S5921_233_0	1	1		06/01/2011	2012.02	06/01/2011 10:01:15 PM Central Daylight Time		06/04/2011 02:53:29 PM Central Daylight Time		06/04/2011 08:03:05 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Enhanced (PDP)	10	29					S5921	233	0	2012	Arizona		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5921	235	0		29	10	S5921_235_0	1	1		06/01/2011	2012.02	06/01/2011 10:01:18 PM Central Daylight Time		06/04/2011 03:03:23 PM Central Daylight Time		06/04/2011 08:03:05 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Enhanced (PDP)	10	29					S5921	235	0	2012	Oklahoma		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5921	239	0		29	10	S5921_239_0	1	1		06/01/2011	2012.02	06/01/2011 10:01:20 PM Central Daylight Time		06/04/2011 03:03:50 PM Central Daylight Time		06/04/2011 08:03:05 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Enhanced (PDP)	10	29					S5921	239	0	2012	Delaware, Maryland and Washington D.C.		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5921	249	0		29	10	S5921_249_0	1	1		06/01/2011	2012.02	06/01/2011 10:01:23 PM Central Daylight Time		06/04/2011 02:53:46 PM Central Daylight Time		06/04/2011 08:03:05 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Enhanced (PDP)	10	29					S5921	249	0	2012	IA, MN, MT, ND, NE, SD, WY		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5921	263	0		29	10	S5921_263_0	1	1		06/01/2011	2012.02	06/01/2011 10:01:25 PM Central Daylight Time		06/04/2011 02:54:04 PM Central Daylight Time		06/04/2011 08:03:05 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Enhanced (PDP)	10	29					S5921	263	0	2012	New Mexico		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5921	273	0		29	10	S5921_273_0	1	1		06/01/2011	2012.02	06/01/2011 10:01:28 PM Central Daylight Time		06/04/2011 02:54:21 PM Central Daylight Time		06/04/2011 08:03:05 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Enhanced (PDP)	10	29					S5921	273	0	2012	Nevada		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5921	283	0		29	10	S5921_283_0	1	1		06/01/2011	2012.02	06/01/2011 10:01:30 PM Central Daylight Time		06/04/2011 03:04:17 PM Central Daylight Time		06/04/2011 08:03:05 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Enhanced (PDP)	10	29					S5921	283	0	2012	Kansas		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5921	293	0		29	10	S5921_293_0	1	1		06/01/2011	2012.02	06/01/2011 10:01:33 PM Central Daylight Time		06/04/2011 03:04:45 PM Central Daylight Time		06/04/2011 08:03:05 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Enhanced (PDP)	10	29					S5921	293	0	2012	New Jersey		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5921	303	0		29	10	S5921_303_0	1	1		06/01/2011	2012.02	06/01/2011 10:01:35 PM Central Daylight Time		06/04/2011 03:05:15 PM Central Daylight Time		06/04/2011 08:03:05 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Enhanced (PDP)	10	29					S5921	303	0	2012	Missouri		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5921	313	0		29	10	S5921_313_0	1	1		06/01/2011	2012.02	06/01/2011 10:01:38 PM Central Daylight Time		06/04/2011 03:05:43 PM Central Daylight Time		06/04/2011 08:03:05 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Enhanced (PDP)	10	29					S5921	313	0	2012	Arkansas		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5921	323	0		29	10	S5921_323_0	1	1		06/01/2011	2012.02	06/01/2011 10:01:41 PM Central Daylight Time		06/04/2011 03:06:14 PM Central Daylight Time		06/04/2011 08:03:05 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Enhanced (PDP)	10	29					S5921	323	0	2012	Mississippi		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5921	333	0		29	10	S5921_333_0	1	1		06/01/2011	2012.02	06/01/2011 10:01:43 PM Central Daylight Time		06/04/2011 03:06:40 PM Central Daylight Time		06/04/2011 08:03:05 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	AARP MedicareRx Enhanced (PDP)	10	29					S5921	333	0	2012	Louisiana		2					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-867-5575		(888)-867-5575		(888)-867-5564		(888)-867-5564										(711)		(711)		(711)		(711)				
S5921	802	0		29	10	S5921_802_0	1	1		06/06/2011	2012.02	06/06/2011 12:12:04 PM Central Daylight Time				06/06/2011 12:13:03 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5921	802	0	2012	National		1					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-556-6648		(888)-556-6648		(888)-556-6648		(888)-556-6648										(711)		(711)		(711)		(711)				
S5921	837	0		29	10	S5921_837_0	1	1		06/06/2011	2012.02	06/06/2011 12:12:13 PM Central Daylight Time				06/06/2011 12:13:03 PM Central Daylight Time	UNITEDHEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY	UnitedHealthcare	www.AARPMedicareRx.com	UnitedHealthcare MedicareRx for Groups (PDP)	10	29					S5921	837	0	2012	National		1					2							www.AARPMedicarePlans.com/tools/find-prescription-drugs.html?type=PDP	www.AARPMedicarePlans.com/tools/aarp-pharmacy.html									(888)-556-6648		(888)-556-6648		(888)-556-6648		(888)-556-6648										(711)		(711)		(711)		(711)				
S5932	001	0		29	10	S5932_001_0	3	1		06/03/2011	2012.02	06/03/2011 09:21:20 AM Central Daylight Time		07/21/2011 10:12:21 AM Central Daylight Time		07/21/2011 06:55:45 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Prescription Drug Plan -Reg12 (PDP)	10	29					S5932	001	0	2012	Alabama, Tennessee		2					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	002	0		29	10	S5932_002_0	3	1		05/31/2011	2012.02	05/31/2011 12:43:35 PM Central Daylight Time		07/21/2011 10:13:10 AM Central Daylight Time		07/21/2011 06:55:45 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Prescription Drug Plan -Reg 1 (PDP)	10	29					S5932	002	0	2012	Northern New England		2					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	003	0		29	10	S5932_003_0	2	1		05/31/2011	2012.02	05/31/2011 12:45:49 PM Central Daylight Time		06/06/2011 02:48:07 PM Central Daylight Time		06/06/2011 05:48:02 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Prescription Drug Plan -Reg 2 (PDP)	10	29					S5932	003	0	2012	Central New England		2					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	004	0		29	10	S5932_004_0	3	1		04/12/2011	2012.02	04/12/2011 05:13:05 PM Central Daylight Time		07/21/2011 10:13:54 AM Central Daylight Time		07/21/2011 06:55:45 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Prescription Drug Plan -Reg 3 (PDP)	10	29					S5932	004	0	2012	New York		2					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	005	0		29	10	S5932_005_0	2	1		04/13/2011	2012.02	04/13/2011 01:48:17 PM Central Daylight Time		06/06/2011 02:49:37 PM Central Daylight Time		06/06/2011 05:48:02 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Prescription Drug Plan -Reg 4 (PDP)	10	29					S5932	005	0	2012	New Jersey		2					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	006	0		29	10	S5932_006_0	3	1		04/13/2011	2012.02	04/13/2011 01:48:35 PM Central Daylight Time		07/21/2011 10:14:37 AM Central Daylight Time		07/21/2011 06:55:45 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Prescription Drug Plan -Reg 6 (PDP)	10	29					S5932	006	0	2012	Pennsylvania, West Virginia		2					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	007	0		29	10	S5932_007_0	2	1		04/13/2011	2012.02	04/13/2011 01:48:55 PM Central Daylight Time		06/06/2011 02:51:07 PM Central Daylight Time		06/06/2011 05:48:02 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Prescription Drug Plan -Reg 7 (PDP)	10	29					S5932	007	0	2012	Virginia		2					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	008	0		29	10	S5932_008_0	3	1		04/13/2011	2012.02	04/13/2011 01:49:02 PM Central Daylight Time		07/21/2011 10:15:22 AM Central Daylight Time		07/21/2011 06:55:45 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Prescription Drug Plan -Reg 8 (PDP)	10	29					S5932	008	0	2012	North Carolina		2					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	009	0		29	10	S5932_009_0	3	1		05/31/2011	2012.02	05/31/2011 01:33:25 PM Central Daylight Time		07/21/2011 10:16:07 AM Central Daylight Time		07/21/2011 06:55:45 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Prescription Drug Plan -Reg 9 (PDP)	10	29					S5932	009	0	2012	South Carolina		2					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	010	0		29	10	S5932_010_0	3	1		04/13/2011	2012.02	04/13/2011 01:49:28 PM Central Daylight Time		07/21/2011 10:16:47 AM Central Daylight Time		07/21/2011 06:55:45 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Prescription Drug Plan-Reg 10 (PDP)	10	29					S5932	010	0	2012	Georgia		2					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	011	0		29	10	S5932_011_0	3	1		04/13/2011	2012.02	04/13/2011 01:49:32 PM Central Daylight Time		07/21/2011 10:17:27 AM Central Daylight Time		07/21/2011 06:55:45 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Prescription Drug Plan-Reg 11 (PDP)	10	29					S5932	011	0	2012	Florida		2					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	012	0		29	10	S5932_012_0	2	1		04/13/2011	2012.02	04/13/2011 01:49:40 PM Central Daylight Time		06/06/2011 02:54:35 PM Central Daylight Time		06/06/2011 05:48:02 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Prescription Drug Plan-Reg 13 (PDP)	10	29					S5932	012	0	2012	Michigan		2					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	013	0		29	10	S5932_013_0	3	1		04/13/2011	2012.02	04/13/2011 01:49:45 PM Central Daylight Time		07/21/2011 10:18:14 AM Central Daylight Time		07/21/2011 06:55:45 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Prescription Drug Plan-Reg 14 (PDP)	10	29					S5932	013	0	2012	Ohio		2					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	014	0		29	10	S5932_014_0	2	1		04/13/2011	2012.02	04/13/2011 01:49:50 PM Central Daylight Time		06/06/2011 02:55:55 PM Central Daylight Time		06/06/2011 05:48:02 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Prescription Drug Plan-Reg 15 (PDP)	10	29					S5932	014	0	2012	Indiana, Kentucky		2					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	015	0		29	10	S5932_015_0	3	1		04/13/2011	2012.02	04/13/2011 01:49:55 PM Central Daylight Time		07/21/2011 10:18:56 AM Central Daylight Time		07/21/2011 06:55:45 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Prescription Drug Plan-Reg 16 (PDP)	10	29					S5932	015	0	2012	Wisconsin		2					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	016	0		29	10	S5932_016_0	3	1		05/31/2011	2012.02	05/31/2011 03:38:09 PM Central Daylight Time		07/21/2011 10:19:40 AM Central Daylight Time		07/21/2011 06:55:45 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Prescription Drug Plan-Reg 17 (PDP)	10	29					S5932	016	0	2012	Illinois		2					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	017	0		29	10	S5932_017_0	3	1		04/13/2011	2012.02	04/13/2011 01:50:05 PM Central Daylight Time		07/21/2011 10:20:29 AM Central Daylight Time		07/21/2011 06:55:45 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Prescription Drug Plan-Reg 18 (PDP)	10	29					S5932	017	0	2012	Missouri		2					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	018	0		29	10	S5932_018_0	3	1		04/13/2011	2012.02	04/13/2011 01:50:10 PM Central Daylight Time		07/21/2011 10:21:11 AM Central Daylight Time		07/21/2011 06:55:45 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Prescription Drug Plan-Reg 19 (PDP)	10	29					S5932	018	0	2012	Arkansas		2					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	019	0		29	10	S5932_019_0	3	1		04/13/2011	2012.02	04/13/2011 01:50:13 PM Central Daylight Time		07/21/2011 10:21:56 AM Central Daylight Time		07/21/2011 06:55:45 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Prescription Drug Plan-Reg 20 (PDP)	10	29					S5932	019	0	2012	Mississippi		2					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	020	0		29	10	S5932_020_0	2	1		04/13/2011	2012.02	04/13/2011 01:50:17 PM Central Daylight Time		06/06/2011 03:00:17 PM Central Daylight Time		06/06/2011 05:48:02 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Prescription Drug Plan-Reg 21 (PDP)	10	29					S5932	020	0	2012	Louisiana		2					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	021	0		29	10	S5932_021_0	3	1		04/13/2011	2012.02	04/13/2011 01:50:22 PM Central Daylight Time		07/21/2011 10:22:40 AM Central Daylight Time		07/21/2011 06:55:45 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Prescription Drug Plan-Reg 22 (PDP)	10	29					S5932	021	0	2012	Texas		2					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	022	0		29	10	S5932_022_0	3	1		04/13/2011	2012.02	04/13/2011 01:50:26 PM Central Daylight Time		07/21/2011 10:23:30 AM Central Daylight Time		07/21/2011 06:55:45 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Prescription Drug Plan-Reg 23 (PDP)	10	29					S5932	022	0	2012	Oklahoma		2					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	023	0		29	10	S5932_023_0	3	1		04/13/2011	2012.02	04/13/2011 01:50:31 PM Central Daylight Time		07/21/2011 10:24:11 AM Central Daylight Time		07/21/2011 06:55:45 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Prescription Drug Plan-Reg 24 (PDP)	10	29					S5932	023	0	2012	Kansas		2					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	024	0		29	10	S5932_024_0	2	1		04/13/2011	2012.02	04/13/2011 01:50:35 PM Central Daylight Time		06/06/2011 03:03:12 PM Central Daylight Time		06/06/2011 05:48:02 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Prescription Drug Plan-Reg 25 (PDP)	10	29					S5932	024	0	2012	Upper Midwest and Northern Plains		2					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	025	0		29	10	S5932_025_0	3	1		05/31/2011	2012.02	05/31/2011 03:46:17 PM Central Daylight Time		07/21/2011 10:24:49 AM Central Daylight Time		07/21/2011 06:55:45 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Prescription Drug Plan-Reg 26 (PDP)	10	29					S5932	025	0	2012	New Mexico		2					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	026	0		29	10	S5932_026_0	3	1		04/13/2011	2012.02	04/13/2011 01:50:44 PM Central Daylight Time		07/21/2011 10:25:30 AM Central Daylight Time		07/21/2011 06:55:45 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Prescription Drug Plan-Reg 27 (PDP)	10	29					S5932	026	0	2012	Colorado		2					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	027	0		29	10	S5932_027_0	3	1		04/13/2011	2012.02	04/13/2011 01:50:49 PM Central Daylight Time		07/21/2011 10:26:15 AM Central Daylight Time		07/21/2011 06:55:45 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Prescription Drug Plan-Reg 28 (PDP)	10	29					S5932	027	0	2012	Arizona		2					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	028	0		29	10	S5932_028_0	3	1		04/13/2011	2012.02	04/13/2011 01:50:52 PM Central Daylight Time		07/21/2011 10:27:00 AM Central Daylight Time		07/21/2011 06:55:45 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Prescription Drug Plan-Reg 29 (PDP)	10	29					S5932	028	0	2012	Nevada		2					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	029	0		29	10	S5932_029_0	3	1		04/13/2011	2012.02	04/13/2011 01:50:57 PM Central Daylight Time		07/21/2011 10:27:40 AM Central Daylight Time		07/21/2011 06:55:45 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Prescription Drug Plan-Reg 30 (PDP)	10	29					S5932	029	0	2012	Oregon, Washington		2					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	030	0		29	10	S5932_030_0	2	1		04/13/2011	2012.02	04/13/2011 01:51:01 PM Central Daylight Time		06/06/2011 03:07:26 PM Central Daylight Time		06/06/2011 05:48:02 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Prescription Drug Plan-Reg 31 (PDP)	10	29					S5932	030	0	2012	Idaho, Utah		2					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	031	0		29	10	S5932_031_0	2	1		04/13/2011	2012.02	04/13/2011 01:51:04 PM Central Daylight Time		06/06/2011 03:08:08 PM Central Daylight Time		06/06/2011 05:48:02 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Prescription Drug Plan-Reg 32 (PDP)	10	29					S5932	031	0	2012	California		2					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	032	0		29	10	S5932_032_0	3	1		04/13/2011	2012.02	04/13/2011 01:51:08 PM Central Daylight Time		07/21/2011 10:28:22 AM Central Daylight Time		07/21/2011 06:55:45 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Prescription Drug Plan-Reg 33 (PDP)	10	29					S5932	032	0	2012	Hawaii		2					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	033	0		29	10	S5932_033_0	3	1		04/13/2011	2012.02	04/13/2011 01:51:11 PM Central Daylight Time		07/21/2011 10:29:05 AM Central Daylight Time		07/21/2011 06:55:45 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Prescription Drug Plan-Reg 34 (PDP)	10	29					S5932	033	0	2012	Alaska		2					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	034	0		29	10	S5932_034_0	2	1		04/13/2011	2012.02	04/13/2011 01:51:18 PM Central Daylight Time		06/06/2011 03:10:16 PM Central Daylight Time		06/06/2011 05:48:02 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Prescription Drug Plan -Reg 5 (PDP)	10	29					S5932	034	0	2012	Mid-Atlantic		2					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	802	0		29	10	S5932_802_0	4	1		06/03/2011	2012.02	06/03/2011 12:12:28 PM Central Daylight Time				06/06/2011 05:48:02 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Retiree Prescription Plan (PDP)	10	29					S5932	802	0	2012	National		1					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5932	803	0		29	10	S5932_803_0	4	1		06/03/2011	2012.02	06/03/2011 12:12:34 PM Central Daylight Time				06/06/2011 05:48:02 PM Central Daylight Time	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	HealthSpring Retiree Drug Plan (PDP)	10	29					S5932	803	0	2012	National		1					2							www.healthspring.com	www.healthspring.com									(800)-331-6293		(615)-291-7024		(877)-357-1685		(615)-291-7024										(866)-845-7230		(866)-845-7230		(866)-845-7230		(866)-845-7230				
S5937	001	0		29	10	S5937_001_0	4	1		07/22/2011	2012.02	07/22/2011 12:19:25 PM Central Daylight Time		06/06/2011 05:34:51 PM Central Daylight Time		07/22/2011 12:22:56 PM Central Daylight Time	LOUISIANA HEALTH SERVICE AND INDEMNITY COMPANY	Blue Cross and Blue Shield of Louisiana	www.bcbsla.com	RxBLUE BASIC (PDP)	10	29					S5937	001	0	2012	Louisiana		2					2							http://www.bcbsla.com/RxBLUEFormulary	http://www.express-scripts.com									(888)-223-2583		(225)-298-7788		(800)-593-9735		(800)-593-9735										(800)-947-5277		(000)-000-0000		(800)-947-5277		(000)-000-0000				
S5937	002	0		29	10	S5937_002_0	4	1		06/03/2011	2012.02	06/03/2011 05:54:04 PM Central Daylight Time		07/26/2011 08:33:59 AM Central Daylight Time		07/26/2011 03:08:12 PM Central Daylight Time	LOUISIANA HEALTH SERVICE AND INDEMNITY COMPANY	Blue Cross and Blue Shield of Louisiana	www.bcbsla.com	RxBLUE PLUS (PDP)	10	29					S5937	002	0	2012	Louisiana		2					2							http://www.bcbsla.com/RxBLUEFormulary	http://www.express-scripts.com									(888)-223-2583		(225)-298-7788		(800)-593-9735		(800)-593-9735										(800)-947-5277		(000)-000-0000		(800)-947-5277		(000)-000-0000				
S5953	001	0		29	10	S5953_001_0	3	1		05/25/2011	2012.02	05/25/2011 03:59:58 PM Eastern Daylight Time		06/04/2011 01:33:20 PM Eastern Daylight Time		06/04/2011 10:33:18 PM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.scbluesmedadvantage.com/rx12	MedBlue Rx (PDP)	10	29					S5953	001	0	2012	South Carolina		2					2							www.scbluesmedadvantage.com/marx12	www.scbluesmedadvantage.com/marx12									(888)-645-6025		(888)-645-6025		(800)-930-2836		(800)-930-2836										(888)-645-6023		(888)-645-6023		(800)-681-3846		(800)-681-3846				
S5953	002	0		29	10	S5953_002_0	4	1		05/26/2011	2012.02	05/26/2011 11:34:37 AM Eastern Daylight Time		07/21/2011 02:10:12 PM Eastern Daylight Time		07/22/2011 09:27:08 AM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.scbluesmedadvantage.com/rxplus12	MedBlue Rx Plus (PDP)	10	29					S5953	002	0	2012	South Carolina		2					2							www.scbluesmedadvantage.com/marx12	www.scbluesmedadvantage.com/marx12									(888)-645-6025		(888)-645-6025		(800)-930-2836		(800)-930-2836										(888)-645-6023		(888)-645-6023		(800)-681-3846		(800)-681-3846				
S5953	801	0		29	10	S5953_801_0	1	1		05/03/2011	2012.02	05/03/2011 09:58:58 AM Eastern Daylight Time				06/03/2011 10:10:52 AM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.scbluesmedadvantage.com/marx12	Group Blue Rx Plus (PDP)	10	29					S5953	801	0	2012	South Carolina		1					2							www.scbluesmedadvantage.com/marx12	www.scbluesmedadvantage.com/marx12									(888)-645-6025		(888)-645-6025		(800)-930-2836		(800)-930-2836										(888)-645-6023		(888)-645-6023		(800)-681-3846		(800)-681-3846				
S5953	802	0		29	10	S5953_802_0	1	1		05/03/2011	2012.02	05/03/2011 09:59:14 AM Eastern Daylight Time				06/03/2011 10:10:52 AM Eastern Daylight Time	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.scbluesmedadvantage.com/marx12	Group Blue Rx Plus (PDP)	10	29					S5953	802	0	2012	South Carolina		1					2							www.scbluesmedadvantage.com/marx12	www.scbluesmedadvantage.com/marx12									(888)-645-6025		(888)-645-6025		(800)-930-2836		(800)-930-2836										(888)-645-6023		(888)-645-6023		(800)-681-3846		(800)-681-3846				
S5960	108	0		29	10	S5960_108_0	5	1		06/27/2011	2012.02	06/27/2011 01:56:56 PM Pacific Daylight Time		07/14/2011 05:07:10 PM Pacific Daylight Time		07/21/2011 02:18:35 PM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Standard (PDP)	10	29					S5960	108	0	2012	Central New England (CT, MA, RI, VT)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	109	0		29	10	S5960_109_0	4	1		06/27/2011	2012.02	06/27/2011 01:57:03 PM Pacific Daylight Time		07/14/2011 05:07:22 PM Pacific Daylight Time		07/21/2011 02:18:35 PM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Standard (PDP)	10	29					S5960	109	0	2012	New York (NY)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	110	0		29	10	S5960_110_0	4	1		06/27/2011	2012.02	06/27/2011 01:57:10 PM Pacific Daylight Time		07/14/2011 05:07:36 PM Pacific Daylight Time		07/21/2011 02:18:35 PM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Standard (PDP)	10	29					S5960	110	0	2012	New Jersey (NJ)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	111	0		29	10	S5960_111_0	4	1		06/27/2011	2012.02	06/27/2011 01:57:19 PM Pacific Daylight Time		07/14/2011 05:07:52 PM Pacific Daylight Time		07/21/2011 02:18:35 PM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Standard (PDP)	10	29					S5960	111	0	2012	Mid-Atlantic (DE, DC, MD)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	112	0		29	10	S5960_112_0	4	1		06/27/2011	2012.02	06/27/2011 01:57:26 PM Pacific Daylight Time		07/14/2011 05:08:06 PM Pacific Daylight Time		07/21/2011 02:18:35 PM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Standard (PDP)	10	29					S5960	112	0	2012	Pennsylvania, West Virginia (PA, WV)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	114	0		29	10	S5960_114_0	4	1		06/27/2011	2012.02	06/27/2011 01:57:34 PM Pacific Daylight Time		07/14/2011 05:08:20 PM Pacific Daylight Time		07/21/2011 02:18:35 PM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Standard (PDP)	10	29					S5960	114	0	2012	North Carolina (NC)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	115	0		29	10	S5960_115_0	4	1		06/27/2011	2012.02	06/27/2011 01:57:43 PM Pacific Daylight Time		07/21/2011 09:12:44 AM Pacific Daylight Time		07/21/2011 02:18:35 PM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Standard (PDP)	10	29					S5960	115	0	2012	South Carolina (SC)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	117	0		29	10	S5960_117_0	4	1		06/27/2011	2012.02	06/27/2011 01:57:51 PM Pacific Daylight Time		07/14/2011 05:08:46 PM Pacific Daylight Time		07/21/2011 02:18:35 PM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Standard (PDP)	10	29					S5960	117	0	2012	Florida (FL)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	118	0		29	10	S5960_118_0	4	1		06/27/2011	2012.02	06/27/2011 01:57:59 PM Pacific Daylight Time		07/14/2011 05:09:00 PM Pacific Daylight Time		07/21/2011 02:18:35 PM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Standard (PDP)	10	29					S5960	118	0	2012	Alabama, Tennessee (AL, TN)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	119	0		29	10	S5960_119_0	4	1		06/27/2011	2012.02	06/27/2011 01:58:08 PM Pacific Daylight Time		07/14/2011 05:09:12 PM Pacific Daylight Time		07/21/2011 02:18:35 PM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Standard (PDP)	10	29					S5960	119	0	2012	Michigan (MI)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	123	0		29	10	S5960_123_0	4	1		06/27/2011	2012.02	06/27/2011 01:58:17 PM Pacific Daylight Time		07/14/2011 05:09:24 PM Pacific Daylight Time		07/21/2011 02:18:35 PM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Standard (PDP)	10	29					S5960	123	0	2012	Illinois (IL)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	125	0		29	10	S5960_125_0	4	1		06/27/2011	2012.02	06/27/2011 01:58:29 PM Pacific Daylight Time		07/14/2011 05:09:38 PM Pacific Daylight Time		07/21/2011 02:18:35 PM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Standard (PDP)	10	29					S5960	125	0	2012	Arkansas (AR)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	126	0		29	10	S5960_126_0	4	1		06/27/2011	2012.02	06/27/2011 01:58:41 PM Pacific Daylight Time		07/14/2011 05:09:52 PM Pacific Daylight Time		07/21/2011 02:18:35 PM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Standard (PDP)	10	29					S5960	126	0	2012	Mississippi (MS)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	127	0		29	10	S5960_127_0	4	1		06/27/2011	2012.02	06/27/2011 01:58:49 PM Pacific Daylight Time		07/14/2011 05:10:04 PM Pacific Daylight Time		07/21/2011 02:18:35 PM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Standard (PDP)	10	29					S5960	127	0	2012	Louisiana (LA)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	128	0		29	10	S5960_128_0	4	1		06/27/2011	2012.02	06/27/2011 01:58:57 PM Pacific Daylight Time		07/14/2011 05:10:18 PM Pacific Daylight Time		07/21/2011 02:18:35 PM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Standard (PDP)	10	29					S5960	128	0	2012	Texas (TX)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	129	0		29	10	S5960_129_0	4	1		06/27/2011	2012.02	06/27/2011 01:59:27 PM Pacific Daylight Time		07/14/2011 05:10:32 PM Pacific Daylight Time		07/21/2011 02:18:35 PM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Standard (PDP)	10	29					S5960	129	0	2012	Oklahoma (OK)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	130	0		29	10	S5960_130_0	4	1		06/27/2011	2012.02	06/27/2011 01:59:37 PM Pacific Daylight Time		07/14/2011 05:10:44 PM Pacific Daylight Time		07/21/2011 02:18:35 PM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Standard (PDP)	10	29					S5960	130	0	2012	Kansas (KS)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	131	0		29	10	S5960_131_0	4	1		06/27/2011	2012.02	06/27/2011 01:59:44 PM Pacific Daylight Time		07/14/2011 05:10:56 PM Pacific Daylight Time		07/21/2011 02:18:35 PM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Standard (PDP)	10	29					S5960	131	0	2012	Upper Midwest and Northern Plains		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	132	0		29	10	S5960_132_0	4	1		06/27/2011	2012.02	06/27/2011 01:59:51 PM Pacific Daylight Time		07/14/2011 05:11:08 PM Pacific Daylight Time		07/21/2011 02:18:35 PM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Standard (PDP)	10	29					S5960	132	0	2012	New Mexico (NM)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	134	0		29	10	S5960_134_0	4	1		06/27/2011	2012.02	06/27/2011 02:00:00 PM Pacific Daylight Time		07/14/2011 05:11:20 PM Pacific Daylight Time		07/21/2011 02:18:35 PM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Standard (PDP)	10	29					S5960	134	0	2012	Arizona (AZ)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	136	0		29	10	S5960_136_0	4	1		06/27/2011	2012.02	06/27/2011 02:00:08 PM Pacific Daylight Time		07/14/2011 05:11:34 PM Pacific Daylight Time		07/21/2011 02:18:35 PM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Standard (PDP)	10	29					S5960	136	0	2012	Oregon, Washington (OR, WA)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	137	0		29	10	S5960_137_0	4	1		06/27/2011	2012.02	06/27/2011 02:00:22 PM Pacific Daylight Time		07/14/2011 05:11:48 PM Pacific Daylight Time		07/21/2011 02:18:35 PM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Standard (PDP)	10	29					S5960	137	0	2012	Idaho, Utah (ID, UT)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	139	0		29	10	S5960_139_0	4	1		06/27/2011	2012.02	06/27/2011 02:00:30 PM Pacific Daylight Time		07/19/2011 09:52:36 AM Pacific Daylight Time		07/21/2011 02:18:35 PM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Standard (PDP)	10	29					S5960	139	0	2012	Hawaii (HI)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	140	0		29	10	S5960_140_0	4	1		06/27/2011	2012.02	06/27/2011 02:00:38 PM Pacific Daylight Time		07/14/2011 05:12:14 PM Pacific Daylight Time		07/21/2011 02:18:35 PM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Standard (PDP)	10	29					S5960	140	0	2012	Alaska (AK)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	141	0		29	10	S5960_141_0	4	1		06/27/2011	2012.02	06/27/2011 02:00:48 PM Pacific Daylight Time		07/21/2011 05:19:36 PM Pacific Daylight Time		07/22/2011 10:51:24 AM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Plus (PDP)	10	29					S5960	141	0	2012	New York (NY)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	142	0		29	10	S5960_142_0	4	1		06/27/2011	2012.02	06/27/2011 02:00:57 PM Pacific Daylight Time		07/21/2011 05:19:50 PM Pacific Daylight Time		07/22/2011 10:51:24 AM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Plus (PDP)	10	29					S5960	142	0	2012	New Jersey (NJ)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	143	0		29	10	S5960_143_0	4	1		06/27/2011	2012.02	06/27/2011 02:01:06 PM Pacific Daylight Time		07/21/2011 05:20:00 PM Pacific Daylight Time		07/22/2011 10:51:24 AM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Plus (PDP)	10	29					S5960	143	0	2012	Mid-Atlantic (DC, DE, MD)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	144	0		29	10	S5960_144_0	4	1		06/27/2011	2012.02	06/27/2011 02:01:18 PM Pacific Daylight Time		07/21/2011 05:20:12 PM Pacific Daylight Time		07/22/2011 10:51:24 AM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Plus (PDP)	10	29					S5960	144	0	2012	Pennsylvania, West Virginia (PA, WV)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	145	0		29	10	S5960_145_0	4	1		06/27/2011	2012.02	06/27/2011 02:01:26 PM Pacific Daylight Time		07/21/2011 05:20:24 PM Pacific Daylight Time		07/22/2011 10:51:24 AM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Plus (PDP)	10	29					S5960	145	0	2012	North Carolina (NC)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	146	0		29	10	S5960_146_0	4	1		06/27/2011	2012.02	06/27/2011 02:01:46 PM Pacific Daylight Time		07/21/2011 05:20:36 PM Pacific Daylight Time		07/22/2011 10:51:24 AM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Plus (PDP)	10	29					S5960	146	0	2012	South Carolina (SC)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	147	0		29	10	S5960_147_0	4	1		06/27/2011	2012.02	06/27/2011 02:01:54 PM Pacific Daylight Time		07/21/2011 05:20:48 PM Pacific Daylight Time		07/22/2011 10:51:24 AM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Plus (PDP)	10	29					S5960	147	0	2012	Florida (FL)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	148	0		29	10	S5960_148_0	4	1		06/27/2011	2012.02	06/27/2011 02:02:03 PM Pacific Daylight Time		07/21/2011 05:21:00 PM Pacific Daylight Time		07/22/2011 10:51:24 AM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Plus (PDP)	10	29					S5960	148	0	2012	Alabama, Tennessee (AL, TN)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	149	0		29	10	S5960_149_0	4	1		06/27/2011	2012.02	06/27/2011 02:02:16 PM Pacific Daylight Time		07/21/2011 05:21:16 PM Pacific Daylight Time		07/22/2011 10:51:24 AM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Plus (PDP)	10	29					S5960	149	0	2012	Michigan (MI)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	150	0		29	10	S5960_150_0	4	1		06/27/2011	2012.02	06/27/2011 02:02:25 PM Pacific Daylight Time		07/21/2011 05:21:34 PM Pacific Daylight Time		07/22/2011 10:51:24 AM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Plus (PDP)	10	29					S5960	150	0	2012	Illinois (IL)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	151	0		29	10	S5960_151_0	4	1		06/27/2011	2012.02	06/27/2011 02:02:32 PM Pacific Daylight Time		07/21/2011 05:21:46 PM Pacific Daylight Time		07/22/2011 10:51:24 AM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Plus (PDP)	10	29					S5960	151	0	2012	Arkansas (AR)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	152	0		29	10	S5960_152_0	4	1		06/27/2011	2012.02	06/27/2011 02:02:41 PM Pacific Daylight Time		07/21/2011 05:21:58 PM Pacific Daylight Time		07/22/2011 10:51:24 AM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Plus (PDP)	10	29					S5960	152	0	2012	Mississippi (MS)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	153	0		29	10	S5960_153_0	4	1		06/27/2011	2012.02	06/27/2011 02:02:50 PM Pacific Daylight Time		07/21/2011 05:22:14 PM Pacific Daylight Time		07/22/2011 10:51:24 AM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Plus (PDP)	10	29					S5960	153	0	2012	Louisiana (LA)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	154	0		29	10	S5960_154_0	4	1		06/27/2011	2012.02	06/27/2011 02:02:59 PM Pacific Daylight Time		07/21/2011 05:22:30 PM Pacific Daylight Time		07/22/2011 10:51:24 AM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Plus (PDP)	10	29					S5960	154	0	2012	Texas (TX)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	155	0		29	10	S5960_155_0	4	1		06/27/2011	2012.02	06/27/2011 02:03:11 PM Pacific Daylight Time		07/21/2011 05:22:42 PM Pacific Daylight Time		07/22/2011 10:51:24 AM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Plus (PDP)	10	29					S5960	155	0	2012	Oklahoma (OK)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	156	0		29	10	S5960_156_0	4	1		06/27/2011	2012.02	06/27/2011 02:03:18 PM Pacific Daylight Time		07/21/2011 05:22:56 PM Pacific Daylight Time		07/22/2011 10:51:24 AM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Plus (PDP)	10	29					S5960	156	0	2012	Upper Midwest and Northern Plains		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	157	0		29	10	S5960_157_0	4	1		06/27/2011	2012.02	06/27/2011 02:03:26 PM Pacific Daylight Time		07/21/2011 05:23:12 PM Pacific Daylight Time		07/22/2011 10:51:24 AM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Plus (PDP)	10	29					S5960	157	0	2012	New Mexico (NM)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	158	0		29	10	S5960_158_0	4	1		06/27/2011	2012.02	06/27/2011 02:03:34 PM Pacific Daylight Time		07/21/2011 05:23:24 PM Pacific Daylight Time		07/22/2011 10:51:24 AM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Plus (PDP)	10	29					S5960	158	0	2012	Arizona (AZ)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	159	0		29	10	S5960_159_0	4	1		06/27/2011	2012.02	06/27/2011 02:03:42 PM Pacific Daylight Time		07/21/2011 05:23:42 PM Pacific Daylight Time		07/22/2011 10:51:24 AM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Plus (PDP)	10	29					S5960	159	0	2012	Oregon, Washington (OR, WA)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	160	0		29	10	S5960_160_0	4	1		06/27/2011	2012.02	06/27/2011 02:03:51 PM Pacific Daylight Time		07/21/2011 05:23:58 PM Pacific Daylight Time		07/22/2011 10:51:24 AM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Plus (PDP)	10	29					S5960	160	0	2012	Idaho, Utah (ID, UT)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	161	0		29	10	S5960_161_0	4	1		06/27/2011	2012.02	06/27/2011 02:04:28 PM Pacific Daylight Time		07/21/2011 05:24:14 PM Pacific Daylight Time		07/22/2011 10:51:24 AM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Plus (PDP)	10	29					S5960	161	0	2012	Hawaii (HI)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	162	0		29	10	S5960_162_0	5	1		06/27/2011	2012.02	06/27/2011 02:04:35 PM Pacific Daylight Time		07/21/2011 05:24:30 PM Pacific Daylight Time		07/22/2011 10:51:24 AM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards Plus (PDP)	10	29					S5960	162	0	2012	Alaska (AK)		2					2							www.unicare.com/shop	www.unicare.com/shop									(800)-928-6201		(800)-928-6201		(877)-541-7382		(877)-541-7382										(877)-247-1657		(877)-247-1657		(800)-241-6894		(800)-241-6894				
S5960	801	0		29	10	S5960_801_0	3	1		05/31/2011	2012.02	05/31/2011 09:13:47 AM Pacific Daylight Time				06/06/2011 02:12:35 PM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards (PDP)	10	29					S5960	801	0	2012	All States (Nationwide)		1					2							www.unicare.com/shop	www.unicare.com/shop									(866)-470-6265		(866)-470-6265		(866)-646-2436		(866)-646-2436										(877)-247-1657		(866)-646-2436		(877)-247-1657		(877)-247-1657				
S5960	803	0		29	10	S5960_803_0	3	1		05/31/2011	2012.02	05/31/2011 09:13:52 AM Pacific Daylight Time				06/06/2011 02:12:35 PM Pacific Daylight Time	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.unicare.com/shop	MedicareRx Rewards (PDP)	10	29					S5960	803	0	2012	All States (Nationwide)		1					2							www.unicare.com/shop	www.unicare.com/shop									(866)-470-6265		(866)-470-6265		(866)-646-2436		(866)-646-2436										(877)-247-1657		(866)-646-2436		(877)-247-1657		(877)-247-1657				
S5966	001	0		29	10	S5966_001_0	9	1		09/20/2011	2012.02	09/20/2011 01:04:19 PM Eastern Daylight Time		09/20/2011 02:05:04 PM Eastern Daylight Time		09/20/2011 02:09:00 PM Eastern Daylight Time	GROUP HEALTH INCORPORATED	EmblemHealth Medicare PDP	www.emblemhealth.com	Medicare Prescription Drug Plan (PDP)	10	29					S5966	001	0	2012	New York State		2					2							www.emblemhealth.com	www.emblemhealth.com									(877)-444-7241		(877)-444-7241		(800)-325-9792		(800)-325-9792										(888)-447-4833		(888)-447-4833		(877)-444-2786		(877)-444-2786				
S5966	803	0		29	10	S5966_803_0	4	1		05/11/2011	2012.02	05/11/2011 03:37:55 PM Eastern Daylight Time				06/03/2011 01:29:01 PM Eastern Daylight Time	GROUP HEALTH INCORPORATED	EmblemHealth Medicare PDP	www.emblemhealth.com	National Drug Plan (PDP)	10	29					S5966	803	0	2012	United States		1					2							www.emblemhealth.com	www.emblemhealth.com									(800)-585-5786		(800)-585-5786		(800)-325-9792		(800)-325-9792										(800)-899-2114		(800)-899-2114		(877)-444-2786		(877)-444-2786				
S5967	035	0		29	10	S5967_035_0	3	1		06/01/2011	2012.02	06/01/2011 08:16:39 AM Eastern Daylight Time		07/18/2011 04:04:47 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Signature (PDP)	10	29					S5967	035	0	2012	Northern New England		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	036	0		29	10	S5967_036_0	3	1		06/01/2011	2012.02	06/01/2011 08:17:52 AM Eastern Daylight Time		07/18/2011 04:05:20 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Signature (PDP)	10	29					S5967	036	0	2012	Central New England		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	037	0		29	10	S5967_037_0	4	1		05/31/2011	2012.02	05/31/2011 05:08:08 PM Eastern Daylight Time		07/18/2011 04:05:45 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Signature (PDP)	10	29					S5967	037	0	2012	New York		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	038	0		29	10	S5967_038_0	3	1		05/31/2011	2012.02	05/31/2011 05:09:03 PM Eastern Daylight Time		07/18/2011 04:06:10 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Signature (PDP)	10	29					S5967	038	0	2012	New Jersey		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	039	0		29	10	S5967_039_0	3	1		06/01/2011	2012.02	06/01/2011 08:18:04 AM Eastern Daylight Time		07/18/2011 04:06:36 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Signature (PDP)	10	29					S5967	039	0	2012	Mid-Atlantic		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	040	0		29	10	S5967_040_0	3	1		06/01/2011	2012.02	06/01/2011 11:12:45 AM Eastern Daylight Time		07/18/2011 04:07:08 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Signature (PDP)	10	29					S5967	040	0	2012	Pennsylvania, West Virginia		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	041	0		29	10	S5967_041_0	3	1		06/01/2011	2012.02	06/01/2011 11:13:52 AM Eastern Daylight Time		07/18/2011 04:07:29 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Signature (PDP)	10	29					S5967	041	0	2012	Virginia		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	042	0		29	10	S5967_042_0	3	1		05/31/2011	2012.02	05/31/2011 05:09:16 PM Eastern Daylight Time		07/18/2011 04:07:54 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Signature (PDP)	10	29					S5967	042	0	2012	North Carolina		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	043	0		29	10	S5967_043_0	3	1		06/01/2011	2012.02	06/01/2011 11:14:03 AM Eastern Daylight Time		07/18/2011 04:08:20 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Signature (PDP)	10	29					S5967	043	0	2012	South Carolina		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	044	0		29	10	S5967_044_0	3	1		06/01/2011	2012.02	06/01/2011 11:14:12 AM Eastern Daylight Time		07/18/2011 04:09:03 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Signature (PDP)	10	29					S5967	044	0	2012	Georgia		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	045	0		29	10	S5967_045_0	3	1		06/01/2011	2012.02	06/01/2011 11:14:22 AM Eastern Daylight Time		07/18/2011 04:09:34 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Signature (PDP)	10	29					S5967	045	0	2012	Florida		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	046	0		29	10	S5967_046_0	3	1		06/01/2011	2012.02	06/01/2011 11:14:33 AM Eastern Daylight Time		07/18/2011 04:09:59 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Signature (PDP)	10	29					S5967	046	0	2012	Alabama, Tennessee		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	047	0		29	10	S5967_047_0	3	1		06/01/2011	2012.02	06/01/2011 01:51:13 PM Eastern Daylight Time		07/18/2011 04:10:26 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Signature (PDP)	10	29					S5967	047	0	2012	Michigan		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	048	0		29	10	S5967_048_0	3	1		06/01/2011	2012.02	06/01/2011 11:14:43 AM Eastern Daylight Time		07/18/2011 04:10:54 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Signature (PDP)	10	29					S5967	048	0	2012	Ohio		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	049	0		29	10	S5967_049_0	3	1		06/01/2011	2012.02	06/01/2011 08:18:14 AM Eastern Daylight Time		07/18/2011 04:11:25 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Signature (PDP)	10	29					S5967	049	0	2012	Indiana, Kentucky		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	051	0		29	10	S5967_051_0	3	1		06/01/2011	2012.02	06/01/2011 08:18:26 AM Eastern Daylight Time		07/18/2011 04:11:58 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Signature (PDP)	10	29					S5967	051	0	2012	Illinois		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	052	0		29	10	S5967_052_0	3	1		06/01/2011	2012.02	06/01/2011 11:14:54 AM Eastern Daylight Time		07/18/2011 04:12:27 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Signature (PDP)	10	29					S5967	052	0	2012	Missouri		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	053	0		29	10	S5967_053_0	3	1		06/01/2011	2012.02	06/01/2011 11:15:04 AM Eastern Daylight Time		07/18/2011 04:12:52 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Signature (PDP)	10	29					S5967	053	0	2012	Arkansas		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	054	0		29	10	S5967_054_0	3	1		06/01/2011	2012.02	06/01/2011 11:15:14 AM Eastern Daylight Time		07/18/2011 04:13:19 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Signature (PDP)	10	29					S5967	054	0	2012	Mississippi		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	055	0		29	10	S5967_055_0	3	1		06/01/2011	2012.02	06/01/2011 11:15:27 AM Eastern Daylight Time		07/18/2011 04:13:42 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Signature (PDP)	10	29					S5967	055	0	2012	Louisiana		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	056	0		29	10	S5967_056_0	3	1		06/01/2011	2012.02	06/01/2011 01:49:26 PM Eastern Daylight Time		07/18/2011 04:14:07 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Signature (PDP)	10	29					S5967	056	0	2012	Texas		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	057	0		29	10	S5967_057_0	3	1		06/01/2011	2012.02	06/01/2011 08:18:36 AM Eastern Daylight Time		07/18/2011 04:14:42 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Signature (PDP)	10	29					S5967	057	0	2012	Oklahoma		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	058	0		29	10	S5967_058_0	3	1		06/01/2011	2012.02	06/01/2011 11:15:36 AM Eastern Daylight Time		07/18/2011 04:15:11 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Signature (PDP)	10	29					S5967	058	0	2012	Kansas		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	059	0		29	10	S5967_059_0	3	1		06/01/2011	2012.02	06/01/2011 01:49:37 PM Eastern Daylight Time		07/18/2011 04:15:43 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Signature (PDP)	10	29					S5967	059	0	2012	Upper Midwest and Northern Plains		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	060	0		29	10	S5967_060_0	3	1		06/01/2011	2012.02	06/01/2011 01:49:44 PM Eastern Daylight Time		07/18/2011 04:16:15 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Signature (PDP)	10	29					S5967	060	0	2012	New Mexico		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	061	0		29	10	S5967_061_0	3	1		06/01/2011	2012.02	06/01/2011 08:18:44 AM Eastern Daylight Time		07/18/2011 04:16:51 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Signature (PDP)	10	29					S5967	061	0	2012	Colorado		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	062	0		29	10	S5967_062_0	3	1		06/01/2011	2012.02	06/01/2011 01:49:54 PM Eastern Daylight Time		07/18/2011 04:21:44 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Signature (PDP)	10	29					S5967	062	0	2012	Arizona		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	063	0		29	10	S5967_063_0	3	1		05/31/2011	2012.02	05/31/2011 05:09:26 PM Eastern Daylight Time		07/18/2011 04:23:47 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Signature (PDP)	10	29					S5967	063	0	2012	Nevada		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	064	0		29	10	S5967_064_0	3	1		06/01/2011	2012.02	06/01/2011 01:50:04 PM Eastern Daylight Time		07/18/2011 04:28:10 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Signature (PDP)	10	29					S5967	064	0	2012	Oregon, Washington		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	065	0		29	10	S5967_065_0	3	1		06/01/2011	2012.02	06/01/2011 01:50:14 PM Eastern Daylight Time		07/18/2011 04:29:04 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Signature (PDP)	10	29					S5967	065	0	2012	Idaho, Utah		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	066	0		29	10	S5967_066_0	3	1		06/01/2011	2012.02	06/01/2011 08:18:54 AM Eastern Daylight Time		07/18/2011 04:29:28 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Signature (PDP)	10	29					S5967	066	0	2012	California		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	067	0		29	10	S5967_067_0	3	1		05/31/2011	2012.02	05/31/2011 05:09:38 PM Eastern Daylight Time		07/18/2011 04:29:59 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Signature (PDP)	10	29					S5967	067	0	2012	Hawaii		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	068	0		29	10	S5967_068_0	3	1		06/01/2011	2012.02	06/01/2011 11:15:45 AM Eastern Daylight Time		07/18/2011 04:30:53 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Signature (PDP)	10	29					S5967	068	0	2012	Alaska		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	138	0		29	10	S5967_138_0	2	1		06/03/2011	2012.02	06/03/2011 03:37:31 PM Eastern Daylight Time		07/18/2011 04:31:40 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S5967	138	0	2012	Northern New England		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	139	0		29	10	S5967_139_0	2	1		06/01/2011	2012.02	06/01/2011 12:17:10 PM Eastern Daylight Time		07/18/2011 04:32:03 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S5967	139	0	2012	Central New England		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	140	0		29	10	S5967_140_0	2	1		06/04/2011	2012.02	06/04/2011 05:22:51 PM Eastern Daylight Time		07/18/2011 04:33:04 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S5967	140	0	2012	New York		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	141	0		29	10	S5967_141_0	2	1		06/04/2011	2012.02	06/04/2011 05:24:32 PM Eastern Daylight Time		07/18/2011 04:33:35 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S5967	141	0	2012	New Jersey		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	142	0		29	10	S5967_142_0	2	1		06/01/2011	2012.02	06/01/2011 12:31:58 PM Eastern Daylight Time		07/18/2011 04:34:02 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S5967	142	0	2012	Mid-Atlantic		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	143	0		29	10	S5967_143_0	2	1		06/03/2011	2012.02	06/03/2011 02:36:59 PM Eastern Daylight Time		07/18/2011 04:34:33 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S5967	143	0	2012	Pennsylvania, West Virginia		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	144	0		29	10	S5967_144_0	2	1		06/01/2011	2012.02	06/01/2011 12:20:36 PM Eastern Daylight Time		07/18/2011 04:35:08 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S5967	144	0	2012	Virginia		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	145	0		29	10	S5967_145_0	2	1		06/03/2011	2012.02	06/03/2011 03:36:35 PM Eastern Daylight Time		07/18/2011 04:35:32 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S5967	145	0	2012	North Carolina		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	146	0		29	10	S5967_146_0	2	1		06/01/2011	2012.02	06/01/2011 12:52:11 PM Eastern Daylight Time		07/18/2011 04:35:59 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S5967	146	0	2012	South Carolina		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	147	0		29	10	S5967_147_0	2	1		06/01/2011	2012.02	06/01/2011 12:22:02 PM Eastern Daylight Time		07/18/2011 04:37:35 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S5967	147	0	2012	Georgia		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	148	0		29	10	S5967_148_0	2	1		06/03/2011	2012.02	06/03/2011 02:33:04 PM Eastern Daylight Time		07/18/2011 04:38:20 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S5967	148	0	2012	Florida		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	149	0		29	10	S5967_149_0	2	1		06/01/2011	2012.02	06/01/2011 01:01:42 PM Eastern Daylight Time		07/18/2011 04:38:43 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S5967	149	0	2012	Alabama, Tennessee		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	150	0		29	10	S5967_150_0	2	1		06/01/2011	2012.02	06/01/2011 12:40:11 PM Eastern Daylight Time		07/18/2011 04:39:36 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S5967	150	0	2012	Michigan		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	151	0		29	10	S5967_151_0	2	1		06/03/2011	2012.02	06/03/2011 02:34:00 PM Eastern Daylight Time		07/18/2011 04:40:21 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S5967	151	0	2012	Ohio		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	152	0		29	10	S5967_152_0	2	1		06/01/2011	2012.02	06/01/2011 12:44:55 PM Eastern Daylight Time		07/18/2011 04:41:13 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S5967	152	0	2012	Indiana, Kentucky		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	154	0		29	10	S5967_154_0	2	1		06/01/2011	2012.02	06/01/2011 12:33:16 PM Eastern Daylight Time		07/18/2011 04:41:36 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S5967	154	0	2012	Illinois		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	155	0		29	10	S5967_155_0	2	1		06/01/2011	2012.02	06/01/2011 12:52:35 PM Eastern Daylight Time		07/18/2011 04:42:03 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S5967	155	0	2012	Missouri		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	156	0		29	10	S5967_156_0	2	1		06/01/2011	2012.02	06/01/2011 12:23:34 PM Eastern Daylight Time		07/18/2011 04:42:35 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S5967	156	0	2012	Arkansas		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	157	0		29	10	S5967_157_0	2	1		06/01/2011	2012.02	06/01/2011 01:04:06 PM Eastern Daylight Time		07/18/2011 04:43:09 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S5967	157	0	2012	Mississippi		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	158	0		29	10	S5967_158_0	2	1		06/01/2011	2012.02	06/01/2011 12:59:00 PM Eastern Daylight Time		07/18/2011 04:43:44 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S5967	158	0	2012	Louisiana		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	159	0		29	10	S5967_159_0	3	1		06/01/2011	2012.02	06/01/2011 12:41:42 PM Eastern Daylight Time		07/18/2011 04:44:12 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S5967	159	0	2012	Texas		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	160	0		29	10	S5967_160_0	3	1		06/01/2011	2012.02	06/01/2011 12:59:58 PM Eastern Daylight Time		07/18/2011 04:44:42 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S5967	160	0	2012	Oklahoma		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	161	0		29	10	S5967_161_0	2	1		06/01/2011	2012.02	06/01/2011 12:25:14 PM Eastern Daylight Time		07/18/2011 04:45:08 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S5967	161	0	2012	Kansas		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	162	0		29	10	S5967_162_0	2	1		06/01/2011	2012.02	06/01/2011 12:41:52 PM Eastern Daylight Time		07/18/2011 04:45:34 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S5967	162	0	2012	Upper Midwest and Northern Plains		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	163	0		29	10	S5967_163_0	2	1		06/01/2011	2012.02	06/01/2011 12:42:01 PM Eastern Daylight Time		07/18/2011 04:46:04 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S5967	163	0	2012	New Mexico		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	164	0		29	10	S5967_164_0	2	1		06/01/2011	2012.02	06/01/2011 12:33:29 PM Eastern Daylight Time		07/18/2011 04:46:35 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S5967	164	0	2012	Colorado		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	165	0		29	10	S5967_165_0	2	1		06/01/2011	2012.02	06/01/2011 12:42:11 PM Eastern Daylight Time		07/18/2011 04:47:01 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S5967	165	0	2012	Arizona		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	166	0		29	10	S5967_166_0	2	1		06/03/2011	2012.02	06/03/2011 02:34:29 PM Eastern Daylight Time		07/18/2011 04:47:26 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S5967	166	0	2012	Nevada		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	167	0		29	10	S5967_167_0	2	1		06/01/2011	2012.02	06/01/2011 12:46:13 PM Eastern Daylight Time		07/18/2011 04:48:17 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S5967	167	0	2012	Oregon, Washington		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	168	0		29	10	S5967_168_0	2	1		06/01/2011	2012.02	06/01/2011 12:42:22 PM Eastern Daylight Time		07/18/2011 04:48:48 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S5967	168	0	2012	Idaho, Utah		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	169	0		29	10	S5967_169_0	2	1		06/01/2011	2012.02	06/01/2011 12:33:39 PM Eastern Daylight Time		07/18/2011 04:49:10 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S5967	169	0	2012	California		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	170	0		29	10	S5967_170_0	2	1		06/03/2011	2012.02	06/03/2011 02:30:10 PM Eastern Daylight Time		07/18/2011 04:49:48 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S5967	170	0	2012	Hawaii		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	171	0		29	10	S5967_171_0	2	1		06/03/2011	2012.02	06/03/2011 02:31:48 PM Eastern Daylight Time		07/18/2011 05:17:45 PM Eastern Daylight Time		07/18/2011 05:27:24 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	WellCare Classic (PDP)	10	29					S5967	171	0	2012	Alaska		2					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	803	0		29	10	S5967_803_0	2	1		06/02/2011	2012.02	06/02/2011 10:37:32 AM Eastern Daylight Time				06/02/2011 12:32:48 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	PDP Employer Plan1 (PDP)	10	29					S5967	803	0	2012	National		1					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5967	804	0		29	10	S5967_804_0	2	1		05/06/2011	2012.02	05/06/2011 03:48:50 PM Eastern Daylight Time				06/02/2011 12:32:48 PM Eastern Daylight Time	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	PDP Employer - Plan2 (PDP)	10	29					S5967	804	0	2012	National		1					2							www.wellcarepdp.com	www.wellcarepdp.com									(888)-550-5252		(888)-550-5252		(888)-293-5151		(888)-293-5151										(888)-816-5252		(888)-816-5252		(888)-816-5252		(888)-816-5252				
S5975	801	0		29	10	S5975_801_0	3	1		05/31/2011	2012.02	05/31/2011 04:48:56 PM Pacific Daylight Time				06/03/2011 05:12:40 PM Pacific Daylight Time	ODS HEALTH PLAN, INC.	ODS Health Plan, Inc.	www.odscompanies.com/odsadvantage	ODS Advantage Rx Employer Option (PDP)	10	29					S5975	801	0	2012	National		1					2							www.odscompanies.com/odsadvantage	www.odscompanies.com/odsadvantage									(888)-786-7509		(503)-265-4709		(888)-217-2375		(503)-265-2975										(711)		(711)		(711)		(711)				
S5975	805	0		29	10	S5975_805_0	3	1		06/01/2011	2012.02	06/01/2011 11:27:27 AM Pacific Daylight Time				06/03/2011 05:12:40 PM Pacific Daylight Time	ODS HEALTH PLAN, INC.	ODS Health Plan, Inc.	www.odscompanies.com/odsadvantage	ODS Advantage Rx Employer Option (PDP)	10	29					S5975	805	0	2012	National		1					2							www.odscompanies.com/odsadvantage	www.odscompanies.com/odsadvantage									(888)-786-7509		(503)-265-4709		(888)-217-2375		(503)-265-2975										(711)		(711)		(711)		(711)				
S5983	004	0		29	10	S5983_004_0	5	1		06/04/2011	2012.02	06/04/2011 03:51:11 PM Eastern Daylight Time		06/05/2011 02:07:18 PM Eastern Daylight Time		06/06/2011 10:02:06 AM Eastern Daylight Time	MEDCO CONTAINMENT INSURANCE COMPANY OF NEW YORK	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan - Value (PDP)	10	29					S5983	004	0	2012	State of New York		2					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4570		(800)-758-4570		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5983	801	0		29	10	S5983_801_0	1	1		05/31/2011	2012.02	05/31/2011 02:24:25 PM Eastern Daylight Time				06/05/2011 02:34:19 PM Eastern Daylight Time	MEDCO CONTAINMENT INSURANCE COMPANY OF NEW YORK	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan (PDP)	10	29					S5983	801	0	2012	National Plan - Employer, Calendar Year		1					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4570		(800)-758-4570		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5983	802	0		29	10	S5983_802_0	1	1		05/31/2011	2012.02	05/31/2011 02:54:13 PM Eastern Daylight Time				06/05/2011 02:34:19 PM Eastern Daylight Time	MEDCO CONTAINMENT INSURANCE COMPANY OF NEW YORK	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan (PDP)	10	29					S5983	802	0	2012	National Plan - Employer, Non-Calendar Year		1					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4570		(800)-758-4570		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5983	803	0		29	10	S5983_803_0	1	1		05/31/2011	2012.02	05/31/2011 02:54:23 PM Eastern Daylight Time				06/05/2011 02:34:19 PM Eastern Daylight Time	MEDCO CONTAINMENT INSURANCE COMPANY OF NEW YORK	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan (PDP)	10	29					S5983	803	0	2012	National Plan K - Calendar Year		1					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4570		(800)-758-4570		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5983	804	0		29	10	S5983_804_0	1	1		06/04/2011	2012.02	06/04/2011 03:55:56 PM Eastern Daylight Time				06/05/2011 02:34:19 PM Eastern Daylight Time	MEDCO CONTAINMENT INSURANCE COMPANY OF NEW YORK	Medco Medicare Prescription Plan	www.medcomedicare.com	Medco Medicare Prescription Plan (PDP)	10	29					S5983	804	0	2012	National Plan - Employer, Calendar Year		1					2							www.medcomedicare.com	www.medcomedicare.com									(800)-758-4570		(800)-758-4570		(800)-758-3605		(800)-758-3605										(800)-716-3231		(800)-716-3231		(800)-716-3231		(800)-716-3231				
S5993	001	0		29	10	S5993_001_0	6	1		05/11/2011	2012.02	05/11/2011 10:03:08 AM Eastern Daylight Time		07/13/2011 11:13:11 AM Eastern Daylight Time		07/13/2011 11:16:06 AM Eastern Daylight Time	HORIZON HEALTHCARE SERVICES DBA HORIZON BCBS NJ	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www.horizonblue.com	Horizon Medicare Blue Rx Standard (PDP)	10	29					S5993	001	0	2012	New Jersey		2					2							http://www.horizonblue.com/medicare/partd/Pharmacy_Formulary_search.aspx	http://www.horizonblue.com/medicare/partd/									(866)-236-7376		(866)-236-7376		(800)-224-1234		(800)-224-1234										(866)-236-1069		(866)-236-1069		(800)-852-7899		(800)-852-7899				
S5993	003	0		29	10	S5993_003_0	6	1		05/17/2011	2012.02	05/17/2011 11:18:17 AM Eastern Daylight Time		06/06/2011 01:18:11 PM Eastern Daylight Time		06/06/2011 01:31:36 PM Eastern Daylight Time	HORIZON HEALTHCARE SERVICES DBA HORIZON BCBS NJ	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www.horizonblue.com	Horizon Medicare Blue Rx Enhanced (PDP)	10	29					S5993	003	0	2012	New Jersey		2					2							http://www.horizonblue.com/medicare/partd/Pharmacy_Formulary_search.aspx	http://www.horizonblue.com/medicare/partd/									(866)-236-7376		(866)-236-7376		(800)-224-1234		(800)-224-1234										(866)-236-1069		(866)-236-1069		(800)-852-7899		(800)-852-7899				
S5993	801	0		29	10	S5993_801_0	3	1		05/20/2011	2012.02	05/20/2011 09:05:55 AM Eastern Daylight Time				06/06/2011 01:31:36 PM Eastern Daylight Time	HORIZON HEALTHCARE SERVICES DBA HORIZON BCBS NJ	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www.horizonblue.com	Horizon Medicare Blue Group Rx (PDP)	10	29					S5993	801	0	2012	National		1					2							http://www.horizonblue.com/medicare/partd/Pharmacy_Formulary_search.aspx	http://www.horizonblue.com/medicare/partd/									(866)-236-7376		(866)-236-7376		(800)-224-1234		(800)-224-1234										(866)-236-1069		(866)-236-1069		(800)-852-7899		(800)-852-7899				
S5993	802	0		29	10	S5993_802_0	3	1		05/27/2011	2012.02	05/27/2011 09:28:15 AM Eastern Daylight Time				06/06/2011 01:31:36 PM Eastern Daylight Time	HORIZON HEALTHCARE SERVICES DBA HORIZON BCBS NJ	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www.horizonblue.com	Horizon Medicare Blue Group Rx Non-CY (PDP)	10	29					S5993	802	0	2012	National		1					2							http://www.horizonblue.com/medicare/partd/Pharmacy_Formulary_search.aspx	http://www.horizonblue.com/medicare/partd/									(866)-236-7376		(866)-236-7376		(800)-224-1234		(800)-224-1234										(866)-236-1069		(866)-236-1069		(800)-852-7899		(800)-852-7899				
S5993	803	0		29	10	S5993_803_0	3	1		05/20/2011	2012.02	05/20/2011 09:07:05 AM Eastern Daylight Time				06/06/2011 01:31:36 PM Eastern Daylight Time	HORIZON HEALTHCARE SERVICES DBA HORIZON BCBS NJ	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www.horizonblue.com	Horizon Medicare Blue Group Plan 803 (PDP)	10	29					S5993	803	0	2012	National		1					2							http://www.horizonblue.com/medicare/partd/Pharmacy_Formulary_search.aspx	http://www.horizonblue.com/medicare/partd/									(866)-236-7376		(866)-236-7376		(800)-224-1234		(800)-224-1234										(866)-236-1069		(866)-236-1069		(800)-852-7899		(800)-852-7899				
S5998	001	0		29	10	S5998_001_0	3	1		06/06/2011	2012.02	06/06/2011 02:56:29 PM Central Daylight Time		07/21/2011 09:42:50 AM Central Daylight Time		07/21/2011 06:44:26 PM Central Daylight Time	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	BravoRx (PDP)	10	29					S5998	001	0	2012	New York BravoRx		2					2							www.mybravohealth.com/formulary	www.mybravohealth.com									(877)-504-7252		(877)-504-7252		(800)-723-9209		(800)-723-9209										(711)		(711)		(711)		(711)				
S5998	003	0		29	10	S5998_003_0	3	1		06/02/2011	2012.02	06/02/2011 11:02:05 AM Central Daylight Time		07/21/2011 09:43:41 AM Central Daylight Time		07/21/2011 06:44:26 PM Central Daylight Time	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	BravoRx (PDP)	10	29					S5998	003	0	2012	New Jersey BravoRx		2					2							www.mybravohealth.com/formulary	www.mybravohealth.com									(877)-504-7252		(877)-504-7252		(800)-723-9209		(800)-723-9209										(711)		(711)		(711)		(711)				
S5998	005	0		29	10	S5998_005_0	3	1		06/02/2011	2012.02	06/02/2011 11:00:29 AM Central Daylight Time		07/21/2011 09:44:31 AM Central Daylight Time		07/21/2011 06:44:26 PM Central Daylight Time	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	BravoRx (PDP)	10	29					S5998	005	0	2012	PA/WV BravoRx		2					2							www.mybravohealth.com/formulary	www.mybravohealth.com									(877)-504-7252		(877)-504-7252		(800)-723-9209		(800)-723-9209										(711)		(711)		(711)		(711)				
S5998	009	0		29	10	S5998_009_0	3	1		06/02/2011	2012.02	06/02/2011 11:00:29 AM Central Daylight Time		07/21/2011 09:45:21 AM Central Daylight Time		07/21/2011 06:44:26 PM Central Daylight Time	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	BravoRx (PDP)	10	29					S5998	009	0	2012	Michigan BravoRx		2					2							www.mybravohealth.com/formulary	www.mybravohealth.com									(877)-504-7252		(877)-504-7252		(800)-723-9209		(800)-723-9209										(711)		(711)		(711)		(711)				
S5998	011	0		29	10	S5998_011_0	3	1		06/02/2011	2012.02	06/02/2011 11:00:30 AM Central Daylight Time		07/21/2011 09:46:08 AM Central Daylight Time		07/21/2011 06:44:26 PM Central Daylight Time	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	BravoRx (PDP)	10	29					S5998	011	0	2012	Ohio BravoRx		2					2							www.mybravohealth.com/formulary	www.mybravohealth.com									(877)-504-7252		(877)-504-7252		(800)-723-9209		(800)-723-9209										(711)		(711)		(711)		(711)				
S5998	013	0		29	10	S5998_013_0	3	1		06/02/2011	2012.02	06/02/2011 11:00:31 AM Central Daylight Time		07/21/2011 09:46:53 AM Central Daylight Time		07/21/2011 06:44:26 PM Central Daylight Time	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	BravoRx (PDP)	10	29					S5998	013	0	2012	California BravoRx		2					2							www.mybravohealth.com/formulary	www.mybravohealth.com									(877)-504-7252		(877)-504-7252		(800)-723-9209		(800)-723-9209										(711)		(711)		(711)		(711)				
S5998	015	0		29	10	S5998_015_0	3	1		06/02/2011	2012.02	06/02/2011 11:00:32 AM Central Daylight Time		07/21/2011 09:47:35 AM Central Daylight Time		07/21/2011 06:44:26 PM Central Daylight Time	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	BravoRx (PDP)	10	29					S5998	015	0	2012	Central New England BravoRx		2					2							www.mybravohealth.com/formulary	www.mybravohealth.com									(877)-504-7252		(877)-504-7252		(800)-723-9209		(800)-723-9209										(711)		(711)		(711)		(711)				
S5998	016	0		29	10	S5998_016_0	3	1		06/02/2011	2012.02	06/02/2011 11:00:32 AM Central Daylight Time		07/21/2011 09:48:17 AM Central Daylight Time		07/21/2011 06:44:26 PM Central Daylight Time	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	BravoRx (PDP)	10	29					S5998	016	0	2012	Virginia BravoRx		2					2							www.mybravohealth.com/formulary	www.mybravohealth.com									(877)-504-7252		(877)-504-7252		(800)-723-9209		(800)-723-9209										(711)		(711)		(711)		(711)				
S5998	018	0		29	10	S5998_018_0	3	1		06/02/2011	2012.02	06/02/2011 11:00:34 AM Central Daylight Time		07/21/2011 09:49:48 AM Central Daylight Time		07/21/2011 06:44:26 PM Central Daylight Time	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	BravoRx (PDP)	10	29					S5998	018	0	2012	South Carolina BravoRx		2					2							www.mybravohealth.com/formulary	www.mybravohealth.com									(877)-504-7252		(877)-504-7252		(800)-723-9209		(800)-723-9209										(711)		(711)		(711)		(711)				
S5998	019	0		29	10	S5998_019_0	3	1		06/02/2011	2012.02	06/02/2011 11:00:35 AM Central Daylight Time		07/21/2011 09:50:36 AM Central Daylight Time		07/21/2011 06:44:26 PM Central Daylight Time	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	BravoRx (PDP)	10	29					S5998	019	0	2012	Georgia BravoRx		2					2							www.mybravohealth.com/formulary	www.mybravohealth.com									(877)-504-7252		(877)-504-7252		(800)-723-9209		(800)-723-9209										(711)		(711)		(711)		(711)				
S5998	021	0		29	10	S5998_021_0	3	1		06/02/2011	2012.02	06/02/2011 11:00:39 AM Central Daylight Time		07/21/2011 09:51:58 AM Central Daylight Time		07/21/2011 06:44:26 PM Central Daylight Time	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	BravoRx (PDP)	10	29					S5998	021	0	2012	Indiana and Kentucky BravoRx		2					2							www.mybravohealth.com/formulary	www.mybravohealth.com									(877)-504-7252		(877)-504-7252		(800)-723-9209		(800)-723-9209										(711)		(711)		(711)		(711)				
S5998	023	0		29	10	S5998_023_0	3	1		06/02/2011	2012.02	06/02/2011 11:00:42 AM Central Daylight Time		07/21/2011 09:53:24 AM Central Daylight Time		07/21/2011 06:44:26 PM Central Daylight Time	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	BravoRx (PDP)	10	29					S5998	023	0	2012	Missouri BravoRx		2					2							www.mybravohealth.com/formulary	www.mybravohealth.com									(877)-504-7252		(877)-504-7252		(800)-723-9209		(800)-723-9209										(711)		(711)		(711)		(711)				
S5998	024	0		29	10	S5998_024_0	4	1		06/02/2011	2012.02	06/02/2011 11:00:43 AM Central Daylight Time		07/22/2011 04:01:53 PM Central Daylight Time		07/26/2011 12:06:15 PM Central Daylight Time	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	BravoRx (PDP)	10	29					S5998	024	0	2012	Arkansas BravoRx		2					2							www.mybravohealth.com/formulary	www.mybravohealth.com									(877)-504-7252		(877)-504-7252		(800)-723-9209		(800)-723-9209										(711)		(711)		(711)		(711)				
S5998	025	0		29	10	S5998_025_0	3	1		06/02/2011	2012.02	06/02/2011 11:00:44 AM Central Daylight Time		07/21/2011 09:54:48 AM Central Daylight Time		07/21/2011 06:44:26 PM Central Daylight Time	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	BravoRx (PDP)	10	29					S5998	025	0	2012	Mississippi BravoRx		2					2							www.mybravohealth.com/formulary	www.mybravohealth.com									(877)-504-7252		(877)-504-7252		(800)-723-9209		(800)-723-9209										(711)		(711)		(711)		(711)				
S5998	026	0		29	10	S5998_026_0	3	1		06/02/2011	2012.02	06/02/2011 11:00:45 AM Central Daylight Time		07/21/2011 09:55:27 AM Central Daylight Time		07/21/2011 06:44:26 PM Central Daylight Time	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	BravoRx (PDP)	10	29					S5998	026	0	2012	Louisiana BravoRx		2					2							www.mybravohealth.com/formulary	www.mybravohealth.com									(877)-504-7252		(877)-504-7252		(800)-723-9209		(800)-723-9209										(711)		(711)		(711)		(711)				
S5998	027	0		29	10	S5998_027_0	4	1		06/02/2011	2012.02	06/02/2011 11:00:45 AM Central Daylight Time		07/22/2011 04:02:36 PM Central Daylight Time		07/26/2011 12:06:15 PM Central Daylight Time	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	BravoRx (PDP)	10	29					S5998	027	0	2012	Oklahoma BravoRx		2					2							www.mybravohealth.com/formulary	www.mybravohealth.com									(877)-504-7252		(877)-504-7252		(800)-723-9209		(800)-723-9209										(711)		(711)		(711)		(711)				
S5998	028	0		29	10	S5998_028_0	4	1		06/02/2011	2012.02	06/02/2011 11:00:46 AM Central Daylight Time		07/22/2011 04:03:21 PM Central Daylight Time		07/26/2011 12:06:15 PM Central Daylight Time	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	BravoRx (PDP)	10	29					S5998	028	0	2012	Kansas BravoRx		2					2							www.mybravohealth.com/formulary	www.mybravohealth.com									(877)-504-7252		(877)-504-7252		(800)-723-9209		(800)-723-9209										(711)		(711)		(711)		(711)				
S5998	029	0		29	10	S5998_029_0	3	1		06/02/2011	2012.02	06/02/2011 11:00:47 AM Central Daylight Time		07/21/2011 09:57:31 AM Central Daylight Time		07/21/2011 06:44:26 PM Central Daylight Time	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	BravoRx (PDP)	10	29					S5998	029	0	2012	Upper Midwest and Northern Plains BravoRx		2					2							www.mybravohealth.com/formulary	www.mybravohealth.com									(877)-504-7252		(877)-504-7252		(800)-723-9209		(800)-723-9209										(711)		(711)		(711)		(711)				
S5998	030	0		29	10	S5998_030_0	4	1		06/02/2011	2012.02	06/02/2011 11:00:47 AM Central Daylight Time		07/22/2011 04:04:03 PM Central Daylight Time		07/26/2011 12:06:15 PM Central Daylight Time	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	BravoRx (PDP)	10	29					S5998	030	0	2012	New Mexico BravoRx		2					2							www.mybravohealth.com/formulary	www.mybravohealth.com									(877)-504-7252		(877)-504-7252		(800)-723-9209		(800)-723-9209										(711)		(711)		(711)		(711)				
S5998	032	0		29	10	S5998_032_0	3	1		06/02/2011	2012.02	06/02/2011 11:00:49 AM Central Daylight Time		07/21/2011 09:59:32 AM Central Daylight Time		07/21/2011 06:44:26 PM Central Daylight Time	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	BravoRx (PDP)	10	29					S5998	032	0	2012	Arizona BravoRx		2					2							www.mybravohealth.com/formulary	www.mybravohealth.com									(877)-504-7252		(877)-504-7252		(800)-723-9209		(800)-723-9209										(711)		(711)		(711)		(711)				
S5998	033	0		29	10	S5998_033_0	3	1		06/02/2011	2012.02	06/02/2011 11:00:49 AM Central Daylight Time		07/21/2011 10:00:19 AM Central Daylight Time		07/21/2011 06:44:26 PM Central Daylight Time	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	BravoRx (PDP)	10	29					S5998	033	0	2012	Nevada BravoRx		2					2							www.mybravohealth.com/formulary	www.mybravohealth.com									(877)-504-7252		(877)-504-7252		(800)-723-9209		(800)-723-9209										(711)		(711)		(711)		(711)				
S5998	034	0		29	10	S5998_034_0	3	1		06/02/2011	2012.02	06/02/2011 11:00:50 AM Central Daylight Time		07/21/2011 10:01:00 AM Central Daylight Time		07/21/2011 06:44:26 PM Central Daylight Time	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	BravoRx (PDP)	10	29					S5998	034	0	2012	Idaho and Utah BravoRx		2					2							www.mybravohealth.com/formulary	www.mybravohealth.com									(877)-504-7252		(877)-504-7252		(800)-723-9209		(800)-723-9209										(711)		(711)		(711)		(711)				
S5998	037	0		29	10	S5998_037_0	3	1		06/02/2011	2012.02	06/02/2011 11:00:51 AM Central Daylight Time		07/21/2011 10:01:40 AM Central Daylight Time		07/21/2011 06:44:26 PM Central Daylight Time	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	BravoRx (PDP)	10	29					S5998	037	0	2012	Mid-Atlantic Region (MD, DE and DC) BravoRx		2					2							www.mybravohealth.com/formulary	www.mybravohealth.com									(877)-504-7252		(877)-504-7252		(800)-723-9209		(800)-723-9209										(711)		(711)		(711)		(711)				
S5998	038	0		29	10	S5998_038_0	3	1		06/02/2011	2012.02	06/02/2011 11:00:51 AM Central Daylight Time		07/21/2011 10:02:19 AM Central Daylight Time		07/21/2011 06:44:26 PM Central Daylight Time	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	BravoRx (PDP)	10	29					S5998	038	0	2012	Illinois Bravo Rx		2					2							www.mybravohealth.com/formulary	www.mybravohealth.com									(877)-504-7252		(877)-504-7252		(800)-723-9209		(800)-723-9209										(711)		(711)		(711)		(711)				
S5998	039	0		29	10	S5998_039_0	3	1		06/02/2011	2012.02	06/02/2011 11:00:52 AM Central Daylight Time		07/21/2011 10:03:02 AM Central Daylight Time		07/21/2011 06:44:26 PM Central Daylight Time	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	BravoRx (PDP)	10	29					S5998	039	0	2012	Texas BravoRx		2					2							www.mybravohealth.com/formulary	www.mybravohealth.com									(877)-504-7252		(877)-504-7252		(800)-723-9209		(800)-723-9209										(711)		(711)		(711)		(711)				
S5998	801	0		29	10	S5998_801_0	1	1		06/06/2011	2012.02	06/06/2011 02:56:55 PM Central Daylight Time				06/06/2011 02:58:32 PM Central Daylight Time	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	Bravo Employer Group PDP CY (PDP)	10	29					S5998	801	0	2012	Nationwide		1					2							www.mybravohealth.com/formulary	www.mybravohealth.com									(877)-504-7252		(877)-504-7252		(800)-723-9209		(800)-723-9209										(711)		(711)		(711)		(711)				
S5998	802	0		29	10	S5998_802_0	1	1		06/06/2011	2012.02	06/06/2011 02:56:49 PM Central Daylight Time				06/06/2011 02:58:32 PM Central Daylight Time	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	Bravo Employer Group PDP Non-CY (PDP)	10	29					S5998	802	0	2012	Nationwide		1					2							www.mybravohealth.com/formulary	www.mybravohealth.com									(877)-504-7252		(877)-504-7252		(800)-723-9209		(800)-723-9209										(711)		(711)		(711)		(711)				
S6506	001	0		29	10	S6506_001_0	2	1		05/31/2011	2012.02	05/31/2011 11:50:37 AM Central Daylight Time		06/01/2011 11:52:00 AM Central Daylight Time		06/03/2011 09:56:42 AM Central Daylight Time	BLUE CROSS AND BLUE SHIELD ARIZONA, INC.	Blue MedicareRx	www.YourAZMedicareSolutions.com	Blue MedicareRx (PDP)	10	29					S6506	001	0	2012	Arizona		2					2							www.YourAZMedicareSolutions.com	www.YourAZMedicareSolutions.com									(877)-853-7693		(877)-853-7693		(877)-560-8058		(877)-560-8058										(711)		(711)		(711)		(711)				
S6506	801	0		29	10	S6506_801_0	2	1		05/31/2011	2012.02	05/31/2011 11:33:23 AM Central Daylight Time				06/03/2011 09:56:42 AM Central Daylight Time	BLUE CROSS AND BLUE SHIELD ARIZONA, INC.	Blue MedicareRx	www.YourAZMedicareSolutions.com	Blue MedicareRx for Groups (PDP)	10	29					S6506	801	0	2012	Nation-wide		1					2							www.YourAZMedicareSolutions.com	www.YourAZMedicareSolutions.com									(877)-560-8058		(877)-560-8058		(877)-560-8058		(877)-560-8058										(711)		(711)		(711)		(711)				
S6875	801	0		29	10	S6875_801_0	1	1		05/31/2011	2012.02	05/31/2011 11:36:07 AM Eastern Daylight Time				06/03/2011 09:54:35 PM Eastern Daylight Time	QCC INS CO D/B/A AMERIHEALTH INS CO	Select Option	www.ibxmedicare.com	Select Option Rx Group Option I CY (PDP)	10	29					S6875	801	0	2012	Pennsylvania, West Virginia area		1					2							http://www.ibxmedicare.com/prescription_drugs/formulary.html	http://www.ibxmedicare.com/prescription_drugs/rx_network.html									(888)-678-7009		(888)-678-7009		(877)-393-6733		(877)-393-6733										(888)-457-3002		(888)-457-3002		(877)-219-5457		(877)-219-5457				
S6875	802	0		29	10	S6875_802_0	1	1		05/31/2011	2012.02	05/31/2011 11:32:16 AM Eastern Daylight Time				06/03/2011 09:54:35 PM Eastern Daylight Time	QCC INS CO D/B/A AMERIHEALTH INS CO	Select Option	www.ibxmedicare.com	Select Option Rx Group Option I Non-CY (PDP)	10	29					S6875	802	0	2012	Pennsylvania, West Virginia Area		1					2							http://www.ibxmedicare.com/prescription_drugs/formulary.html	http://www.ibxmedicare.com/prescription_drugs/rx_network.html									(888)-678-7009		(888)-678-7009		(877)-393-6733		(877)-393-6733										(888)-457-3002		(888)-457-3002		(877)-219-5457		(877)-219-5457				
S7694	001	0		29	10	S7694_001_0	4	1		06/04/2011	2012.02	06/04/2011 11:04:23 AM Eastern Daylight Time		07/14/2011 09:00:00 PM Eastern Daylight Time		07/15/2011 09:34:46 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Silver (PDP)	10	29					S7694	001	0	2012	Northern New England Region 1 Silver - ME, NH		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	002	0		29	10	S7694_002_0	3	1		06/03/2011	2012.02	06/03/2011 11:20:39 AM Eastern Daylight Time		07/14/2011 09:01:00 PM Eastern Daylight Time		07/15/2011 09:34:46 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Silver (PDP)	10	29					S7694	002	0	2012	Central New England EnvisionRxPlusSilver-CT/MA/RI		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	003	0		29	10	S7694_003_0	3	1		06/03/2011	2012.02	06/03/2011 11:20:40 AM Eastern Daylight Time		07/14/2011 09:01:00 PM Eastern Daylight Time		07/15/2011 09:34:46 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Silver (PDP)	10	29					S7694	003	0	2012	New York EnvsionRxPlus Silver Region 03		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	004	0		29	10	S7694_004_0	3	1		06/03/2011	2012.02	06/03/2011 11:20:40 AM Eastern Daylight Time		07/14/2011 09:01:00 PM Eastern Daylight Time		07/15/2011 09:34:46 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Silver (PDP)	10	29					S7694	004	0	2012	New Jersey EnvisionRxPlus Silver Region 04		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	005	0		29	10	S7694_005_0	3	1		06/03/2011	2012.02	06/03/2011 11:20:40 AM Eastern Daylight Time		07/14/2011 09:02:00 PM Eastern Daylight Time		07/15/2011 09:34:46 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Silver (PDP)	10	29					S7694	005	0	2012	Mid-Atlantic EnvisionRxPlusSilverRegion05(DE/DC/MD		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	006	0		29	10	S7694_006_0	3	1		06/03/2011	2012.02	06/03/2011 11:20:40 AM Eastern Daylight Time		07/14/2011 09:02:00 PM Eastern Daylight Time		07/15/2011 09:34:46 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Silver (PDP)	10	29					S7694	006	0	2012	Pennsylvania, WV,EnvisionRxPlus Silver Region 06		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	007	0		29	10	S7694_007_0	3	1		06/03/2011	2012.02	06/03/2011 11:20:40 AM Eastern Daylight Time		07/14/2011 09:03:00 PM Eastern Daylight Time		07/15/2011 09:34:46 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Silver (PDP)	10	29					S7694	007	0	2012	Virginia EnvisionRxPlus Silver Region 07		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	008	0		29	10	S7694_008_0	3	1		06/03/2011	2012.02	06/03/2011 11:20:40 AM Eastern Daylight Time		07/14/2011 09:03:00 PM Eastern Daylight Time		07/15/2011 09:34:46 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Silver (PDP)	10	29					S7694	008	0	2012	North Carolina EnvisionRxPlus Silver Region 08		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	009	0		29	10	S7694_009_0	3	1		06/03/2011	2012.02	06/03/2011 11:20:40 AM Eastern Daylight Time		07/14/2011 09:03:00 PM Eastern Daylight Time		07/15/2011 09:34:46 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Silver (PDP)	10	29					S7694	009	0	2012	South Carolina EnvsionRxPlus Silver Region 09		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	010	0		29	10	S7694_010_0	3	1		06/03/2011	2012.02	06/03/2011 11:20:40 AM Eastern Daylight Time		07/14/2011 09:04:00 PM Eastern Daylight Time		07/15/2011 09:34:46 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Silver (PDP)	10	29					S7694	010	0	2012	Georgia EnvisionRxPlus Silver Region 10		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	011	0		29	10	S7694_011_0	3	1		06/03/2011	2012.02	06/03/2011 11:20:41 AM Eastern Daylight Time		07/14/2011 09:04:00 PM Eastern Daylight Time		07/15/2011 09:34:46 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Silver (PDP)	10	29					S7694	011	0	2012	Florida EnvisionRxPlus Silver Region 11		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	012	0		29	10	S7694_012_0	3	1		06/03/2011	2012.02	06/03/2011 11:20:41 AM Eastern Daylight Time		07/14/2011 09:05:00 PM Eastern Daylight Time		07/15/2011 09:34:46 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Silver (PDP)	10	29					S7694	012	0	2012	Alabama,Tennessee EnvisionRxPlus Silver Region 12		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	014	0		29	10	S7694_014_0	3	1		06/03/2011	2012.02	06/03/2011 11:20:41 AM Eastern Daylight Time		07/14/2011 09:05:00 PM Eastern Daylight Time		07/15/2011 09:34:46 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Silver (PDP)	10	29					S7694	014	0	2012	Ohio EnvisionRxPlus Silver Region 14		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	015	0		29	10	S7694_015_0	3	1		06/03/2011	2012.02	06/03/2011 11:20:41 AM Eastern Daylight Time		07/14/2011 09:05:00 PM Eastern Daylight Time		07/15/2011 09:34:46 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Silver (PDP)	10	29					S7694	015	0	2012	Indiana, Kentucky EnvisionRxPlus Silver Region 15		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	016	0		29	10	S7694_016_0	3	1		06/03/2011	2012.02	06/03/2011 11:20:41 AM Eastern Daylight Time		07/14/2011 09:06:00 PM Eastern Daylight Time		07/15/2011 09:34:46 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Silver (PDP)	10	29					S7694	016	0	2012	Wisconsin EnvisionRxPlus Silver Region 16		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	017	0		29	10	S7694_017_0	3	1		06/03/2011	2012.02	06/03/2011 11:20:41 AM Eastern Daylight Time		07/14/2011 09:06:00 PM Eastern Daylight Time		07/15/2011 09:34:46 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Silver (PDP)	10	29					S7694	017	0	2012	Illinois EnvisionRxPlus Silver Region 17		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	018	0		29	10	S7694_018_0	3	1		06/03/2011	2012.02	06/03/2011 11:20:42 AM Eastern Daylight Time		07/14/2011 09:06:00 PM Eastern Daylight Time		07/15/2011 09:34:46 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Silver (PDP)	10	29					S7694	018	0	2012	Missouri EnvisionRxPlus Silver Region 18		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	019	0		29	10	S7694_019_0	3	1		06/03/2011	2012.02	06/03/2011 11:20:42 AM Eastern Daylight Time		07/14/2011 09:07:00 PM Eastern Daylight Time		07/15/2011 09:34:46 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Silver (PDP)	10	29					S7694	019	0	2012	Arkansas EnvisionRxPlus Silver Region 19		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	020	0		29	10	S7694_020_0	3	1		06/03/2011	2012.02	06/03/2011 11:20:42 AM Eastern Daylight Time		07/14/2011 09:07:00 PM Eastern Daylight Time		07/15/2011 09:34:46 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Silver (PDP)	10	29					S7694	020	0	2012	Mississippi EnvisionRxPlus Silver Region 20		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	021	0		29	10	S7694_021_0	3	1		06/03/2011	2012.02	06/03/2011 11:20:42 AM Eastern Daylight Time		07/14/2011 09:07:00 PM Eastern Daylight Time		07/15/2011 09:34:46 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Silver (PDP)	10	29					S7694	021	0	2012	Louisiana EnvisionRxPlus Silver Region 21		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	022	0		29	10	S7694_022_0	3	1		06/03/2011	2012.02	06/03/2011 11:20:42 AM Eastern Daylight Time		07/14/2011 09:08:00 PM Eastern Daylight Time		07/15/2011 09:34:46 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Silver (PDP)	10	29					S7694	022	0	2012	Texas EnvisionRxPlus Silver Region 22		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	023	0		29	10	S7694_023_0	3	1		06/03/2011	2012.02	06/03/2011 11:20:42 AM Eastern Daylight Time		07/14/2011 09:08:00 PM Eastern Daylight Time		07/15/2011 09:34:46 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Silver (PDP)	10	29					S7694	023	0	2012	Oklahoma EnvisionRxPlus Silver Region 23		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	024	0		29	10	S7694_024_0	3	1		06/03/2011	2012.02	06/03/2011 11:20:42 AM Eastern Daylight Time		07/14/2011 09:08:00 PM Eastern Daylight Time		07/15/2011 09:34:46 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Silver (PDP)	10	29					S7694	024	0	2012	Kansas EnvisionRxPlus Silver Region 24		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	025	0		29	10	S7694_025_0	3	1		06/03/2011	2012.02	06/03/2011 11:20:43 AM Eastern Daylight Time		07/14/2011 09:09:00 PM Eastern Daylight Time		07/15/2011 09:34:46 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Silver (PDP)	10	29					S7694	025	0	2012	Upper Midwest (IA,EnvisionRxPlus Silver Reg 25		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	026	0		29	10	S7694_026_0	3	1		06/03/2011	2012.02	06/03/2011 11:20:43 AM Eastern Daylight Time		07/14/2011 09:09:00 PM Eastern Daylight Time		07/15/2011 09:34:46 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Silver (PDP)	10	29					S7694	026	0	2012	New Mexico EnvisionRxPlus Silver Region 26		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	027	0		29	10	S7694_027_0	3	1		06/03/2011	2012.02	06/03/2011 11:20:43 AM Eastern Daylight Time		07/14/2011 09:09:00 PM Eastern Daylight Time		07/15/2011 09:34:46 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Silver (PDP)	10	29					S7694	027	0	2012	Colorado EnvisionRxPlus Silver Region 27		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	028	0		29	10	S7694_028_0	3	1		06/03/2011	2012.02	06/03/2011 11:20:43 AM Eastern Daylight Time		07/14/2011 09:10:00 PM Eastern Daylight Time		07/15/2011 09:34:46 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Silver (PDP)	10	29					S7694	028	0	2012	Arizona EnvisionRxPlus Silver Region 28		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	029	0		29	10	S7694_029_0	3	1		06/03/2011	2012.02	06/03/2011 11:20:43 AM Eastern Daylight Time		07/14/2011 09:10:00 PM Eastern Daylight Time		07/15/2011 09:34:46 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Silver (PDP)	10	29					S7694	029	0	2012	Nevada EnvisionRxPlus Silver Region 29		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	030	0		29	10	S7694_030_0	3	1		06/03/2011	2012.02	06/03/2011 11:20:43 AM Eastern Daylight Time		07/14/2011 09:11:00 PM Eastern Daylight Time		07/15/2011 09:34:46 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Silver (PDP)	10	29					S7694	030	0	2012	Oregon, Washington EnvisionRxPlus Silver Region 30		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	031	0		29	10	S7694_031_0	3	1		06/03/2011	2012.02	06/03/2011 11:20:44 AM Eastern Daylight Time		07/14/2011 09:11:00 PM Eastern Daylight Time		07/15/2011 09:34:46 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Silver (PDP)	10	29					S7694	031	0	2012	Idaho, Utah EnvisionRxPlus Silver Region 31		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	032	0		29	10	S7694_032_0	3	1		06/03/2011	2012.02	06/03/2011 11:20:44 AM Eastern Daylight Time		07/14/2011 09:11:00 PM Eastern Daylight Time		07/15/2011 09:34:46 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Silver (PDP)	10	29					S7694	032	0	2012	California EnvisionRxPlus Silver Region 32		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	033	0		29	10	S7694_033_0	3	1		06/03/2011	2012.02	06/03/2011 11:20:44 AM Eastern Daylight Time		07/14/2011 09:12:00 PM Eastern Daylight Time		07/15/2011 09:34:46 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Silver (PDP)	10	29					S7694	033	0	2012	Hawaii EnvisionRxPlus Silver Region 33		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	034	0		29	10	S7694_034_0	3	1		06/03/2011	2012.02	06/03/2011 11:20:44 AM Eastern Daylight Time		07/14/2011 09:12:00 PM Eastern Daylight Time		07/15/2011 09:34:46 AM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Silver (PDP)	10	29					S7694	034	0	2012	Alaska EnvisionRxPlus Silver Region 34		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	070	0		29	10	S7694_070_0	3	1		06/03/2011	2012.02	06/03/2011 11:20:44 AM Eastern Daylight Time		07/12/2011 07:51:00 PM Eastern Daylight Time		07/13/2011 12:56:35 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Silver (PDP)	10	29					S7694	070	0	2012	Michigan Region 13		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	071	0		29	10	S7694_071_0	5	1		06/04/2011	2012.02	06/04/2011 10:39:58 AM Eastern Daylight Time		07/21/2011 05:42:00 PM Eastern Daylight Time		07/21/2011 06:09:31 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	Rite Aid/EnvisionRxPlus (PDP)	10	29					S7694	071	0	2012	Michigan RiteAid/Envision Region 13		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	072	0		29	10	S7694_072_0	4	1		06/04/2011	2012.02	06/04/2011 11:06:09 AM Eastern Daylight Time		07/21/2011 05:42:00 PM Eastern Daylight Time		07/21/2011 06:09:31 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	Rite Aid/EnvisionRxPlus (PDP)	10	29					S7694	072	0	2012	Northern New England Rite Aid/EnvisionRxPlus 072		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	073	0		29	10	S7694_073_0	4	1		06/04/2011	2012.02	06/04/2011 11:06:09 AM Eastern Daylight Time		07/21/2011 05:42:00 PM Eastern Daylight Time		07/21/2011 06:09:31 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	Rite Aid/EnvisionRxPlus (PDP)	10	29					S7694	073	0	2012	Central New England RiteAidEnvision (CT,MA,RI,VT)		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	074	0		29	10	S7694_074_0	4	1		06/04/2011	2012.02	06/04/2011 11:06:10 AM Eastern Daylight Time		07/21/2011 05:42:00 PM Eastern Daylight Time		07/21/2011 06:09:31 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	Rite Aid/EnvisionRxPlus (PDP)	10	29					S7694	074	0	2012	New York RiteAid/Envision Region 3		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	075	0		29	10	S7694_075_0	4	1		06/04/2011	2012.02	06/04/2011 11:06:10 AM Eastern Daylight Time		07/21/2011 05:43:00 PM Eastern Daylight Time		07/21/2011 06:09:31 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	Rite Aid/EnvisionRxPlus (PDP)	10	29					S7694	075	0	2012	New Jersey RiteAid/Envision Region 4		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	076	0		29	10	S7694_076_0	4	1		06/04/2011	2012.02	06/04/2011 11:06:10 AM Eastern Daylight Time		07/21/2011 05:43:00 PM Eastern Daylight Time		07/21/2011 06:09:31 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	Rite Aid/EnvisionRxPlus (PDP)	10	29					S7694	076	0	2012	Mid-Atlantic RiteAid/Envision Region 5 (DE,DC,MD)		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	077	0		29	10	S7694_077_0	4	1		06/04/2011	2012.02	06/04/2011 11:06:11 AM Eastern Daylight Time		07/21/2011 05:43:00 PM Eastern Daylight Time		07/21/2011 06:09:31 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	Rite Aid/EnvisionRxPlus (PDP)	10	29					S7694	077	0	2012	PA, WV RiteAid/Envision Region 6		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	078	0		29	10	S7694_078_0	4	1		06/04/2011	2012.02	06/04/2011 11:06:11 AM Eastern Daylight Time		07/21/2011 05:43:00 PM Eastern Daylight Time		07/21/2011 06:09:31 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	Rite Aid/EnvisionRxPlus (PDP)	10	29					S7694	078	0	2012	Virginia RiteAid/Envision Region 7		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	079	0		29	10	S7694_079_0	4	1		06/04/2011	2012.02	06/04/2011 11:06:11 AM Eastern Daylight Time		07/21/2011 05:44:00 PM Eastern Daylight Time		07/21/2011 06:09:31 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	Rite Aid/EnvisionRxPlus (PDP)	10	29					S7694	079	0	2012	North Carolina RiteAid/Envision Region 8		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	080	0		29	10	S7694_080_0	4	1		06/04/2011	2012.02	06/04/2011 11:06:12 AM Eastern Daylight Time		07/21/2011 05:44:00 PM Eastern Daylight Time		07/21/2011 06:09:31 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	Rite Aid/EnvisionRxPlus (PDP)	10	29					S7694	080	0	2012	South Carolina RiteAid/Envision Region 9		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	081	0		29	10	S7694_081_0	4	1		06/04/2011	2012.02	06/04/2011 11:06:12 AM Eastern Daylight Time		07/21/2011 05:44:00 PM Eastern Daylight Time		07/21/2011 06:09:31 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	Rite Aid/EnvisionRxPlus (PDP)	10	29					S7694	081	0	2012	Georgia RiteAid/Envision Region 10		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	082	0		29	10	S7694_082_0	6	1		07/08/2011	2012.02	07/08/2011 12:34:26 PM Eastern Daylight Time		07/21/2011 05:44:00 PM Eastern Daylight Time		07/21/2011 06:09:31 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Gold (PDP)	10	29					S7694	082	0	2012	Florida Envision Gold Region 11		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	083	0		29	10	S7694_083_0	4	1		06/04/2011	2012.02	06/04/2011 11:07:18 AM Eastern Daylight Time		07/21/2011 05:45:00 PM Eastern Daylight Time		07/21/2011 06:09:31 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	Rite Aid/EnvisionRxPlus (PDP)	10	29					S7694	083	0	2012	Alabama, Tennessee RiteAid/Envision Region 12		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	084	0		29	10	S7694_084_0	3	1		06/04/2011	2012.02	06/04/2011 11:07:18 AM Eastern Daylight Time		07/21/2011 05:45:00 PM Eastern Daylight Time		07/21/2011 06:09:31 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	Rite Aid/EnvisionRxPlus (PDP)	10	29					S7694	084	0	2012	Ohio RiteAid/Envision Region 14		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	085	0		29	10	S7694_085_0	3	1		06/04/2011	2012.02	06/04/2011 11:07:18 AM Eastern Daylight Time		07/21/2011 05:45:00 PM Eastern Daylight Time		07/21/2011 06:09:31 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	Rite Aid/EnvisionRxPlus (PDP)	10	29					S7694	085	0	2012	Indiana, Kentucky RiteAid/Envision Region 15		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	086	0		29	10	S7694_086_0	4	1		07/08/2011	2012.02	07/08/2011 12:36:24 PM Eastern Daylight Time		07/21/2011 05:45:00 PM Eastern Daylight Time		07/21/2011 06:09:31 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Gold (PDP)	10	29					S7694	086	0	2012	Wisconsin Envision Gold Region 16		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	087	0		29	10	S7694_087_0	4	1		07/08/2011	2012.02	07/08/2011 12:36:24 PM Eastern Daylight Time		07/21/2011 05:46:00 PM Eastern Daylight Time		07/21/2011 06:09:31 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Gold (PDP)	10	29					S7694	087	0	2012	Illinois Envision Gold Region 17		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	088	0		29	10	S7694_088_0	4	1		07/08/2011	2012.02	07/08/2011 12:36:24 PM Eastern Daylight Time		07/21/2011 05:46:00 PM Eastern Daylight Time		07/21/2011 06:09:31 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Gold (PDP)	10	29					S7694	088	0	2012	Missouri Envision Gold Region 18		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	089	0		29	10	S7694_089_0	4	1		07/08/2011	2012.02	07/08/2011 12:36:25 PM Eastern Daylight Time		07/21/2011 05:46:00 PM Eastern Daylight Time		07/21/2011 06:09:31 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Gold (PDP)	10	29					S7694	089	0	2012	Arkansas Envision Gold Region 19		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	090	0		29	10	S7694_090_0	3	1		06/04/2011	2012.02	06/04/2011 11:08:25 AM Eastern Daylight Time		07/21/2011 05:46:00 PM Eastern Daylight Time		07/21/2011 06:09:31 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	Rite Aid/EnvisionRxPlus (PDP)	10	29					S7694	090	0	2012	Mississippi RiteAid/Envision Region 20		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	091	0		29	10	S7694_091_0	3	1		06/04/2011	2012.02	06/04/2011 11:08:25 AM Eastern Daylight Time		07/21/2011 05:46:00 PM Eastern Daylight Time		07/21/2011 06:09:31 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	Rite Aid/EnvisionRxPlus (PDP)	10	29					S7694	091	0	2012	Louisiana RiteAid/Envision Region 21		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	092	0		29	10	S7694_092_0	4	1		07/08/2011	2012.02	07/08/2011 12:36:25 PM Eastern Daylight Time		07/21/2011 05:47:00 PM Eastern Daylight Time		07/21/2011 06:09:31 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Gold (PDP)	10	29					S7694	092	0	2012	Texas Envision Gold Region 22		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	093	0		29	10	S7694_093_0	4	1		07/08/2011	2012.02	07/08/2011 12:36:25 PM Eastern Daylight Time		07/21/2011 05:47:00 PM Eastern Daylight Time		07/21/2011 06:09:31 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Gold (PDP)	10	29					S7694	093	0	2012	Oklahoma Envision Gold Region 23		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	094	0		29	10	S7694_094_0	4	1		07/08/2011	2012.02	07/08/2011 12:36:25 PM Eastern Daylight Time		07/21/2011 05:47:00 PM Eastern Daylight Time		07/21/2011 06:09:31 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Gold (PDP)	10	29					S7694	094	0	2012	Kansas Envision Gold Region 24		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	095	0		29	10	S7694_095_0	4	1		07/08/2011	2012.02	07/08/2011 12:36:26 PM Eastern Daylight Time		07/21/2011 05:47:00 PM Eastern Daylight Time		07/21/2011 06:09:31 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Gold (PDP)	10	29					S7694	095	0	2012	IA,MN,MT,NE,ND,SD Envision Gold Region 25		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	096	0		29	10	S7694_096_0	4	1		07/08/2011	2012.02	07/08/2011 12:37:16 PM Eastern Daylight Time		07/21/2011 05:48:00 PM Eastern Daylight Time		07/21/2011 06:09:31 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Gold (PDP)	10	29					S7694	096	0	2012	New Mexico Envision Gold Region 26		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	097	0		29	10	S7694_097_0	3	1		06/04/2011	2012.02	06/04/2011 11:08:25 AM Eastern Daylight Time		07/21/2011 05:48:00 PM Eastern Daylight Time		07/21/2011 06:09:31 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	Rite Aid/EnvisionRxPlus (PDP)	10	29					S7694	097	0	2012	Colorado RiteAid/Envision Region 27		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	098	0		29	10	S7694_098_0	3	1		06/04/2011	2012.02	06/04/2011 11:08:26 AM Eastern Daylight Time		07/21/2011 05:48:00 PM Eastern Daylight Time		07/21/2011 06:09:31 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	Rite Aid/EnvisionRxPlus (PDP)	10	29					S7694	098	0	2012	Arizona RiteAid/Envision Region 28		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	099	0		29	10	S7694_099_0	3	1		06/04/2011	2012.02	06/04/2011 11:08:26 AM Eastern Daylight Time		07/21/2011 05:48:00 PM Eastern Daylight Time		07/21/2011 06:09:31 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	Rite Aid/EnvisionRxPlus (PDP)	10	29					S7694	099	0	2012	Nevada RiteAid/Envision Region 29		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	100	0		29	10	S7694_100_0	3	1		06/04/2011	2012.02	06/04/2011 11:08:26 AM Eastern Daylight Time		07/21/2011 05:48:00 PM Eastern Daylight Time		07/21/2011 06:09:31 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	Rite Aid/EnvisionRxPlus (PDP)	10	29					S7694	100	0	2012	Oregon, Washington RiteAid/Envision Region 30		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	101	0		29	10	S7694_101_0	3	1		06/04/2011	2012.02	06/04/2011 11:08:26 AM Eastern Daylight Time		07/21/2011 05:49:00 PM Eastern Daylight Time		07/21/2011 06:09:31 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	Rite Aid/EnvisionRxPlus (PDP)	10	29					S7694	101	0	2012	Idaho, Utah RiteAid/Envision Region 31		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	102	0		29	10	S7694_102_0	3	1		06/04/2011	2012.02	06/04/2011 11:08:27 AM Eastern Daylight Time		07/21/2011 05:49:00 PM Eastern Daylight Time		07/21/2011 06:09:31 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	Rite Aid/EnvisionRxPlus (PDP)	10	29					S7694	102	0	2012	California RiteAid/Envision Region 32		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	103	0		29	10	S7694_103_0	4	1		07/08/2011	2012.02	07/08/2011 12:36:26 PM Eastern Daylight Time		07/21/2011 05:49:00 PM Eastern Daylight Time		07/21/2011 06:09:31 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Gold (PDP)	10	29					S7694	103	0	2012	Hawaii Envision Gold Region 33		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	104	0		29	10	S7694_104_0	4	1		07/08/2011	2012.02	07/08/2011 12:36:27 PM Eastern Daylight Time		07/21/2011 05:49:00 PM Eastern Daylight Time		07/21/2011 06:09:31 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	EnvisionRxPlus Gold (PDP)	10	29					S7694	104	0	2012	Alaska Envision Gold Region 34		2					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	801	0		29	10	S7694_801_0	1	1		06/05/2011	2012.02	06/05/2011 12:36:02 PM Eastern Daylight Time				06/05/2011 01:30:36 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	Employer Plan Calendar Year (PDP)	10	29					S7694	801	0	2012	National EGWP		1					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7694	802	0		29	10	S7694_802_0	1	1		06/05/2011	2012.02	06/05/2011 12:36:16 PM Eastern Daylight Time				06/05/2011 01:30:36 PM Eastern Daylight Time	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	Employer Group Non-Calendar Year (PDP)	10	29					S7694	802	0	2012	National EGWP		1					2							www.envisionrxplus.com	www.envisionrxplus.com									(866)-250-2005		(866)-250-2005		(866)-250-2005		(866)-250-2005										(866)-763-9630		(866)-763-9630		(711)		(711)				
S7950	801	0		29	10	S7950_801_0	1	1		05/16/2011	2012.02	05/16/2011 01:31:57 PM Central Daylight Time				05/25/2011 12:12:50 PM Central Daylight Time	EXPRESS SCRIPTS INSURANCE CO.	SAMAscript	www.samascript.com	SAMAscript (PDP)	10	29					S7950	801	0	2012	SAMAscript		1					2							www.samascript.com	www.samascript.com									(866)-273-5788		(866)-273-5788		(866)-273-5788		(866)-273-5788										(800)-899-2114		(800)-899-2114		(800)-899-2114		(800)-899-2114				
S7950	802	0		29	10	S7950_802_0	2	1		05/13/2011	2012.02	05/13/2011 01:25:00 PM Central Daylight Time				05/25/2011 01:14:11 PM Central Daylight Time	EXPRESS SCRIPTS INSURANCE CO.	SAMAscript	www.samascript.com	SAMAscript (PDP)	10	29					S7950	802	0	2012	SAMAscript		1					2							www.samascript.com	www.samascript.com									(866)-273-5788		(866)-273-5788		(866)-273-5788		(866)-273-5788										(800)-899-2114		(800)-899-2114		(800)-899-2114		(800)-899-2114				
S8067	001	0		29	10	S8067_001_0	7	1		07/27/2011	2012.02	07/27/2011 04:39:19 PM Eastern Daylight Time		07/27/2011 12:11:50 PM Eastern Daylight Time		07/27/2011 06:29:14 PM Eastern Daylight Time	AVALON INSURANCE COMPANY	Avalon Insurance Company	www.securerxpdp.com	SecureRx - Option 3 (PDP)	10	29					S8067	001	0	2012	Region 6 - Pennsylvania, West Virginia		2					2							https://www.securerxpdp.com/DrugFormularies/	https://www.securerxpdp.com/									(877)-234-3853		(877)-234-3853		(888)-839-7330		(888)-839-7330										(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961				
S8067	003	0		29	10	S8067_003_0	6	1		06/02/2011	2012.02	06/02/2011 06:23:32 PM Eastern Daylight Time		07/20/2011 04:31:22 PM Eastern Daylight Time		07/21/2011 06:27:40 PM Eastern Daylight Time	AVALON INSURANCE COMPANY	Avalon Insurance Company	www.securerxpdp.com	SecureRx - Option 1 (PDP)	10	29					S8067	003	0	2012	Region 06 - Pennsylvania and West Virginia		2					2							https://www.securerxpdp.com/DrugFormularies/	https://www.securerxpdp.com/									(877)-234-3853		(877)-234-3853		(888)-839-7330		(888)-839-7330										(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961				
S8067	801	0		29	10	S8067_801_0	3	1		05/23/2011	2012.02	05/23/2011 11:26:58 AM Eastern Daylight Time				06/06/2011 01:31:01 AM Eastern Daylight Time	AVALON INSURANCE COMPANY	Avalon Insurance Company	www.securerxpdp.com	SecureRx - ER (PDP)	10	29					S8067	801	0	2012	National		1					2							https://www.securerxpdp.com/DrugFormularies/	https://www.securerxpdp.com/									(877)-234-3853		(877)-234-3853		(888)-839-7330		(888)-839-7330										(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961				
S8067	802	0		29	10	S8067_802_0	3	1		04/11/2011	2012.02	04/11/2011 03:05:11 PM Eastern Daylight Time				06/06/2011 01:31:01 AM Eastern Daylight Time	AVALON INSURANCE COMPANY	Avalon Insurance Company	www.securerxpdp.com	SecureRx - ER - Non-Calendar PY (PDP)	10	29					S8067	802	0	2012	National		1					2							https://www.securerxpdp.com/DrugFormularies/	https://www.securerxpdp.com/									(877)-234-3853		(877)-234-3853		(888)-839-7330		(888)-839-7330										(800)-779-6961		(800)-779-6961		(800)-779-6961		(800)-779-6961				
S8841	803	0		29	10	S8841_803_0	1	1		06/02/2011	2012.02	06/02/2011 04:58:44 PM Eastern Daylight Time				06/02/2011 05:00:55 PM Eastern Daylight Time	NMHC GROUP SOLUTION INSURANCE, INC.	NMHC Group Solutions	www.sxc.com	EGWP 2012 Calendar Year Plan (PDP)	10	29					S8841	803	0	2012	National		1					2							www.myinformedRx.com	www.myinformedRx.com									(866)-443-1095		(866)-443-1095		(866)-443-1095		(866)-443-1095										(866)-443-1094		(866)-443-1094		(866)-443-1094		(866)-443-1094				
S8841	804	0		29	10	S8841_804_0	2	1		06/08/2011	2012.02	06/08/2011 02:33:13 PM Eastern Daylight Time				06/08/2011 02:33:33 PM Eastern Daylight Time	NMHC GROUP SOLUTION INSURANCE, INC.	NMHC Group Solutions	www.sxc.com	EGWP 2012 Non-Calendar Year Plan (PDP)	10	29					S8841	804	0	2012	National		1					2							www.myinformedRx.com	www.myinformedRx.com									(866)-443-1095		(866)-443-1095		(866)-443-1095		(866)-443-1095										(866)-443-1094		(866)-443-1094		(866)-443-1094		(866)-443-1094				
S9579	803	0		29	10	S9579_803_0	2	1		05/27/2011	2012.02	05/27/2011 02:47:32 PM Pacific Daylight Time				05/27/2011 02:48:31 PM Pacific Daylight Time	STONEBRIDGE LIFE INSURANCE COMPANY	Medicare GenerationRx (Employer PDP)	http://www.aegonins.com/	Medicare Generation Rx (PDP)	10	29					S9579	803	0	2012	Medicare Generation Rx		1					2							http://www.aegonins.com/	http://www.aegonins.com/									(877)-633-7943		(877)-633-7943		(877)-633-7943		(877)-633-7943										(711)		(711)		(711)		(711)				
S9579	804	0		29	10	S9579_804_0	4	1		05/27/2011	2012.02	05/27/2011 11:02:58 AM Pacific Daylight Time				05/27/2011 02:48:31 PM Pacific Daylight Time	STONEBRIDGE LIFE INSURANCE COMPANY	Medicare GenerationRx (Employer PDP)	http://www.aegonins.com/	Medicare Generation Rx (PDP)	10	29					S9579	804	0	2012	Medicare Generation Rx		1					2							http://www.aegonins.com/	http://www.aegonins.com/									(877)-633-7943		(877)-633-7943		(877)-633-7943		(877)-633-7943										(711)		(711)		(711)		(711)				
