Page 81

Effective Date:

Approval Date: 81

Attachment 13 hawk-i Health and Dental Plan Coverage Area Enrollment Effective March 1, 2009 County

Plans Adair Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Adams Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Allamakee Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Appanoose Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Audubon Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Benton Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Black Hawk Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Boone Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Bremer Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Buchanan Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Buena Vista Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Butler Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Calhoun Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Carroll Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Cass Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Cedar Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Cerro Gordo Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Cherokee Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Chickasaw Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Clarke Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Clay Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Clayton Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Clinton Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Crawford Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Dallas Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Davis Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Decatur Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Delaware Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Des Moines Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Dickinson Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Dubuque Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Emmet Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Fayette Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Floyd Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Franklin Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Fremont Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Greene Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Grundy Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Guthrie Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Hamilton Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Harding Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Harrison Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Henry Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Howard Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Humboldt Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Ida Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA Iowa Wellmark Health Plan of Iowa or United Healthcare, Delta Dental of IA