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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-434787

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1. WellCare Health Plans, Inc. PAC (WellCare PAC)

    8735 Henderson Road
    Tampa, FL 33634
    Email: paccorrespondence@wellcare.com

2. Date: 09/30/2009

3. FEC Committee ID #: C00390575 This committee is a separate segregated fund. Its connected organization is a

Affiliated Committees/Organizations

WellCare Health Plans, Inc.
8735 Henderson Road
Tampa, Florida 33634
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Nancy H. Watkins
610 S. Boulevard
Tampa, FL 33606
Title: Custodian
Phone # (813) 254-3369

Treasurer:

Tom Tran
8735 Henderson Road
Tampa, Florida 33634
Title: Treasurer
Phone # (813) 290-6200

Designated Agent(s):

Banks or Depositories

Wachovia Bank
100 S. Ashley
Tampa, Florida 33602

Signed: Tom Tran
Date Signed: 10/11/2009

(End FEC FORM 1)

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