Exhibit 10.1

AMENDMENT NO. 1

TO CREDIT AGREEMENT

This AMENDMENT NO. 1 dated as of November 2, 2012 (this “Amendment”) to the
Credit Agreement dated as of January 31, 2011 (as amended, supplemented or
otherwise modified from time to time, the “Credit Agreement”) is entered into
among CENTENE CORPORATION (the “Company”), the financial institutions from time
to time party thereto (the “Lenders”) and BARCLAYS BANK PLC, as administrative
agent for the Lenders (in such capacity, the “Administrative Agent”).

WHEREAS, the Company, each Lender party hereto and the Administrative Agent wish
to amend, in certain respects, the Credit Agreement as described herein;

NOW, THEREFORE, in consideration of the premises and the mutual covenants and
provisions hereinafter contained, the parties hereto hereby agree as follows:

Section 1. Definitions. Capitalized terms used in this Amendment and not
otherwise defined are used herein as defined in the Credit Agreement.

Section 2. Amendments to the Credit Agreement. Effective as of the Amendment
Effective Date (as defined in Section 5), the Credit Agreement shall be amended
as follows:

(a) Section 1.1 of the Credit Agreement is hereby amended by amending and
restating the definitions of “Senior Notes” and “Senior Notes Indenture” in
their entirety as follows:

“Senior Notes” means 5.75% Senior Notes of the Company due 2017 issued under the
Senior Indenture in an aggregate principal amount of up to $400,000,000.

“Senior Notes Indenture” means that certain Indenture, dated May 27, 2011
entered into by the Company in connection with the issuance of the Senior Notes,
together with all instruments and other agreements entered into by the Company
in connection therewith.

(b) Section 1.1 of the Credit Agreement is hereby amended by amending and
restating the definition of EBITDA in its entirety as follows:

“EBITDA” means, for any period, Consolidated Net Income for such period plus, to
the extent deducted in determining such Consolidated Net Income, Interest
Expense, income tax expense, depreciation and amortization for such period,
non-cash charges associated with stock-based compensation expenses pursuant to
the financial reporting guidance of the Financial Accounting Standards Board
concerning stock-based compensation as in effect from time to time, and other
extraordinary or non-recurring non-cash expenses (including any expenses as a
result of any premium deficiency reserve related to any health plan operated by
the Company or any Subsidiaries), minus, to the extent added in determining such
Consolidated Net Income, any extraordinary or non-recurring non-cash income
(including any income as a result of any premium deficiency reserve related to
any health plan operated by the Company or any Subsidiaries). EBITDA shall be
determined on a pro forma basis after giving effect to all Acquisitions made by
the Company or any Subsidiary at any time during the applicable fiscal period,
in each case as if such Acquisition had occurred at the beginning of such fiscal
period.

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(c) Section 11.1(c) of the Credit Agreement is hereby amended and restated in
its entirety as follows:

“Debt which is unsecured; provided that (i) after giving effect thereto on a pro
forma basis, the Company and the other Loan Parties shall be in compliance with
a Total Debt to EBITDA Ratio of not greater than 2.75 to 1.00 as of the last day
of the most recently ended period for which financial statements have been
delivered pursuant to Section 10.1.1 or 10.1.2, (ii) no Unmatured Event of
Default or Event of Default shall have occurred and be continuing on the date of
incurrence of such Debt or could reasonably be expected to occur as a result
thereof and (iii) the documents governing such Debt do not contain covenants
(including quantitative covenants and financial covenants) which are more
restrictive than the covenants contained in this Agreement or which the Loan
Parties could violate without violating the covenants contained in this
Agreement;”

(d) Section 11.1(d) of the Credit Agreement is hereby amended and restated in
its entirety as follows:

“Subordinated Debt which is unsecured; provided that (i) after giving effect
thereto on a pro forma basis, the Company and the other Loan Parties shall be in
compliance with a Total Debt to EBITDA Ratio of not greater than 2.75 to 1.00 as
of the last day of the most recently ended period for which financial statements
have been delivered pursuant to Section 10.1.1 or 10.1.2, (ii) no Unmatured
Event of Default or Event of Default shall have occurred and be continuing on
the date of incurrence of such Debt or could reasonably be expected to occur as
a result thereof, (iii) the documents governing such Subordinated Debt shall not
contain covenants (including quantitative covenants and financial covenants)
which are more restrictive than the covenants contained in this Agreement or
which the Loan Parties could violate without violating the covenants contained
in this Agreement, (iv) the final maturity of such Subordinated Debt shall be no
earlier than 90 days after the Termination Date and (v) the weighted average
life to maturity of such Subordinated Debt shall not be shorter than the
weighted average life to maturity of any Loans or Commitments outstanding as of
the time of the issuance thereof;”

(e) Section 11.1(g) of the Credit Agreement is hereby amended and restated in
its entirety as follows:

“(i) the Senior Notes and (ii) Debt described on Schedule 11.1 and, in either
case, any extension, renewal or refinancing thereof so long as the principal
amount thereof is not increased (it being agreed that any increase will be
permitted without the consent of Administrative Agent and the Required Lenders
only to the extent that such additional Debt is otherwise permitted pursuant to
clauses (b), (c), (d) or (n) of this Section 11.1);”

(f) Paragraph 1 of Schedule 11.1 is deleted in its entirety.

 

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Section 3. Representations and Warranties. The Company hereby represents and
warrants to each Lender and the Administrative Agent that:

(a) The execution, delivery and performance by the Borrower of this Amendment is
within the Borrower’s corporate powers and has been duly authorized by all
necessary corporate and, if required, stockholder action. This Amendment has
been duly executed and delivered by the Borrower and constitutes a legal, valid
and binding obligation of the Borrower, enforceable in accordance with its
terms, subject to applicable bankruptcy, insolvency, reorganization, moratorium
or other laws affecting creditors’ rights generally and subject to general
principles of equity regardless of whether considered in a proceeding in equity
or at law.

(b) No consent or approval of any Governmental Authority or any other Person is
required for the Borrower to execute, deliver and perform this Amendment.

(c) Each of the representations and warranties made by the Company or any Loan
Party in the Credit Agreement, any Loan Document or any certificate furnished at
any time under or in connection with the Credit Agreement, as applicable, are
true and correct in all material respects (or, in the case of any representation
or warranty qualified by materiality, in all respects) on and as of the
Amendment Effective Date as if made on and as of such date (except for those
which expressly relate to an earlier date which shall be true as of such earlier
date).

(d) No Unmatured Event of Default or Event of Default has occurred and is
continuing on the Amendment Effective Date.

Section 4. Confirmation of Loan Documents. The Company confirms and ratifies all
of its obligations under the Credit Agreement and the obligations of itself and
each Loan Party under each Loan Document to which it is a party.

Section 5. Conditions Precedent to Effectiveness. This Amendment shall become
effective as of the date (the “Amendment Effective Date”) on which each of the
following conditions precedent shall have first been satisfied:

(a) Amendment. The Administrative Agent shall have received counterparts of this
Amendment duly executed by the Company, the Required Lenders and the
Administrative Agent.

(b) Representations and Warranties. Each of the representations and warranties
made by the Company or any Loan Party in the Credit Agreement, any Loan Document
or any certificate furnished at any time under or in connection with the Credit
Agreement, as applicable, shall be true and correct in all material respects
(or, in the case of any representation or warranty qualified by materiality, in
all respects) on and as of the Amendment Effective Date as if made on and as of
such date (except for those which expressly relate to an earlier date which
shall be true as of such earlier date).

(c) No Event of Default. No Unmatured Event of Default or Event of Default shall
have occurred and be continuing on the Amendment Effective Date.

(d) Expenses Paid. The Company shall have paid to the Administrative Agent all
fees, costs, and expenses payable pursuant to this Amendment and the other Loan
Documents, including those payable in accordance with Section 15.4 of the Credit
Agreement, including the reasonable fees and out-of-pocket costs and expenses of
counsel for the Administrative Agent incurred prior to or otherwise in
connection with this Amendment to the extent invoiced to the Company. For
purposes of clarification, no amendment fee will be payable in connection with
this Amendment.

Section 6. Effect of Amendment. Except as expressly set forth herein, this
Amendment shall not by implication or otherwise limit, impair, constitute a
waiver of or otherwise affect the rights and remedies of the Lenders or the
Administrative Agent under the Credit Agreement or any other Loan Document, and
shall not alter, modify, amend or in any way affect any of the terms,

 

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conditions, obligations, covenants or agreements contained in the Credit
Agreement or any other provision of the Credit Agreement or any other Loan
Document, all of which are ratified and affirmed in all respects and shall
continue in full force and effect. References in the Credit Agreement (including
references to the Credit Agreement as amended hereby) to “this Agreement” and
“this Credit Agreement” (and indirect references such as “hereunder,” “hereby,”
“herein,” and “hereof”) shall be deemed to be references to the Credit Agreement
as amended hereby. This Amendment is deemed to be a “Loan Document” for the
purposes of the Credit Agreement.

Section 7. Miscellaneous. The jurisdiction and waiver of right to trial by jury
provisions in Sections 15.18 and 15.19 of the Credit Agreement are incorporated
herein by reference mutatis mutandis. This Amendment may be executed in any
number of counterparts, all of which taken together shall constitute one and the
same agreement and any of the parties hereto may execute this Amendment by
signing any such counterpart. This Amendment shall be governed by, and construed
in accordance with, the laws of the State of New York.

[signature pages follow]

 

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IN WITNESS WHEREOF, the parties hereto have caused this Amendment to be duly
executed as of the date first above written.

 

BORROWER: CENTENE CORPORATION By:   /s/ William N. Scheffel Name:   William N.
Scheffel Title:   Executive Vice President and Chief Financial Officer

 

[SIGNATURE PAGE TO AMENDMENT NO. 1]

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BARCLAYS BANK PLC, as Administrative Agent and Lender By:   /s/ Ronnie Glenn
Name:   Ronnie Glenn Title:   Vice President

 

[SIGNATURE PAGE TO AMENDMENT NO. 1]

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LENDERS: SunTrust Bank By:   /s/ Mary E. Coke Name:   Mary E. Coke Title:   Vice
President

 

[SIGNATURE PAGE TO AMENDMENT NO. 1]

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LENDERS: REGIONS BANK By:   /s/ Gregory M. Ratliff Name:   Gregory M. Ratliff
Title:   Senior Vice President

 

[SIGNATURE PAGE TO AMENDMENT NO. 1]

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LENDERS: Wells Fargo Bank, N.A. By:   /s/ Beth A. Tiffin Name:   Beth A. Tiffin
Title:   Senior Vice President

 

[SIGNATURE PAGE TO AMENDMENT NO. 1]

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LENDERS: Fifth Third Bank By:   /s/ Richard J. Johnsen Name:   Richard J.
Johnsen Title:   Senior Vice President

 

[SIGNATURE PAGE TO AMENDMENT NO. 1]

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LENDERS: Bank of America, N.A. By:   /s/ Yinghua Zhang Name:   Yinghua Zhang
Title:   Vice President

 

[SIGNATURE PAGE TO AMENDMENT NO. 1]

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LENDERS: U.S. Bank, N.A. By:   /s/ Christopher T. Kordes Name:   Christopher T.
Kordes Title:   Senior Vice President

 

[SIGNATURE PAGE TO AMENDMENT NO. 1]

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LENDERS: The PrivateBank and Trust Company, an Illinois banking corporation, as
a Lender By:   /s/ Khary Kenyatta Name:   Khary Kenyatta Title:   Associate
Managing Director

 

[SIGNATURE PAGE TO AMENDMENT NO. 1]