FOURTH AMENDMENT TO LEASE

     This Fourth  Amendment  to Lease is made and entered  into this 18th day of
October,  1995,  by and between THE MUTUAL LIFE  INSURANCE  COMPANY OF NEW YORK,
hereinafter called  "Landlord",  and HEALTH RISK MANAGEMENT,  INC.,  hereinafter
called "Tenant".

     WHEREAS,  Landlord and Tenant entered into a lease  agreement  dated August
14, 1987 which was amended on June 25, 1990,  January 8, 1992,  and May 12, 1994
(the lease agreement and amendments are hereinafter  collectively referred to as
the "Lease"),  wherein Landlord leased to Tenant the Demised Premises as defined
in  the  Lease  located  at  7900  West  78th  Street,  Edina,   Minnesota  (the
"Building").

     WHEREAS,  Landlord and Tenant  mutually  desire to further  amend the Lease
with respect to base and  additional  rent for the Existing Space as hereinafter
provided.

     NOW THEREFORE, it is mutually agreed as follows:

1. Existing  Space Base Rent.  Section 4 of the Third  Amendment to Lease (which
amended  Section 3 of the August 14, 1987 lease  agreement)  is hereby  deleted.
Section 3 of the Lease is hereby  amended to provide the  following  schedule of
Base Rent for the Existing Space:

<PAGE>
                           Rentable
 Period                    Area           Per S.F. Rate         Monthly Rate
 1/1/95 - 6/30/95          51,393           $14.54               $62,271.85
 7/1/95 - 6/30/96          51,393           $14.79               $63,341.87
 7/1/96 - 6/30/97          51,393           $15.04               $64,412.56
 7/1/97 - 9/30/98          51,393           $15.29               $65,483.25

2.  Section 6 of the Third  Amendment to Lease  (which  amended  August 14, 1987
lease agreement) is hereby Section 4 of the deleted.  For the period  commencing
January  1,  1995  and  continuing  for the  remaining  term of the  Lease,  the
introductory paragraph of Section 4 of the Lease shall read as follows:

         Operating Costs Adjustment. The Base Rent payable pursuant to Section 1
         of the  Fourth  Amendment  to Lease  is  predicated,  in part,  upon an
         operating  cost "stop" for the  Building of $5.79 per  rentable  square
         foot.  Tenant shall pay to Landlord as additional rent for the Existing
         Space the amount derived by multiplying 51,393 (being the rentable area
         of the Existing Space)by the amount by which the total annual operating
         costs of the Building exceed $5.79 per rentable square foot.

3.  Section  4(B) of the Lease as  originally  agreed by Landlord  and Tenant on
August 14, 1987 is reinstated as to the Existing Space as of January 1, 1995 and
any contrary provisions of the Lease shall be disregarded as to such period.


<PAGE>


4. The parties  acknowledge  that projected  Operating Costs for 1995 are $6.83.
Commencing  with rent due on January  1, 1995 and  continuing  until  Landlord's
projection shall be revised,  Tenant shall pay in addition to Base Rent adjusted
Operating Costs of $ 1.04 per rentable square foot per month.

TENANT:                                 LANDLORD:
HEALTH RISK MANAGEMENT, INC.            THE MUTUAL LIFE INSURANCE
                                        COMPANY OF NEW YORK
BY:      /s/Thomas P. Clark             BY:  Illegible
ITS:     Chief Financial Officer        ITS:     Vice President
DATE: 10/18/95                          DATE:    12/6/95