**EXHIBIT      10.9**

**FY      2006 MANAGEMENT INCENTIVE COMPENSATION PLAN**

**TARGET      PAYOUT:**

| CEO/Chief                of Staff                  | 100%                     |   |
|----------------------------------------------------|--------------------------|--------|
|                                               |                     |
| Vice                President/Subsidiary President | 25%                - 90% |   |
| Assistant                Vice President            | 30%                - 40% |        |
| Director                                           | 15%                - 35% |        |

**PLAN      DESIGN**

| Financial                Performance | 85%      |        |
|--------------------------------------|----------|--------|
|                                 |     |
| Quality                Objectives    | 10%      |        |
|                                 |     |
| Turnover                Objectives   | 5%       |   |
|                                 |     |
| **Total**                            | **100%** |   |

**See      page 3 for former W/C employee bonus Calculations.*

**CEO’S      CHALLENGE**

**INDIVIDUAL      PERFORMANCE/CONTRIBUTION**

|   | **Example:**                                       | Director                at $100,000 salary, eligible for 25% Incentive |                            |
|--------|----------------------------------------------------|------------------------------------------------------------------------|---------------------------------|
|   | Financial                Performance               | 95%                                                                    | Times                85% weight |   | =                     .808 |   |
|   | Quality                Objective                   | 100%                                                                   | Times                10% weight |   | =                     .100 |   |
|   | Turnover                Objective                  | 100%                                                                   | Times                5% weight  |   | =                     .050 |   |
|   |                                               |                                                                   |                            |   |          .958 |   |
|   | Individual                Performance/Contribution |                                                                   | X                1.05           |   |
|   |                                               |                                                                   |                            | =                1.005 X $100,000 X 25% |
|   |                                               |                                                                   |                            | =                $25,134.38 |   |

|                                                                                                                                                                 | **Rating**                                       | **Maximum                Percent** |
|----------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------|------------------------------------|
| ·  115%                -125%                                                                                                                          | 10%                of eligible Participants      |
| ·  105%                -114%                                                                                                                          | 20%                of eligible Participants      |
| ·  95%                -104%                                                                                                                           | 40%                of eligible Participants      |
| ·  85%                - 94%                                                                                                                           | 20%                of eligible Participants      |
| ·  75%                - 84%                                                                                                                           | 7%-10%                of eligible Participants   |
| ·  50%                - 74%                                                                                                                           | Up                to 3% of eligible Participants |
| ·  <                50% will be considered unsatisfactory performance such that Participants                may be ineligible for a Plan incentive |
| payment                as determined in its sole discretion, by the Incentive Plan Compensation                Committee.                                            |

**Notes:**

| ·   |  | The                bonus of certain employees who were previously employed with the                Workers                Compensation Division will be subject to such additional performance                or                financial factors as determined by the Chief Executive Officer of                Sierra                Health Services and/or the Incentive Plan Compensation Committee. |
|--------------------|--|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   |  | Financial                Performance is defined as Operating Income, including eligible bonus                expense, expressed as a percent of targeted Operating Income. Financial                Cash Flow will be expressed as a percent of Target Cash Flow, (EBITA).                The                Company’s financial objective is actual consolidated Net Income compared                to Net Income target. All figures are expressed as actual results                divided                by planned financial results, expressed as a percent. The Company’s Chief                Financial Officer will determine the interpretation of Operating                Income,                Taxes, Depreciation Expense, and Cash Flow. Disputes regarding Plan                definitions will be resolved as determined by the Incentive Plan                Compensation Committee in their sole                discretion. |
|--------------------|--|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   |  | No                payments will be made under the Plan to the extent that such payments                would place the Company in violation of any laws, regulations or                bank                covenants under its credit                facility. |
|--------------------|--|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

**POOL      THRESHOLD & SIZE**

*.*

**COMPANY/SUBSIDIARY      ACHIEVEMENT**

**COMPANY      OBJECTIVES**

*quality      of care, quality of service, turnover rates, growth objectives, expense      management, specific management objectives, community or public relations,      or      specific individual competency development objectives*

----

**The      FY 2006 Targeted Operating Segment Objectives are:**

| **1.  ** | **Quality                of Service & Quality of                Care** |
|--------------------|----------------------------------------------------------------------------|

| **Percent                  of****Bonus****Achieved** | **Range                of****HEDIS/CAHPS****+                Standard Score** | **Percent                  Increase**                      |
|------------------------------------------------------|-------------------------------------------------------------------------------|------------------------------------------------------------|
| 150%                                                 | 86.1-100.0                                                                    | Achieve                “Excellent” Status      |
| 125%                                                 | 85.9+86.0                                                                     | Achieve                “Commendable” Status    |
| 120%                                                 | 85.7-85.8                                                                     | Achieve                “Commendable” Status    |
| 115%                                                 | 85.5-85.6                                                                     | Achieve                “Commendable” Status    |
| 110%                                                 | 85.3-85.4                                                                     | Achieve                “Commendable” Status    |
| 105%                                                 | 85.1-85.2                                                                     | Achieve                “Commendable” Status    |
| 100%                                                 | 80.0-85.0                                                                     | Achieve                “Commendable” Status    |
| 50%                                                  | 65.0-79.99                                                                    | Achieve                “Accredited” Status     |
| 0%                                                   | <65.0                                                                      | Falls                Below “Accredited” Status |

| **2.  ** | **Employee                Turnover** |
|--------------------|--------------------------------------|

| **Business                Unit** | **2006****Objective** | **2005                  Actual****Voluntary** |
|----------------------------------|-----------------------|-----------------------------------------------|
| BHO                              | 14.0%                 | 30.0%                                         |
| FHH                              | 14.0%                 | 14.0%                                         |
| FHS                              | 12.6%                 | 12.6%                                         |
| THC                              | 15.1%                 | 21.2%                                         |
| HPN                              | 15.0%                 | 15.5%                                         |
| SHL                              | 14.0%                 | 15.2%                                         |
| SHO                              | 14.0%                 | 22.2%                                         |
| SMA                              | 18.0%                 | 20.5%                                         |
| SNA                              | 20.0%                 | 23.3%                                         |
| SHS                              | 10.0%                 | 10.0%                                         |

**INDIVIDUAL      OBJECTIVES**

*meeting      specified revenue, market penetration, geographic business expansion goals,      cost      targets and goals relating to acquisitions or divestitures.*

**MINIMUM      PERFORMANCE**

**PLAN      DOCUMENT FOR**

**THE      FY 2006 MANAGEMENT INCENTIVE COMPENSATION PLAN**

*TERMS      & CONDITIONS*

| 1.   | The                Plan shall be known as “The Sierra Health Services, Inc. (hereafter known                as the “Company”) FY 2006 Management Incentive Compensation                Plan”. |
|----------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| 2.   | Plan                Year will be January 1, 2006 - December 31,                2006. |
|----------------|--------------------------------------------------------------------------------------|

| 3.   | Participants                are defined as active eligible employees as defined by the Compensation                Committee, Sierra Health Services, Inc. The **Incentive                Plan Compensation Committee**                is                comprised of the Chief of Staff, SHS, the Vice President of Human                Resources, the Senior Vice President Legal and Administration for                Sierra                Health Services, the Chief Financial Officer for Sierra Health Services                and the President of the Managed Healthcare                Division. |
|----------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| A.   | The                participant must be employed at Sierra Health Services or one of                its                Subsidiaries. |
|----------------|-------------------------------------------------------------------------------------------------------------------------------------|

| B.   | If                the employee is no longer employed by or has given notice of intent                to                terminate from Sierra Health Services *on                the date of the Payout*,                he/she will be ineligible for a bonus payout unless otherwise recommended                by the Incentive Plan Compensation                Committee. |
|----------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| C.   | Participants                who are not in an eligible position for the full plan year may receive                a                prorated bonus, at the Incentive Plan Compensation committee’s discretion,                if all other eligibility and performance requirements are otherwise                satisfied. |
|----------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| D.   | The                participant’s performance appraisal rating for the plan year must be at                least a “Successful” to be eligible for a payout under the                Plan. |
|----------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

*TERMS      & CONDITIONS - CONTINUED*

| 4.   | Payment                under this Plan, if any, shall be based on the employee’s accomplishment                of the specified objectives, subject to the approval of the Incentive                Plan                Compensation Committee and the Compensation Committee of the Sierra                Health                Services’ Board of Directors. Accomplishment of individual objectives                shall fall within the attached bonus range and may exceed or may                be less                than 100% of target and shall be determined by Incentive Plan Compensation                Committee. The Incentive Plan Compensation Committee reserves the                right to                offer Sierra Health Services stock options or other equity to Participants                up to 50% of value of their incentive                payment. |
|----------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| 5.   | All                payouts under this Plan, including those for 16(b) employees, are                subject                to prior approval by the Compensation Committee of the Company’s Board of                Directors. |
|----------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| 6.   | Participant’s                rights under the Plan may not be assigned or transferred in any                way. |
|----------------|------------------------------------------------------------------------------------------------------------------------|

| 7.   | The                Plan may be amended, modified, suspended or terminated by the Company                at                any time without prior consent by or notice to employees. The Company                at                its sole discretion without prior consent or notice may change objectives                at any time for eligible                participants. |
|----------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| 8.   | The                Plan shall be unfunded. The Company shall not be required to establish                any                special or separate fund or to make any other segregation of assets                to                assure the payment of the amounts under the Plan. Rights to the payment                of                amounts under the Plan shall be no greater than the rights of the                Company’s general creditors. |
|----------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| 9.   | Nevada                State law governs the validity, construction, interpretation,                administration and effect of the Plan, and the substantive laws,                except                for the choice of law, and rules of the State of Nevada shall govern                rights relating to the Plan. If any part of this Plan is ruled to                be                invalid by any judicial body, the remainder of the document shall                continue                to be in force. |
|----------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| 10.   | All                applicable employment, benefit and tax deductions will be withheld                from                the incentive payout. |
|-----------------|------------------------------------------------------------------------------------------------------------------------------------------------|

*TERMS      & CONDITIONS - CONTINUED*

| 11.**  ** | **Participant**                -                A Participant in the Plan is an employee of Sierra Health Services                Inc.,                or its subsidiaries who has been: (a) selected by the Company to                participate for the Plan Year; (b) who executes this agreement to                participate in the Plan for the Plan Year; and (c) who is employed                by the                Company on the date of the payout. No employee of the Company has                the                right or is guaranteed the right to participate in the Plan by virtue                of                being an employee of the Company or fulfilling any specific position                with                the Company. Selection for participation in the Plan is solely within                the                discretion of the Company. Sierra Health Services, Inc. may offer                participation in the Plan to additional employees or terminate the                participation of any Participant in the Plan any time during the                Plan                Year. |
|---------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| 12.**  ** | **Transfer/Promotion                within the Business Unit Organization**                -                Plan Participants who are transferred or promoted during the Plan                Year to                another job within Sierra Health Services, Inc. or its subsidiaries,                not                covered by the Plan will receive, subject to approvals, a prorated                payment                following year-end based on their achievement of specified objectives                during eligible month(s) as determined by Company. Similarly, an                employee                who becomes an eligible Participant in the Plan Year, *with                at least 3 months service as an eligible Participant*,                may receive, subject to approvals, a prorated payment following year-end                based on their achievement of specified objectives during eligible                month(s) as determined by Company in its sole                discretion. |
|---------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| 13.**  ** | **Termination                of Employment**                -                Participants, who terminate their employment voluntarily or involuntarily                from the Company or who have given notice of intent to terminate                from the                Company during the Plan Year and until the Plan date of payout, will                not                be eligible for any bonus payment under the Plan. Any exceptions                will be                determined on an individual basis at the sole discretion of the Incentive                Plan Compensation Committee. |
|---------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| 14.   | **Retirement/Death/Disability**                -                Termination of employment during the Plan Year and until the Plan                date of                payout as a result of retirement, death, or disability may constitute                eligibility for a prorated payment as determined by the Company in                their                sole discretion. |
|-----------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

*TERMS      & CONDITIONS - CONTINUED*

| 15.   | **Windfalls/Business                Losses**                -                Revenues classified as “windfalls” or business losses or charges against                net income may or may not be excluded in whole or in part from the                calculation of revenue or profit objectives at the sole discretion                of the                Chief Executive Officer. Similarly, significant declines in revenue                volume                will be reviewed prior to any bonus award. Examples of such circumstances                include, but are not limited to: excluding acquisition-related and                FY 2006                charges and non operating unusual charges, windfalls or business                losses                resulting from any acquisition or disposition by the corporation                as                determined by the Compensation Committee of Sierra Health Services                Board                of Directors or the absence of cash flow through the majority of                the                fiscal year and the subsequent receipt of a large cash receivable                in the                last quarter of the fiscal year when evaluating the achievement of                cash                flow objectives. |
|-----------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| 16.**  ** | **Company                Rights**                -                Notice of participation in the Plan shall not impair or limit the                Company’s right to transfer, promote, or demote plan participants to other                jobs or to terminate their employment. Nor shall the Plan create                either                claim or right to receive any payment under the Plan or any right                to be                retained in the employment of the Company or its                affiliates. |
|---------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| 17.   | **Non-Continuation**                -                The Plan is established for the current fiscal year. There shall                be no                obligation on the part of the Company to continue the Plan in the                same or                a modified form for any future                years. |
|-----------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| 18.**  ** | **Resolution                of Disputes**                -                In the event that a Participant has a dispute concerning the                administration of this Plan, it should first be submitted in writing                to                the Vice President, Human Resources. In the event that the Vice President                does not provide a response satisfactory to the participant with                fifteen                (15) days, the Participant may submit the dispute in writing, within                five                (5) working days thereafter, to the Incentive Plan Compensation Committee                - Sierra Health Services, Inc., whose decision regarding the dispute                shall                be final and binding on each Participant or person making a claim                under                the Plan. |
|---------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| 19.   | **Effect                on Previous Plans**                -                The Plan is effective **January                1, 2006**,                and supersedes and replaces all previous management bonus plans.                All such                previous Plans, unless earlier terminated, are terminated effective                at                midnight,**December 31, 2005**.                If not renewed by the Company or its designated representative(s),                the                Plan will automatically terminate on December 31 of each year. Any                changes                in the Plan will constitute a new Plan for the next Plan                year. |
|-----------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| 20.   | **Achievement                Beyond Payout Grids -**Sierra                Health Services reserves the right to increase the level of individual                payouts up**to 3 Times the 100% payout level**,                based upon improved profitability and or other performance measures                as                determined by the Incentive Compensation                Committee. |
|-----------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|