**EXHIBIT      10.1**

** **

**Contract      with Approved Entity Pursuant to Sections 1860D-1**

**through      1860D-42 of **
**the      Social Security Act for the Operation of a Voluntary Medicare      Prescription**

**Drug      Plan**

**Article      I **

**Medicare      Voluntary Prescription Drug Benefit**

|  A. |  PDP                Sponsor agrees to operate one or more Medicare Voluntary Prescription                Drug                Plans (hereinafter referred to as a "PDP"), as described in its                application and related materials, including but not limited to all                the                attestations contained therein and all supplemental guidance, for                Medicare                approval and in compliance with the provisions of this contract,                which                incorporates in its entirety the Solicitation For Applications                from                Prescription Drug Plans released on January 21, 2005(as revised on                March                9, 2005)                (hereinafter collectively referred to as "the contract"). The PDP                Sponsor                also agrees                to operate in accordance with the regulations at 42 CFR §423.1 through 42                CFR                §423.910 (with the exception of Subparts Q, R, and S), sections 1860D-1                through 1860D-42 (with the exception of sections 1860D-22(a) and                1860D-31)                of the Social                Security Act, and the solicitation, as well as all other applicable                Federal statutes,                regulations, and policies. This contract is deemed to incorporate                any                changes                that are required by statute to be implemented during the term of                this                contract and                any regulations or policies implementing or interpreting such statutory                provisions. |
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|  B. |  CMS                agrees to perform its obligations to the PDP Sponsor consistent with                the                regulations at 42 CFR §423.1 through 42 CFR §423.910 (with the exception                of Subparts                Q, R and S), sections 1860D-1 through 1860D-42 of the Social Security                Act                (with                the exception of sections 1860D-22(a) and 1860D-31) and the solicitation,                as well as all other applicable Federal statutes, regulations, and                policies.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |
|  C. |  CMS                agrees that it will not implement, other than at the beginning of                a                calendar year, regulations                under 42 CFR Part 423 that impose new, significant regulatory requirements                on the PDP Sponsor. This provision does not apply to new requirements                mandated by statute.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       |
|  D. |  This                contract is in no way intended to supersede or modify 42 CFR, Part                423.                Failure to                reference a regulatory requirement in this contract does not affect                the                applicability of such requirements to the PDP Sponsor and                CMS.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  |

**Article      II **

**Functions      to be Performed by the PDP Sponsor**

|   |  1. |  PDP                Sponsor agrees to accept new enrollments, make enrollments effective,                process                voluntary disenrollments, and limit involuntary disenrollments, as                described in 42 CFR, Part 423, Subpart B. |
|--------|----------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
|   |  2. |  PDP                Sponsor agrees to comply with the prohibition in 42 CFR 423.104(b)                on                discrimination in beneficiary                enrollment.                                                                            |

|  B. |  PRESCRIPTION                DRUG BENEFIT                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          |
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|     |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |   |
|     | 1.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      | PDP                Sponsor agrees to provide the basic prescription drug coverage as                defined                under 42 CFR §423.100 and, to the extent applicable, supplemental benefits                as defined in 42 CFR §423.100 and in accordance with Subpart C of 42 CFR                Part 423.                PDP Sponsor also agrees to provide Part D benefits as described in                the PDP                Sponsor's bid(s) approved each year by CMS (as referenced in Attachment                A,                to be                replaced each year upon renewal of the contract to reflect the Sponsor's                approved bids for the succeeding contract year). |
|     |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |   |
|     | 2.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      | PDP                Sponsor agrees to calculate and collect beneficiary premiums in accordance                with 42 CFR §§423. 286 and 423.293. |
|     |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |   |
| C.       | DISSEMINATION                OF PLAN INFORMATION                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|     |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |   |
|     | 1.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      | PDP                Sponsor agrees to provide the information required in 42 CFR                §423.48. |
|     |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |   |
|     | 2.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      | PDP                Sponsor agrees to disclose information to beneficiaries in the manner                and                the form                specified by CMS under 42 CFR §§423.128,423.50 and in the "Marketing                Materials                Guidelines for Medicare Advantage-Prescription Drug Plans (MA-PDs)                and                Prescription Drug Plans (PDPs)," and to comply with requirements                in 42 CFR                §423.50                requiring certain approvals of marketing materials prior to                distribution. |
|     |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |   |
|     | 3.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      | PDP                Sponsor certifies that all materials it submits to CMS under the                File and                Use Certification                authority described in the Marketing Materials Guidelines are accurate,                truthful, not misleading, and consistent with CMS marketing                guidelines. |
|     |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |   |
| D.       | QUALITY                ASSURANCE/UTILIZATION MANAGEMENT                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |
|     |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |   |
|     | PDP                Sponsor agrees to operate quality assurance, drug utilization management,                and medication therapy management programs, and to support electronic                prescribing in accordance with Subpart D of 42 CFR Part                423.                                                                                                                                                                                                                                                                                                                                            |
|     |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |   |
| E.       | APPEALS                AND GRIEVANCES                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   |
|     |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |   |
|     | PDP                Sponsor agrees to comply with all requirements in Subpart M of 42                CFR Part                423                governing coverage determinations, grievances and appeals, and formulary                exceptions.                                                                                                                                                                                                                                                                                                                                                                      |
|     |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |   |
| F.       | PAYMENT                TO PDP SPONSOR                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   |
|     |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |   |
|     | 1.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      | PDP                Sponsor and CMS agree that payment under this contract will be governed                by                the rules in Subpart G of 42 CFR Part 423. |
|     |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |   |
|     | 2.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      | If                the PDP Sponsor is participating in the Part D Reinsurance Payment                Demonstration,                described in 70 FR 9360 (Feb. 25, 2005) it affirms that it will not                seek                payment under the demonstration for services provided to employer                group                enrollees. |
|     |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |   |
|     | 3.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      | PDP                Sponsor agrees that it is bound by all applicable federal laws and                regulations, guidance,                and authorities pertaining to claims and debt collections. In the                event                that                the government determines that the PDP Sponsor has been overpaid,                the PDP                Sponsor agrees to return those overpaid monies back to the federal                government. |
|     |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |   |
| G.       | BID                SUBMISSION AND REVIEW                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                |
|     |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |   |
|     | If                the PDP Sponsor intends to participate in the Part D program for                the next                program year,                PDP Sponsor agrees to submit the next year's bid, including all required                information on premiums, benefits, and cost-sharing, by the applicable                due                date, as provided in Subpart F of 42 CFR Part 423 so that CMS and                the Part                D plan sponsor may                conduct negotiations regarding the terms and conditions of the proposed                bid and benefit plan renewal. |
|     |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |   |
| H.       | STATE                LAW AND LICENSURE REQUIREMENTS                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     |
|     |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |   |
|     | 1.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      | PDP                Sponsor agrees to comply with State law to the extent that it is                not                preempted                by Federal law as described in Subpart I of 42 CFR Part                423. |
|     |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |   |
|     | 2.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      | PDP                Sponsor agrees that where it is operating in a State using a waiver                granted pursuant to 42 CFR §423.410, such waiver shall be valid for three                consecutive program                years. PDP Sponsor agrees that expiration of the licensure waiver                (and                the                failure to obtain a license from the relevant State) may be the basis                for                CMS deleting from the PDP Sponsor's service area those PDP Regions                affected by the waiver expiration. CMS may terminate or non-renew                the PDP                Sponsor's contract where the expiration of the waiver results in                the PDP                Sponsor not being qualified to                offer a PDP plan in any PDP Region. |
|     |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |   |
|     | 3.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      | PDP                Sponsor agrees that where it is operating in a State using a waiver                granted pursuant to 42 CFR §423.415, such waiver shall be valid for the                period that the Secretary of the Department of Health and Human Services                determines is appropriate                for timely processing of the PDP Sponsor's license application by                the                State,                but in no case no more than one year only, beginning on January 1                of the                contract year for which CMS granted the waiver. |
|     |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |   |
| I.       | COORDINATION                WITH OTHER PRESCRIPTION DRUG COVERAGE                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       |
|     |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |   |
|     | 1.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      | PDP                Sponsor agrees to comply with the coordination requirements with                State                Pharmacy                Assistance Programs (SPAPs) and plans that provide other prescription                drug                coverage as described in Subpart J of 42 CFR Part                423. |

|   |                                                                                                                                                                                                                                                                          |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               |
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|   | 2.                                                                                                                                                                                                                                                                            | PDP                Sponsor agrees to comply with Medicare Secondary Payer procedures                as                stated in 42 CFR §423.462.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              |
|   |                                                                                                                                                                                                                                                                          |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               |
| J.     | SERVICE                AREA AND PHARMACY ACCESS                                                                                                                                                                                                                               |
|   |                                                                                                                                                                                                                                                                          |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               |
|   | 1.                                                                                                                                                                                                                                                                            | The                PDP Sponsor agrees to provide Part D benefits in the service area                for                which it has been approved by CMS utilizing a pharmacy network and                formulary approved by CMS that meet the requirements of 42 CFR                §423.120.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              |
|   |                                                                                                                                                                                                                                                                          |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               |
|   | 2.                                                                                                                                                                                                                                                                            | The                PDP Sponsor agrees to provide Part D benefits through out-of-network                pharmacies according to 42 CFR §423.124.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               |
|   |                                                                                                                                                                                                                                                                          |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               |
|   | 3.                                                                                                                                                                                                                                                                            | PDP                Sponsor agrees to provide benefits by means of point of service systems                to                adjudicate                prescription drug claims in a timely and efficient manner in compliance                with CMS standards, except when necessary to provide access in                underserved                areas, I/T/U pharmacies (as defined in 42 CFR §423.100), and long-term                care pharmacies (as defined in 42 CFR §423.100).                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             |
|   |                                                                                                                                                                                                                                                                          |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               |
|   | 4.                                                                                                                                                                                                                                                                            | PDP                Sponsor agrees to contract with any pharmacy that meets the PDP Sponsor's                reasonable and relevant standard terms and conditions.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |
|   |                                                                                                                                                                                                                                                                          |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               |
| K.     | COMPLIANCE                PLAN/PROGRAM INTEGRITY                                                                                                                                                                                                                              |
|   |                                                                                                                                                                                                                                                                          |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               |
|   | 1.                                                                                                                                                                                                                                                                            | PDP                Sponsor agrees that it will develop and implement a compliance plan                that                applies                to its Part D-related operations, consistent with 42 CFR §423.504(b)(4)(vi).                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |
|   |                                                                                                                                                                                                                                                                          |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               |
|   | 2.                                                                                                                                                                                                                                                                            | The                PDP Sponsor agrees to provide notice based on best knowledge, information,                and                belief to CMS of any integrity items related to payments from governmental                entities, both federal and state, for healthcare or prescription                drug                services that would                have been reported as part of 3.1.4 of the PDP application. These                items                include                any investigations, legal actions or matters subject to arbitration                brought involving the sponsor (or sponsor's firm if applicable) and                its                subcontractors (excluding contracted network providers), including                any key                management or executive                staff, or any major shareholders (5% or more), by a government agency                (state or federal) on matters relating to payments from governmental                entities, both federal                and state, for healthcare and/or prescription drug services. In providing                the                notice, the sponsor shall keep the government informed of when the                integrity item                is initiated and when it is closed. Notice should be provided of                the                details concerning                any resolution and monetary payments as well as any settlement agreements                or corporate integrity agreements. |
|   |                                                                                                                                                                                                                                                                          |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               |
|   | 3.                                                                                                                                                                                                                                                                            | The                PDP Sponsor agrees to provide notice based on best knowledge, information,                and                belief to CMS in the event the Sponsor or any of its subcontractors                is                criminally convicted or has a civil judgment entered against it for                fraudulent activities or is sanctioned under any Federal program                involving                the provision of                health care or prescription drug services.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|   |                                                                                                                                                                                                                                                                          |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               |
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| L.     | LOW-INCOME                SUBSIDY                                                                                                                                                                                                                                             |
|   |                                                                                                                                                                                                                                                                          |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               |
|   | PDP                Sponsor agrees that it will participate in the administration of                subsidies                for low-income individuals according to Subpart P of 42 CFR Part                423.                                                              |
|   |                                                                                                                                                                                                                                                                          |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               |
| M.     | COMMUNICATION                WITH CMS                                                                                                                                                                                                                                         |
|   |                                                                                                                                                                                                                                                                          |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               |
|   | PDP                Sponsor agrees that it shall maintain the capacity to communicate                with CMS                electronically in accordance with CMS requirements.                                                                                               |
|   |                                                                                                                                                                                                                                                                          |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               |
| N.     | BENEFICIARY                FINANCIAL PROTECTIONS                                                                                                                                                                                                                              |
|   |                                                                                                                                                                                                                                                                          |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               |
|   | The                PDP Sponsor agrees to afford its enrollees protection from liability                for                payment of                fees that are the obligation of the PDP Sponsor in accordance with                42 CFR                §423.505(g). |
|   |                                                                                                                                                                                                                                                                          |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               |
| O.     | RELATIONSHIP                WITH RELATED ENTITIES, CONTRACTORS, AND SUBCONTRACTORS                                                                                                                                                                                            |
|   |                                                                                                                                                                                                                                                                          |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               |
|   | 1.                                                                                                                                                                                                                                                                            | The                PDP Sponsor agrees it maintains ultimate responsibility for adhering                to                and otherwise                fully complying with all terms and conditions of this contract with                CMS.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      |
|   |                                                                                                                                                                                                                                                                          |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               |
|   | 2.                                                                                                                                                                                                                                                                            | The                PDP Sponsor shall ensure that any contracts or agreements with                subcontractors or agents performing functions on the PDP Sponsor's                behalf                related                to the operation of the Part D benefit are in compliance with 42                CFR                §423.505(i).                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               |
|   |                                                                                                                                                                                                                                                                          |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               |
|   | 3.                                                                                                                                                                                                                                                                            | The                PDP Sponsor agrees to act in accordance with 45 CFR Part 76 and agrees                that it                will not contract with or employ entities or individuals that are                excluded                by the Department of Health and Human Services, Office of the Inspector                General or included                on the Excluded Parties List System maintained by the General Services                Administration.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           |
|   |                                                                                                                                                                                                                                                                          |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               |
| P.     | CERTIFICATION                OF DATA THAT DETERMINE PAYMENT                                                                                                                                                                                                                   |
|   |                                                                                                                                                                                                                                                                          |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               |
|   | PDP                Sponsor must provide certifications in accordance with 42 CFR                §423.505(k).                                                                                                                                                             |
|   |                                                                                                                                                                                                                                                                          |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               |
| Q.     | ENROLLMENT                RELATED COSTS                                                                                                                                                                                                                                       |
|   |                                                                                                                                                                                                                                                                          |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               |
|   | PDP                Sponsor agrees to payment of fees established by CMS for cost sharing                of                enrollment                related costs in accordance with 42 CFR §423.6.                                                                      |
|   |                                                                                                                                                                                                                                                                          |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               |

**Article      III **

**Record      Retention and Reporting Requirements**

|   |                     1. | If                the PDP Sponsor is operating under a CMS-granted licensure waiver                in any                State,                the PDP Sponsor agrees to notify CMS in writing of the State's disposition                of                the Sponsor's license application within ten business days of the                date                that it receives                notice of the State's action. |
|--------|--------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

|   |                     2. | For                those States where the PDP Sponsor is operating under a risk-bearing                license, the                Sponsor agrees to provide written notice to CMS of the State's non-renewal                of the                Sponsor's license within ten days of receiving notice of the State's                action. |
|--------|--------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

|   |                     3. | In                the event that a State regulator imposes a sanction against the PDP                Sponsor or requires                the implementation of a corrective action plan, the Sponsor agrees                to                provide                written notice to CMS of such sanction or corrective action requirement                (including basis for the sanction and/or timeline for corrective                action)                within ten days                of receiving notice of the State's                action. |
|--------|---------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

|   |                   4. | In                the event that there is a change in the status of the PDP Sponsor's                risk-bearing license                in any State (e.g., suspension, revocation), the Sponsor agrees to                provide                written                notice to CMS of the change in status (including basis for the change                in                status and effective date) within ten days of receiving notice of                the                State's action. |
|--------|--------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

|   |                   5. | If                the PDP Sponsor is operating a Part D benefit under a CMS-granted                waiver                in every                State in its service area, and the Sponsor is terminating or reducing                the                amount of an existing letter of credit obtained for the purposes                of                funding projected                losses, the Sponsor shall provide written notice to CMS of such action                30                days prior to its effective date. The PDP Sponsor agrees that it                must                obtain CMS                approval prior to terminating or reducing the amount of a letter                of credit                obtained for the purposes of funding projected losses under Appendix                X of                the PDP Solicitation. |
|--------|--------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

**Article      IV**

**HIPAA      Provisions**

| A. | PDP                Sponsor agrees to comply with the confidentiality and enrollee record                accuracy requirements specified in 42 CFR                §423.136. |
|----|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

|  B. |   | PDP                Sponsor agrees to enter into a business associate agreement with                the                entity with which CMS has contracted to track Medicare beneficiaries'                true                out-of- pocket costs. |
|----------|--------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

**Article      V**

**Requirements      of Other Laws and Regulations**

**Article      VI **

**Contract      Term and Renewal**

|   | (a)    |      CMS                informs the PDP Sponsor that it is qualified to renew its contract;                and |
|--------|-----------------------|-----------------------------------------------------------------------------------------------------------------------------------------|

|   | (b) |                     The PDP Sponsor has not provided CMS with a notice of intention                not                to renew in accordance with Article VII of this                contract. |
|--------|-----|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

|   | 2. |  Although                PDP Sponsor may be determined qualified to renew its contract under                this                Article, if the PDP Sponsor and CMS cannot reach agreement on the                bid                under Subpart F of 42 CFR Part 423, no renewal takes place, and the                failure to reach                agreement is not subject to the appeals provisions in Subpart N of                42 CFR                Part                423. |
|--------|----|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

**Article      VII**

**Nonrenewal      of Contract**

|            1. |   | The                PDP Sponsor may elect not to renew its contract with CMS, effective                at the                end                of the term of the contract for any reason as long as PDP Sponsor                provides                proper    notice of the decision according to the required                timeframes. |
|----------------------------------------------------------------------|--------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

|                         2. |   | If                the PDP Sponsor does not intend to renew its contract, it must notify                - |
|------------------------------------------------------------------------------|--------|----------------------------------------------------------------------------------------------------------|

|                                 (a) |   | CMS                in writing by the first Monday of June in the year in which the current                contract period ends; |
|-------------------------------------------------------------------------------------------------------------------------------|--------|---------------------------------------------------------------------------------------------------------------------------------|

|                                     (b) |  | Each                Medicare enrollee, at least 90 days before the date on which the                nonrenewal                is effective. This notice must include a written description of                alternatives                available for obtaining qualified prescription drug coverage within                the                PDP region, including Medicare Advantage-Prescription Drug plans,                Medicare                cost plans offering a Part D plan, and other PDPs, and must receive                CMS                approval prior to issuance; and |
|-------------------------------------------------------------------------------------------------------------------------------------------------------|--|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

|                    (c) |   | The                general public, at least 90 days before the end of the current calendar                year, by publishing a notice in one or more newspapers of general                circulation in                each community or county located in the Part D plan sponsor's service                area. |
|-----------------------------------------------------------------------------------------------------------------------|--------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

|           3. |   |  If                the PDP Sponsor does                not renew a contract CMS cannot enter into a contract with                the organization for 2 years unless there are special circumstances                that                warrant   special consideration, as determined by                CMS. |
|----------------------------------------------------------------|--------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

|     4. |  | If                the PDP Sponsor does not renew a contract, it must ensure the timely                transfer of any                data or files in accordance with CMS                instructions. |
|----------------------------|--|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

|   |                    1. | CMS                may determine that the PDP Sponsor is not qualified to renew its                contract                for any of the following reasons:                                                                                                                 |
|--------|--------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
|   | (a)                                  |                                                                                                                                                                                                                                                                              | The                reasons listed in 42 CFR §423.509(a) that also permit CMS to terminate the                contract. |
|   | (b)                                  | The                PDP Sponsor has committed any of the acts in 42 CFR §423.752 that                support                the imposition of intermediate sanctions or civil money penalties                under                42 CFR §423.750.                  |
|   |                    2. | CMS                will provide notice of its decision whether the PDP Sponsor is qualified                to renew its contract as follows:                                                                                                                                 |
|   |                                 | (i)                                                                                                                                                                                                                                                                          | To                the PDP Sponsor by May 1 of the current contract year. |
|   |                                 | (ii)                                                                                                                                                                                                                                                                         | If                CMS decides that the PDP Sponsor is not qualified to renew its contract,                to the PDP Sponsor's Medicare enrollees by mail at least 90 days                before                the end of the current calendar year. |
|   |                                 | (iii)                                                                                                                                                                                                                                                                        | If                CMS determines that the PDP Sponsor is not qualified to renew its                contract, to the general public at least 90 days before the end of                the                current calendar year, by publishing a notice in one or more newspapers                of                general circulation                in each community or county located in the PDP Sponsor's service                area. |
|   |                                 | (iv)                                                                                                                                                                                                                                                                         | CMS                will provide the notice described in (B)(2)(ii)and (iii) of this                Article                where                a non-renewal results because CMS and the PDP Sponsor are unable                to reach                agreement on the bid under 42 CFR Part 423, Subpart F. |
|   |                    3. | CMS                shall give the PDP Sponsor written notice of its right to appeal                the                decision that                the sponsor is not qualified renew its contract in accordance with                42 CFR                §423.642(b). |
|   |                                 |                                                                                                                                                                                                                                                                         |   |   |

**Article      VIII**

**Modification      or Termination of Contract**

|   | 1. | This                contract may be modified or terminated at any time by written mutual                consent of the parties. |
|--------|----|---------------------------------------------------------------------------------------------------------------------------------|

|   | 2. | If                this contract is terminated by mutual consent, the PDP Sponsor must                provide notice                to its Medicare enrollees and the general public in accordance with                CMS's                instructions. |
|--------|----|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

|   | 3. | If                the contract is modified by mutual consent, the PDP Sponsor must                notify                its Medicare                enrollees of any changes that CMS determines are appropriate for                notification according to the process and timeframes specified by                CMS. |
|--------|----|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

|   | 4. | If                a contract is terminated under section A of this Article, the PDP                Sponsor                must                ensure the timely transfer of any data or                files. |
|--------|----|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

**Article      IX **

**Intermediate      Sanctions**

**Article      X **

**Severability**

**Article      XI **

**Miscellaneous**

|                                                                                            |  In                witness whereof, the parties hereby execute this contract.   |                                      |
|-------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------|-------------------------------------------|
|                           FOR THE PDP SPONSOR |                                                                                 |                                      |   |
|                                                                                            |                   /s/ Jonathon W. Bunker                                   |                                      |                     September 7, 2005 |
|                                                                                            |                  Name: Jonathon W. Bunker                 Title: President |                                      |                    Date |   |
|                                                                                            |                                                                                 |                                      |   |
|                                                                                            |                                                                                 |                                      |   |   |
|                                                                                            |  Sierra                Health and Life Insurance Company, Inc. (S5917)          |                                      | 2720                North Tenaya Way                    Las Vegas, Nevada 89128 |
|                                                                                            |                                                                                      |                                      |  |
|                                                                                            |                   Organization                                             |                    Address |   |
|                                                                                            |                                                                                 |                                      |   |

|   | /s/                Robert Donnelly                                                                                                                        |   | September                29, 2005 |
|--------|-----------------------------------------------------------------------------------------------------------------------------------------------------------|--------|-----------------------------------|
|   | Name:                Robert DonnellyTitle:                DirectorMedicare                Drug Benefit GroupCenter                for Beneficiary Choices |   | Date                              |   |
|   |                                                                                                                                                      |   |                              |   |   |
|   |                                                                                                                                                      |   |                              |   |   |