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

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

----

|   | Financial      Performance          | 95%                         | Times      85% weight | = | .808 |
|--------|------------------------------------------|-----------------------------|-----------------------|---|------|
|   | Quality      Objective              | 100%                        | Times      10% weight | = | .100 |
|   | Turnover      Objective             | 100%                        | Times      5% weight  | = | .050 |
|   | .958                                     |                        |
|   | Individual      Performance/Contribution | X      1.05                 |                  |
|   | =                                        | 1.005      X $100,000 X 25% |
|   | =                                        | $25,134.38                  |                  |

| ·   | 115%      -125%                             10%      of eligible Participants |
|--------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | 105%      -114%                              20%      of eligible Participants |
|--------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | 95%      -104%                                40%      of eligible Participants |
|--------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | 85%      -      94%                                 20%      of eligible Participants |
|--------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | 75%      -      84%                                 7%-10%      of eligible Participants |
|--------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | 50%      -      74%                                 Up      to 3% of eligible Participants |
|--------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | <      50% will be considered unsatisfactory performance such that Participants      may be ineligible for a Plan incentive payment as determined in its sole      discretion, by the Incentive Plan Compensation  Committee. |
|--------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

----

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

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

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

|   | COMPANY/SUBSIDIARY      ACHIEVEMENT |
|--------|-------------------------------------|

|   | COMPANY      OBJECTIVES |
|--------|-------------------------|

----

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

| Percent      of Bonus Achieved | Range      of HEDIS/CAHPS+      Standard Score | Percent      Increase                            |
|--------------------------------|------------------------------------------------|--------------------------------------------------|
| 150%                           | 90.0-100.0                                     | Achieve      “Excellent” Status      |
| 125%                           | 85.9-89.99                                     | Achieve      “Commendable” Status    |
| 120%                           | 85.8-85.89                                     | Achieve      “Commendable” Status    |
| 115%                           | 85.6-85.79                                     | Achieve      “Commendable” Status    |
| 110%                           | 85.3-85.59                                     | Achieve      “Commendable” Status    |
| 105%                           | 85.1-85.29                                     | Achieve      “Commendable” Status    |
| 100%                           | 80.0-85.09                                     | Achieve      “Commendable” Status    |
| 50%                            | 65.0-79.99                                     | Achieve      “Accredited” Status     |
| 0%                             | <65.0                                       | Falls      Below “Accredited” Status |

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

| Business      Unit | 2007Objective | 2006      ActualVoluntary |
|--------------------|---------------|---------------------------|
| BHO                | 16.5%         | 19.1%                     |
| FHH                | 14.0%         | 16.3%                     |
| FHS                | 10.0%         | 10.7%                     |
| THC                | 16.5%         | 26.6%                     |
| HPN                | 15.0%         | 17.0%                     |
| SHL                | 16.1%         | 20.7%                     |
| SHO                | 16.5%         | 25.7%                     |
| SMA                | 15.0%         | 15.9%                     |
| SNA                | 12.5%         | 13.3%                     |
| SHS                | 10.0%         | 8.9%                      |

----

----

| 1.   | The      Plan shall be known as “The Sierra Health Services, Inc. (hereafter known      as the “Company”) FY 2007 Management Incentive Compensation      Plan”. |
|----------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| 2.   | Plan      Year will be January 1, 2007 – December 31,  2007. |
|----------------|--------------------------------------------------------------------|

| 3.   | Participants      are defined as active eligible employees as defined by the Compensation      Committee, Sierra Health Services, Inc.  The Incentive Plan Compensation      Committee is comprised of the President & COO; the Vice      President of Human Resources; the Senior Executive Vice President Legal      and Administration; and, the Chief Financial  Officer. |
|----------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

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

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

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

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

| E.   | No      employee of the Company has the right or is guaranteed the right to      participate in the Plan by virtue of being an employee of the Company or      fulfilling any specific position with the Company.  Selection      for participation in the Plan is solely within the discretion of the      Company.  Sierra Health Services, Inc. may offer participation      in the Plan to additional employees or terminate the participation of any      Participant in the Plan any time during the Plan  Year. |
|----------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

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

----

| 5.   | All      payouts under this Plan, including those for 16(b) employees, are subject      to prior approval by the Compensation Committee of the Company’s Board of      Directors.  No payments will be made under the Plan to the      extent that such payments would place the Company in violation of any      laws, regulations or bank covenants under its credit    facility. |
|----------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

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

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

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

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

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

| 11.   | Transfer/Promotion within the      Business Unit Organization – Plan Participants who are transferred      or promoted during the Plan Year to another job within Sierra Health      Services, Inc. or its subsidiaries, not covered by the Plan will receive,      subject to approvals, a prorated payment following year-end based on their      achievement of specified objectives during eligible month(s) as determined      by Company. Similarly, an employee who becomes an eligible Participant in      the Plan Year, with at      least 3 months service as an eligible Participant, may receive,      subject to approvals, a prorated payment following year-end based on their      achievement of specified objectives during eligible month(s) as determined      by Company in its sole discretion. |
|-----------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| 12.   | Termination of      Employment – Participants, who terminate their employment      voluntarily or involuntarily from the Company during the Plan Year and      until the Plan date of payout, will not be eligible for any bonus payment      under the Plan.  Any exceptions will be determined on an      individual basis at the sole discretion of the Incentive Plan Compensation      Committee. |
|-----------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| 13.   | Retirement/Death/Disability      – Termination of employment during the Plan Year and until the Plan date      of payout as a result of retirement, death, or disability may constitute      eligibility for a prorated payment as determined by the Company in their      sole discretion. |
|-----------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

----

| 14.   | Windfalls/Business      Losses – Revenues classified as “windfalls” or business losses or      charges against net income may or may not be excluded in whole or in part      from the calculation of revenue or profit objectives at the sole      discretion of the Chief Executive Officer.  Similarly,      significant declines in revenue volume will be reviewed prior to any bonus      award. Examples of such circumstances include, but are not limited to:      excluding acquisition-related and FY 2007 charges and non operating      unusual charges, windfalls or business losses resulting from any      acquisition or disposition by the corporation as determined by the      Compensation Committee of Sierra Health Services Board of Directors or the      absence of cash flow through the majority of the fiscal year and the      subsequent receipt of a large cash receivable in the last quarter of the      fiscal year when evaluating the achievement of cash flow      objectives. |
|-----------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| 15.   | Company Rights – Notice      of participation in the Plan shall not impair or limit the Company’s right      to transfer, promote, or demote plan participants to other jobs or to      terminate their employment.  Nor shall the Plan create either      claim or right to receive any payment under the Plan or any right to be      retained in the employment of the Company or its    affiliates. |
|-----------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| 16.   | Non-Continuation – The      Plan is established for the current fiscal year.  There shall be      no obligation on the part of the Company to continue the Plan in the same      or a modified form for any futureyears. |
|-----------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| 17.   | Resolution of Disputes –      In the event that a Participant has a dispute concerning the      administration of this Plan, it should first be submitted in writing to      the Vice President, Human Resources.  In the event that the Vice      President does not provide a response satisfactory to the participant with      fifteen (15) days, the Participant may submit the dispute in writing,      within five (5) working days thereafter, to the Incentive Plan      Compensation Committee – Sierra Health Services, Inc., whose decision      regarding the dispute shall be final and binding on each Participant or      person making a claim under thePlan. |
|-----------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| 18.   | Effect on Previous Plans      – The Plan is effective January 1, 2007, and supersedes and replaces all      previous management bonus plans.  If not renewed by the Company      or its designated representative(s), the Plan will automatically terminate      on December 31 of each year. Any changes in the Plan will constitute a new      Plan for the next Plan year. |
|-----------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| 19.   | Achievement Beyond Payout      Grids - In the event that Company performance exceeds the maximum      provided by the Payout Grids, Sierra Health Services reserves the right to      increase the level of individual payouts up to 3 Times the Target Award      level based upon improved profitability and or other performance measures      as determined by the Incentive Compensation  Committee. |
|-----------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|