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Exhibit 10.3
 2003-000021H
HEALTH INSURANCE CONTRACT
NO. 03-021H FOR THE
SOUTH WEST HEALTH REGION
BETWEEN
PUERTO RICO HEALTH INSURANCE ADMINISTRATION
AND
TRIPLE S, INC.
 18 th  day of July, 2006 PUERTO RICO HEALTH INSURANCE ADMINISTRATION ADMINISTRATION TRIPLE S, INC INSURER Socorro Rivas
 WITNESSETH
  WHEREAS: ADMINISTRATION INSURER st South West Health Area/Region Adjuntas, Guánica, Guayanilla, Jayuya, Peñuelas, Ponce and Yauco.
 WHEREAS: ADMINISTRATION




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WHEREAS: ADMINISTRATION Insurer
 HENCEFORTH:
 ARTICLE I
DEFINITIONS
 In Article I, the following definition is amended and substituted to read as follows:
 CONTRACT TERM July 1 st , 2002 until September 30, 2007
 ARTICLE XVIII
 PAYMENT OF PREMIUMS
 In Article XVIII letters (c, d and e) are added to paragraph three (3) to read as follows:
 3.
    
    The monthly premiums
 a.1.b.1.
 c.
    
    The aforementioned premium rates (FY 2005-2006, amendment number 03-021Gsigned
October 10, 2005) constitute the interim rates for the period beginning July
1st, 2006 to September 30, 2006, until a final rate be negotiated and agreed
upon by the parties. Payments will be made from account number 5030-113.d.
    
    The interim rate for July 1st, 2006 to September 30, 2006, shall be
subject to an adjustment in the event there is a difference between the interim and
final agreed premium rate.e.
    
    For the period beginning October 1st, 2006 to September 30, 2007 a
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different rate will be negotiated between the parties in accordance with the new
coverage that will become effective on October 1st , 2006.
 ARTICLE XXVIII
  1.
    
    This contract shall be in effect starting at 12:01 AM Puerto Rico Time on July
1st, 2002, and is due on September 30, 2007
 ARTICLE XL
 MODIFICATION OF COVERAGE AND CONTRACT
  A.
    
    The Administration will define the health services coverage
for the population in accordance with their health needs, determined eligibility type and
income level.B.
    
    Several dispositions of the contract could be amended to include:
 1.
    
    Utilizations review and Quality Assurance2.
    
    Information Systems and Reporting Requirements3.
    
    Plan Compliance Evaluation Program4.
    
    Preventive Medicine Program5.
    
    Mental Health Program6.
    
    Demonstration Project7.
    
    Pharmacy Benefits Management8.
    
    Penalties and Sanctions Clauses
 C.
    
    The aforementioned clauses do not preclude that during the process of
evaluation of the contract and implementation of new models, other dispositions could
be amended.D.
    
    The ADMINISTRATION reserves the right to modify the contract to replicate, on
any Region, the Integrated Regional Services Model being
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implemented in the
Metro-North Region. Such modification will be the result of either an RFP process or
an extension of the contract with current region insurers.
 The present amendments take precedence and shall prevail over any remaining sections and articles
of the contract which are maintained but could conflict with these amendments.
 th day of July, 2006.
 /s/ Nancy Vega RamosNANCY VEGA RAMOS, MHs, HIA, MHPExecutive DirectorPuerto Rico Health Insurance Administration/s/ Socorro RivasSOCORRO RIVASChief Executive OfficerTriple S, Inc./s/ Luis A. MariniLUIS A. MARINI, DMD

Chief Executive Officer

Triple-C, Inc.
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