Document:

Exhibit 10.6

NEITHER THIS WARRANT NOR THE  SECURITIES  ISSUABLE UPON EXERCISE OF THIS WARRANT
HAVE BEEN  REGISTERED  UNDER THE SECURITIES ACT OF 1933, AS AMENDED (THE "ACT"),
OR QUALIFIED UNDER APPLICABLE STATE SECURITIES LAWS AND MAY ONLY BE ACQUIRED FOR
INVESTMENT PURPOSES ONLY AND NOT WITH A VIEW TO, OR IN CONNECTION WITH, THE SALE
OR  DISTRIBUTION  THEREOF.  THIS WARRANT AND THE  SECURITIES  ISSUABLE  UPON THE
EXERCISE OF THIS WARRANT,  IF ANY, MAY NOT BE SOLD, OFFERED FOR SALE, PLEDGED OR
HYPOTHECATED  IN THE ABSENCE OF AN EFFECTIVE  REGISTRATION  STATEMENT AS TO SUCH
SECURITIES UNDER THE ACT AND QUALIFICATION UNDER APPLICABLE STATE LAW WITHOUT AN
OPINION  OF COUNSEL  SATISFACTORY  TO THE  COMPANY  THAT SUCH  REGISTRATION  AND
QUALIFICATION  ARE NOT REQUIRED  UNDER THE ACT OR RECEIPT OF A NO-ACTION  LETTER
FROM THE SECURITIES AND EXCHANGE COMMISION.

_____________, 2006

                              HC INNOVATIONS, INC.

           WARRANT FOR THE PURCHASE OF SHARES OF COMMON STOCK

      For value received,  this warrant (the "WARRANT") is hereby issued
by HC INNOVATIONS,  INC., a Delaware  corporation  (the  "COMPANY"),  to
________________(the  "HOLDER").  Subject  to  the  provisions  of  this
Warrant,  the Company  hereby grants to the Holder the right to purchase
from the  Company  up to  _____________  fully  paid and  non-assessable
shares  of  the  Company's  Common  Stock,  at  an  aggregate  price  of
$__________ or $1.25 per share (the "EXERCISE PRICE").

      The term  "COMMON  STOCK"  means the Common  Stock,  par value  $0.001 per
share, of the Company.  The number of shares of Common Stock to be received upon
the  exercise of this Warrant may be adjusted  from time to time as  hereinafter
set forth.  The shares of Common Stock  deliverable  upon such exercise,  and as
adjusted from time to time, are hereinafter referred to as "WARRANT SHARES."

      The Holder  agrees with the Company that this  Warrant is issued,  and all
the  rights  hereunder  shall  be  held,  subject  to  all  of  the  conditions,
limitations and provisions set forth herein.

      1. EXERCISE OF WARRANT.  (a) Subject to the terms and conditions set forth
herein,  this  Warrant  may be  exercised  in whole or in part,  pursuant to the
procedures  provided  below,  at any time on or before  the  earlier of (i) 5:00
p.m., New York time, on the day occurring two (2) years from  ___________,  2006
(the "EXPIRATION  DATE") or, if such day is a day on which banking  institutions
in New York are authorized by law to close, then on the next succeeding day that
shall not be such a day. The Warrant shall only be  exercisable on a cash basis.
To exercise this Warrant the Holder shall present and surrender  this Warrant to
the Company at its  principal  office,  with the Warrant  Exercise Form attached
hereto duly  executed  by the Holder and

<PAGE>

accompanied by payment in cash, wire transfer or by check,  payable to the order
of the Company,  of the aggregate  Exercise Price for the total aggregate number
of shares for which this  Warrant is  exercised.  Upon receipt by the Company of
this Warrant,  together with the executed  Warrant  Exercise Form and payment of
the Exercise  Price for the shares to be acquired,  in proper form for exercise,
and subject to the Holder's compliance with all requirements of this Warrant for
the  exercise  hereof,  the Holder shall be deemed to be the holder of record of
the shares of Common Stock issuable upon such exercise, notwithstanding that the
stock  transfer  books of the Company shall then be closed or that  certificates
representing such shares of Common Stock shall not then be actually delivered to
the  Holder;  PROVIDED,  HOWEVER,  that no  exercise  of this  Warrant  shall be
effective, and the Company shall have no obligation to issue any Common Stock to
the Holder upon any attempted exercise of this Warrant,  unless the Holder shall
have  first  delivered  to  the  Company,  in  form  and  substance   reasonably
satisfactory to the Company,  appropriate  representations  so as to provide the
Company reasonable  assurances that the securities issuable upon exercise may be
issued without violation of the registration  requirements of the Securities Act
and   applicable   state   securities   laws,   including   without   limitation
representations  that the Holder is familiar  with the Company and its  business
and financial  condition and has had an opportunity to ask questions and receive
documents relating thereto to his reasonable satisfaction.

      2.  RESERVATION  OF SHARES.  The  Company  will at all times  reserve  for
issuance and delivery  upon  exercise of this Warrant all shares of Common Stock
from time to time  receivable  upon  exercise of this  Warrant.  All such shares
shall be duly authorized  and, when issued upon such exercise,  shall be validly
issued, fully paid and non-assessable and free of all preemptive rights.

      3.  FRACTIONAL   SHARES.  No  fractional  shares  or  scrip   representing
fractional  shares  shall be issued upon the exercise of this  Warrant,  but the
Company  shall  pay the  Holder  an amount  equal to the Fair  Market  Value (as
defined below) of such fractional share of Common Stock in lieu of each fraction
of a share otherwise called for upon any exercise of this Warrant.

      4.  REDEMPTION.  The Company has no optional right to redeem this Warrant.
This  Warrant is subject to mandatory  redemption  by the Company on thirty (30)
days' notice,  if the Company's common stock has traded at a closing price of at
least $3.50 per share for twenty (20)  consecutive  trading days. The redemption
price is $.05 per Warrant Share.

      5.   REGISTRATION   RIGHTS.   The  Holder  shall  have  certain  piggyback
registration  rights with  respect to the  registration  the  Warrant  Shares as
provided  in that  certain  Registration  Rights  Agreement  by and  between the
Company and the parties thereto.

      6.  ASSIGNMENT  OR LOSS OF WARRANT.  Subject to the transfer  restrictions
herein  (including  Section 9), upon surrender of this Warrant to the Company or
at the office of its stock  transfer  agent,  if any, with the  Assignment  Form
annexed  hereto duly executed and funds  sufficient to pay any transfer tax, the
Company shall, without charge,  execute and deliver a new Warrant in the name of
the assignee  named in such  instrument  of  assignment  and this Warrant  shall
promptly  be  canceled.  Upon  receipt  by the  Company of  evidence  reasonably
satisfactory  to it of the  loss,  theft,  destruction,  or  mutilation  of this
Warrant, and of reasonably satisfactory  indemnification by the Holder, and upon
surrender  and  cancellation  of this Warrant,  if mutilated,  the Company shall
execute and deliver a replacement Warrant of like tenor and date.

                                      -2-
<PAGE>

      7.  RIGHTS OF THE  HOLDER.  The Holder  shall not,  by virtue  hereof,  be
entitled  to any rights of a  stockholder  in the  Company,  either at law or in
equity,  and the  rights of the Holder are  limited to those  expressed  in this
Warrant.

      8. ADJUSTMENTS.

            8.1  ADJUSTMENT  FOR  RECAPITALIZATION.  If the Company shall at any
time after the date hereof  subdivide its outstanding  shares of Common Stock by
recapitalization, reclassification, or split-up thereof, the number of shares of
Common Stock subject to this Warrant immediately prior to such subdivision shall
be  proportionately  increased,  and if the Company  shall at any time after the
date hereof combine the outstanding shares of Common Stock by  recapitalization,
reclassification,  or combination  thereof, the number of shares of Common Stock
subject  to  this  Warrant  immediately  prior  to  such  combination  shall  be
proportionately  decreased.  Any such  adjustment and adjustment to the Exercise
Price  pursuant to this  Section 8.1 shall be effective at the close of business
on the effective date of such subdivision or combination.

      Whenever  the  number  of  shares of  Common  Stock  purchasable  upon the
exercise of this  Warrant is  adjusted,  as provided in this  Section  8.1,  the
Exercise  Price  shall be  adjusted  to the  nearest  cent by  multiplying  such
Exercise  Price  immediately  prior to such  adjustment  by a  fraction  (x) the
numerator  of which  shall be the number of shares of Common  Stock  purchasable
upon the exercise immediately prior to such adjustment,  and (y) the denominator
of  which  shall  be the  number  of  shares  of  Common  Stock  so  purchasable
immediately thereafter.

            8.2 ADJUSTMENT FOR REORGANIZATION, CONSOLIDATION, MERGER. In case of
any  reorganization  of the Company  after the date hereof or in case after such
date the Company shall  consolidate  with or merge into another  corporation  or
convey all or substantially all of its assets to another corporation,  then, and
in each such  case,  the Holder of this  Warrant  upon the  exercise  thereof as
provided in Section 1 at any time after the consummation of such reorganization,
consolidation,  merger, or conveyance,  shall be entitled to receive, in lieu of
the securities and property  receivable  upon the exercise of this Warrant prior
to such consummation, the securities or property to which such Holder would have
been entitled upon such  consummation  if such Holder had exercised this Warrant
immediately prior thereto; in each such case, the terms of this Warrant shall be
applicable to the  securities or property  receivable  upon the exercise of this
Warrant after such consummation.

            8.3 CERTIFICATE AS TO ADJUSTMENTS.  The adjustments provided in this
Section 8 shall be  interpreted  and applied by the Company in such a fashion so
as to reasonably  preserve the  applicability  and benefits of this Warrant (but
not to  increase  or  diminish  the  benefits  hereunder).  In  each  case of an
adjustment in the number of shares of Common Stock receivable on the exercise of
the Warrant, the Company at its expense will promptly compute such adjustment in
accordance  with the terms of the Warrant and prepare a certificate  executed by
two executive  officers of the Company setting forth such adjustment and showing
in detail the facts  upon  which such  adjustment  is based.  The  Company  will
forthwith mail a copy of each such certificate to each Holder.

                                      -3-
<PAGE>

            8.4   NOTICES OF RECORD DATE, ETC.  In the event that:
                  ---------------------------

            (a) the Company  authorizes  the granting to Common Stock holders of
      any right to subscribe  for,  purchase or otherwise  acquire any shares of
      stock of any class or any other securities; or

            (b)  the  Company  authorizes  any  capital  reorganization  of  the
      Company,  any  reclassification  of the capital stock of the Company,  any
      consolidation  or merger of the Company with or into another  corporation,
      or any conveyance of all or substantially all of the assets of the Company
      to another corporation or entity; or

            (c) the Company authorizes any voluntary or involuntary dissolution,
      liquidation, or winding up of the Company,

then, and in each such case, the Company shall mail or cause to be mailed to the
holder of this Warrant at the time outstanding a notice specifying,  as the case
may be,  (i) the date on which a record is to be taken for the  purpose  of such
right,  and stating the amount and character of such right,  or (ii) the date on
which such reorganization, reclassification,  consolidation, merger, conveyance,
dissolution,  liquidation,  or winding up is to take place, and the time, if any
is to be fixed,  as to which the  holders  of  record of Common  Stock  shall be
entitled  to  exchange  their  shares of Common  Stock for  securities  or other
property deliverable upon such reorganization, reclassification,  consolidation,
merger, conveyance,  dissolution,  liquidation, or winding up. Such notice shall
be mailed at least twenty (20) days prior to the date therein specified.

            8.5 NO  IMPAIRMENT.  The Company will not, by any voluntary  action,
avoid or seek to avoid the  observance or  performance of any of the terms to be
observed or performed  hereunder  by the Company,  but will at all times in good
faith assist in the carrying out of all the provisions of this Section 10 and in
the taking of all such action as may be  necessary  or  appropriate  in order to
protect the rights of the Holder of this Warrant against impairment.

      9.  TRANSFER  TO COMPLY  WITH THE  SECURITIES  ACT.  This  Warrant and any
Warrant Shares may not be sold, transferred,  pledged, hypothecated or otherwise
disposed of except as follows: (a) to a person who, in the opinion of counsel to
the Company,  is a person to whom this Warrant or the Warrant Shares may legally
be  transferred  without  registration  and  without  the  delivery of a current
prospectus  under the Securities Act with respect  thereto and then only against
receipt of an  agreement  of such person to comply with the  provisions  of this
Section 9 with respect to any resale or other disposition of such securities; or
(b) to any person upon delivery of a prospectus then meeting the requirements of
the Securities Act relating to such securities and the offering thereof for such
sale or disposition, and thereafter to all successive assignees.

      10. LEGEND. Unless the shares of Warrant Shares have been registered under
the Securities Act, upon exercise of any of the Warrants and the issuance of any
of the shares of Warrant Shares, all certificates representing shares shall bear
on the face thereof substantially the following legend:

             THE SECURITIES  REPRESENTED BY THIS  CERTIFICATE HAVE NOT
             BEEN  REGISTERED  UNDER THE  SECURITIES  ACT OF 1933,  AS
             AMENDED, AND MAY NOT BE SOLD, OFFERED FOR SALE, ASSIGNED,
             TRANSFERRED OR OTHERWISE  DISPOSED OF, UNLESS  REGISTERED
             PURSUANT TO THE

                                 -4-
<PAGE>

             PROVISIONS OF THAT ACT OR UNLESS AN OPINION OF COUNSEL TO
             THE CORPORATION IS OBTAINED STATING THAT SUCH DISPOSITION
             IS IN COMPLIANCE  WITH AN AVAILABLE  EXEMPTION  FROM SUCH
             REGISTRATION.

      11. NOTICES.  All notices required hereunder shall be in writing and shall
be deemed given when telegraphed,  delivered personally or within two days after
mailing when mailed by certified or registered mail,  return receipt  requested,
to the  Company  or the  Holder,  as the case may be,  for whom  such  notice is
intended,  if to the Holder,  at the address of such party shown on the books of
the  Company,  or if to the Company,  at the address set forth on the  signature
page hereof, Attn:  President,  or at such other address of which the Company or
the Holder has been advised by notice hereunder.

      12. APPLICABLE LAW. The Warrant is issued under and shall for all purposes
be  governed  by and  construed  in  accordance  with the  laws of the  State of
Delaware, without regard to the conflict of laws provisions of such State.

      IN WITNESS  WHEREOF,  the Company has caused this  Warrant to be signed on
its behalf, in its corporate name, by its duly authorized officer, all as of the
day and year first above written.

                                          HC INNOVATIONS, INC.

                                          By:
                                             --------------------------------
                                          Name: David Chess M.D.
                                          Title: Chief Executive Officer

                                 -5-
<PAGE>

                              WARRANT EXERCISE FORM

      The  undersigned  hereby  irrevocably  elects to (i)  exercise  the within
Warrant to purchase  __________  shares of the Common  Stock of HC  INNOVATIONS,
INC., a Delaware  corporation,  pursuant to the  provisions  of Section 1 of the
attached Warrant,  and hereby makes payment of $__________ in payment therefore.
The undersigned's execution of this form constitutes the undersigned's agreement
to all the terms of the Warrant and to comply therewith.

                                          --------------------------------------
                                          Signature
                                          Print Name:

                                          --------------------------------------
                                          Signature, if jointly held

                                          Print Name:

                                          --------------------------------------
                                          Date

                                      -6-
<PAGE>

                                 ASSIGNMENT FORM

FOR  VALUE  RECEIVED_____________________________   ("Assignor")  hereby  sells,
assigns, and transfers unto _______________________________  ("Assignee") all of
Assignor's right,  title and interest in, to and under this Warrant issued by HC
INNOVATIONS, INC. dated ______________.

DATED:
       -----------------------

                                                ASSIGNOR:

                                                --------------------------------
                                                Signature
                                                Print Name:

                                                --------------------------------
                                                Signature, if jointly held
                                                Print Name:

                                                ASSIGNEE:

The  undersigned  agrees  to all of the  terms  of  the  Warrant  and to  comply
therewith.

                                                --------------------------------
                                                Signature
                                                Print Name:

                                                --------------------------------
                                                Signature, if jointly held
                                                Print Name:

                                      -7-DISEASE MANAGEMENT
                               SERVICES AGREEMENT
                         ENHANCED CARE INITIATIVES, INC.

              This DISEASE MANAGEMENT SERVICES AGREEMENT (this "DMSA"), is made
     and entered into as of October 16, 2006, by and between ALERE MEDICAL
     INCORPORATED., a California corporation ("ALERE") and ENHANCED CARE
     INITIATIVES, INC., a Connecticut corporation, ("Subcontractor") (sometimes
     hereinafter, ALERE and Subcontractor may each be referred to individually
     as a "Party" and collectively as the "Parties"), with reference to the
     following facts:

                                    RECITALS

     A. ALERE offers disease management tools, services and systems to Payors
     which are designed to assist with and improve management of health care
     outcomes for patients

     B. ALERE provides said disease management tools, services and systems both
     directly and through contracts with DM Vendors.

     C. ALERE has contracted to provide disease management services to TUFTS
     HEALTH PLAN, ("Tufts").

     D. Tufts offers various Commercial and Medicare Health Plans to Members.

     E. Tufts has engaged ALERE to provide, directly or indirectly through
     subcontracts with DM Vendors, disease management services to Tuft's
     Members, and ALERE desires to provide or arrange for Subcontractor to
     provide ALERE with some of those disease management services on behalf of
     Tufts, all in accordance with the terms and subject to the conditions of
     this Agreement.

     F. Capitalized terms used in this DMSA and through this Agreement shall
     have the respective meanings set forth in the Schedule of Definitions
     attached to this DMSA as EXHIBIT A or as otherwise defined herein.

                                    AGREEMENT

     NOW, THEREFORE, in consideration of the foregoing recitals (which are
     incorporated in full herein by this reference), the representations,
     warranties, covenants and conditions exchanged by the Parties herein below,
     and for other good and valuable consideration, the receipt and sufficiency
     of which are hereby acknowledged, Subcontractor and ALERE hereby agree as
     follows:

                                      A-1
<PAGE>

1        SCOPE AND INTERPRETATION OF AGREEMENT.

1.1      SCOPE OF DISEASE MANAGEMENT AND MANAGEMENT SERVICES/TUFTS.
         ---------------------------------------------------------

1.1.1  DISEASE MANAGEMENT SERVICES. Subject to the terms and conditions of this
       DMSA, Subcontractor, as a subcontractor of ALERE, shall provide disease
       management services to Tufts and/or its Members in accordance with the
       services, functions, tasks and responsibilities described in various
       statements of work to be executed by Subcontractor and ALERE (each a
       "Statement or Work" or "SOW") (the "Disease Management Services").
       Subcontractor shall perform all Disease Management Services in accordance
       with all applicable terms and conditions of this Agreement and all
       then-applicable Laws and Regulations.

1.1.2  APPLICABILITY TO TUFTS AFFILIATES. At ALERE's request, Subcontractor will
       provide Disease Management Services pursuant to the terms and conditions
       of a SOW to any current or future Tufts Affiliate that desires to
       participate in one or more programs being administered by ALERE. To the
       extent that it may be required by the law of the state in which a Tufts
       Affiliate is licensed, ALERE, Subcontractor and such Tufts Affiliate will
       enter into a separate agreement in form and content similar to this
       Agreement. However, the Parties understand that no current or future
       Tufts Affiliate is required to utilize Subcontractor's Disease Management
       Services or participate in programs administered by ALERE which utilize
       Subcontractor's services at any time during the Term. Furthermore, ALERE
       shall be free to provide the Disease Management Services to Tufts
       directly, through Affiliates or through contracts with Third Party
       vendors, including those vendors which may compete with Subcontractor.

1.1.3  GUARANTEES. Alere make no guarantees or representations to Subcontractor
       concerning any minimum or maximum number of Tuft's Members which may be
       the subject of Subcontractor's Disease Management Services, or of any
       minimum or maximum amount of Service Fees or other compensation that will
       be generated from Subcontractor's performance or administration of the
       Disease Management Services, unless explicitly provided to the otherwise
       in the applicable SOW.

1.2    STATEMENTS OF WORK. This DMSA establishes the standard terms and
       conditions pursuant to which the Disease Management Services and all
       other Services and Deliverables shall be furnished by Subcontractor to
       ALERE. Subject to the terms and conditions of this DMSA, the Parties will
       prepare one or more SOWs to identify and describe such Services and
       Deliverables and the Parties' responsibilities with respect thereto,
       which SOW must be dated and executed by Subcontractor and ALERE in order
       to become effective. Each SOW shall set forth in detail: (i) a reference
       to this DMSA, which reference will be deemed to incorporate all of the
       provisions of this DMSA

                                      A-2
<PAGE>

       into the SOW; (ii) an effective date for the SOW and/or for the
       commencement of Services to be furnished under such SOW; (iii) an
       identification of the involved Tufts Affiliate and the specific programs
       comprising the Disease Management Services to be furnished by
       Subcontractor to ALERE; (iv) a description of the services, functions,
       tasks and responsibilities of Subcontractor in furnishing such Disease
       Management Services and of the Tufts Affiliates for whom such Disease
       Management Services are being furnished; (v) a description of any other
       specific Services or Deliverables to be furnished by Subcontractor; (vi)
       Performance Targets and/or Service Level Standards to which the Services
       may be subject and/or the manner in which such targets or standards will
       be determined or developed on an annual basis; (vii) the Service Fees
       payable to Subcontractor for any Disease Management Services or other
       Services; and (viii) such other matters as the Parties shall mutually
       agree upon. A SOW will be developed for each Disease Management Service
       now or hereinafter furnished by Subcontractor hereunder. This DMSA shall
       remain in effect for the term specified in, and subject to the Parties'
       respective rights under, Section 13 hereof. Each SOW may be separately
       terminated pursuant to its terms or as otherwise set forth herein without
       affecting any other SOW. However, the termination of this DMSA shall
       terminate all then outstanding SOWs.

1.3    PROPERTY USED TO PERFORM SERVICES. Unless any SOW expressly provides to
       the contrary, (i) all tangible and intangible property required by
       Subcontractor to perform any Services hereunder ("Necessary Property")
       shall be the sole financial responsibility of Subcontractor, and (ii) all
       such Necessary Property shall remain the sole and exclusive property of
       Subcontractor. In the event a SOW provides that Alere or Tufts is
       financially responsible (as defined below) for any several Necessary
       Property , all such several Necessary Property shall remain the sole and
       exclusive property of that entity. As used herein, "financial
       responsibility" shall mean the ultimate responsibility for incurring the
       costs and expenses required in order to purchase, lease, license, develop
       or otherwise acquire Necessary Property that is separate and distinct
       from the fees payable to Subcontractor under any SOW.

1.4    INTERPRETATION OF SOWS; ORDER OF PRECEDENCE. In the event of conflict or
       inconsistency between the provisions of any SOW and the provisions of
       this DMSA with respect to the provision of any particular Disease
       Management service or other service, the provisions of the SOW will
       govern and control with respect to the interpretation of the provision as
       used in that SOW; provided, however, that the provisions of such SOW
       shall be construed so as to give effect to all applicable provisions of
       this DMSA to the fullest extent possible. In the event of conflict or
       inconsistency between two or more SOWs that must be interpreted together,
       the SOW most recently dated shall govern with respect the conflicting
       provision.

2        PROVISION OF SERVICES BY SUBCONTRACTOR.

                                      A-3
<PAGE>

2.1    GENERAL REQUIREMENTS. Subcontractor shall perform all Services in
       accordance with (i) the general terms and conditions of this DMSA, and
       (ii) the specific terms, conditions, scope, specifications, schedules,
       and all other requirements set forth in each SOW applicable to such
       Services (collectively, "SOW Requirements"). Any material changes to any
       SOW Requirements shall be made pursuant to the Change Order Process set
       forth in Section 10 below.

2.2    READINESS; IMPLEMENTATION SERVICES.

2.2.1  OPERATIONAL AND SYSTEM READINESS. Subcontractor represents, warrants and
       covenants to ALERE that, prior to any SOW Effective Date, Subcontractor
       shall have achieved Operational and System Readiness to provide all
       Services contemplated by such SOW in accordance with the terms and
       conditions of this Agreement.

2.2.2  IMPLEMENTATION SERVICES; IT DEVELOPMENT WORK FOR TUFTS. Subcontractor
       agrees to perform and complete any IT Development Work, personnel
       training, implementation of operating procedures and protocols and other
       work as may be necessary or appropriate to achieve Operational and System
       Readiness with respect to Disease Management Services or other Services
       required to be furnished to Tufts under a SOW ("Implementation Services")
       prior to the applicable SOW Effective Date. All Implementation Services
       shall be performed at the sole cost and expense of Subcontractor unless
       otherwise expressly provided in a SOW.

2.3    COMPLIANCE WITH LAWS AND REGULATIONS. As an integral part of any Services
       provided pursuant to this Agreement, Subcontractor shall obtain all
       licenses and permits necessary under applicable Laws and Regulations to
       perform such Services and shall comply with all Laws and Regulations
       applicable to performance of such Services and the operation of
       Subcontractor's business. Subcontractor shall be financially responsible
       for all costs and fees and taxes associated with securing and maintaining
       such licenses and permits and complying with its obligations under this
       Section. In addition, and without any additional cost, Subcontractor
       shall assist and cooperate with ALERE as reasonably necessary for Tufts
       to maintain compliance with any Laws and Regulations and any CMS
       policies, guidelines and manuals pertaining to the marketing, offering or
       operation of their Health Plans, including, but not limited to,
       compliance with any such Laws and Regulations, policies, guidelines and
       manuals applicable to Subcontractor as a contractor of Tufts and any
       notice or filing requirements with CMS or any other Governmental
       Authority. Without limiting the generality of the foregoing,
       Subcontractor agrees to the following:

2.3.1  INCORPORATION OF LEGAL AND REGULATORY REQUIREMENTS. The performance of
       the Services may be subject to the requirements of Laws and Regulations
       applicable to the ALERE, the Tufts Affiliates or their Health

                                      A-4
<PAGE>

       Plans, the Services or Subcontractor's operations that have not been
       specifically identified in this Agreement. In such case, any provisions
       now or hereafter required to be included in this Agreement by applicable
       Laws and Regulations or by Governmental Authorities exercising
       jurisdiction over ALERE, Tufts, their Health Plans, the Services or
       Subcontractor's operations, including, without limitation, Medicare Laws
       and Regulations, administrative guidelines issued by CMS and requirements
       relating to Federal Employees Health Benefit Programs, shall be binding
       upon and enforceable against Subcontractor, ALERE or Tufts, whether or
       not expressly provided in this DMSA.

2.3.2  REGULATED ACTIVITIES; DELEGATION. The Parties acknowledge and agree that
       the Services shall not include the selection or credentialing of medical
       professionals or providers. To the extent that any Services include other
       activities that are regulated by Laws and Regulations or governed by
       standards adopted by Accreditation Organizations ("Regulated
       Activities"), Subcontractor shall cooperate with Tufts to facilitate its
       compliance with such Laws and Regulations and such standards.
       Subcontractor shall not subcontract or delegate any Services or any other
       Regulated Activities (including as a result of a Change of Control) to a
       Third Party without the prior written consent of ALERE. Any such
       subcontract or delegation, if consented to (an "Approved Delegation"),
       shall be performed by the delegate in accordance with the terms and
       conditions of this Agreement and, if pertaining to the Medicare Health
       Plans, Tuft's contractual obligations to CMS. Subcontractor agrees that
       any agreements of Subcontractor with respect to an Approved Delegation
       shall be in writing, signed by the parties to be bound thereby and in
       compliance with all applicable Medicare and other Laws and Regulations.
       In the event that a delegate of Subcontractor fails or is unable (for any
       reason whatsoever) to perform in a satisfactory manner any services,
       activities or other obligations which have been sub-delegated pursuant to
       an Approved Delegation, then ALERE shall have the right to suspend,
       revoke or terminate such Approved Delegation effective upon the date set
       forth in a written notice furnished to Subcontractor. Any purported
       delegation or subcontract in violation of this Section shall be not
       binding upon or recognized.

2.3.3  MAINTENANCE OF BOOKS AND RECORDS. Subcontractor shall keep and maintain,
       in accordance with prudent business practices and applicable Laws and
       Regulations, accurate, complete and timely books, documents, records and
       accounts of all transactions occurring as part of the Services, and
       Compensation Records (collectively, "Records"). Subcontractor shall
       retain all Records during the Term and for an additional period of six
       (6) years (or such longer period as may be required under applicable law)
       from this Agreement's termination and the expiration of any Transition
       Assistance Period and for such longer period as may be required by (i)
       any SOW, (ii) any on-going audit or investigation of Tufts, ALERE,
       Subcontractor or any other Person being conducted by any Governmental
       Authority related to this

                                      A-5
<PAGE>

       Agreement or (iii) applicable Laws and Regulations. Subcontractor shall,
       promptly upon request by ALERE, provide ALERE with electronic copies of
       any and all Records relating to the performance of any Services for them
       hereunder at Subcontractor's expense. In addition, Subcontractor shall
       permit originals or copies of such Records to be inspected by
       Governmental Authorities at the Service Locations or elsewhere, both
       before and after any termination or expiration of this DMSA. The
       provisions of this Section shall survive the expiration or earlier
       termination of any SOW or this DMSA for any reason whatsoever.

2.3.4  INSPECTION AND AUDIT OF RECORDS AND FACILITIES. Upon request, demand or
       court order, Subcontractor shall provide timely access to ALERE, Tufts,
       any Accreditation Organization or any Governmental Authority (including,
       without limitation, the U.S. Department of Health and Human Services,
       CMS, the Comptroller General or their designees) (each a "Requesting
       Entity") for the purpose of auditing and/or inspecting the facilities,
       offices, equipment and Records of Subcontractor relating to the
       performance of the Services. In connection with such audits or
       inspections, Subcontractor shall cooperate and comply with any lawful
       requirements or directives of the Requesting Entity within the time
       periods specified by such Requesting Entity. If, as a result of any audit
       or inspection, or otherwise, an Accreditation Organization or
       Governmental Authority requires changes to the facilities, books,
       Records, processes, operations or Services of Subcontractor,
       Subcontractor shall, subject to Subcontractor's right to terminate set
       forth in Section 10, make such changes in a timely manner, and at
       Subcontractor's sole expense. Subject to Subcontractor's right to
       terminate set forth in Section 10, all changes required for Subcontractor
       to be in compliance with any standards required by any Accreditation
       Organization or Governmental Authority shall be made timely by
       Subcontractor and at Subcontractor's sole expense, unless otherwise
       agreed in writing by the Parties.

2.3.5  MEDICARE PARTICIPATION STANDARDS. Subcontractor acknowledges that some of
       the Service Fees, compensation or expenses payable pursuant to this DMSA
       will consist of Federal funds. In view of the foregoing, Subcontractor
       agrees to comply with the following: Title VI of the Civil Rights Act of
       1964, as amended (42 USC ss. 2000d et seq.); Sections 503 and 504 of the
       Rehabilitation Act of 1973, as amended (29 USC ss.ss. 793 and 794); Title
       IX of the Education Amendments of 1972, as amended (20 USC ss. 1681 et
       seq.); Section 654 of the Omnibus Budget Reconciliation Act of 1981, as
       amended (41 USC ss. 9849); the Americans with Disabilities Act (42 USC
       ss. 12101 et seq); the Age Discrimination Act of 1975, as amended (42 USC
       ss. 6101 et seq.); and the Vietnam Era Veterans Readjustment Assistant
       Act (38 USC ss. 4212); together with all applicable implementing
       regulations, rules guidelines and standards as from time to time are
       promulgated thereunder by applicable Governmental Authorities.

                                      A-6
<PAGE>

2.3.6  COMPLIANCE WITH MEDICARE LAW AND CMS GUIDELINES. Subcontractor shall
       comply with all Medicare Laws and Regulations and administrative
       guidelines issued by CMS to the extent applicable to the performance of
       the Services. Subcontractor shall perform the Services in a manner that
       is consistent with, and permits Tufts to comply with their contractual
       obligations to CMS. Without limiting any other provision of this
       Agreement, Subcontractor shall comply with all Medicare Laws and
       Regulations and CMS guidelines, instructions and policies with respect to
       the security and confidentiality of medical records and personal
       information of Tuft's Members and Member record accuracy requirements, as
       set forth in applicable Medicare Laws and Regulations. The obligations
       imposed upon Subcontractor by the preceding sentence survive the
       termination of the Agreement.

2.3.7  NONDISCRIMINATION. Subcontractor agrees that the Services shall be
       rendered without regard to health status, race, religion, color, creed,
       national origin, ancestry, religion, physical handicap, medical condition
       (including HIV status), mental status, age (except as provided by law),
       martial status, sex, sexual orientation or gender identity. In addition,
       Subcontractor agrees that it shall not unlawfully discriminate against
       any employee or applicant for employment because of race, religion,
       color, creed, national origin, ancestry, religion, physical handicap,
       medical condition (including HIV status), mental status, age, martial
       status, sex, sexual orientation or gender identity. Subcontractor agrees
       that the evaluation and treatment of its employees and applicants for
       employment are, and will be, free from such unlawful discrimination.
       Subcontractor agrees that it shall comply with the provisions of all Laws
       and Regulations relating to equal and fair employment.

2.3.8  EQUAL OPPORTUNITY EMPLOYER/AFFIRMATIVE ACTION. The provisions of
       Executive Order 11246, as amended (Equal Opportunity/Affirmative Action),
       38 USC ss.4212, as amended, (Vietnam Era Veterans Readjustment Act), and
       Section 503 of the Rehabilitation Act of 1973, as amended (Handicapped
       Regulations), together with the implementing regulations (found at 41 CFR
       ss.ss. 60-1, & 60-2, 41 CFR ss. 60-250, and 41 CFR ss. 60-741,
       respectively), rules guidelines and standards as from time to time are
       promulgated thereunder by applicable Governmental Authorities, are
       incorporated by reference into this DMSA, and Subcontractor agrees to
       abide by the foregoing provisions that, as a contractor of Tufts, are
       applicable to Subcontractor.

2.3.9  FEDERAL EMPLOYEES HEALTH BENEFIT PROGRAM. To the extent Services are
       provided to Members who are enrolled in the Federal Employees Health
       Benefit Program, Subcontractor shall comply with all of the provisions of
       the Federal Employees Health Benefit Program Standard Contract for
       Community-Rated Health Maintenance Organization Carriers (the "FEHBP
       Contract") set forth in EXHIBIT B to this Agreement, which provisions are
       hereby incorporated into this Agreement. Subcontractor shall

                                      A-7
<PAGE>

       comply with each of the provisions set forth in EXHIBIT B to the same
       extent that such provisions apply to Tufts as "Contractor" or "Prime
       Contractor" in the applicable FEHBP Contract. ALERE may amend EXHIBIT B
       by providing written notice of such amendment to Subcontractor at the
       address set forth in the Notice provision of this Agreement to the extent
       that amendments to the FEHBP Contract or a new or replacement contract
       between Tufts and the U.S. Office of Personnel Management require that
       other provisions be incorporated into their subcontracts.

2.3.10 MONITORING AND ASSESSMENTS. ALERE shall have the right to evaluate, audit
       and monitor Subcontractor's performance of all Services on a periodic and
       on-going basis throughout the Term. In connection therewith,
       Subcontractor shall: (i) furnish ALERE's designated representatives with
       such access to the Subcontractor's facilities, operations, Records,
       activities and personnel as may be reasonably necessary or appropriate
       for ALERE to monitor, assess and evaluate all activities associated with
       the Services or this Agreement and/or as otherwise required or
       recommended by, and in accordance with, applicable Laws and Regulations,
       the standards of Accreditation Organizations; (ii) to the extent such
       conversations are recorded, provide ALERE, promptly upon request, with an
       accurate and complete CD ROM containing a recording of all calls with
       Members that are handled by any or all Subcontractor representatives in
       accordance with ALERE's specifications (which may include specifications
       as to the call dates, the specific Members called, the Subcontractor
       representative making the call, or other requirements); and (iii)
       reasonably cooperate with ALERE as necessary for ALERE or Tufts to
       monitor, evaluate and audit the activities of Subcontractor in connection
       with the performance of the Services, including furnishing ALERE or Tufts
       with reasonable and appropriate access to Subcontractor's operations and
       activities. The rights granted to ALERE in this Section shall not relieve
       Subcontractor from any obligations imposed upon Subcontractor under this
       Agreement or any SOW.

2.3.11 BUSINESS INTEGRITY. Subcontractor agrees to be bound by the provisions
       set forth at 45 C.F.R. Part 76 during the Term and so long as any SOW is
       outstanding relating to any Medicare Health Plan. Subcontractor
       represents, warrants and covenants to ALERE that neither Subcontractor
       nor any personnel or Authorized Contractor of Subcontractor is presently
       excluded by the Department of Health and Human Services Office of the
       Inspector General or by the General Services Administration from
       participation in federal health care programs or has any officer,
       director or principal who is convicted of a felony. In the event that any
       personnel or Authorized Contractors of Subcontractor become excluded from
       participation in federal health care programs or convicted of a felony
       during the Agreement, then Subcontractor shall immediately notify ALERE
       thereof and discontinue using such personnel or Authorized Contractors in
       the performance of any Services. In the event that Subcontractor has
       breached its representations in this Section, becomes excluded from
       participation in federal

                                      A-8
<PAGE>

       health care programs or has officers, directors or principals convicted
       of a felony, or Subcontractor fails to take immediate actions as required
       by the preceding sentence, then ALERE shall be permitted to terminate
       this Agreement, in its entirety or as to any relevant part, immediately
       upon the furnishing of written notice to Subcontractor and/or take such
       other corrective or remedial action as warranted under the circumstances.

2.3.12 ADDITIONAL STATE REGULATORY REQUIREMENTS. In addition to the foregoing,
       the Parties shall comply with any state regulatory requirements set forth
       in any applicable SOW ("Additional State Requirements").

2.3.13 SUSPENSION AND TERMINATION. Subcontractor, on behalf of itself and its
       Affiliates and Contractors, understands and agrees that if Subcontractor
       fails to perform its obligations under this Section 2.3, then ALERE shall
       have the right to suspend or terminate this Agreement or applicable SOW,
       in its entirety or as to any applicable service or function included
       within the Services. Any termination of this Agreement or a SOW shall be
       effective immediately upon the sending of written notice to Subcontractor
       unless such default or noncompliance with the obligations of this Section
       2.3 are curable and, in such event, this Agreement, the SOW or
       Contractor, as the case may be, shall only be terminated if Subcontractor
       fails to cure such default of noncompliance within thirty (30) days after
       receipt of written notice or within such lesser period of time as
       directed by a Governmental Authority.

2.4    FINES AND PENALTIES. As between Subcontractor and ALERE/Tufts and,
       Subcontractor shall be solely responsible for any fines or penalties
       arising out of or related to any noncompliance by Subcontractor with any
       Laws and Regulations applicable to Subcontractor, the performance of the
       Services or noncompliance with the obligations under Section 2.3 by
       Subcontractor.

2.5    ACCURACY OF DATA. Subcontractor shall be responsible for ensuring that
       all data and information submitted by Subcontractor to ALERE or Tufts, or
       generated or created by Subcontractor during the performance of its
       obligations under this Agreement is accurate, complete, provided in a
       timely manner and free from any errors when used or transmitted in
       connection with performance of the Services; provided, however that
       Subcontractor shall not be responsible for the use or re-transmission of
       data that was inaccurate when originally transmitted to Subcontractor by
       ALERE or Tufts. Subcontractor shall be responsible for correcting any
       errors or inaccuracies in any such data or information within the
       possession or control of Subcontractor promptly (but in no event more
       than two (2) business days) after learning of such errors or
       inaccuracies. Subcontractor's failure to comply with this Section shall
       constitute a material breach of this DMSA.

                                      A-9
<PAGE>

2.6    REPORTING REQUIREMENTS. Subcontractor shall be responsible for providing
       ALERE, Tufts, any Governmental Authorities or other Third Parties with
       all such standard and customized reports as may be required by each SOW,
       in accordance with the time requirements specified in such SOW. All such
       reports shall be accurate and complete when furnished and provided at
       Subcontractor's sole cost and expense unless otherwise expressly provided
       in the applicable SOW.

2.7    SUBCONTRACTOR ACCOUNT EXECUTIVE. During the Term and for so long as any
       SOW remains outstanding, Subcontractor shall designate and make available
       to ALERE an individual approved by ALERE (the "Subcontractor Account
       Executive") who will serve as primary liaison between Subcontractor and
       ALERE. The Subcontractor Account Executive shall (i) be the primary
       Subcontractor contact for ALERE with respect to all matters related to
       this Agreement, except as otherwise provided in any SOW, (ii) have
       overall responsibility for managing and coordinating the performance of
       the Services, and (iii) meet regularly (and as frequently as is needed)
       with the ALERE Representative. The Subcontractor Account Executive may
       designate in writing another individual to be the point of contact for
       ALERE with respect to the Services to be performed under a particular SOW
       so long as such individual is acceptable to ALERE.

2.8    ALERE REPRESENTATIVE. During the Term and for so long as any SOW remains
       outstanding, ALERE will designate an individual who will serve as primary
       liaison between Subcontractor and ALERE (the "ALERE Representative"). The
       ALERE Representative shall (i) be the primary ALERE contact for
       Subcontractor with respect to all matters related to this Agreement,
       except as otherwise provided in any SOW, (ii) have overall responsibility
       for managing and coordinating the performance of the Services, and (iii)
       meet regularly (and as frequently as is needed) with the Subcontractor
       Representative, and (iv) will have the necessary authority to make
       routine decisions with respect to actions to be taken by ALERE under this
       DMSA. The ALERE Representative may designate in writing (i) another
       individual to be the point of contact for Subcontractor with respect to
       the Services to be performed under a particular SOW, and (ii) a
       reasonable number of additional employees of ALERE to be points of
       contact for Subcontractor with respect to particular matters of expertise
       relating to one or more SOWs or particular geographic regions.

2.9    COMPENSATION RECORDS; AUDITS. Subcontractor shall maintain complete and
       accurate accounting records in accordance with GAAP as shall be necessary
       to substantiate all Service Fees, expense reimbursements or other
       Compensation paid under each SOW, (ii) each invoice submitted to or paid
       by ALERE(collectively, "Compensation Records"). Subcontractor shall
       provide the ALERE with access to all Compensation Records for purposes of
       audit or review, either through its own representatives or through an
       accounting firm selected and paid for by ALERE; provided, however, that
       in the event any

                                      A-10
<PAGE>

       audit demonstrates that Subcontractor owes ALERE, then such funds and the
       costs of the audit, should the amount owed ALERE be greater than
       $10,000,shall be subtracted from the next Subcontractor invoice/payment.
       Any such audit or review of Compensation Records shall be conducted at
       reasonable times during normal business hours and upon reasonable advance
       notice.

2.10   NO CONFLICT WITH PERFORMANCE. Under no circumstances shall Subcontractor
       engage in any work or undertaking that prevents Subcontractor from fully
       performing the Services in accordance with all requirements of this
       Agreement and each SOW.

2.11   COOPERATION. Subcontractor shall reasonably cooperate with ALERE, Tufts
       and any other vendor (including other disease management vendors) that
       any of them may use in connection with this DMSA or the operations of
       their Health Plans or other businesses without any additional charge,
       unless otherwise agreed by the Parties in writing; provided, however,
       that in so cooperating, Subcontractor shall not be required to take or
       forebear from taking any action that, absent appropriate safeguards and
       contractual protections, adversely affects the confidentiality or
       proprietary nature of r any Confidential Information of Subcontractor.

3      PERSONNEL REQUIREMENTS.

3.1    USE OF ACCEPTABLE PERSONNEL. Subcontractor shall make available
       appropriate staffing to perform the Services and to monitor and supervise
       such performance in accordance with all requirements of each SOW and this
       Agreement. Subcontractor shall employ or otherwise contract with
       sufficient numbers of trained, competent and qualified individuals as
       shall be necessary to perform the Services in accordance with the
       requirements of this Agreement and shall assign to the performance of the
       Services only personnel who are adequately and appropriately trained,
       competent and otherwise qualified to perform the Services. Each
       individual performing or supervising Services shall be legally qualified
       to be employed and to perform the Services in compliance with all
       applicable Laws and Regulations, including, without limitation, United
       States immigration laws.

3.2    STAFFING. In the event that ALERE is at any time dissatisfied for any
       reason with any of Subcontractor's personnel providing any of the
       Services (including the Subcontractor Account Executive), ALERE may give
       written notice to Subcontractor, setting forth in reasonable detail the
       reason(s) for such dissatisfaction. Upon receipt of ALERE's notice,
       Subcontractor will promptly meet with ALERE to determine by mutual
       agreement the appropriate course of action to take with respect to such
       personnel, which may include, without limitation, discontinuing the use
       of such objectionable personnel for the performance of any Services
       hereunder. ALERE's rights under this Agreement to object to certain
       Subcontractor personnel shall not

                                      A-11
<PAGE>

       relieve Subcontractor from its obligations to staff, supervise and
       monitor all Services in accordance with the requirements of each SOW and
       this Agreement.

3.3    TRAINING. Subcontractor, at its sole cost and expense, shall provide
       initial and on-going training to its personnel and Contractors who are
       engaged in the performance of Services hereunder. Subcontractor promptly
       shall incorporate into its training program any training materials
       furnished by ALERE, Tufts that may contain information regarding the
       Tuft's Health Plans or customer service policies.

3.4    USE OF CONTRACTORS. Except as otherwise provided herein, the consent of
       ALERE to any subcontracting of the Services to a Contractor shall not
       relieve Subcontractor from its responsibility for the performance of the
       Services required to be furnished to ALERE under this Agreement and the
       other obligations imposed upon Subcontractor hereunder. If the use of any
       other Contractors is approved, Subcontractor shall actively monitor,
       review and manage the performance of such Contractors and their
       subcontracts on a regular basis.

3.5    OBSERVANCE OF EMPLOYMENT RELATED LAWS. During any period in which
       Subcontractor is performing Services for ALERE, Subcontractor shall, and
       shall contractually require all Contractors to, comply with all labor and
       employment Laws and Regulations in respect of personnel, including,
       without limitation, Laws and Regulations relating to wages and hours,
       mandatory employee benefits, collective bargaining, unemployment
       insurance, workers' compensation, equal employment opportunity,
       occupational health and safety, severance and withholding and payment of
       social security contributions and employment taxes.

3.6    TRANSLATION. In the event translation services are necessary or
       appropriate to communicate with Members in connection with the
       performance of the Disease Management Services under this Agreement,
       Subcontractor shall be responsible for obtaining all such translation
       services so that Subcontractor may properly communicate with such
       Members. Subcontractor shall be solely responsible for all costs of such
       translation services.

4      LOCATIONS OF SERVICES.

       SERVICE LOCATIONS. Subcontractor shall perform the Services at the
       locations established in the applicable SOWs (the "Service Locations").
       In the event that Subcontractor or a Contractor relocates to another
       location or migrates all or any portion of the Services to another
       location, (i) Subcontractor shall be responsible for all costs associated
       with such relocation or migration, (ii) to the extent ALERE must incur
       any costs associated with the relocation or migration, Subcontractor
       shall reimburse ALERE for the amount of such costs

                                      A-12
<PAGE>

       within thirty (30) days after receipt of written demand therefore, (iii)
       Subcontractor shall continue to perform all Services, directly or through
       arrangements with Authorized Contractors, in accordance with the
       requirements of applicable SOWs and this Agreement without reduction of
       any service level standard, and (iv) such relocation or migration shall
       not disrupt or interfere with the operation of the ALERE's business, the
       Health Plans or Tuft's business.

       SAFETY AND SECURITY PROCEDURES. Subcontractor shall maintain and enforce
       at the Service Locations reasonable and appropriate safety and security
       procedures, with respect to the Subcontractor Systems and the storage and
       transmission of Tufts Data. Subcontractor shall adopt current industry
       standards and practices to safeguard the security, confidentiality and
       integrity of Tufts Data (including PHI) located on or transmitted through
       the Subcontractor Systems. The safety and security procedures for
       telecommunications operations used in the transmission of any Tufts Data
       by Subcontractor or its Contractors shall protect the Tufts Data and
       other information of Tufts, and the Members from unauthorized access.

4.1    -COMPLIANCE WITH PRIVACY, CONFIDENTIALITY AND SECURITY LAWS. Without
       limiting the generality of any other provision of this Agreement,
       Subcontractor, at its sole cost and expense, shall comply with, shall
       cause its Contractors comply with, and shall cause the Subcontractor
       Systems and all electronic or other transactions processed in connection
       with the Services (whether by Subcontractor or a Contractor) comply with
       all applicable provisions of: (i) HIPAA and the HIPAA Regulations; (ii)
       the GLB, if applicable; (iii) the HCFA Internet Security Policy; (iv) any
       other current or, when applicable, future Laws and Regulations relating
       to the privacy, confidentiality, security, integrity, transmission or
       exchange of Tufts Data, PHI or medical, personal, consumer or financial
       information of Members, including, but not limited to, Laws and
       Regulations relating to the maintenance, use, transmission (by any
       means), exchange or other activity concerning patient records,
       confidentiality of medical data, the security and protection of PHI; (v)
       any other applicable privacy, security or electronic data transmission
       standards included within HIPAA and the HIPAA Regulations, and (vi) any
       business associate agreement or trading partner agreement entered into
       between Subcontractor and ALERE or with any Authorized Contractor in
       connection with this Agreement or otherwise. Subcontractor shall comply
       at all times (during and after the Term) with all requirements of the
       Business Associate Agreement, in the form attached to this DMSA as
       EXHIBIT C, and shall cause any Contractor to execute a business associate
       agreement in the same form if such Contractor may have access to or may
       be exposed to PHI or if directed by ALERE. Upon ALERE's request,
       Subcontractor shall enter into, and shall cause any Contractor to enter
       into, such updated, amended or modified form of Business Associate
       Agreement as ALERE may require or adopt for use with its vendors and
       business associates.

                                      A-13
<PAGE>

5      PERFORMANCE TARGETS; SERVICE LEVEL STANDARDS; MEMBER GRIEVANCES.

5.1    SERVICE LEVEL STANDARDS AND PERFORMANCE TARGETS. Subcontractor agrees
       that the Disease Management Services shall be performed, by Subcontractor
       in a manner that meets or exceeds the Service Level Standards and
       Performance Targets, if any, established in each applicable SOW and
       Annual Plan. Subcontractor acknowledges and agrees that Service Level
       Standards and Performance Targets may be specific to and different for
       each SOW, each Health Plan, and each different Disease Management Service
       to be performed, directly or indirectly, by Subcontractor hereunder.
       Subcontractor acknowledges and agrees that, unless otherwise specified in
       a SOW, meeting all Service Level Standards and Performance Targets is a
       material obligation under this Agreement and that the failure to satisfy
       Service Level Standards or failure to reach Performance Targets, by
       Subcontractor or any Contractor, may result in the termination by ALERE
       of all or part of this Agreement or any applicable SOW as specifically
       permitted in this Agreement or applicable SOW.

5.2    ANNUAL PLAN. The Parties shall establish a mutually acceptable annual
       plan establishing the goals and Performance Targets applicable to the
       performance of Disease Management Services under each SOW (the "Annual
       Plan"). The Parties shall work cooperatively and in good faith to
       establish an Annual Plan no later than thirty (30) days prior to the
       commencement of each annual period under any outstanding SOW commencing
       on the anniversary date of the SOW Effective Date.

5.3    MEMBER AND PROVIDER GRIEVANCE PROCEDURES. Subcontractor shall use
       reasonable business efforts to assist ALERE and/or Tufts in the handling
       of Member complaints, grievances and appeals, consistent with the
       involved Member Appeal and Grievance Procedures, to the extent they arise
       out of this Agreement or any Services. In the event that an oral or
       written complaint, grievance or appeal is presented to Subcontractor,
       Subcontractor will immediately deliver such complaint, grievance or
       appeal to ALERE for handling. Subcontractor shall comply with all final
       determinations made by Tufts through the involved Member Appeal and
       Grievance Procedures. Member claims against Subcontractor, other than
       claims for benefits under the Health Plans, are not subject to the Member
       Appeals and Grievances Procedures and are not governed by this DMSA.

6      QUALITY STANDARDS AND CONTINUOUS IMPROVEMENT. Subcontractor, in
       cooperation with ALERE and subject to ALERE's reasonable satisfaction,
       shall as part of the Services as defined under the SOW or any future
       mutually agreeable standards, develop and implement quality improvement
       standards, monitoring programs and protocols with respect to the Disease
       Management Services.

7      COMPENSATION FOR SERVICES.

                                      A-14
<PAGE>

7.1    SERVICE FEES. All provisions for billing and payment of Service Fees and
       expense reimbursement for the Services to be furnished to ALERE under
       this Agreement will be set forth in the SOW (including any fee schedule
       attached thereto) applicable to the Services and Tufts Affiliate for
       which such compensation and reimbursement is made; provided, however,
       that, in all cases, payment of the Service Fees and expense reimbursement
       is conditioned upon timely and satisfactory delivery of the Services in
       accordance with the SOW to which such Service Fees relate and the other
       requirements of this Agreement.

7.2    DISPUTED AMOUNTS. ALERE shall be permitted to withhold payment of any
       amounts, invoiced to or otherwise payable by ALERE pursuant to this
       Agreement that ALERE, in good faith, disputes or contests ("Disputed
       Amounts"), either by deducting the Disputed Amount from ALERE's payment
       on such invoice or payment due or by recouping the Disputed Amount
       against future Service Fees or other amounts owing for Services furnished
       or arranged by Subcontractor pursuant to this Agreement. However, Dispute
       Amounts may only be withheld and deducted by ALERE to the extent that the
       aggregate amounts so withheld do not at any time exceed twenty-five
       percent (25%) of the total annual aggregate compensation payable to
       Subcontractor pursuant to this Agreement (if ALERE wishes to dispute a
       greater amount, it shall pay the disputed invoices and refer the matter
       to arbitration hereunder) and ALERE has delivered to Subcontractor
       written notice (a "Payment Dispute Notice") setting forth a detailed
       explanation of the factual basis for the dispute. To contest any such
       withheld, offset or recouped amounts, Subcontractor shall, within ten
       (10) business days following receipt of the Payment Dispute Notice,
       provide the ALERE Representative with a detailed written explanation of
       the factual basis upon which Subcontractor, in good faith, contests the
       Payment Dispute Notice. Thereafter, the Parties shall negotiate in good
       faith to resolve all issues raised by the Payment Dispute Notice. In the
       event that ALERE and Subcontractor are unable to resolve the dispute
       within ten (10) business days following from the date of Subcontractor's
       response, either Party may proceed to arbitration as provided herein.
       Subcontractor acknowledges that all recoupment, withhold and offset
       rights authorized by this Agreement shall be deemed to be and to
       constitute rights of recoupment authorized in state or federal law or in
       equity to the maximum extent possible under law or in equity and that
       such rights shall not be subject to any requirement or prior or other
       approval from any court or other Government Authority that may now or
       hereafter have jurisdiction over ALERE or Subcontractor.

7.3    ADEQUATE COMPENSATION. Subcontractor hereby agrees that its execution of
       any SOW or commencement of any Services contemplated therein shall
       constitute Subcontractor's agreement that any Service Fees or other
       compensation, expense reimbursements or other amounts owing to
       Subcontractor in respect of the Services or Deliverables described in
       such SOW (i) are adequate and appropriate for such Services or
       Deliverables, (ii)

                                      A-15
<PAGE>

       will be accepted by Subcontractor in full and complete satisfaction and
       discharge of any and all monetary or non-monetary obligations owed to
       Subcontractor by ALERE in respect of such Services and Deliverables and
       (iii) represent the reasonable and fair market value for the Services and
       Deliverables being furnished by Subcontractor pursuant to such SOW.
       Nothing contained in this Agreement or in any SOW shall confer upon
       Subcontractor any right, in consideration or in respect of any Services
       or Deliverables, to receive additional amounts, benefits, profits or
       other economic consideration derived from ALERE's present or prospective
       operations or from any present or prospective venture, enterprise or
       business in which ALERE now or hereafter may engage.

7.4    PASS-THROUGH EXPENSES. Any pass-through expenses of Subcontractor that
       will be the financial responsibility of ALERE must be expressly
       identified in a SOW, shall remain subject to the prior written approval
       of ALERE, and shall be reimbursed by ALERE at the actual cost thereof to
       Subcontractor without any markup.

7.5    TAXES. Each Party shall be responsible for all Taxes and other charges
       levied on its business or product(s). Subcontractor shall pay, or
       reimburse and indemnify ALERE, for all Taxes imposed in connection with
       Subcontractor's provision of the Services, excluding Taxes based upon
       ALERE's gross or net income.

8      REPRESENTATIONS, WARRANTIES AND COVENANTS.

       Subcontractor represents, warrants and covenants to ALERE as follows:

8.1    AUTHORITY. Subcontractor has the full power and authority to enter into
       this DMSA and will have the full power and authority to enter into every
       SOW executed by Subcontractor and to perform all Services and comply with
       all terms and satisfy all conditions set forth in this DMSA. This DMSA
       and each current and future SOW will be executed by a duly authorized
       representative of Subcontractor and, when so executed, shall constitute
       the valid and binding obligation of Subcontractor, enforceable against
       Subcontractor in accordance with its terms, subject to applicable
       bankruptcy, insolvency, reorganization and other laws of general
       applicability relating to or affecting creditors' rights and to general
       equity principles.

8.2    LICENSURE. Subcontractor will maintain throughout the Term all licenses,
       permits, certificates, approvals, authorizations, registrations,
       accreditations and qualifications (collectively, "Authorizations")
       necessary for Subcontractor to provide the Services and Deliverables
       pursuant to this DMSA, and all such Authorizations shall be and remain
       valid, subsisting and in good standing during the Term. In addition to
       the Authorizations required by the preceding sentence, Subcontractor is
       and shall remain during the Term duly and validly licensed, approved,
       authorized, registered, accredited and qualified to do

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       business and in good standing in every jurisdiction in which any
       Authorization is required for the ownership or leasing of its assets and
       the transaction of business of the character transacted by it, including,
       without limitation, the performance of the Services and furnishing of the
       Deliverables as required hereunder. No approval, authorization or consent
       of any Governmental Authority is or shall be required for Subcontractor
       to enter into and perform its obligations under this Agreement that has
       not been obtained prior to the Effective Date or the applicable SOW
       Effective Date.

8.3    PERFORMANCE OF SERVICES. Subcontractor possesses and shall maintain
       staffing and administrative capacity, and financial, operational and
       information technology resources (collectively, "Capacity and Resources")
       necessary to perform all Services under this Agreement in accordance with
       the terms and conditions hereof. All Services shall be performed or
       delivered (i) in a good, professional and workmanlike manner by personnel
       who are fully qualified and competent to perform or deliver such
       Services, without the advice, control or supervision of ALERE, (ii) in
       accordance with generally accepted professional and technical standards
       applicable to such Service; and (iii) in accordance with all Laws and
       Regulations and requirements of Governmental Authorities applicable to
       them. No Services or Deliverables shall infringe upon or violate any
       Intellectual Property Rights of a Third Party.

8.4    RIGHTS IN PRE-EXISTING INTELLECTUAL PROPERTY. To the extent that the
       performance of any Service or delivery of any Deliverable under this
       Agreement involves Subcontractor's license or assignment to ALERE of
       Pre-Existing Intellectual Property, (i) Subcontractor owns or has
       sufficient legal rights in and to the Pre-Existing Intellectual Property
       to perform all such Services and deliver all such Deliverables; (ii)
       Subcontractor has all requisite power, authority and legal rights to
       license or assign such Pre-Existing Intellectual Property to ALERE as
       shall be necessary for ALERE to use the Services or Deliverables
       furnished by Subcontractor without limitation or restriction and without
       infringing upon or violating the Intellectual Property Rights of any
       Third Party; and (iii) ALERE's or Tuft's use of any IT Development Work
       or other Deliverable will not result in any additional fees, charges,
       licenses or penalties payable by ALERE or Tufts.

8.5    VIRUSES; DISABLING CODES. To the best of its ability (which shall include
       no less than commercially reasonable efforts), Subcontractor will ensure
       that no software (including any Subcontractor interfaces facilitating
       transmission of data between Subcontractor, Tufts, and/or ALERE)
       furnished or developed by Subcontractor in respect of any IT Development
       Work or licensed, assigned or used in connection with any Services or
       Deliverables will contain any "virus" or other computer software routine
       or hardware components which are designed to (i) permit any unintended
       Third Party access to or use of any software or systems developed for
       ALERE or Tufts to their systems, (ii) disable or damage hardware or
       damage, erase or delay access to software or data or (iii) perform any
       other similar destructive or malicious actions.

                                      A-17
<PAGE>

       With respect to the development or use of any software (including any
       Subcontractor interfaces facilitating transmission of data between
       Subcontractor, Tufts, and/or ALERE) or software systems in connection
       with Subcontractor's performance and delivery of any Services or
       Deliverables (including, without limitation, in connection with the
       Subcontractor Systems), Subcontractor will not, nor permit any employee
       or Contractor to, insert into such software or systems any code or other
       device which would have the effect of disabling, damaging, erasing,
       delaying or otherwise shutting down all or any hardware, software,
       systems or data belonging to, claimed by or in the possession of Tufts or
       Alere. Subcontractor will not invoke, and will use all commercially
       reasonable efforts to prevent any employee or Contractor from invoking,
       any such code or other device.

8.6    PASS-THROUGH WARRANTIES AND INDEMNITIES. In connection with the Services
       performed under any SOW or this Agreement, Subcontractor hereby assigns
       and passes through to ALERE, and Tufts any representations, warranties,
       indemnities or other rights or protections (collectively, "Warranties")
       which from time to time may inure to Subcontractor from owners, vendors
       or licensors of any Pre-Existing Intellectual Property, from owners,
       vendors or lessors of equipment or from Contractors, to the full extent
       of such Warranties. All such Warranties that relate to any products or
       services that comprise part of any Services or Deliverables shall be
       reasonably acceptable to ALERE. To the extent that any such Warranties
       cannot be assigned or passed through as provided, Subcontractor shall
       take all commercially reasonable steps to enforce such rights and seek
       appropriate remedies in Subcontractor's own name for the benefit of the
       other parties.

ALERE represents, warrants and covenants to Subcontractor as follows:

8.7    AUTHORITY. ALERE has the full power and authority to enter into this DMSA
       and will have the full power and authority to enter into every SOW
       (unless ALERE determines that any particular SOW or SOWs must be executed
       separately by a particular Tufts Affiliate) and comply with all terms and
       satisfy all conditions set forth in this Agreement. This DMSA and each
       current and future SOW will be executed by a duly authorized
       representative of ALERE and, when so executed, shall constitute the valid
       and binding obligations of ALERE, enforceable in accordance with their
       terms, subject to applicable bankruptcy, insolvency, reorganization and
       other laws of general applicability relating to or affecting creditors'
       rights and to general equity principles.

8.9    COOPERATION. ALERE shall use reasonable business efforts to facilitate
       the performance by Subcontractor of the Services under this DMSA and any
       SOW, and ALERE, through its arrangements with Tufts, shall cause Tufts to
       provide all information and take all actions necessary for Subcontractor
       to provide its Services hereunder.

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<PAGE>

9      INFORMATION AND TELECOMMUNICATIONS TECHNOLOGY AND EQUIPMENT. Except as
       expressly provided to the contrary in any SOW, Subcontractor shall, at
       its sole cost and expense, provide, obtain and maintain all
       telecommunications service, equipment, hardware, lines and line usage
       necessary or appropriate for provision of the Services. In the event that
       ALERE is responsible for paying for any telecommunications services or
       equipment in connection with the Services, ALERE shall have the right to
       pre-approve the telecommunications service provider and the rates payable
       by ALERE, which rates shall be set forth in a SOW executed by ALERE. Any
       hardware or other fixed assets provided or paid for by ALERE for
       installation at Subcontractor's premises shall remain the sole property
       of ALERE and shall be returned to ALERE at its request or upon the
       expiration or earlier termination of this DMSA or applicable SOW.
       Subcontractor shall not make any changes or modifications to, or
       substitutions for, such ALERE purchased or provided hardware or fixed
       assets without the prior consent of ALERE, which consent may be given or
       withheld in ALERE's sole discretion.

10     CHANGE ORDER PROCESS. ALERE may request that Subcontractor make material
       changes to a SOW by giving written notice to Subcontractor setting forth
       in reasonable detail all requested changes (a "Change Order Request").
       Within seven (7) business days (or such longer period as the Parties may
       agree in writing) after Subcontractor's receipt of a Change Order
       Request, Subcontractor shall provide ALERE with a written proposal (a
       "Change Order Proposal") setting forth in reasonable detail all changes
       necessary to effect or that may result from the Change Order Request,
       including, without limitation, modifications to Services, Service Level
       Standards or Performance Targets, the additional cost for or cost savings
       from effecting the requested changes (if any), the time required to
       effect the Change Order Request, and any reasonably foreseeable
       consequences to Members, Services or the Parties resulting from effecting
       the Change Order Request. Subcontractor shall not initiate any change
       pursuant to a Change Order Request until the Parties memorialize all
       agreed-upon portions of the Change Order Proposal in a written amendment
       to the applicable SOW or in a new SOW, at which time such amendment or
       new SOW shall become a part and subject to all of the terms and
       conditions of this DMSA. Notwithstanding the foregoing, the following
       changes requested by ALERE shall not be subject to the change order
       requirements of this Section, and shall be effected by Subcontractor as
       expeditiously as possible (but no later than thirty (30) days) following
       request by ALERE: (i) immaterial changes to the Services, Service Level
       Standards or Performance Targets mutually agreed to by the Parties; and
       (ii) changes necessary to bring the Services in compliance with
       applicable Laws and Regulations (including, without limitation, Privacy
       Laws), standards of Accreditation Organizations; provided that
       Subcontractor may, in lieu of making the changes set forth in (ii) above,
       Subcontractor may elect to terminate the Agreement by giving Alere not
       less than thirty (30) days prior written notice of termination.

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<PAGE>

11     PROTECTION OF INFORMATION; NONSOLICITATION. The Parties agree as follows:

11.1   CONFIDENTIALITY OBLIGATIONS OF THE PARTIES. Each of Subcontractor and
       ALERE (each, a "Receiving Party") receiving or having access to
       Confidential Information of the other Party (or in Subcontractor's case,
       the Confidential Information of Tufts) (the "Disclosing Party") shall use
       commercially reasonable efforts to protect and maintain the
       confidentiality and, to the extent applicable, proprietary character, of
       such Disclosing Party's Confidential Information by, among other things:
       (i) treating such information with at least the same standard of care and
       protection that the Receiving Party accords its own Confidential
       Information, which shall be no less than a commercially reasonable
       standard; (ii) using great care in the assignment of personnel and
       contractors who have access to Confidential Information and obtaining the
       written agreement of all such personnel and contractors to take all
       reasonable precautions to prevent unauthorized use or disclosure thereof;
       (iii) not using, disclosing or exploiting such Confidential Information
       except as reasonably necessary to perform its duties and obligations
       under a SOW or this Agreement; and (iv) complying with any Laws and
       Regulations applicable to the Confidential Information, including
       following directives or recommendations from Governmental Authorities
       exercising jurisdiction over, or Accreditation Organizations adopting
       standards for ALERE, Tufts, the Health Plans, the Services or the Service
       Location(s). Furthermore, no Receiving Party shall disclose, publish,
       release, transfer or otherwise make available Confidential Information of
       the Disclosing Party in any form whatsoever to, or for the use or benefit
       of, the Receiving Party or a Third Party without the Disclosing Party's
       prior written consent; provided, however, that a Receiving Party may
       disclose relevant aspects of the Disclosing Party's Confidential
       Information to the Receiving Party's officers, agents, subcontractors and
       employees and to the officers, agents, subcontractors and employees of
       its Affiliates to the extent that such disclosure is reasonably necessary
       for the performance of the Receiving Party's duties and obligations under
       this Agreement; provided, further, that the Receiving Party shall take
       all reasonable measures to ensure that Confidential Information of the
       Disclosing Party is not disclosed or duplicated in contravention of the
       provisions of this DMSA by such Persons; and provided, further, that the
       Receiving Party shall be responsible for any breach of the provisions of
       this Section by such Persons. The obligations imposed on the Parties in
       this Section shall not restrict disclosures made by the Receiving Party
       that are compelled by applicable Laws and Regulations (including
       disclosures required by CMS or other Governmental Authorities in
       connection with an audit, investigation or otherwise), court order or the
       order of a Governmental Authority with competent jurisdiction over the
       Receiving Party; provided that the Receiving Party being compelled to
       disclose any such information shall give prompt notice thereof after
       learning of the need therefore to the Disclosing Party (if allowed by
       law) and shall disclose only that portion of the Disclosing Party's
       Confidential Information which the

                                      A-20
<PAGE>

       Receiving Party's outside legal counsel advises is necessary to comply
       with such Laws and Regulations, court order or Governmental Authority
       order.

11.2   DETERMINATION OF CONFIDENTIAL INFORMATION. As used in this DMSA, the term
       "Confidential Information" shall mean: (i) the existence and terms
       (including, but not limited to, the pricing terms) of this DMSA and all
       SOWs, which shall be confidential to both Parties; (ii) all material,
       non-public information, materials or data in any form (whether disclosed
       before or after the Effective Date or whether oral, written, graphic,
       electronic, visual or fixed in any other tangible medium of expression)
       which the Receiving Party knows or has reason to know is confidential or
       proprietary to the Disclosing Party or its Related Party; (iii) any other
       information which is clearly marked or designated as "Confidential,"
       "Proprietary" or "Secret" by the Disclosing Party or a Related Party
       thereof; (iv) the trade secrets, know how, technology, inventions
       (whether or not patented), software programs, source or object codes,
       algorithms, technical drawings, schematics, formulae and technology plans
       and specifications (whether, in the case of any of the foregoing, they
       are owned, licensed or used by the Disclosing Party); and (v) current and
       future business plans, marketing plans and strategies, business methods
       and practices, business workflows and rules, matrices, customer or
       prospect data, records, information and profiles, supplier or vendor
       information and data, historical or prospective financial information,
       budgets, cost and expense data and employment records and contracts and
       personnel information of the Disclosing Party or of its Related Parties.
       Notwithstanding the foregoing provisions of this Section, "Confidential
       Information" shall not include any information (1) after it has become
       generally available to the public through no fault of the Receiving Party
       and without a breach of this Agreement, or (2) which can be demonstrated
       by the Receiving Party was developed independently or in its possession
       prior to entering into this DMSA so long as, in either case, the
       Receiving Party did not acquire such information from a source which had
       a fiduciary, confidential or contractual duty to the Disclosing Party to
       maintain such information as confidential.

11.3   CONFIDENTIALITY OF PATIENT RECORDS AND PHI. Subcontractor acknowledges
       that, in the performance of the Services, Subcontractor will have access
       to Member-identifiable information and PHI which is transmitted via or
       obtained through Subcontractor's performance of the Services, or stored
       on, or accessible via, the Subcontractor Systems. Subcontractor
       understands that such identifiable information and PHI are protected by
       various state and Federal Laws and Regulations, including, but not
       limited to, the HCFA Internet Security Policy, HIPAA and the HIPAA
       Regulations (collectively, all such state and Federal Laws and
       Regulations, "Privacy Laws"). Subcontractor understands and agrees that
       any medical information or PHI accessed by or disclosed to it or its
       Contractors during the course of performing any Services or otherwise
       must be maintained in strictest confidence. Accordingly, except as
       absolutely necessary to provide the Services and permitted by the
       Business Associate Agreement, Subcontractor

                                      A-21
<PAGE>

       shall not disclose (except to ALERE and Tufts), divulge, use or
       commercially or otherwise exploit any such medical information or PHI for
       any purpose or under any circumstance, and shall comply with all state
       and Federal Laws and Regulations applicable to Subcontractor regarding
       the security, confidentiality and transmission of such information
       including, but not limited to, the Privacy Laws (including those rules,
       regulations and standards that Tufts , as a Covered Entity (as defined in
       HIPAA), must impose upon ALERE and/or Subcontractor, as a Business
       Associate (as defined in HIPAA)). Subcontractor shall require all of its
       personnel and to contractually require all of its Contractors to fully
       abide by the provisions of this Section and Subcontractor shall be
       responsible for any breach by its personnel or Contractors of this
       Section. In the event of a breach of the provisions of this Section,
       ALERE may terminate this DMSA and any and all SOWs as provided in Section
       13.2.4.

11.4   RETURN OF CONFIDENTIAL INFORMATION. Upon termination of this DMSA for any
       reason whatsoever or at any time upon the Disclosing Party's request, the
       Receiving Party immediately shall return all Confidential Information of
       the Disclosing Party within the possession or control of the Receiving
       Party or its personnel, Related Parties or Contractors. In the event that
       any Confidential Information is contained in analyses, compilations,
       studies or other documents prepared by the Receiving Party, its
       personnel, its Related Parties or its Contractors, the Receiving Party
       agrees to promptly destroy, and to instruct its personnel, Related
       Parties and Contractors to destroy, all such items where feasible, and
       certify in writing to the Disclosing Party that such destruction has
       occurred. To the extent that the Receiving Party is required to retain
       the Confidential Information to comply with any record retention
       requirement set forth herein or to comply with (i) any standard of an
       Accreditation Organization applicable to ALERE, Subcontractor or Tufts,
       or (ii) any Laws and Regulations, the Receiving Party shall so notify the
       Disclosing Party; in such event, the Receiving Party may retain the
       Confidential Information solely for such purposes and the Confidential
       Information shall remain subject to the restrictions on use and
       disclosure set forth herein until returned to the Disclosing Party or
       destroyed.

11.5   SURVIVAL. The provisions of this Section shall survive the expiration or
       termination of any SOW and this DMSA.

12     INTELLECTUAL PROPERTY RIGHTS. The Parties agree as follows:

12.1   ALERE MARKS AND CONTENT. Alere owns and shall remain the sole and
       exclusive owner of all right, title and interest in and to the Alere
       Marks and Alere Content, and of all Intellectual Property Rights in and
       derivative works of the Alere Marks and the Alere Content. Subcontractor
       is not granted any right or license to, and shall not use, the Alere
       Marks or Alere Content in any manner or for any purpose except as may be
       agreed in writing in advance by Alere (including in any SOW).
       Subcontractor agrees not to assert any rights

                                      A-22
<PAGE>

       in or to any Alere Marks or Alere Content except as granted to
       Subcontractor pursuant to this Agreement or as otherwise may be granted
       in writing by Alere to Subcontractor. Without express prior written
       authorization from ALERE, Subcontractor shall not use any Alere Marks or
       other words or phrases identifying Alere or any Alere Affiliate in any
       promotional or other materials of Subcontractor nor otherwise publicly
       identify ALERE or refer to the existence or terms of this Agreement in
       any public announcement, press release, promotional or other material.

12.2   SUBCONTRACTOR MARKS AND CONTENT. Subcontractor owns and shall remain the
       sole and exclusive owner of all right, title and interest in and to the
       Subcontractor Marks and Subcontractor Content, and of all Intellectual
       Property Rights in and derivative works of the Subcontractor Marks and
       the Subcontractor Content. Alere is not granted any right or license to,
       and shall not use, the Subcontractor Marks or Subcontractor Content in
       any manner or for any purpose except as may be agreed in writing in
       advance by Subcontractor (including in any SOW). Alere agrees not to
       assert any rights in or to any Subcontractor Marks or Subcontractor
       Content except as granted to Alere pursuant to this Agreement or as
       otherwise may be granted in writing by Subcontractor. Without express
       prior written authorization from Subcontractor, ALERE shall not use any
       Subcontractor Marks or other words or phrases identifying Subcontractor
       in any promotional or other materials of Subcontractor nor otherwise
       publicly identify Subcontractor or refer to the existence or terms of
       this Agreement in any public announcement, press release, promotional or
       other material for any other purpose.

12.3   TUFTS MARKS AND CONTENT. Tufts owns and shall remain the sole and
       exclusive owner of all right, title and interest in and to the Tufts
       Marks and Tufts Content, and of all Intellectual Property Rights in and
       derivative works of the Tufts Marks and the Tufts Content. Subcontractor
       is not granted any right or license to, and shall not use, the Tufts
       Marks or Tufts Content in any manner or for any purpose except (i) as
       necessary to perform the Services and to communicate with third parties
       on Tuft's behalf as directed by Tufts or Alere, and (ii) as may be agreed
       in writing (including in any SOW) in advance by Tufts. Except as granted
       to Subcontractor in this Agreement, Subcontractor shall not assert any
       rights in or to any Tufts Marks or Tufts Content. Any and all uses of the
       Tufts Marks and Tufts Content by Subcontractor in connection with the
       Services or otherwise shall inure to the sole benefit of Tufts. Without
       express prior written authorization from Tufts, Subcontractor shall not
       use any Tufts Marks or other words or phrases identifying Tufts or any
       Tufts Affiliate in any promotional or other materials of Subcontractor
       nor otherwise publicly identify Tufts or refer to the existence or terms
       of this Agreement in any public announcement, press release, promotional
       or other material.

12.4   ALERE DEVELOPED MATERIALS. Alere shall be the sole and exclusive owner of
       all rights in and to any of the Alere Developed Materials. In the event
       that

                                      A-23
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       Subcontractor participates in the making, creation, authorship,
       conception or development of any Alere Developed Materials, such Alere
       Developed Materials shall be considered a "work made for hire" to the
       fullest extent permitted by the U.S. Copyright Act. However, without
       further consideration, upon execution of this Agreement, Subcontractor,
       on behalf of itself and its personnel and agents, hereby fully and
       irrevocably assigns, transfers and conveys to Alere all of the right,
       title and interest of Subcontractor in and to the Alere Developed
       Materials (whether or not a work made for hire) effective automatically
       upon the development, creation, authorship or inception of any Alere
       Developed Materials, together with all Intellectual Property Rights in or
       to such Alere Developed Materials and derivative works thereof.
       Subcontractor shall cause any of its personnel involved in any Alere
       Developed Materials to execute any assignments, conveyances, documents of
       transfer or releases to give full legal effect to such assignment and
       conveyance of their respective rights or interests (if any) in any Alere
       Developed Materials or to otherwise fully effectuate Alere's exclusive
       ownership rights in and to the Alere Developed Materials and any
       derivative works thereof. Subcontractor agrees not to assert any rights
       in or to any Alere Developed Materials or their Intellectual Property
       Rights except as may be expressly granted by this Agreement.
       Subcontractor, on behalf of itself and its Affiliates, shareholders,
       predecessors, successors, successors-in-interest, assigns, directors,
       employees, contractors and agents, hereby forever and fully releases and
       discharges Alere from any known or unknown, foreseeable or unforeseeable
       claims, demands, lawsuits, causes of action or payments arising from any
       rights or ownership which they now or hereafter may allege in or to any
       of the Alere Developed Materials or the Intellectual Property Rights
       therein. It is expressly understood that Section 1542 of the Civil Code
       of California provides as follows:

       "A general release does not extend to claims which the creditor does not
       know or suspect to exist in his favor at the time of executing the
       release, which if known by him must have materially affected his
       settlement with the debtor."

       The provisions of said Section 1542 of the Civil Code of California, as
       well as the provisions of all comparable, equivalent or similar statutes
       and principles of common law of California and of other states of the
       United States, are hereby waived by Subcontractor.

       Notwithstanding the foregoing, the Parties expressly agree that
       Subcontractor shall be entitled to use and reproduce, on a royalty-free
       basis, any of the Alere Developed Materials in connection with
       Subcontractor's performance of its duties, obligations and
       responsibilities under this Agreement.

12.5   SUBCONTRACTOR DEVELOPED MATERIALS. Subcontractor shall be the sole and
       exclusive owner of all rights in and to any of the Subcontractor
       Developed Materials. In the event that Alere participates in the making,
       creation, authorship, conception or development of any Subcontractor
       Developed Materials, such Subcontractor Developed Materials shall be
       considered a

                                      A-24
<PAGE>

       "work made for hire" to the fullest extent permitted by the U.S.
       Copyright Act. However, without further consideration, upon execution of
       this Agreement, Alere, on behalf of itself and its personnel and agents,
       hereby fully and irrevocably assigns, transfers and conveys to
       Subcontractor all of the right, title and interest of Alere in and to the
       Subcontractor Developed Materials (whether or not a work made for hire)
       effective automatically upon the development, creation, authorship or
       inception of any Subcontractor Developed Materials, together with all
       Intellectual Property Rights in or to such Subcontractor Developed
       Materials and derivative works thereof. Alere shall cause any of its
       personnel involved in any Subcontractor Developed Materials to execute
       any assignments, conveyances, documents of transfer or releases to give
       full legal effect to such assignment and conveyance of their respective
       rights or interests (if any) in any Subcontractor Developed Materials or
       to otherwise fully effectuate Subcontractor's exclusive ownership rights
       in and to the Subcontractor Developed Materials and any derivative works
       thereof. Alere agrees not to assert any rights in or to any Subcontractor
       Developed Materials or their Intellectual Property Rights except as may
       be expressly granted by this Agreement. Alere, on behalf of itself and
       its Affiliates, shareholders, predecessors, successors,
       successors-in-interest, assigns, directors, employees, contractors and
       agents, hereby forever and fully release and discharge Subcontractor from
       any known or unknown, foreseeable or unforeseeable claims, demands,
       lawsuits, causes of action or payments arising from any rights or
       ownership which it now or hereafter may allege in or to any of the
       Subcontractor Developed Materials or the Intellectual Property Rights
       therein. It is expressly understood that Section 1542 of the Civil Code
       of California provides as follows:

       "A general release does not extend to claims which the creditor does not
       know or suspect to exist in his favor at the time of executing the
       release, which if known by him must have materially affected his
       settlement with the debtor."

       The provisions of said Section 1542 of the Civil Code of California, as
       well as the provisions of all comparable, equivalent or similar statutes
       and principles of common law of California and of other states of the
       United States, are hereby waived by Alere.

       Notwithstanding the foregoing, it is expressly agreed that Alere shall be
       entitled to use and reproduce, on a royalty-free basis, any of the
       Subcontractor Developed Materials in connection with Alere's performance
       of its duties, obligations and responsibilities under this Agreement.

12.6   SURVIVAL. The provisions of this Section 12 shall survive the expiration
       or termination of any SOW and this DMSA.

13     TERMINATION OF AGREEMENT.

13.1   TERM AND DURATION. The initial term of this DMSA shall commence on the
       Effective Date and continue for a period of one (1) year thereafter until
       12:00

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<PAGE>

       midnight on the last day of such period (the "Initial Term") unless
       terminated earlier pursuant to the provisions of this Section or as
       permitted elsewhere in this DMSA. Any termination or nonrenewal of this
       DMSA shall terminate the entire Agreement, including all then-outstanding
       SOWs; provided, however, that any provisions contained in this DMSA
       (including, without limitation any SOW) that expressly survive
       termination of this DMSA shall survive any such termination or
       nonrenewal.

13.2   TERMINATION OF DMSA OR SOW.

13.2.1 FOR CAUSE. In the event that either ALERE or Subcontractor (i) fails or
       is unable to perform the obligations, duties or responsibilities required
       of it under any SOW or this Agreement, (ii) otherwise violates a material
       term of this Agreement, or (iii) engages in conduct in connection with
       this Agreement or any Services that is grossly negligent or amounts to
       willful misconduct (each a "Default"), the non-Defaulting Party, at its
       election, may terminate either this DMSA (in its entirety) or the
       applicable SOW, by giving thirty (30) days prior written notice to the
       Defaulting Party (a "Default Notice"). Any Default Notice provided
       hereunder shall specify in reasonable detail the nature of the Default,
       the actions required to cure the Default if it is curable, and whether
       the non-Defaulting Party is seeking to terminate the entire DMSA or only
       the applicable SOW(s). If the Defaulting Party fails or is unable to cure
       the Default to the reasonable satisfaction of the non-Defaulting Party
       within thirty (30) days following the date of the Default Notice, then
       this DMSA or the applicable SOW, as the case may be, shall be terminated
       upon the expiration of said 30-day period, or at such later date as may
       be specified in the Default Notice.

13.2.2 AUTOMATIC TERMINATION. To the fullest extent permitted by applicable Laws
       and Regulations, this DMSA shall automatically terminate, without the
       need for any further act, deed or notice by either Party upon the
       occurrence of a Bankruptcy Event or Business Cessation Event affecting
       Subcontractor or ALERE.

13.2.3 IMMEDIATE TERMINATION. Notwithstanding the provisions of Section 13.2.1
       above, either party may terminate this DMSA immediately by giving written
       notice to the other in the event that the other party fails or is unable
       to fully comply with its obligations under Section 11 or 12 of this DMSA
       provided, however, termination as a result of violation of the Business
       Associate Agreement shall be governed by the termination provisions
       therein.

13.2.4 ADVERSE LEGAL DETERMINATION. Subject to the provisions of Section 27 of
       this DMSA and the Parties' obligations thereunder, either Subcontractor
       or ALERE may terminate this DMSA or the affected SOW immediately upon the
       giving of written notice to the other Party following a

                                      A-26
<PAGE>

       Judgment, an order of a court or Governmental Authority or a change in
       any Laws or Regulations (including a change in the interpretation or
       enforcement of existing Laws or Regulations) that would make (based upon
       a reasonably, good faith legal determination) such Party's continued
       performance of its obligations under this DMSA or such SOW unlawful,
       illegal or commercially impracticable.

13.3   EFFECTS OF TERMINATION. The termination of this DMSA shall not affect the
       continued enforceability of the provisions of this DMSA that survive such
       termination and any other provisions necessary to interpret or construe
       such provisions. The termination of any SOW (without termination of this
       DMSA) shall not in and of itself, alter, effect or terminate this DMSA or
       any other SOW unless expressly provided in this DMSA or such other SOW.

13.4   TRANSITION ASSISTANCE FOLLOWING TERMINATION. Upon the expiration or
       earlier termination of any SOW or this DMSA for any reason whatsoever
       other than default by ALERE, (a "Transition Event"), ALERE, at its option
       exercised by written notice to Subcontractor (a "Transition Notice"), may
       require (i) Subcontractor to continue providing Disease Management
       Services ("Continuing Services") for up to one hundred eighty (180) days
       following the Transition Event (the "Transition Assistance Period"), and
       (ii) Subcontractor to provide such transition assistance, as ALERE may
       reasonable require, to transition and transfer the Disease Management
       Services under any SOW to ALERE or to another vendor ("Transition
       Assistance Services"), the nature and extent of which assistance shall be
       as reasonably determined by ALERE, provided, however, that in so
       providing such Continuing Services and Transition Assistance Services
       following a Transition Event, Subcontractor shall not be required to take
       or forebear from taking any action that, absent appropriate safeguards
       and contractual protections, adversely affects the confidentiality or
       proprietary nature of the Subcontractor Proprietary System or any
       Confidential Information of Subcontractor.

13.4.1 Subcontractor shall provide Continuing Services and Transition Assistance
       Services in accordance with all applicable Service Level Standards and
       Performance Targets and any other applicable provisions of this DMSA.
       ALERE shall pay Subcontractor for (i) Continuing Services at the Service
       Fees in effect under the applicable SOW(s) at the time of the Transition
       Event, and (ii) Transitions Services (other than those required under
       13.6) at the applicable Service Fees in effect or, if none, at
       Subcontractor's cost. As part of the Transition Assistance Services,
       Subcontractor shall cooperate with ALERE and take all actions reasonably
       requested by ALERE in order to transition the Services to another vendor
       or ALERE, provided, however, that in so cooperating, Subcontractor shall
       not be required to take or forebear from taking any action that, absent
       appropriate safeguards and contractual protections, adversely affects the
       confidentiality or proprietary nature of the Subcontractor Proprietary
       System or any Confidential Information of Subcontractor.

                                      A-27
<PAGE>

13.4.2 Following the Continuing Services Period, Subcontractor, at no additional
       cost, shall continue to answer questions regarding the Services on an "as
       needed" basis for up to one hundred (100) days.

13.5   TERMINATION AND BANKRUPTCY. Any rights or licenses granted by
       Subcontractor in respect of the Subcontractor Independent Materials or
       Pre-Existing Intellectual Property Rights under or pursuant to this DMSA
       are and shall otherwise by deemed to be licenses and rights to
       "intellectual property" (as defined under Section 101 of the Bankruptcy
       Code) for the purposes of Section 365(n) of the Bankruptcy Code. The
       Parties agree that the licensee of such rights shall retain and may fully
       exercise all of its rights and elections under the Bankruptcy Code during
       the Term and following any termination of a SOW or this DMSA. The Parties
       further agree that the occurrence of any Bankruptcy Event and the grant
       of rights and license provided for in this Section shall not, and shall
       not be deemed or construed to, in any way restrict or impair the
       termination of this DMSA by ALERE.

CHANGE OF CONTROL. SUBCONTRACTOR SHALL PROVIDE ALERE WITH AT LEAST THIRTY (30)
DAYS PRIOR WRITTEN NOTICE OF A CHANGE OF CONTROL OF SUBCONTRACTOR.
Indemnification and Reimbursement Rights and Obligations.

13.6   MUTUAL COVENANTS. Each Party hereby acknowledges, represents and warrants
       to the other that (i) it is a sophisticated business Person that was
       represented by legal counsel during the negotiations with respect to this
       Agreement, including, without limitation, the negotiations of this
       Section 14, (ii) it is fully informed regarding all of the provisions of
       this Agreement and all matters addressed herein and (iii) the provisions
       of this Section 14 fairly allocate the risks with respect to matters for
       which indemnification or reimbursement may be sought under this
       Agreement. The provisions of this Section 14 shall survive the expiration
       or earlier termination of any SOW or this DMSA.

13.7   ALERE'S INDEMNIFICATION OBLIGATIONS. ALERE shall indemnify, defend and
       hold harmless Subcontractor, its Affiliates and their respective owners,
       subsidiaries, directors, officers, employees, representatives, agents,
       independent contractors, successors, successors-in-interest and assigns
       (collectively, the "Subcontractor Indemnitees") from and against, any and
       all Claims made by a Third Party against any Subcontractor Indemnitee
       arising out of or attributable to (i) any breach or inaccuracy in ALERE's
       representations or warranties in this Agreement (including any SOW); (ii)
       any failure or inability of ALERE or its personnel or Contractors to
       comply with any applicable requirement of this Agreement (including any
       SOW), including, without limitation, obligations of ALERE (or such
       personnel or Contractors) arising under the Business Associate Agreement;
       (iii) any actions or omissions of ALERE or its personnel or Contractors
       occurring during or in connection with the performance of any Services,
       including, without

                                      A-28
<PAGE>

       limitation, any harm, injury or death to Persons or damage to property;
       (iv) the violation by ALERE or by its personnel or Contractors of any
       Laws and Regulations, including any fines, penalties or assessments
       imposed upon Subcontractor as a result thereof; (v) the infringement,
       misappropriation or violation of the Intellectual Property Rights,
       contract rights or tort rights (including the right of publicity or right
       of privacy) of any Person arising out of the performance or
       non-performance of this Agreement by ALERE or its personnel or
       Contractors; or (vi) any compensation, fees, salary, bonuses, mandatory
       or fringe employee benefits, social security, employment taxes or other
       withholdings that are alleged to be owed in respect of any personnel or
       Contractors of ALERE. ALERE shall promptly pay and fully satisfy any and
       all Losses, Judgments or Expenses incurred or sustained by Subcontractor
       or any Subcontractor Indemnitee as a result of any Claims of the types
       described in this Section 14.2.

13.8   SUBCONTRACTOR'S INDEMNIFICATION OBLIGATIONS. Subcontractor shall
       indemnify, defend and hold harmless ALERE, its Affiliates and their
       respective owners, subsidiaries, directors, officers, employees,
       representatives, agents, independent contractors, successors,
       successors-in-interest and assigns (collectively, the "ALERE
       Indemnitees") from and against, any and all Claims made by a Third Party
       against any ALERE Indemnitee arising out of or attributable to (i) any
       breach or inaccuracy in Subcontractor's representations or warranties in
       this Agreement (including any SOW); (ii) any failure or inability of
       Subcontractor or its personnel or Contractors to comply with any
       applicable requirement of this Agreement (including any SOW), including,
       without limitation, obligations of Subcontractor (or such personnel or
       Contractors) arising under the Business Associate Agreement; (iii) any
       actions or omissions of Subcontractor or its personnel or Contractors
       occurring during or in connection with the performance of any Services,
       including, without limitation, any harm, injury or death to Persons or
       damage to property; (iv) the violation by Subcontractor or by its
       personnel or Contractors engaged by Subcontractor of any Laws and
       Regulations, including any fines, penalties or assessments imposed upon
       Subcontractor as a result thereof; (v) the infringement, misappropriation
       or violation of the Intellectual Property Rights, contract rights or tort
       rights (including the right of publicity or right of privacy) of any
       Person arising out of the performance or non-performance of this
       Agreement by Subcontractor or its personnel or Subcontractor's
       Contractors; or (vi) any compensation, fees, salary, bonuses, mandatory
       or fringe employee benefits, social security, employment taxes or other
       withholdings that are alleged to be owed in respect of any personnel or
       Contractors of Subcontractor. Subcontractor shall promptly pay and fully
       satisfy any and all Losses, Judgments or Expenses incurred or sustained
       by ALERE or any ALERE Indemnitee as a result of any Claims of the types
       described in this Section 14.3.

13.9   PROCEDURE FOR HANDLING CLAIMS.

                                      A-29
<PAGE>

13.9.1 THIRD PARTY CLAIMS. Promptly after the receipt by either Party of a
       notice of a Claim made by a Third Party that is the subject of
       indemnification pursuant to this Section 15 (collectively, "Third Party
       Claim"), such Party (the "Indemnified Party") shall deliver to the Party
       from which indemnification is sought (the "Indemnifying Party") a written
       notice that specifies in reasonable detail the basis of the claim for
       indemnification hereunder ("Notice of Indemnity Claim"). Subject to any
       applicable statute of limitation periods, the failure of the Indemnified
       Party to give a Notice of Indemnity Claim shall not relieve the
       Indemnifying Party of its indemnification obligations hereunder except to
       the extent that such failure shall result in material prejudice to the
       Indemnifying Party. The Indemnifying Party shall, at its sole expense and
       liability, assume the defense of any Third Party Claim within ten (10)
       business days after receipt of a Notice of Indemnity Claim with respect
       thereto. Should the Indemnifying Party, within ten (10) business days
       after receipt of the Notice of Indemnity Claim, fail to (i) notify the
       Indemnified Party in writing of the Indemnifying Party's intention to
       assume the defense thereof, or (ii) retain legal counsel reasonably
       satisfactory to the Indemnified Party to conduct the defense of such
       Third Party Claim, then the Indemnified Party shall be entitled, at the
       sole expense and liability of the Indemnifying Party, to exercise full
       control of the defense, compromise or settlement of such Third Party
       Claim.

       Provided that the Indemnifying Party assumes the defense of any Third
       Party Claim, the Indemnifying Party shall have the right to exercise full
       control of the defense, compromise or settlement of such Third Party
       Claim. The Indemnified Party shall have the right to engage separate
       legal counsel and to participate in the defense, compromise or settlement
       thereof; provided, however, that the expenses of such legal counsel shall
       be paid by the Indemnified Party unless (i) the Indemnifying Party has
       agreed in writing to pay such expenses, (ii) any relief other than the
       payment of money damages is sought against the Indemnified Party or (iii)
       the Indemnified Party shall have one or more legal defenses available to
       it which are in conflict with those available to the Indemnifying Party,
       in any of which cases identified in clause (i), (ii) or (iii), the
       expenses of such separate legal counsel shall be borne by the
       Indemnifying Party. The Party not assuming the defense of any Third Party
       Claim shall cooperate with the Party assuming such defense in any manner
       that the Party assuming such defense reasonably may request, except to
       the extent such cooperation may result in liability or damages to the
       cooperating Party not indemnified against by the other Party hereunder.

       The Indemnified Party shall not settle or compromise any Third Party
       Claim for which it is entitled to indemnification hereunder without the
       prior written consent of the Indemnifying Party unless the Indemnifying
       Party shall have failed to undertake the defense and control of such
       Third Party Claim in the manner hereinabove required. For any Third Party
       Claim in which the relief sought is other than monetary damages, the
       Indemnifying Party shall not settle

                                      A-30
<PAGE>

       or compromise the non-damage component of such Third Party Claim unless
       the Indemnified Party consents in writing to such compromise or
       settlement.

       The respective rights and remedies of the Parties in this Section 14.4
       shall survive the expiration or termination of this Agreement until
       ninety (90) days following the expiration of the statute of limitations
       applicable to the Third Party Claim for which indemnification may be
       sought hereunder; provided, that if a Notice of Claim respecting a Third
       Party Claim has been timely given, the limitations period shall be
       extended until the final, binding and nonappealable resolution of such
       Third Party Claim and the Indemnified Party's right to indemnification
       hereunder, but for only so long as the Indemnified Party continues to
       pursue its indemnification rights with reasonable diligence under the
       circumstances.

13.10  PROCEDURE FOR HANDLING DIRECT CLAIMS PRIOR TO ARBITRATION. In the event
       that Subcontractor or ALERE makes a Claim against the other Party under
       or by virtue of this Agreement which is not a Third Party Claim (a
       "Direct Claim"), the Party making the claim (the "Aggrieved Party") shall
       deliver to the Party from whom recovery or reimbursement of the Claim is
       sought (the "Responsible Party") a notice specifying in reasonable detail
       the basis of the Claim for which recovery or reimbursement is sought,
       together with the estimated amount of such Claim, as determined by the
       Aggrieved Party (a "Notice of Direct Claim"). Without limiting either
       Party's termination rights under this Agreement, neither Party may
       institute arbitration or, when permitted, litigation under this Agreement
       with respect to a Direct Claim unless the Aggrieved Party has furnished
       the Responsible Party with the Notice of Direct Claim and the Direct
       Claim remains unpaid or unresolved to the mutual satisfaction of the
       Parties for at least forty-five (45) days following receipt of the Notice
       of Direct Claim. Subject to any applicable limitations periods, the
       failure of the Aggrieved Party to give a Notice of Direct Claim shall not
       relieve the Responsible Party of its obligations under this Agreement
       except to the extent that such failure shall result in material prejudice
       to the Responsible Party. The rights of the Parties to make a Direct
       Claim shall survive the termination of this Agreement until the
       expiration of the statute of limitations applicable to such Direct Claim;
       provided, that if a Notice of Direct Claim has been timely given prior to
       the expiration of the limitations period, the limitations period shall be
       extended until the final, binding, and nonappealable resolution of such
       Claim and the Aggrieved Party's right to recovery, but only for so long
       as the Aggrieved Party continues to pursue its rights with reasonable
       diligence under the circumstances. Notwithstanding the foregoing
       provisions of this Section 14.5 or any other provisions of this
       Agreement, either Party shall have the right to seek immediate injunctive
       or other equitable relief in a court of competent jurisdiction without
       notice (except as required by applicable Laws and Regulations) or delay.

14     LIABILITY AND REMEDIES.

                                      A-31
<PAGE>

14.1   EQUITABLE RELIEF. Each Party acknowledges and agrees (i) that it would be
       difficult or impossible to measure the damage to the other Party or such
       other Party's Related Parties from any breach of a Party's obligations
       under Sections 11 or 12 of this DMSA, (ii) that injury to the other Party
       or such other Party's Related Parties arising from any such breach would
       be impossible to calculate, and (iii) that money damages therefor would
       be an inadequate remedy for any such breach. Therefore, each Party
       acknowledges and agrees that either Party, in addition to any of their
       other rights or remedies, shall be entitled to seek injunctive and other
       equitable relief without bond or other security in the event of an actual
       or threatened breach of the provisions of Sections 11 or 12 of this DMSA
       by the other Party. The obligations of each Party and the rights and
       remedies of each Party under Sections 11 and 12 of this DMSA are
       cumulative and in addition to, and not in lieu of, any obligations,
       rights or remedies created by laws protecting or enforcing Intellectual
       Property Rights, including the statutory and common laws governing unfair
       competition or misappropriation or theft of trade secrets, proprietary
       rights or confidential information.

14.2   SUSPECTED INFRINGEMENT OF INTELLECTUAL PROPERTY RIGHTS. In the event that
       Tuft's or ALERE's use of any Services or Deliverables is reasonably
       likely to become, or becomes, the subject of a Claim of infringement of
       the Intellectual Property Rights of one or more Third Parties, then, in
       addition to any other license fees, penalties or other Losses, Expenses
       or Judgments against which ALERE or any Alere Indemnitees is indemnified
       pursuant to Section 14 above, Subcontractor shall, at its option and
       expense, either (i) procure for the effected person the right to continue
       using such Services or Deliverables with the infringing component(s)
       thereof, or (ii) modify the Services or Deliverables or substitute
       components or parts therein so that they will no longer infringe or
       violate the Intellectual Property Rights of Third Parties; provided,
       however, that no such modification or substitution shall relieve
       Subcontractor from its obligations to perform in accordance with the
       Service Level Standards, Performance Targets and all other requirements
       of this Agreement and all applicable SOWs.

14.3   BREACH BY PERSONNEL OR CONTRACTOR. Each Party shall indemnify, defend and
       hold harmless the other Party, its Affiliates and Related Parties
       against, and be responsible, financially and otherwise for, any breach or
       violation of any provision of this Agreement made by any personnel or
       Contractor of ALERE or Subcontractor, including, but not limited to, the
       provisions of Sections 11 and 12 hereof. In addition to all other
       remedies specified in this Agreement or available at law or in equity,
       ALERE and Subcontractor shall be entitled to seek damages or other
       appropriate remedies against the other Party in all cases where the
       conduct or omission of any of Party's personnel or Contractor breaches or
       violates, or threatens to breach or violate, the terms of any SOW or this
       Agreement.

                                      A-32
<PAGE>

14.4   CONSEQUENTIAL AND SPECIAL DAMAGES. Neither Party shall be liable to the
       other Party for any incidental, consequential, special, punitive or other
       indirect damages, including, but not limited to, damages for economic
       loss, lost profits, loss of reputation or lost opportunities, even if the
       Party had been advised of the possibility of any such loss and/or such
       damages resulting from the breach, except in the case of Losses,
       Judgments or Expenses arising or resulting from, or attributable to, any
       of the following circumstances: (i) any breach or violation of the
       Parties' respective obligations under Section 11 (Protection of
       Information; Nonsolicitation) or Section 12 (Intellectual Property
       Rights) of this DMSA; (ii) any violation by Subcontractor or its
       personnel or Contractors of Laws and Regulations applicable to the
       Services; (iii) personal injury, death or damage to tangible property;
       (iv) the Parties' respective indemnification obligations for Third Party
       Claims under Section 14 (Indemnification and Reimbursement Rights of the
       Parties) of this DMSA; or (v) the gross negligence, willful misconduct or
       fraud of either Party.

14.5   SURVIVAL. The following provisions of this DMSA shall survive the
       expiration or earlier termination of any SOW or this DMSA for any reason
       whatsoever: (i) representations, warranties and covenants furnished by
       Alere and Subcontractor in Section 8 of this DMSA; (ii) the Parties'
       respective obligations under Sections 11, 12, 13.4, 14, 15 and 16 of this
       DMSA; (iii) the remedies to which either Party may be entitled under
       Sections 7, 8, 11, 14, 15 and 16 of this DMSA; (iv) or any other
       provision of this Agreement (including any SOW) which expressly survives
       such termination; and (v) any other provisions of this DMSA (including
       any SOW) that is necessary to interpret or enforce any of the foregoing
       provisions.

15     INSURANCE. Except as otherwise noted, Subcontractor shall at all times
       during the Term carry and maintain in full force and effect the following
       insurance, at its sole cost and expense, to insure against risks or
       liability for which Subcontractor is responsible during the Initial Term
       and any Renewal Term and for such additional period of time as may be
       required to complete the Services to be performed or furnished under any
       SOW:

15.1   COMMERCIAL GENERAL LIABILITY INSURANCE. Subcontractor shall maintain
       commercial general liability insurance, including premises liability,
       products liability (if products are being provided), completed operations
       coverage (if services are being provided), and contractual liability
       insurance, with limits of not less than One Million Dollars ($1,000,000)
       per occurrence and Two Million Dollars ($2,000,000) annual aggregate, for
       bodily injury (including death) and property damage, covering all of
       Subcontractor's operations in connection with this DMSA. Said insurance
       shall be on an "occurrence" form.

15.2   WORKERS' COMPENSATION AND EMPLOYER'S LIABILITY. Subcontractor shall
       maintain workers' compensation and employer's liability coverage with
       minimum limits as follows:

                                      A-33
<PAGE>

15.2.1 WORKERS COMPENSATION:Statutory limits as required by law

15.2.2 EMPLOYERS LIABILITY:

              Bodily Injury by accident:    $1,000,000 each accident
              Bodily Injury by disease:              $1,000,000 each employee
              Bodily Injury by disease:              $1,000,000 policy limit

15.3   PROFESSIONAL (ERRORS AND OMISSIONS) LIABILITY. Subcontractor shall
       maintain professional liability coverage with minimum limits of Five
       Million Dollars ($5,000,000) per occurrence and Five Million Dollars
       ($5,000,000) annual aggregate. Each of such insurance coverages shall be
       maintained for a period of not less than three (3) years after the
       expiration or termination of this DMSA. In addition, Subcontractor shall
       maintain Internet errors and omission insurance liability coverage with
       minimum LIMITS OF FIVE MILLION DOLLARS ($5,000,000) PER OCCURRENCE AND
       FIVE Million Dollars ($5,000,000) annual aggregate.

       If, in any of the foregoing cases, if Subcontractor has procured a
       claims-made based policy (or policies) and such policy (or policies) are
       cancelled or not renewed, Subcontractor agrees to exercise any option
       contained in said policy (or policies) to extend the reporting period to
       the maximum period permitted; provided, however, that Subcontractor need
       not exercise such option if the superseding insurer will accept all prior
       claims.

15.4   TYPES OF INSURANCE CARRIERS. Each of Subcontractor's insurance policies
       shall: (i) be issued by companies that have an A. M. Best rating of not
       less than "A-", and are in a size category which is not lower than
       "VIII"; (ii) be primary and noncontributory with any of the ALERE's
       insurance; (iii) name ALERE as an additional insured (except workers'
       compensation and employer's liability); and (iv) provide ALERE with
       written notice of cancellation, non-renewal or material change in the
       form or limits of coverage. Subcontractor shall cause its insurance
       carriers, brokers or agents to issue to ALERE certificates of insurance
       evidencing all insurance coverages required by this Section 16.
       Notwithstanding any other provision of this DMSA, failure to provide the
       coverages provided for herein, or the certificates of insurance, shall be
       grounds for immediate termination of this DMSA upon receipt written
       notice thereof.

15.5   NO LIMITATION ON LIABILITY. None of the foregoing requirements as to the
       type and limits of insurance to be maintained by Subcontractor are
       intended to and shall not in any manner limit or qualify the liabilities
       and obligations for which Subcontractor is responsible under any SOW, any
       other provision of this DMSA or by law.

                                      A-34
<PAGE>

15.6   SURVIVAl. The obligations under this Section 16 shall survive the
       termination of this DMSA or any SOW.

16     FORCE MAJEURE. Neither Party shall be liable to the other for any breach
       of a SOW or other provision of this Agreement resulting from any failure
       to perform if such performance is delayed, impaired or prevented by any
       event of force majeure such as fire or explosion, act of terror, flood,
       earthquake, severe weather or other act of God, strike, lockout, boycott,
       picketing, labor dispute or disturbance, order or act of any Governmental
       Authority, or any cause beyond the reasonable control of the
       non-performing Party (the "Affected Party"), including, but not limited
       to, failures, fluctuations or interruptions in electrical power, heat,
       light, telecommunication lines or telephones (any such cause, a "Force
       Majeure Event"); provided that such non-performance (i) was not caused by
       the fault or negligence of the Affected Party, (ii) could not have been
       prevented by reasonable precautions taken by the Affected Party and (iii)
       cannot reasonably be circumvented by the Affected Party through the use
       of alternate resources, work-around plans or other means; and provided,
       further, that the occurrence of a Force Majeure Event in respect of
       another customer of Subcontractor shall not, by itself, constitute a
       Force Majeure Event with respect to ALERE. Upon the occurrence of a Force
       Majeure Event, the Affected Party shall immediately notify the other
       Party of the occurrence thereof, and describe in reasonable detail the
       nature and effect on the Affected Party's operations of the Force Majeure
       Event. The Affected Party shall be excused from the performance of those
       obligations under this Agreement that are adversely affected by the Force
       Majeure Event for as long as (a) such Force Majeure Event continues, and
       (b) such Affected Party continues to use best efforts to resume
       performance of the Services whenever and to whatever extent possible. If
       any Force Majeure Event delays, impairs or prevents Subcontractor's
       performance or arrangement of the Services for more than seventy-two (72)
       hours, ALERE may immediately terminate this DMSA or any affected SOW,
       without, in either case, providing any opportunity to cure pursuant to
       Section 13.2.1 or otherwise, by giving written notice of such termination
       to Subcontractor.

17     NOTICES. Any and all notices, requests, consents, demands or other
       communications required or permitted to be given under this Agreement
       shall be in writing and shall be deemed to have been duly given (i) when
       delivered, if sent by United States registered or certified mail (return
       receipt requested), (ii) when delivered, if delivered personally by
       commercial courier, (iii) on the second following business day, if sent
       by United States Express Mail, Federal Express or other commercial
       overnight courier or (iv) upon the date reflected on a facsimile
       confirmation from the transmitting facsimile machine, if sent by
       facsimile transmission and delivery of the facsimile transmission is
       subsequently confirmed telephonically within one (1) business day, in
       each case to the Parties at the following addresses or facsimile numbers
       (or at such other addresses or facsimile numbers as shall be specified by
       like notice) with applicable postage or delivery charges prepaid:

                                      A-35
<PAGE>

              If to Subcontractor:

              Enhanced Care Initiatives, Inc.
              Six Corporate Drive
              Suite 420
              Shelton, CT 06484
              Facsimile No. 203-926-0594
              Attn: David Chess, MD
              Chief Executive Officer

              If to ALERE:

              ALERE Medical Incorporated
              595 Double Eagle Drive, Suite 1000
              Reno, NV  89502
              Facsimile No.:775-829-8637
              Attention:   Ron Geraty, M.D.
              Chief Executive Officer

18     ASSIGNMENT. Except as provided otherwise herein, neither party shall
       assign its rights or, except as permitted by this Agreement, delegate its
       duties under any SOW or this DMSA, without the prior written consent of
       the other party, which consent shall not be unreasonably withheld,
       conditioned or delayed, and any attempt to do so shall be void and of no
       force or effect for any purpose whatsoever and shall constitute a
       material breach of this DMSA that shall allow the aggrieved Party to
       immediately terminate this DMSA. Not withstanding a party's consent to
       any assignment or delegation by the other party, the assigning Party
       shall remain primarily liable for the performance of the assignee or
       delegate of the assigning Party's obligations under this Agreement,
       unless otherwise agreed by the other party in writing. Subject to the
       forgoing limitations, this Agreement shall be binding upon the Parties
       hereto and to the permitted successors, successors-in-interest and
       assigns of the Parties.

19     GOVERNING LAW; JURISDICTION. This Agreement shall be construed and
       enforced in accordance with the laws of the State of Nevada without
       regard to its conflicts of laws provisions and, when applicable, the
       Parties' obligations under this Agreement shall be governed by the laws
       of the United States and any other state's Laws and Regulations that must
       be applied. Any legal action, suit or proceeding arising out of or
       relating to this Agreement may be instituted in any state or Federal
       court located within the County of Washoe, State of Nevada, and each
       Party agrees not to assert, by way of motion, as a defense, or otherwise,
       in any such action, suit or proceeding, any claim that such Party is not
       subject personally to the jurisdiction of such court in an inconvenient
       forum, that the venue of the action, suit or proceeding is improper or
       that this DMSA or the subject matter hereof may not be enforced in or by
       such court. Each Party further irrevocably submits to the jurisdiction

                                      A-36
<PAGE>

       of any such court in any such action, suit or proceeding. Any and all
       service of process shall be effective against a Party if given personally
       or by registered or certified mail, return receipt requested, or by any
       other means of mail that requires a signed receipt, postage prepaid,
       mailed to such Party as herein provided. Nothing herein contained shall
       be deemed to affect the right of any Party to serve process in any manner
       permitted by law or to commence legal proceedings or otherwise proceed
       against any other Party in any other jurisdiction.

20     BINDING ARBITRATION. Any claim, controversy dispute or disagreement of
       whatsoever nature between the Parties hereto or involving this Agreement,
       including the disposition of a Direct Claim, shall, except as expressly
       provided below or elsewhere in this Agreement, be resolved by binding
       arbitration by a single arbitrator in accordance with the American
       Arbitration Association ("AAA"), and administration of the arbitration
       shall be performed by AAA or such other arbitration service as the
       Parties may agree in writing. The Parties will endeavor to mutually agree
       to the appointment of the arbitrator, but if such agreement cannot be
       reached within thirty (30) days following the date demand for arbitration
       is made, the arbitrator appointment procedures in the AAA Rules will be
       utilized. Arbitration hearings shall be held in Washoe County, Nevada or
       at such other location as the parties may agree in writing. Civil
       discovery may be taken in such arbitration as provided by federal law and
       civil procedure. The arbitrator selected shall have the power to control
       the timing, scope and manner of the taking of discovery and shall further
       have the same powers to enforce the parties' respective duties concerning
       discovery as would a federal district court including, but not limited
       to, the imposition of sanctions. The arbitrator shall have the power to
       grant all remedies provided by Nevada law. The Parties shall divide
       equally the expenses of AAA and the arbitrator; provided, however, that
       the arbitrator shall have the power to assess all such costs and expenses
       to the non-prevailing Party in the arbitrator's award. The arbitrator
       shall prepare in writing an award that includes the legal and factual
       reasons for the decision. The arbitrator shall not have the power to
       commit errors of law or legal reasoning and the award may be vacated or
       corrected pursuant to Nevada law. The arbitrator shall be bound by and
       required to apply to the disputed matters subject to arbitration the
       internal laws of the State of Nevada, without regard to principles of
       conflicts of law, and by federal law where Nevada law is preempted. The
       Federal Arbitration Act, 9 U.S.C. ss.ss. 1-16, shall apply to the
       arbitration. Each Party knowingly acknowledges and agrees that the
       foregoing constitutes a waiver of its right to a jury trial. The entire
       arbitration procedure shall be confidential and neither any party to the
       arbitration nor the arbitrator may disclose the content or results of any
       arbitration hereunder without the written consent of the other parties,
       except to the extent disclosure is required to enforce any applicable
       arbitration award or as may be otherwise required by law or upon the
       request of a Governmental Authority and except that any party may make
       such disclosures to its auditors, accountants, attorneys, insurers,
       actual and prospective investors, and actual and potential

                                      A-37
<PAGE>

       lenders. Notwithstanding anything to the contrary in this Section or
       elsewhere in this Agreement: (i) if a Governmental Authority with
       jurisdiction over either Party determines that a Party is not in
       compliance with applicable Laws and Regulations pertinent to this
       Agreement, then such finding or determination need not be subject to
       arbitration; and (b) a Party shall be permitted to seek a temporary
       restraining order, preliminary injunction, order to compel arbitration or
       in support of arbitration or other provisional remedies from a court of
       competent jurisdiction, including, but not limited to, seeking such
       remedies in connection with any claim, controversy, dispute or
       disagreement contemplated by Section.

21     INDEPENDENT CONTRACTORS. The Parties and their respective personnel are
       and shall continue to be independent contractors with respect to each
       other. Subcontractor and its personnel and Contractors shall not, by
       virtue of any SOW or any provision of this Agreement become, and under no
       circumstances shall any of them be construed as being, an employee,
       agent, joint venturer, partner or Affiliate of ALERE or standing in any
       relationship with respect to ALERE that would impose liability on ALERE
       for the actions or omissions of Subcontractor, its personnel or its
       Contractors. Without limiting the generality of the foregoing, nothing in
       this Agreement, including in any SOW, shall be construed as establishing
       the relationship of employer and employee between ALERE and
       Subcontractor, its employees or Contractors for any purposes, including
       state or Federal tax purposes. Subcontractor and its employees and
       Contractors are not entitled to any mandatory or fringe employee benefits
       from ALERE, including, without limitation, workers' compensation,
       unemployment compensation, health or disability insurance or vacation or
       sick pay.

22     ENTIRE AGREEMENT. This Agreement shall constitute the final written
       integrated expression of all of the understandings and agreements between
       Subcontractor and ALERE with respect to the performance of any Services
       and delivery of any Deliverables contemplated under this Agreement and
       the other subjects addressed in this DMSA and any SOW entered into by
       Subcontractor and ALERE. This Agreement supersedes all prior or
       contemporaneous, written or oral, memoranda, arrangements, contracts or
       understandings between the Parties relating to the subjects addressed
       therein. Any representations, promises warranties or statements made by
       any Party which differ in any way from the terms of this Agreement shall
       be given no force or effect.

23     AMENDMENTS; WAIVERS. Except as otherwise expressly provided in this
       Agreement, changes or modifications to this Agreement or to any SOW may
       not be made orally, but only by a dated, written instrument executed by
       Subcontractor and ALERE; provided, however, that Subcontractor agrees
       that ALERE shall be permitted to amend this Agreement or any SOW
       effective upon thirty (30) days written notice to Subcontractor if the
       substance of such amendment is required by any Laws or Regulations
       applicable to ALERE or

                                      A-38
<PAGE>

       Tufts or any directives from a Governmental Authority or Accreditation
       Organization regulatory or certifying a ALERE, Tufts, or its Health Plans
       or other operations. Any terms or conditions varying from this Agreement
       or any SOW on any order, invoice or other notification from either Party
       shall not be binding upon the Parties unless specifically accepted in
       writing by the Party against whom enforcement is sought. Unless otherwise
       expressly provided in this Agreement, including in any SOW, a delay or
       omission by either Party to exercise any right or power under this
       Agreement shall not be construed to be a waiver thereof. No waiver of any
       breach of any provision of any SOW or this Agreement shall be effective
       unless evidenced by a dated written instrument executed by the Party
       against whom enforcement of such waiver is sought. No waiver of any
       breach of any provision of any SOW or this Agreement will constitute a
       waiver of any prior, concurrent or subsequent breach of the same or any
       other provision hereof or thereof.

24     SEVERABILITY. In the event that any provision in this Agreement shall be
       found by a Governmental Authority, court or arbitrator of competent
       jurisdiction to be invalid, illegal or unenforceable, such provision
       shall be construed and enforced as if it had been narrowly drawn so as
       not to be invalid, illegal or unenforceable, and the validity, legality
       and enforceability of the remaining provisions of this DMSA shall not in
       any way be affected or impaired thereby. In the event, however, that the
       remaining unaffected provisions of this Agreement are inadequate to
       permit each Party to realize the material benefits for which such Party
       has bargained hereunder, then, before this Agreement may be terminated as
       provided herein, the Parties shall, in good faith, attempt to negotiate
       mutually acceptable substitute provisions (which negotiations need not
       exceed thirty (30) calendar days) that are valid, legal and enforceable
       and that most nearly provide for the realization of the material benefits
       sought to be accomplished by the provision or provisions held to have
       been illegal, invalid or unenforceable.

25     CONSTRUCTION OF AGREEMENT. The Parties agree that:

25.1   JOINT PARTICIPATION. This DMSA has been drafted with the joint
       participation of each of the Parties hereto and shall be construed to be
       neither against nor in favor of either Party, but rather in accordance
       with the fair meaning hereof.

25.2   NO THIRD PARTY BENEFICIARIES. This Agreement does not create, and shall
       not be construed as creating, any rights enforceable by any Person who is
       not a Party to this Agreement.

25.3   USE OF DEFINED TERMS. Any defined term used in this Agreement in the
       plural shall refer to all members of the relevant class and any defined
       term used in the singular shall refer to any one or more of the members
       of the relevant class.

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<PAGE>

25.4   DAY OR DAYS. Use of the terms "day" or "days" in this DMSA shall mean and
       refer to calendar days unless either term is expressly modified by a
       reference to "business" day(s).

25.5   ARTICLES, SECTIONS, EXHIBITS AND SCHEDULES. References in this DMSA to
       articles, sections, exhibits and schedules are to articles, sections,
       exhibits and schedules of and to this DMSA. All exhibits and schedules to
       this DMSA, either as originally existing or as the same from time to time
       may be supplemented, modified or amended, are hereby incorporated in full
       into this DMSA by this reference.

26     COUNTERPARTS. This DMSA, the SOWs or any other instrument to be entered
       into by the Parties in connection with this DMSA may be executed in any
       number of counterparts, all of which taken together shall constitute one
       single agreement between the Parties.

       IN WITNESS WHEREOF, each Party has caused this DMSA to be signed by its
       duly authorized representative on _________________, 2006 to be effective
       as of the Effective Date.

       ALERE MEDICAL
       INCORPORATED                         SUBCONTRACTOR

     By:  /s/_______________________        By:      /s/ ____________________
     Title:                                          Title:

                                      A-40
<PAGE>

                                    EXHIBIT A

                             SCHEDULE OF DEFINITIONS

      "Accreditation Organization" means any organization, including, without
     limitation, the National Committee for Quality Assurance (NCQA), engaged in
     accrediting or certifying Tufts, the Medicare Health Plans and/or Tuft's
     providers of health care services, products or devices, including
     Subcontractor.

     "Affiliate," with respect to any Person, means another Person that directly
     or indirectly controls, is controlled by or is under common control with
     that Person. For purposes of this definition, the term `control' (including
     the terms `controlling', `controlled by' and `under common control with')
     of a Person means possession of the power, directly or indirectly, to
     direct or cause the direction of the management and policies of such
     Person, whether through the ownership of voting securities, membership
     interests, by contract, or otherwise.

     "Aggrieved Party" has the meaning ascribed to it in Section 14.5.

     "Agreement" shall mean the foregoing provisions of this DMSA, together with
     all Exhibits, Schedules, SOWs or other attachments attached to or
     incorporated by reference into the DMSA, and all exhibits, schedules and
     attachments to such SOWs, and any amendment, modification, revision,
     supplement or deletions to any of the foregoing made in accordance with the
     requirements of the this Agreement and any applicable SOW.

     "ALERE" means ALERE Medical Incorporated, a California corporation.

     "ALERE Content" means any text, graphics, photographs, video, audio and/or
     other data or information, including any advertisements, which display any
     of the ALERE Marks (and none of the Subcontractor Marks) or which is used
     by ALERE or any Related Party of ALERE, including, without limitation, any
     marketing, promotional or descriptive materials of ALERE's products,
     devices or services. The content of any ALERE Developed Materials also
     shall constitute ALERE Content.

     "ALERE Data" means and includes (i) all data, records, reports and
     information generated, created or developed by ALERE or its contractors
     (other than Subcontractor) in the performance or arrangement of disease
     management services for clients other than Tufts; (ii) all data, records
     and information generated from ALERE's respective businesses and operations
     other than the performance of this Agreement, including, without
     limitation, contact, personal and other information pertaining to ALERE's
     past, present

                                      A-41
<PAGE>

     or prospective customers, employees and representatives, (iii) all
     information pertaining to the programs, services or products marketed or
     offered by ALERE in general, including, without limitation, information
     pertaining to staffing, policies and procedures, internal methods and
     systems operational protocols of ALERE, and information pertaining to
     amounts paid to ALERE by its customers, (iv) any documentation describing,
     evidencing, marketing or promoting the products, services or programs of
     ALERE generally, (v) any trade secrets or secret business processes or
     methods of ALERE, (vi) ALERE's software and any tangible or readable
     embodiments of such software, (vii) any toll free inbound telephone numbers
     used or established to provide Services under this DMSA or other telephone
     numbers controlled by ALERE, and (viii) in the case of any of the matters
     referenced in any of the foregoing clauses (i) through (vii), data, records
     or information occurring in any form whatsoever, including, but not limited
     to, written, graphic, electronic, visual or fixed in any tangible medium of
     expression.

     "ALERE Developed Materials" mean and include any Development which is made,
     created, authored, conceived or developed by ALERE, alone or jointly with
     others for or in connection with ALERE's business, services or operations.

     "ALERE Indemnitees" has the meaning ascribed to it in Section 14.3.

      "ALERE Marks" means any service marks, trademarks, trade names, domain
     names, URLs, logos, icons, slogans, words or phrases and advertising
     (including text, graphic or audiovisual features of icons, banners or
     frames) which bear the name or identification of ALERE or of any Related
     Party of ALERE.

     "ALERE Systems" means any computer, software, hardware, telecommunications,
     telephone, voice or data systems utilized by ALERE or one of its
     Contractors in the performance of the Services, exclusive of the Tufts
     Systems.

     "Annual Plan" has the meaning ascribed to it in Section 5.2.

     "Authorizations" has the meaning ascribed to it in Section 8.2.

     "Authorized Contractor" means any vendor engaged by the Subcontractor whose
     subcontract with Subcontractor satisfies all applicable obligations of this
     DMSA.

     "Bankruptcy Code" means Title 11 of the United States Code.

     "Bankruptcy Event" with respect to a Person means: (i) a proceeding or case
     has been commenced against a Person, without the application or consent of

                                      A-42
<PAGE>

     such Person, in any court of competent jurisdiction, seeking (a) such
     Person's liquidation, reorganization, dissolution or winding-up, or the
     composition or readjustment of its debts, (b) a petition commencing a case
     under the Bankruptcy Code (as now or hereafter in effect), (c) the
     appointment of a trustee, receiver, custodian, liquidator or the like of
     such Person or of all or any substantial part of any of its assets or (d)
     similar relief in respect of the bankruptcy, insolvency, reorganization,
     winding-up or composition or adjustment of debts, and such proceeding or
     case shall continue undismissed, or an order, Judgment, or decree approving
     or ordering any of the foregoing; (ii) an order for relief against a Person
     shall be entered in an involuntary case under the Bankruptcy Code; (iii) a
     Person shall (a) apply for or consent to the appointment of, or the taking
     of possession by, a receiver, custodian, trustee or liquidator of itself or
     of all or a substantial part of its property, (b) make a general assignment
     for the benefit of its creditors, (c) commence a voluntary case under the
     Bankruptcy Code (as now or hereafter in effect), (d) file a petition
     seeking to take advantage of any other law relating to bankruptcy,
     insolvency, reorganization, winding-up or composition or readjustment of
     debts, (e) fail to controvert in a timely and appropriate manner, or
     acquiesce in writing to, any petition filed against it in an involuntary
     case under the Bankruptcy Code (as now or hereafter in effect); or (f) a
     Person taking any corporate, partnership or other entity action for the
     purpose of effecting any of the foregoing.

     "Business Associate Agreement" means the Business Associate Addendum
     entered into between Subcontractor and ALERE, which is attached to this
     DMSA as EXHIBIT C and any subsequent versions of the Business Associate
     Addendum as ALERE shall adopt for use.

     "Business Cessation Event" with respect to either a Person means that (i)
     such Person dissolves its corporate, partnership or other entity structure,
     winds up its business affairs or ceases to do business for any other
     reason, except pursuant to a (i) sale and acquisition of all or
     substantially all of such Person's business or assets, or (ii)
     reorganization, merger or similar transaction in which its business is
     continued by another Person that is competent to carry on such business, or
     (ii) such Person has taken any official corporate, partnership or other
     entity action for the purpose of effecting any of the foregoing.

     "Change of Control" with respect to Subcontractor means either (i) a sale
     or disposition of all or substantially all of the assets of the
     Subcontractor, (ii) a sale of 50% or more of the voting capital stock of
     the Subcontractor, or (iii) any transaction (or series of related
     transactions involving a person or entity, or a group of affiliated persons
     or entities) in which excess of 50% of the Subcontractor's outstanding
     voting power is transferred.

     "Change Order Proposal" has the meaning ascribed to it in Section 10.

                                      A-43
<PAGE>

     "Claim" means any claim, legal or equitable cause of action, suit,
     litigation, proceeding (including a regulatory or administrative
     proceeding), grievance, complaint, demand, charge, investigation, audit,
     arbitration (or demand therefore), mediation or other process for settling
     disputes or disagreements, including, without limitation, any of the
     foregoing processes or procedures in which injunctive or equitable relief
     is sought.

     "CMS" means the United States Centers for Medicare and Medicaid Services,
     formerly known as the Health Care Financing Administration ("HCFA").

     "Commercial Plan" means a commercial prepaid Health Plan.

     "Compensation Records" has the meaning ascribed to it in Section 2.10.

     "Confidential Information" has the meaning ascribed to it in Section 11.2.

     "Contractor" means any individual or other Person who or which performs, on
     behalf of Subcontractor or ALERE, any Services contemplated by this DMSA
     (including a leased employee) other than an individual who is an employee.

     "Default(ing)" has the meaning ascribed to it in Section 13.2.1.

     "Deliverables" mean and include (i) any tangible materials, products or
     reports to be furnished or delivered by Subcontractor to ALERE or any other
     Person as a result of or as an embodiment of any of the Services to be
     furnished pursuant to this Agreement or any SOW, and (ii) any severable
     part of any of the items referenced in the foregoing clause (i).

      "Developments" means and includes all developments, inventions, concepts,
     plans, techniques, designs, models, literary works, works of authorship
     (including, but not limited to, training materials, curricula scripts,
     reports and computer screens), processes, methodologies, discoveries,
     formulae, contributions, findings or improvements, technology, computer
     software applications, programs, interfaces, systems and databases
     (including with respect to any of the foregoing any source codes or object
     codes relating thereto) and voice or data recordings which are made,
     created, authored, conceived, developed, prepared, irrespective of whether
     new, useful, patentable or protectable under statutory or common law.

     "Disclosing Party" has the meaning in Section 11.1.

     "Disease Management Services" has the meaning in Section 1.1.1.

      "Effective Date" means _________________.

                                      A-44
<PAGE>

     "Expenses" mean any and all costs, expenses and fees, including costs of
     settlement, attorneys' fees, accounting fees, expert costs and fees and
     witness fees incurred in connection with Claims which are the subject of
     indemnification or reimbursement under this DMSA or Losses or Judgments
     arising from such Claims.

     "Force Majeure Event" has the meaning ascribed to it in Section 17.

     "GLB" means the U.S. Gramm-Leach-Bliley Act and the rules and regulations
     from time to time promulgated thereunder.

     "Governmental Authority" means the Federal government, any state, county,
     municipal, local or foreign government or any governmental department,
     political subdivision, agency, bureau, commission, authority, body or
     instrumentality or court, including, but not limited to, CMS and any
     department, division, agency or insurance commissioner that regulates the
     activities or operations of the Parties, Tufts or the Medicare Health
     Plans.

     "HCFA Internet Security Policy" means the HCFA Internet Security Policy
     issued by CMS (then the Health Care Financing Administration) on November
     24, 1998, as the same from time to time may be amended, replaced or
     codified.

     "Health Plan(s)" mean and include one or more of the Commercial or Medicare
     Health Plans underwritten, offered, sold, administered, arranged or managed
     by a Tufts Affiliate.

     "HIPAA" means the Health Insurance Portability and Accountability Act of
     1996, as may be amended, modified, revised or replaced or interpreted by
     any Governmental Authority or court.

     "HIPAA Regulations" means the rules and regulations adopted by the U.S.
     Department of Health and Human Services pursuant to HIPAA, including
     without limitation (i) the Standards for Privacy of Individually
     Identifiable Health Information set forth at 45 C.F.R. Parts 160 and 164
     (subparts A and E), (ii) the Security Standards for the Protection of
     Electronic Protected Health Information, 45 C.F.R. parts 160 and 164
     (subparts A and C), (iii) the Standards for Electronic Transactions and
     Code Sets, 45 C.F.R. parts 160 and 162 and (iv) any amendments,
     modifications, revisions or replacements or interpretations of the
     regulations identified in the foregoing clauses (i), (ii) or (iii) by any
     Governmental Authority or court.

     "Implementation Services" has the meaning ascribed to it in Section 2.2.2.

     "Indemnified Party" has the meaning ascribed to it in Section 14.4.1.

                                      A-45
<PAGE>

     "Indemnifying Party" has the meaning ascribed to it in Section 14.4.1.

     "Initial Term" has the meaning ascribed to it in Section 13.1.

     "Intellectual Property" or "Intellectual Property Rights" means any patent,
     invention, discovery, know-how, moral, technology, software, copyright,
     trade secret, trademark, confidentiality, proprietary, privacy,
     intellectual property or similar rights (including rights in applications,
     registrations, filings and renewals thereof) which are now or hereafter
     protected or legally enforceable under state or Federal common laws or
     statutory laws of the United States or under laws of foreign jurisdictions.

     "IT Development Work" means any software programming and any software
     development, design, configuration, adaptation, integration or installation
     of computer hardware, software (including, applications, programs,
     interfaces, operating systems, databases and the source codes and object
     codes relating to the foregoing), telecommunications or data communications
     infrastructure or systems and other technology products or systems which,
     in the case of any of the foregoing, is developed, created or performed by
     a Party, alone or jointly with its Contractors, whether (i) as any part of
     any Implementation Services or other Services to performed pursuant to a
     SOW or (ii) on or for the Party's systems.

     "Judgments" mean any judgments, writs, orders, injunctions or other orders
     for equitable relief, awards or decrees of or by any court, judge, justice
     or magistrate, including any bankruptcy court or judge, and any binding
     arbitration award and any order of or by any Governmental Authority.

      "Laws and Regulations" means any and all common law and any and all state,
     Federal or local statutes, ordinances, codes, rules, regulations,
     restrictions, orders, procedures, standards, directives, guidelines,
     policies or requirements enacted, adopted, promulgated, applied, followed
     or imposed by any Governmental Authority or court, including, but not
     limited to, HIPAA and the HIPAA Regulations and policies, guidelines and
     manuals adopted by CMS.

     "Losses" mean and include any losses, damages of any kind or nature,
     assessments, fines, penalties, deficiencies, interest, payments, expenses,
     costs, debts, obligations, liabilities, liens or Judgments that are
     sustained, incurred or accrued.

     "Medicare Advantage Plan" shall mean a Medicare managed care plan
     authorized by current or future Federal laws and/or administered by CMS or
     any successor Governmental Authority, formerly known as Medicare+Choice
     plans.

                                      A-46
<PAGE>

     "Medicare Health Plan(s)" mean and include one or more of the Medicare
     Advantage Plans, exclusive of, for the purposes of this Agreement, a
     stand-alone prescription drug only plan offered under Medicare Part D.

     "Member" means an individual subscriber or dependent of such subscriber who
     is enrolled in a Commercial or Medicare Health Plan offered, arranged,
     administered, underwritten or provided by Tufts.

     "Notice of Direct Claim" has the meaning ascribed to it in Section 14.5.

     "Notice of Indemnity Claim" has the meaning ascribed to it in Section
     14.4.1.

     "Operational and System Readiness" with respect to the provision of
     Services under any SOW means that Subcontractor, at a minimum (i) possesses
     IT, voice and data systems and operational processes and protocols that are
     adequate, appropriate and necessary to perform the Services in an orderly,
     efficient and professional manner and otherwise in accordance with this
     DMSA and such SOW; (ii) has developed the necessary software interfaces or
     procedures to communicate securely with the ALERE Systems and Tufts Systems
     and to support the exchange of data (including Tufts Data) between Tufts,
     ALERE and Subcontractor in accordance with HIPAA and the HIPAA Regulations,
     the HCFA Internet Security Policy, other applicable Laws and Regulations
     and any other applicable provisions of this DMSA; and (iii) has completed
     training of adequate and appropriate professional personnel to provide all
     Services contemplated by such SOW in accordance with the requirements of
     this DMSA.

     "Tufts" means Tufts Health Plan and its subsidiaries, parents and other
     Affiliates.

     "Tufts Affiliate" means any current or future Affiliate of Tufts.

     "Tufts Data" means and includes (i) all data and information submitted or
     transmitted to Subcontractor by Tufts, Members, intermediaries or other
     Third Parties in respect of Members (including, without limitation,
     patient-identifiable information, other medical data and PHI), (ii) all
     data, records, reports and information generated, created or developed by
     Subcontractor or its contractors in course of performing the Services,
     (iii) all data, records and information generated from Tuft's respective
     businesses and operations, including, without limitation, contact, personal
     and other information pertaining to Tuft's past, present or prospective
     Members, customers, providers, employees and representatives, (iv) all
     information pertaining to the Health Plans or any other health care or
     consumer programs, services or products marketed, offered or underwritten
     by Tufts, including, without limitation, information pertaining to
     staffing, policies and procedures, internal methods and systems,
     operational protocols, benefit plan or program designs,

                                      A-47
<PAGE>

     reimbursement amounts paid to Tufts by or on behalf of Members, rates and
     compensation paid by Tufts to providers or suppliers of health care or
     consumer services, products or devices, any other historical or prospective
     cost and expense data pertaining to Tufts, (v) any documentation
     describing, evidencing, marketing or promoting the health plan or consumer
     products, services or programs of Tufts, including, but not limited to,
     subscriber materials, enrollment forms, evidences of coverage, evidences of
     benefits, handbooks, identification cards and benefit materials or program
     descriptions of any kind, and any other Tufts Content, (vi) any data,
     information, records or documentation generated by Subcontractor or its
     personnel or Contractors during the course of performing any Services or
     pursuant to any SOW or this DMSA or pursuant to any other arrangement with
     ALERE on behalf of Tufts, (vii) any trade secrets or secret business
     processes or methods of Tufts, (viii) Tuft's software and any tangible or
     readable embodiments of such software, (ix) any and all toll free inbound
     telephone numbers used or established to provide Services under this DMSA
     or other telephone numbers controlled by Tufts and (x) in the case of any
     of the matters referenced in any of the foregoing clauses (i) through (ix),
     data, records or information occurring in any form whatsoever, including,
     but not limited to, written, graphic, electronic, visual or fixed in any
     tangible medium of expression.

      "Tufts Marks" means any service marks, trademarks, trade names, domain
     names, URLs, logos, icons, slogans, words or phrases and advertising
     (including text, graphic or audiovisual features of icons, banners or
     frames) which bear the name or identification of Tufts, any Related Party
     of Tufts other than ALERE, Subcontractor or any Medicare Health Plans,
     other health plans, products, devices or services offered, sold or marketed
     by Tufts or its Related Parties other than ALERE or Subcontractor,
     including, but not limited to, Tufts(R), Secure Horizons(R), Secure
     Horizons(R) Secure Gold and Secure Touch.

     "Party" or "Parties" means one or both of Subcontractor and ALERE.

     "Payment Default" has the meaning in Section 13.2.2.

     "Person" means any individual, trustee, corporation, general or limited
     partnership, limited liability company or partnership, joint venture, joint
     stock company, bank, firm, Governmental Authority, trust, association,
     organization or unincorporated entity of any kind.

     "PHI" or "Protected Health Information," means, as defined at 45 C.F.R.
     Section 164.501, information which (i) relates to the past, present or
     future physical or mental health or condition of an individual, the
     provision of health care to an individual, or the past, present of future
     payment for the provision of health care to an individual, and (ii) with
     respect to which there is a reasonable basis to believe the information can
     be used to identify the

                                      A-48
<PAGE>

     individual; and will have the meaning under 45 C.F.R. Section 164.501 as
     such section from time to time may be amended, modified, revised or
     replaced or interpreted by any Governmental Authority or court.

     "Performance Targets" means the utilization rates in medical expense
     including as appropriate inpatient hospital stays, outpatient hospital
     services, professional services and/or other healthcare services as set
     forth in the applicable SOW to be achieved as a result of the Disease
     Management Services being performed under a particular SOW, in accordance
     with such SOW or an Annual Plan established with respect thereto.

     "Pre-Existing Intellectual Property Right" means any software, software
     systems, Inventions, discoveries, technology or other Intellectual Property
     Rights owned or claimed to be owned by Subcontractor or ALERE any Third
     Party or any Subcontractor or ALERE Independent Materials owned or claimed
     to be owned by Subcontractor, ALERE or any Third Party.

     "Privacy Laws" has the meaning ascribed to it in Section 11.3.

     "Receiving Party" has the meaning in Section 11.1.

     "Regulated Activities" has the meaning ascribed to it in Section 2.3.2.

     "Related Party" means a customer (including a Member) strategic partner,
     vendor, supplier, health care provider, service provider, investor,
     Affiliate, business partner or other contractor of Subcontractor or ALERE,
     as the case may be. For the purposes of this Agreement, ALERE shall not be
     considered a Related Party of Subcontractor and Subcontractor shall not be
     considered a Related Party of ALERE.

     "Renewal Term" has the meaning ascribed to it in Section 13.1.

     "Responsible Party" has the meaning ascribed to it in Section 14.5.

     "Service Fees" or "Fees" means the baseline service fees or other
     compensation payable to Subcontractor by ALERE under a SOW for the
     provision of Disease Management Services to Tufts or its Members. On the
     Effective Date, the Services Fees under applicable SOWs are typically
     determined on a per Member per month (PMPM) basis, a per enrolled Member
     per month basis (PEMPM) or a case rate basis

     "Service Level Standards" shall mean all requirements set forth in this
     Agreement and/or any SOW relating to the quality, timing, personnel,
     procedures, practices, methodologies and other aspects of Subcontractor's
     provision of the Services under this Agreement and/or such SOW.

                                      A-49
<PAGE>

     "Service Locations" has the meaning ascribed to it in Section 4.1.

     "Services" means those Disease Management Services to be furnished or
     arranged by Subcontractor pursuant to this Agreement and any other disease
     management, staffing, resources, support, services, responsibilities, tasks
     or Deliverables that are required to be furnished or performed by
     Subcontractor to ALERE on behalf of, Tufts under this DMSA or one or more
     SOWs issued under this DMSA.

     "Statement of Work" or "SOW" has the meaning ascribed to it in Section
     1.1.1.

     "SOW Effective Date" shall mean the date set forth in each SOW on which
     such SOW shall be effective.

     "Subcontractor Account Executive" has the meaning ascribed to it in Section
     2.8.

     "Subcontractor Content" means any text, graphics, photographs, video, audio
     and/or other data or information, including any advertisements, which
     display any of the Subcontractor Marks (and none of the Subcontractor
     Marks) or which is used by Subcontractor or any Related Party of
     Subcontractor, including, without limitation, any marketing, promotional or
     descriptive materials of Subcontractor's products, devices or services. The
     content of any Subcontractor Developed Materials also shall constitute
     Subcontractor Content.

     "Subcontractor Data" means and includes (i) all data, records, reports and
     information generated, created or developed by Subcontractor or its
     contractors in the performance or arrangement of Disease Management
     Services for clients other than Tufts; (ii) all data, records and
     information generated from Subcontractor's respective businesses and
     operations other than the performance of this Agreement, including, without
     limitation, contact, personal and other information pertaining to
     Subcontractor's past, present or prospective customers (other than Tufts),
     employees and representatives, (iii) all information pertaining to the
     programs, services or products marketed or offered by Subcontractor in
     general (but exclusive of particular Disease Management Services designed
     or tailored for Tufts), including, without limitation, information
     pertaining to staffing, policies and procedures, internal methods and
     systems operational protocols of Subcontractor that have not been developed
     for Tufts or exclusively or primarily for use in connection with the
     Services being furnished to Tufts, and information pertaining to amounts
     paid to Subcontractor by its customers other than Tufts, , (iv) any
     documentation describing, evidencing, marketing or promoting the products,
     services or programs of Subcontractor generally, exclusive of any such
     documentation for Disease Management Services

                                      A-50
<PAGE>

     designed exclusively or primarily for Tufts, (v) any trade secrets or
     secret business processes or methods of Subcontractor, (vi) Subcontractor's
     software and any tangible or readable embodiments of such software, (vii)
     any toll free inbound telephone numbers used or established to provide
     Services under this DMSA or other telephone numbers controlled by
     Subcontractor, and (viii) in the case of any of the matters referenced in
     any of the foregoing clauses (i) through (vii), data, records or
     information occurring in any form whatsoever, including, but not limited
     to, written, graphic, electronic, visual or fixed in any tangible medium of
     expression. Notwithstanding the foregoing, Subcontractor Data shall not
     include any Tufts Data or ALERE Data.

      "Subcontractor Developed Materials" mean and include any Development which
     is made, created, authored, conceived or developed by Subcontractor alone
     or jointly with others for or in connection with Subcontractor's business,
     services or operations.

     "Subcontractor Indemnitees" has the meaning ascribed to it in Section 14.3.

      "Subcontractor Marks" means any service marks, trademarks, trade names,
     domain names, URLs, logos, icons, slogans, words or phrases and advertising
     (including text, graphic or audiovisual features of icons, banners or
     frames) which bear the name or identification of Subcontractor or of any
     Related Party of Subcontractor.

     "Subcontractor Systems" means any computer, software, hardware,
     telecommunications, telephone, voice or data systems utilized by
     Subcontractor or one of its Contractors in the performance of the Services.

     "Taxes" means all sales, use, transfer, ad valorem, gross receipts, or
     excise taxes and any other similar taxes, fees, duties or imposts plus any
     interest and penalties imposed thereon and all expenses (including
     attorney, accountant and expert fees) incurred by a Party in connection
     with the payment or settlement of or defense against any claim for such
     taxes.

     "Term" means the Initial Term of this DMSA and/or any Renewal Term hereof.

     "Third Party" means any Person other than Subcontractor or ALERE.

     "Third Party Claim" has the meaning ascribed to it in Section 14.4.1.

     "Transition Assistance Period" has the meaning ascribed to it in Section
     13.4.

     "Transition Assistance Services" has the meaning ascribed to it in Section
     13.4.

                                      A-51
<PAGE>

                                    EXHIBIT B

                                  OPM AGREEMENT

     The following provisions are incorporated by reference into the Agreement.
     Any capitalized terms used in this Exhibit B shall have the meaning
     ascribed to such term in the Federal Employees Health Benefit Program
     Standard Contract for Community-Rated Health Maintenance Organization
     Carriers for contract year 2002 (the "FEHBP Contract").

1.   FEHBP Contract Section 1.10:

     NOTICE OF SIGNIFICANT EVENTS

(a)  The Carrier agrees to notify the Contracting Officer of any Significant
     Event within ten (10) working days after Carrier becomes aware of it. As
     used in this section, Significant Event is any occurrence that might
     reasonably be expected to have a material effect upon Carrier's ability to
     meet its obligations under this contract, including, but not limited to,
     any of the following:

(1)  Disposal of major assets;

(2)  Loss of 15% or more of Carrier's overall membership;

(3)  Termination or modification of any contract or subcontract if such
     termination or modification might have a material effect on Carrier's
     obligations under this contract;

(4)  Addition or termination of provider agreements;

(5)  Any changes in underwriters, reinsurers or participating plans;

(6)  The imposition of, or notice of the intent to impose, a receivership,
     conservatorship, or special regulatory monitoring;

(7)  The withdrawal of, or notice of intent to withdraw State licensing, HHS
     qualification, or any other status under Federal or State law;

(8)  Default on a loan or other financial obligation;

(9)  Any actual or potential labor dispute that delays or threatens to delay
     timely performance or substantially impairs the functioning of the
     Carrier's facilities or facilities used by the Carrier in the performance
     of the contract;

                                      B-1
<PAGE>

(10) Any change in its charter, constitution, or by-laws which affects any
     provision of this contract or the Carrier's participation in the Federal
     Employees Health Benefits Program;

(11) Any significant changes in policies and procedures or interpretations of
     the contract or brochure which would affect the benefits available under
     the contract or the costs charged to the contract;

(12) Any fraud, embezzlement or misappropriation of FEHB funds; or

(13) Any written exceptions, reservations or qualifications expressed by the
     independent accounting firm (which ascribes to the standards of the
     American Institute of Certified Public Accountants) contracted with by the
     Carrier to provide an opinion on its annual financial statements.

(b)  Upon learning of a Significant Event OPM may institute action, in
     proportion to the seriousness of the event, to protect the interest of
     Members, including, but not limited to--

(1)  Directing The Carrier to take corrective action;

(2)  Suspending new enrollments under this contract;

(3)  Advising Enrollees of the Significant Event and providing them an
     opportunity to transfer to another plan;

(4)  Withholding payment of subscription income or restricting access to The
     Carrier's Letter of Credit account;

(5)  Terminating the enrollment of those Enrollees who, in the judgment of OPM,
     would be adversely affected by the Significant Event; or

(6)  Terminating this contract pursuant to Section 1.15 of the contract between
     Tufts and OPM, RENEWAL AND WITHDRAWAL OF APPROVAL.

(c)  Prior to taking action as described in paragraph (b) of this clause, the
     OPM will notify The Carrier and offer an opportunity to respond.

(d)  The Carrier shall insert this clause in any subcontract or subcontract
     modification if both the amount of the subcontract (or in the case of a
     community-rated carrier, applicable to the FEHBP) exceeds $100,000 and the
     amount of the subcontract or modification to be charged to the FEHBP (or in
     the case of a community-rated carrier, applicable to the FEHBP) exceeds 25
     percent of the total cost of the subcontract or modification. If The
     Carrier is an HMO, it shall also insert this clause in all provider
     agreements over $25,000. If The Carrier is not an HMO, it shall also insert
     this clause in the

                                      B-2
<PAGE>

     contract with its underwriter, if any. The Carrier shall substitute an
     appropriate reference for the term "Carrier".

2.   FEHBP Contract Section 1.11

     FEHB INSPECTION

(a)  The Government or its agent has the right to inspect and evaluate the work
     performed or being performed under the contract, and the premises where the
     work is being performed, at all reasonable times and in a manner that will
     not unduly delay the work. If the Government or its agent performs
     inspection or evaluation on the premises of the Carrier or a subcontractor,
     The Carrier shall furnish and require the subcontractor to furnish all
     reasonable facilities and assistance for the same and convenient
     performance of these duties.

(b)  The Carrier shall insert this clause in all subcontracts for underwriting
     and administrative services and shall substitute an appropriate reference
     for the term "Carrier".

3.   FEHBP Contract Section 1.14

     MISLEADING, DECEPTIVE OR UNFAIR ADVERTISING

(a)  The Carrier agrees that any advertising material, including that labeled
     promotional material, marketing material, or supplemental literature, shall
     be truthful and not misleading.

(b)  Criteria to assess compliance with paragraph (a) of this clause are
     available in the FEHB Supplemental Literature Guidelines which are
     developed by OPM and should be used, along with the additional guidelines
     set forth in FEHBAR 1603.702, as the primary guide in preparing material;
     further guidance is provided in the NAIC ADVERTISEMENTS OF ACCIDENT AND
     SICKNESS INSURANCE MODEL REGULATION. The guidelines contained in this
     document are available at WWW.NAIC.ORG under "Model Laws, Regulations, and
     White Papers".

(c)  Failure to conform to paragraph (a) of this clause may result in a
     reduction in the service charge, if appropriate, and corrective action to
     protect the interest of Federal Members. Corrective action will be
     appropriate to the circumstances and may include, but is not limited to the
     following actions by OPM:

(1)  Directing the Carrier to cease and desist distribution, publication, or
     broadcast of the material;

                                      B-3
<PAGE>

(2)  Directing the Carrier to issue corrections at the Carrier's expense and in
     the same manner and media as the original material was made; and

(3)  Directing the Carrier to provide, at the Carrier's expense, the correction
     in writing by certified mail to all enrollees of the Plan(s) that had been
     the subject of the original material.

(d)  Egregious or repeated offenses may result in the following action by OPM:

(1)  Suspending new enrollments in Carrier's Plan(s);

(2)  Providing Enrollees a opportunity to transfer to another plan; and

(3)  Terminating the contract in accordance with Section 1.15 of the Tufts/OPM
     contract, RENEWAL AND WITHDRAWAL OF APPROVAL.

(e)  Prior to taking action as described in paragraph (c) and (d) of this
     clause, the OPM will notify Carrier and offer an opportunity to respond.

(f)  Carrier shall incorporate this clause in subcontracts with its underwriter,
     if any, and other subcontractors directly involved in the preparation or
     distribution of such advertising material and shall substitute an
     appropriate reference for the term "Carrier".

4.   FEBHP Contract Section 5.5

     ANTI-KICKBACK PROCEDURES

(a)  Definitions.

     "Kickback", as used in this clause, means any money, fee, commission,
     credit, gift, gratuity, thing of value, or compensation of any kind which
     is provided, directly or indirectly, to Carrier, Carrier employee,
     subcontractor, or subcontractor employee for the purpose of improperly
     obtaining or rewarding favorable treatment in connection with a prime
     contract or in connection with a subcontract relating to a prime contract.

     "Person", as used in this clause, means a corporation, partnership,
     business association of any kind, trust, joint-stock company, or
     individual.

     "Prime contract", as used in this clause, means a contract or contractual
     action entered into by the United States for the purpose of obtaining
     supplies, materials, equipment, or services of any kind.

                                      B-4
<PAGE>

     "Prime Contractor", as used in this clause, means a person who has entered
     into a prime contract with the United States.

     "Prime Contractor employee", as used in this clause, means any officer,
     partner, employee, or agent of a prime Contractor.

     "Subcontract", as used in this clause, means a contract or contractual
     action entered into by a Prime Contractor or a subcontractor for the
     purpose of obtaining supplies, materials, equipment, or services of any
     kind under a prime contract.

     "Subcontractor", as used in this clause, (1) means any person, other than
     the Prime Contractor, who offers to furnish or furnishes any supplies,
     materials, equipment, or services of any kind under a prime contract or a
     subcontract entered into in connection with such prime contract, and (2)
     includes any person who offers to furnish or furnishes general supplies to
     Prime Contractor or a higher tier subcontractor.

     "Subcontractor employee", as used in this clause, means any officer,
     partner, employee, or agent of a subcontractor.

(b)  The Anti-Kickback Act of 1986 (41 U.S.C. 51-58) (the Act), prohibits any
     person from --

(1)  Providing or attempting to provide or offering to provide any kickback;

(2)  Soliciting, accepting, or attempting to accept any kickback; or

(3)  Including, directly or indirectly, the amount of any kickback in the
     contract price charged by the Prime Contractor to the United States or in
     the contract price charged by a subcontractor to a Prime Contractor for
     higher tier subcontractor.

(c)

(1)  The Prime Contractor shall have in place and follow reasonable procedures
     designed to prevent and detect possible violations described in paragraph
     (b) of this clause in its own operations and direct business relationships.

(2)  When the Prime Contractor has reasonable grounds to believe that a
     violation described in paragraph (b) of this clause may have occurred, the
     Contractor shall promptly report in writing the possible violation. Such
     reports shall be made to the inspector general of the

                                      B-5
<PAGE>

     contracting agency; the head of the contracting agency if the agency does
     not have an inspector general, or the Department of Justice.

(3)  The Prime Contractor shall cooperate fully with any Federal agency
     investigating a possible violation described in paragraph (b) of this
     clause.

(4)  The Contracting Officer may (i) offset the amount of the kickback against
     any monies owed by the United States under the prime contract and/or (ii)
     direct that the Prime Contractor withhold, from sums owed a subcontractor
     under the prime contract, the amount of any kickback. the Contracting
     Officer may order the monies withheld under subdivision (c)(4)(i) of this
     clause. In either case, the Prime Contractor shall notify the Contracting
     Officer when the monies are withheld.

(5)  The Prime Contractor agrees to incorporate the substance of this clause,
     including this subparagraph (c)(5) but excepting subparagraph (c)(1), in
     all subcontracts under this contract which exceed $100,000.

5.   FEHBP Contract Section 5.7

     AUDIT AND RECORDS-NEGOTIATION

(a)  As used in this clause, "records" includes books, documents, accounting
     procedures and practices, and other data, regardless of type and regardless
     of whether such items are in written form, in the form of computer data, or
     in any other form.

(b)  EXAMINATION OF COSTS. If this is a cost-reimbursement, incentive,
     time-and-materials, labor-hour, or price redeterminable contract, or any
     combination of these, Carrier shall maintain and the Contracting Officer,
     or an authorized representative of the Contracting Officer, shall have the
     right to examine and audit all records and other evidence sufficient to
     reflect properly all costs claimed to have been incurred or anticipated to
     be incurred directly or indirectly in performance of this contract. This
     right of examination shall include inspection at all reasonable times of
     Carrier's plants, or parts of them, engaged in performing the contract.

(c)  COST OR PRICING DATA. If Carrier has been required to submit cost or
     pricing data in connection with any pricing action relating to this
     contract, the Contracting Officer, or an authorized representative of the
     Contracting Officer, in order to evaluate the accuracy, completeness, and
     currency of the cost or pricing data, shall have the right to examine and
     audit all of Carrier's records, including computations and projections,
     related to--

(1)  The proposal for the contract, subcontract, or modification;

                                      B-6
<PAGE>

(2)  The discussions conducted on the proposal(s), including those related to
     negotiating;

(3)  Pricing of the contract, subcontract, or modification; or

(4)  Performance of the contract, subcontract or modification.

(d)  COMPTROLLER GENERAL - (1) The Comptroller General of the United States, or
     an authorized representative, shall have access to and the right to examine
     any of Carrier's directly pertinent records involving transactions related
     to this contract or a subcontract hereunder.

(1)  This paragraph may not be construed to require Carrier or a subcontractor
     to create or maintain any record that Carrier or a subcontractor of Carrier
     does not maintain in the ordinary course of business or pursuant to a
     provision of law.

(e)  REPORTS. If Carrier is required to furnish cost, funding, or performance
     reports, the Contracting Officer or an authorized representative of the
     Contracting Officer shall have the right to examine and audit the
     supporting records and materials, for the purpose of evaluating (1) the
     effectiveness of Carrier's policies and procedures to produce data
     compatible with the objectives of these reports and (2) the data reported.

(f)  AVAILABILITY. Carrier shall make available at its office at all reasonable
     times the records, materials, and other evidence described in paragraph
     (a), (b), (c), (d), and (e) of this clause, for examination, audit, or
     reproduction, until 3 years after final payment under this contract or for
     any shorter period specified in Subpart 4.7, Contractor Records Retention,
     of the Federal Acquisition Regulation (FAR), or for any longer period
     required by statute or by other clauses of this contract. In addition--(1)
     If this contract is completely or partially terminated, Carrier shall make
     available the records relating to the work terminated until 3 years after
     any resulting final termination settlement; and (2) Carrier shall make
     available records relating to appeals under the Disputes clause or to
     litigation or the settlement of claims arising under or relating to this
     contract until such appeals, litigation, or claims are finally resolved.

(g)  Carrier shall insert a clause containing all the terms of this clause,
     including this paragraph (g), in all subcontracts under this contract that
     exceed the simplified acquisition threshold and--

(1)  That are cost-reimbursement, incentive, time-and-materials, labor-hour, or
     price-redeterminable type or any combination of these;

(2)  For which cost or pricing data are required; or

                                      B-7
<PAGE>

(3)  That require the subcontractor to furnish reports as discussed in paragraph
     (e) of this clause.

     The clause may be altered only as necessary to identify properly the
     contracting parties and the Contracting Officer under the Government prime
     contract.

6.   FEHBP Contract Section 5.18:

     CONTRACT WORK HOURS AND SAFETY STANDARDS ACT - OVERTIME COMPENSATION

(a)  OVERTIME REQUIREMENTS. No Contractor or any subcontractor employing
     laborers or mechanics (see Federal Acquisition Regulation 22.300) shall
     require or permit them to work over 40 hours in any workweek unless they
     are paid at least 1 and 1/2 times the basic rate of pay for reach hour
     worked over 40 hours.

(b)  VIOLATION: LIABILITY FOR UNPAID WAGES; LIQUIDATED DAMAGES. The responsible
     Contractor and subcontractor are liable for unpaid wages if they violate
     the terms in paragraph (a) of this clause. In addition, the Contractor and
     subcontractor are liable for unpaid wages if they violate the terms in
     paragraph (a) of this clause. In addition, the Contractor and subcontractor
     are liable for liquidated damages payable to the Government. The
     Contracting Officer will assess liquidated damages at the rate of $10 per
     affected employee for each calendar day on which the employer required or
     permitted the employee to work in excess of the standard workweek of 40
     hours without paying overtime wages required by the Contract Work Hours and
     Safety Standards Act.

(c)  WITHHOLDING FOR UNPAID WAGES AND LIQUIDATED DAMAGES. The Contracting
     Officer will withhold from payments due under the contract sufficient funds
     required to satisfy Contractor or subcontractor liabilities for unpaid
     wages and liquidated damages. If amounts withheld under the contract are
     insufficient to satisfy Contractor's or subcontractor liabilities, the
     Contracting Officer will withhold payments from other Federal or Federally
     assisted contracts held by the same Contractor that are subject to the
     Contract Work Hours and Safety Standards Act.

(d)  Payrolls and basic records. (1) The Contractor and its subcontractors shall
     maintain payrolls and basic payroll records for all laborers and mechanics
     working on the contract during the contract and shall make them available
     to the Government until 3 years after contract completion. The records
     shall contain the name and address of each employee, social security
     number, labor classifications, hourly rates of wages paid, daily and weekly
     number of hours worked, deductions made, and actual wages paid. The records
     need not duplicate those required for construction

                                      B-8
<PAGE>

     work by Department of Labor regulations at 29 CFR 5.5(a)(3) implementing
     the Davis-Bacon Act.

(e)  The Contractor and its subcontractors shall allow authorized
     representatives of the Contracting Officer or the Department of Labor to
     inspect, copy, or transcribe records maintained under paragraph (d)(1) of
     this clause. The Contractor or subcontractor also shall allow authorized
     representatives of the Contracting Officer or Department of Labor to
     interview employees in the workplace during working hours.

(f)  Subcontracts. The Contractor and its subcontractors shall insert the
     provisions set forth in paragraph (a) through (d) of this clause in
     subcontracts exceeding $100,000 and require subcontractors to include these
     provisions in any lower-tier subcontracts. The Contractor shall be
     responsible for compliance by any subcontractor or lower-tier subcontractor
     with the provisions set forth in paragraph (a) through (d) of this clause.

7.   FEHBP Contract Section 5.22

     AFFIRMATIVE ACTON FOR DISABLED VETERANS AND VETERANS OF THE VIETNAM ERA

(a)  Definitions as used in this clause-

     "All employment openings" includes all positions except executive and top
     management, those positions that will be filled from within the
     contractor's organization, and positions lasting 3 days or less. This term
     includes full-time employment, temporary employment of more than 3 days'
     duration, and part-time employment.

     "Appropriate office of the State employment service system", means the
     local office of the Federal-State national system of public employment
     offices with assigned responsibility to serve the area where the employment
     opening is to be filled, including the District of Columbia, Guam, the
     Commonwealth of Puerto Rico, and the Virgin Islands.

     "Positions that will be filled from within the Contractor's organization"
     means employment openings for which no consideration will be given to
     persons outside the Contractor's organization (including any affiliates,
     subsidiaries, and parent companies) and includes any openings that the
     Contractor proposes to fill from regularly established "recall" lists. The
     exception does not apply to a particular opening once an employer decides
     to consider applicants outside of its organization.

     "Veteran of the Vietnam era" means a person who-

(1)  Served on active duty for a period of more than 180 days, any part of which
     occurred between August 5, 1964, and May 7, 1975, and

                                      B-9
<PAGE>

     was discharged or released therefrom with other than a dishonorable
     discharge; or

(2)  Was discharged or released from active duty for a service-connected
     disability if any part of such active duty was performed between August 5,
     1964 and May 7, 1975.

(b)  GENERAL. (1) Regarding any position for which the employee or applicant for
     employment is qualified, the Contractor shall not discriminate against the
     individual because the individual is a disabled veteran or a veteran of the
     Vietnam Era. The Contractor agrees to take affirmative action to employ,
     advance in employment, and otherwise treat qualified disabled veterans and
     veterans of the Vietnam Era without discrimination based upon their
     disability or veterans' status in all employment practices such as

(i)     Employment;

(ii)    Upgrading;

(iii)   Demotion or transfer;

(iv)    Recruitment;

(v)     Advertising;

(vi)    Layoff or termination;

(vii)   Rates of pay or other forms of compensation; and

(viii)  Selection for training, including apprenticeship.

(2)  The Contractor agrees to comply with the rules, regulations, and relevant
     orders of the Secretary of Labor (Secretary) issued under the Vietnam Era
     Veterans' Readjustment Assistance Act of 1972 (the Act), as amended.

(c)  LISTING OPENINGS. (1) Carrier agrees to list all employment openings
     existing at contract award or occurring during contract performance, at an
     appropriate office of the State employment service system in the locality
     where the opening occurs. These openings include those occurring at any
     Contractor facility, including one not connected with performing this
     contract. An independent corporate affiliate is exempt from this
     requirement.

(1)  State and local government agencies holding Federal contracts of $10,000 or
     more shall also list all employment openings with the appropriate office of
     the State employment service.

                                      B-10
<PAGE>

(2)  The listing of employment openings with the State employment service system
     is required at least concurrently with using any other recruitment source
     or effort and involves the obligations of placing a bona fide job order,
     including accepting referrals of veterans and non-veterans. This listing
     does not require hiring any particular job applicant or hiring from any
     particular group of job applicants and is not intended to relieve
     Contractor from any requirements of Executive orders or regulations
     concerning nondiscrimination in employment.

(3)  Whenever Contractor becomes contractually bound to the listing terms of
     this clause, it shall advise the State employment service system, in each
     State where it has establishments of the name and location of each hiring
     location in the State. As long as Contractor is contractually bound to
     these terms and has so advised the State system, it need not advise the
     State system of subsequent contracts. Contractor may advise the State
     system when it is no longer bound by this contract clause.

(d)  APPLICABILITY. This clause does not apply to the listing of employment
     openings that occur and are filled outside the 50 States, the District of
     Columbia, the Commonwealth of Puerto Rico, Guam, and the Virgin Islands.

(e)  POSTINGS. (1) Contractor agrees to post employment notices stating (i)
     Contractor's obligation under the law to take affirmative action to employ
     and advance in employment qualified disabled veterans and veterans of the
     Vietnam era, and (ii) the rights of applicants and employees.

(1)  These notices shall be posted in conspicuous places that are available to
     employees and applicants for employment. They shall be in a form prescribed
     by the Deputy Assistant Secretary for Federal Contract Compliance Programs,
     Department of Labor (Deputy Assistant Secretary), and provided by or
     through the Contracting Officer.

(2)  Contractor shall notify each labor union or representative of workers with
     which it has a collective bargaining agreement or other contract
     understanding, that the Contractor is bound by the terms of the Act, and is
     committed to take affirmative action to employ, and advance in employment,
     qualified disabled veterans and veterans of the Vietnam era.

(f)  NONCOMPLIANCE. If the Contractor does not comply with the requirements of
     this clause, appropriate actions may be taken under the rules, regulations,
     and relevant orders of the Secretary issued pursuant to the Act.

(g)  SUBCONTRACTS. The Contractor shall include the terms of this clause in
     every subcontract or purchase order of $10,000 or more unless exempted by
     rules, regulations, or orders of the Secretary. The Contractor shall act as

                                      B-11
<PAGE>

     specified by the Deputy Assistant Secretary to enforce the terms, including
     action for noncompliance.

8.   FEHBP Contract Section 5.23

         AFFIRMATIVE ACTION FOR WORKERS WITH DISABILITIES

(a)  General.

(1)  Regarding any position for which the employee or applicant for employment
     is qualified, the Contractor shall not discriminate against any employee or
     applicant because of physical or mental disability. the Contractor agrees
     to take affirmative action to employ, advance in employment, and otherwise
     treat qualified individuals with disabilities without discrimination based
     upon their physical or mental disabilities in all employment practices such
     as -

(i)    Recruitment. Advertising, and job application procedures;

(ii)   Hiring, upgrading, promotion, award of tenure, demotion, transfer,
       layoff, termination, right of return from layoff, and rehiring;

(iii)  Rates of pay or any other form of compensation and changes in
       compensation;

(iv)   Job assignments, job classifications, organizational structures, position
       descriptions, lines of progression, and seniority lists;

(v)    Leaves of absence, sick leave, or any other leave;

(vi)   Fringe benefits available by virtue of employment, whether or not
       administered by the Contractor;

(vii)  Selection and financial support for training, including apprenticeships,
       professional meetings, conferences , and other related activities, and
       selections for leaves of absence to pursue training;

(viii) Activities sponsored by the Contractor, including social or recreational
       programs; and

(ix)   Any other term, condition, or privilege of employment.

(2)  The Contractor agrees to comply with the rules, regulations, and relevant
     orders of the Secretary of Labor (Secretary) issued under the
     Rehabilitation Act of 1973 (29 U.S.C. 793) (the Act), as amended.

                                      B-12
<PAGE>

(b)  POSTING.

(1)  The Contractor agrees to post employment notices stating (i) the
     Contractor's obligation under the law to take affirmative action to employ
     and advance in employment qualified individuals with disabilities, and (ii)
     the rights of applicants and employees.

(2)  These notices shall be posted in conspicuous places that are available to
     employees and applicants for employment. The Contractor shall ensure that
     applicants and employees with disabilities are informed of the contents of
     the notice (e.g., the Contractor may have the notice read to a visually
     disabled individual, or may lower the posted notice so that it might be
     read by a person in a wheelchair). The notices shall be in a form
     prescribed by the Deputy Assistant Secretary for Federal Contract
     Compliance of the U.S. Department of Labor (Deputy Assistant Secretary),
     and provided by or through the Contracting Officer.

(3)  The Contractor shall notify each labor union or representative of workers
     with which it has a collective bargaining agreement or other contract
     understanding, that the Contractor is bound by the terms of Section 503 of
     the Act and is committed to take affirmative action to employ, and advance
     in employment, qualified individuals with disabilities.

(c)  NONCOMPLIANCE. If the Contractor does not comply with the requirements of
     this clause, appropriate actions may be taken under the rules, regulations,
     and relevant orders of the Secretary issued pursuant to the Act.

(d)  SUBCONTRACTS. The Contractor shall include the terms of this clause in
     every subcontract or purchase order of $10,000 or more unless exempted by
     rules, regulations, or orders of the Secretary. The Contractor shall act as
     specified by the Deputy Assistant Secretary to enforce the terms, including
     action for noncompliance.

9.   FEHBP Contract Section 5.56

     AUTHORIZATION AND CONSENT

(a)  The Government authorizes and consents to all use and manufacture, in
     performing this contract or any subcontract at any tier, of any invention
     described in or covered by a United States patent (1) embodied in the
     structure or composition of any article the delivery of which is accepted
     by the Government under this contract or (2) used in machinery, tools or
     methods whose use necessarily results from compliance by the Contractor for
     a subcontractor with (i) specifications or written provisions forming a
     part of this contract or (ii) specific written instructions given by the
     Contracting Officer directing the manner of performance. The entire
     liability to the Government for infringement of a patent of the United
     States shall be

                                      B-13
<PAGE>

     determined solely by the provisions of the indemnity clause, if any,
     included in this contract or subcontract hereunder (including any
     lower-tier subcontract), and the Government assumes liability for all other
     infringement to the extent of the authorization and consent hereinabove
     granted.

(b)  Carrier agrees to include, and require inclusion of, this clause, suitably
     modified to identify the parties, in all subcontracts at any tier for
     supplies or services (including construction, architect-engineer services,
     and materials, supplies, models, samples, and design or testing services
     expected to exceed the simplified acquisition threshold); however, omission
     of this clause from any subcontract, including those at or below the
     simplified acquisition threshold, does not affect this authorization and
     consent.

10.  FEHBP Contract Section 5.57

     NOTICE AND ASSISTANCE REGARDING PATENT AND COPYRIGHT INFRINGEMENT

(a)  The Contractor shall report to the Contracting Officer, promptly and in
     reasonable written detail, each notice or claim of patent or copyright
     infringement based on the performance of this contract of which the
     Contractor has knowledge.

(b)  In the event of any claim or suit against the Government on account of any
     alleged patent or copyright infringement arising out of the performance of
     this contract or out of the use of any supplies furnished or work or
     services performed under this contract, the Contractor shall furnish to the
     Government, when requested by the Contracting Officer, all evidence and
     information in possession of the Contractor pertaining to such suit or
     claim. Such evidence and information shall be furnished at the expense of
     the Government except where the Contractor has agreed to indemnify the
     Government.

(c)  The Contractor agrees to include, and require inclusion of, this clause, in
     all subcontracts at any tier for supplies or services (including
     construction and architect-engineer subcontracts and those for materials,
     supplies, models, samples, or design or testing services) expected to
     exceed the simplified acquisition threshold at FAR 2.101.

11.  FEHBP Contract Section 5.59

     PROHIBITION OF SEGREGATED FACILITIES

(a)  "Segregated facilities", as used in this clause, means any waiting rooms,
     work areas, rest rooms and wash rooms, restaurants and other eating areas,
     time clocks, locker rooms and other storage or dressing areas, parking
     lots, drinking fountains, recreation or entertainment areas,
     transportation, and housing facilities provided for employees, that are
     segregated by explicit

                                      B-14
<PAGE>

     directive or are in fact segregated on the basis of race, color, religion,
     sex, or national origin because of written or oral policies or employee
     custom. The term does not include separate or single-user rest rooms or
     necessary dressing or sleeping areas provided to assure privacy between the
     sexes.

(b)  The Contractor agrees that it does not and will not maintain or provide for
     its employees any segregated facilities at any of its establishments, and
     that it does not and will not permit its employees to perform their
     services at any location under its control where segregated facilities are
     maintained. The Contractor agrees that a breach of this clause is a
     violation of the Equal Opportunity clause in this contract.

(c)  The Contractor shall include this clause in every subcontract and purchase
     order that is subject to the Equal Opportunity clause of this contract.

                                      B-15
<PAGE>

                                    EXHIBIT C

                          BUSINESS ASSOCIATION ADDENDUM

                           BUSINESS ASSOCIATE ADDENDUM

         This Business Associate Addendum ("Addendum") is entered into by and
     between Alere Medical, Inc. ("Alere"), acting as Tuft's general contractor
     for disease management services and Subcontractor ("Business Associate")
     and hereby supplements, amends, and is made a part of any and all HIPAA
     Related Agreements. The term "HIPAA Related Agreements" means any and all
     agreements (in effect as of the date of full execution of this Addendum
     ("Effective Date") or entered into any time thereafter) by and between
     Business Associate and Alere under which Business Associate has created or
     received and/or may create or receive Protected Health Information (as
     defined below) from or on behalf of Tufts either directly or indirectly
     through Alere.

                                    RECITALS

A.   Alere and/or Business Associate are parties to the HIPAA Related Agreements
     pursuant to which Business Associate and/or Alere provide certain services
     to Tufts, and, in connection with those services, Tufts and/or Alere
     discloses to Business Associate certain protected health information as
     defined at 45 CFR ss. 160.103 (the "Protected Health Information") that is
     subject to protection under the Health Insurance Portability and
     Accountability Act of 1996 ("HIPAA," found at Public Law 104-191), and
     certain regulations promulgated by the U.S. Department of Health and Human
     Services to implement certain provisions of HIPAA (the "HIPAA Privacy
     Rule," 45 CFR Part 160 and 45 CFR Part 164, subparts "A" and "E" and the
     "HIPAA Security Rule," 45 CFR Part 160 and 45 CFR Part 164, subparts "A"
     and "C," collectively, the "HIPAA Regulations").

B.   Tufts is a "covered entity," as that term is defined in the HIPAA Privacy
     Rule. Business Associate, as recipient of Protected Health Information from
     Tufts under the HIPAA Related Agreements, is a "business associate" of
     Tufts, as that term is defined in the HIPAA Privacy Rule.

C.   Pursuant to the HIPAA Privacy Rule, all business associates of Tufts, as a
     condition of doing business with Tufts, must agree in writing to certain
     mandatory provisions regarding, among other things, the use and disclosure
     of Protected Health Information. The parties agree that the obligations
     specified herein shall commence upon the Effective Date.

D.   The purpose of this Addendum is to satisfy the requirements of the HIPAA
     Regulations.

                                      D-1
<PAGE>

         IN CONSIDERATION OF THE FOREGOING, and the mutual promises and
     covenants contain herein, the parties agree as follows:

                                    AGREEMENT

     1. DEFINITIONS. Unless otherwise provided in this Addendum, capitalized
     terms have the same meaning as set forth in the HIPAA Privacy Rule.

     2. APPLICABILITY. This Addendum shall be applicable to Protected Health
     Information (i) received by Business Associate from Tufts and/or Alere
     pursuant to the HIPAA Related Agreements or (ii) created or received by
     Business Associate on behalf of Tufts and/or Alere pursuant to the HIPAA
     Related Agreements.

     3. SCOPE OF USE OF PROTECTED HEALTH INFORMATION. Business Associate shall
     not use or disclose Protected Health Information for any purpose other
     than:

     (i)   As permitted or required by the HIPAA Related Agreements (including
           this Addendum);
     (ii)  to and/or at the direction of Tufts and Alere, as required to perform
           the HIPAA related Agreements,
     (iii) As otherwise required by law;
     (iv)  The proper management and administration of Business Associate;
     (v)   Business Associate may aggregate PHI with such information of other
           covered entities which Business Associate has received or created in
           its capacity as a business associate of such other covered entities
           provided that the purpose of the aggregation is to provide each
           covered entity with data analysis related to the respective covered
           entities' health care operations and provided further that the PHI
           disclosed hereunder for such purposes shall not be disclosed in the
           data analysis provided to any other covered entity;
     (vi)  Business Associate may de-identify PHI provided that Business
           Associate provided that Business Associate satisfied the applicable
           provisions for de-identification under HIPAA. Any such de-identified
           information shall not constitute PHI and shall not be subject to the
           terms and conditions of this Agreement. Notwithstanding any other
           provision of this Agreement, de-identified information created or
           derived by Business Associate, including PHI of or provided by Tufts
           or Alere, shall be Confidential Information of Business Associate,
           and may be used or disclosed by Business Associate during the Term or
           thereafter for any lawful purpose. Neither Tufts nor Alere shall have
           any right, title or interest in or to such de-identified information.

     4. SAFEGUARDS FOR THE PROTECTION OF PROTECTED HEALTH INFORMATION. Business
     Associate shall implement and use appropriate safeguards, including

                                      D-2
<PAGE>

     but not limited any and all such safeguards directed by Tufts and/or Alere,
     to help ensure that Protected Health Information is not used or disclosed
     by Business Associate, or by any subcontractors, affiliates, or business
     associates of Business Associate, except as provided in the HIPAA Related
     Agreements (including this Addendum).

     5. REPORTING OF UNAUTHORIZED USES OR DISCLOSURES. Business Associate shall
     promptly report to Tufts and Alere any use or disclosure of Protected
     Health Information by Business Associate or its subcontractors of which
     Business Associate becomes aware that is not provided for or permitted in
     the HIPAA Related Agreements (including this Addendum). Business Associate
     shall permit Alere and Tufts reasonable access to Business Associate's
     employees and records (including electronic records) as reasonably
     necessary to investigate any such report.

     6. USE OF SUBCONTRACTORS. To the extent that any HIPAA Related Agreement
     expressly permits Business Associate to use subcontractors and/or agents to
     perform its obligations under such HIPAA Related Agreement or to otherwise
     delegate performance of its obligations (if at all), Business Associate
     shall cause each such subcontractor, agent or delegatee to sign and shall
     ensure their compliance with an agreement with Business Associate
     containing the same provisions and conditions related to the protection and
     confidentiality of Protected Health Information as those that apply to
     Business Associate under the applicable HIPAA Related Agreements (including
     this Addendum).

     7. AUTHORIZED ACCESS TO PROTECTED HEALTH INFORMATION. To the extent that
     Business Associate maintains Protected Health Information in a Designated
     Record Set, at the request of Tufts and/or Alere, Business Associate shall
     provide Tufts and Alere (or an Individual as directed by Tufts or Alere)
     access to such Protected Health Information in a Designated Record Set in
     the time and manner reasonably designated by Tufts and/or Alere in order
     for Tufts to meet the requirements imposed on Tufts by 45 CFR ss. 164.524.

     8. AMENDMENT OF PROTECTED HEALTH INFORMATION. To the extent that Business
     Associate maintains Protected Health Information in a Designated Record
     Set, Business Associate shall make any amendment(s) to Protected Health
     Information in a Designated Record Set that Tufts and/or Alere directs or
     agrees to pursuant to 45 CFR ss. 164.526, and in the time and manner
     reasonably designated by Tufts and/or Alere; provided, however, if Business
     Associates believes that such amendment would render its records
     inaccurate, it shall make the amendment but place a notation in the record
     as to the disagreement.

     9. ACCOUNTING OF DISCLOSURES OF PROTECTED HEALTH INFORMATION. Business
     Associate shall keep records of all disclosures of Protected Health
     Information

                                      D-3
<PAGE>

     made by Business Associate (the "Disclosure Accounting") on an ongoing
     basis for a period of at least six (6) years (or such longer period as may
     be required by the HIPAA Related Agreements or by applicable law), except
     for disclosures:

     (i)   To carry out Treatment, Payment, or Health Care Operations, as
           provided in 45 CFR ss. 164.502;

     (ii)  To individuals of Protected Health Information about them as provided
           in 45 CFR ss. 164.502;

     (iii) That are otherwise excluded from the HIPAA Privacy Rule disclosure
           accounting requirements by the provisions set forth at 45 CFR ss.
           164.528(a)(1), subsection (iii) through (ix); or

     (iii) That occurred prior to April 14, 2003.

                  At a minimum, the Disclosure Accounting shall contain:

(a)  The date of the disclosure;
(b)  The name of the entity or person to whom or which the Protected Health
     Information was provided and, if known, the address of such entity or
     person;
(c)  A brief description of the Protected Health Information disclosed; and
(d)  A brief statement of the purpose of the disclosure that reasonably informs
     the Individual of the basis for the disclosure or, in lieu of such
     statement, a copy of the Individual's written authorization or request for
     disclosure pursuant to the HIPAA Privacy Rule.

                  Business Associate shall provide the Disclosure Accounting to
     Tufts and Alere (or to an Individual, if so directed by Tufts or Alere)
     within sixty (60) days of receiving a written request therefor from Tufts
     or Alere.

     10. RIGHT TO AUDIT. Upon the request of Tufts and/or the Secretary of the
     Department of Health and Human Services, Business Associate shall make its
     practices, books and records related to Protected Health Information
     available to Tufts and/or the Secretary of the Department of Health and
     Human Services for the purpose of determining Tuft's compliance with the
     HIPAA Regulations and/or Business Associate's compliance with this
     Addendum.

     11. FUTURE CONFIDENTIALITY OF PROTECTED HEALTH INFORMATION. Upon the
     expiration or earlier termination of any HIPAA Related Agreement for any
     reason, Business Associate shall return to Tufts, or, at Tuft's direction,
     delete, purge and destroy, all Protected Health Information (in any form,
     recorded on any medium, or stored in any storage system) that was created
     or obtained pursuant to that terminated HIPAA Related Agreement (and that
     Business Associate does not need to maintain to perform its obligations
     under any then-existing HIPAA Related Agreement) and shall retain no copies
     of such information. If Business Associate destroys Protected Health
     Information, an officer of Business Associate shall certify such
     destruction to Tufts in writing.

                                      D-4
<PAGE>

     If such return or destruction is not feasible, Business Associate shall
     extend the protections of this Addendum to the information and shall limit
     further uses and disclosures to those purposes that make the return or
     destruction of the information infeasible.

     12. TERMINATION IN EVENT OF BREACH. In the event that Business Associate
     violates any material term of any HIPAA Related Agreement (including this
     Addendum, Tufts and/or Alere may terminate the HIPAA Related Agreement(s)
     immediately by providing written notice of such termination to Business
     Associate.

     13. INDEMNIFICATION. Business Associate agrees that it shall be financially
     responsible for, and agrees that it shall defend, indemnify, and hold
     harmless, Tufts and Alere (including for each, its corporate affiliates and
     each of its and their shareholders, affiliates, officers, directors,
     employees, agents, attorneys, successors, successors-in-interest, and
     assigns) from and against any and all claims, causes of action, suits,
     litigation, proceedings, complaints, demands, charges, liens, disputes,
     obligations, damages, losses, debts, indebtedness, liabilities, costs
     (including settlement costs and costs of investigation), expenses and fees
     (including reasonable attorneys' fees) arising out of or in connection with
     Business Associate's actions and omissions involving Protected Health
     Information relating to enrollees, subscribers, insureds, customers, or
     patients of Tufts. The provisions of this Section 13 shall survive the
     expiration or earlier termination of this Addendum.

     14. PROVISIONS APPLICABLE TO EPHI. Business Associate agrees that it shall:

              5.1 Implement administrative, physical, and technical safeguards
     that reasonably and appropriately protect the confidentiality, integrity,
     and availability of the Electronic Protected Health Information that it
     creates, receives, maintains, or transmits on behalf of Tufts as required
     by 45 CFR, Part 164, Subpart "C."

              5.2 Require that any agent, including a subcontractor, to whom
     Business Associate provides Electronic Protected Health Information agrees
     to implement reasonable and appropriate safeguards to protect such
     Electronic Protected Health Information; provided, however, that Business
     Associate shall not assign, delegate, or subcontract any obligation of
     Business Associate owed to Tufts in violation of any HIPAA Related
     Agreement;

              5.3 Immediately report to Tufts and Alere any Security Incident of
     which Business Associate becomes aware.

     15. AMENDMENTS. The parties shall negotiate in good faith any amendments to
     this Addendum or a replacement of this Addendum to the extent necessary in
     order to maintain compliance with applicable laws and regulations.

                                      D-5
<PAGE>

     16. EFFECT ON HIPAA RELATED AGREEMENTS. Except as amended herein, all terms
     of all of the HIPAA Related Agreements shall remain in full force and
     effect.

     17. CONSTRUCTION. Any ambiguity in this Addendum shall be resolved in favor
     of a meaning that complies with HIPAA and the HIPAA Regulations.

     18. COUNTERPARTS. This Addendum may be executed in any number of
     counterparts, all of which taken together shall constitute one single
     agreement between the parties.

         IN WITNESS WHEREOF, the parties hereto have caused this Business
     Associate Addendum to be executed as of the Effective Date.

     SUBCONTRACTOR

     By:
        ------------------------------------

    Title:
           ---------------------------------

     ALERE

     By:
        ------------------------------------

     Title:
           ---------------------------------

                                      D-6
<PAGE>

                                STATEMENT OF WORK
                                       FOR
                            CARE MANAGEMENT SERVICES
                           DISEASE MANAGEMENT SERVICES

         This Statement of Work for Care Management Services (this "SOW") is
entered into as of October 16, 2006 (the "SOW Effective Date") between Alere
Medical, Inc. ("Alere") and Enhanced Care Initiatives, Inc. ("ECI"), and is a
part of that certain Disease Management Services Agreement dated as of October
16, 2006 between ECI and Alere (the "DMSA"). This SOW sets forth the
assumptions, expectations, Services and Deliverables to be provided by, and
compensation to be paid to, ECI in connection with ECI's provision of disease
management services to Alere. Capitalized terms used but not defined in this SOW
shall have the respective meanings set forth in the DMSA.

1. DEFINITIONS. In addition to the terms otherwise defined herein or in the
DMSA, the following terms shall have the meanings ascribed to them:

         "Care Management Program" shall mean the program maintained by ECI
pursuant to which ECI provides Care Management Services.

         "Care Management Services" shall mean a nurse-based program of care
managed designed to promote the health of the patient while reducing the
associated costs of treatment by focusing of active management of preventive
health measures that will result in less frequent hospitalizations.

         "Program Participants" means those persons who are Enrollees and who
are identified by ECI and Alere as individuals admitted into the Care Management
Program.

         " Enrollees" shall mean all individuals during the relevant period who
were enrolled in any medical care plan with which Tufts Health Plan or a Tufts
Health Plan Affiliates have contracted to provide medical services.

2. CARE MANAGEMENT SERVICES. ECI shall provide or arrange for the provision of
Care Management Services, as set forth below, to Enrollees who become Program
Participants, and in coordination with the respective primary care and/or
treating physicians of the Program Participants.

         The Care Management Service provided by ECI is a nurse-based program
that supports the services provided by health care providers with individual
Care Management for chronically ill patients. The objective of the program is to
reduce the incidence of hospitalization among patients with some combination of
congestive heart failure, diabetes, respiratory disease, or other illnesses,
through individual monitoring, behavioral modification and preventive health
measures.

         ECI nursing personnel receive special training in accordance with the
confidential and proprietary training materials contained in the ECI
Professional Training Manual.

                                      D-7
<PAGE>

ECI will staff the Care Management Program with one full-time equivalent for
each one hundred (100) Program Participants, plus a number of support staff both
within the community and at the ECI central office.

         The Care Management Nurse will meet with each Program Participant on an
intermittent basis ranging from daily to bimonthly, and will record pertinent
information utilizing a confidential and proprietary Patient Information System
operating upon a hand-held computer.

         The Care Management Services also include weekly physical
therapy/recreational group sessions with each Program Participant during which
the Care Management Nurse will be assisted by physical therapists, nursing
assistants and/or other staff.

         Program Participants will be selected for participation in the Care
Management Program based upon criteria assessed using the confidential and
proprietary Selection Criteria developed by ECI and approved by ALERE.

         Where services are delivered in the home and community centers, ECI
provides the following:

     1. Care coordination to improve adherence to the plan of care.

     2. Availability of on call nurse 24/7 for Program Participants.

     3. Connecting care: ECI personnel visit the doctor with the patient.

     4. Disease-specific exercise prescriptions: working in collaboration with
     the patient's physician and physical therapist.

     5. Home safety programs.

     6. Close collaboration with the family and caregivers.

     7. Health and Disease-specific education for patient and caregiver.

     8. 24/7 Caregiver Support Program.

     9. Initiating Health Monitoring systems (Medi-monitor - an electronic
     medication monitoring and prompting device, scales, etc.)

     10. Safe use of Medications.

     11. Pharmacist medication review.

     12. Geriatrician oversight.

     13. Monitoring adherence to established care guidelines.

     14. Communicating and coordinating care issues with providers.

     15. Community patient wellness program - weekly community based meetings -
     decreasing isolation and depression.

                                      D-8
<PAGE>

     16. Advanced Directives education.

     17. Care Management Functions.
         a. ECI personnel function as a true and trusted patient advocacy - best
     able to assist with appropriate care coordination and use of resources.
         b. ECI personnel are able to advocate for the patient in the ER,
     Hospital, Skilled Nursing Facility or Rehabilitation Facility.
         c. ECI personnel can assist in maximizing appropriate use of community
     resources and limiting unnecessary institutional care.

ECI shall provide Alere with reports as outlined in the Table 1 below:

                                                      TABLE 1
                                      Outcomes Reporting Metrics and Schedule
<TABLE>
<CAPTION>
====================================================================================================================
<S>                              <C>                      <C>                         <C>
1. Outcomes                      METRICS                  DATA SOURCE                 REPORTING FREQUENCY
--------------------------------------------------------------------------------------------------------------------
   REFERRALS    Referral sources (# of patients          ECI system data                    Monthly
                referred by claims, ad-hoc, etc)
--------------------------------------------------------------------------------------------------------------------
                Referral outcomes: disposition of        ECI  system data                   Monthly
                referred patients
--------------------------------------------------------------------------------------------------------------------

--------------------------------------------------------------------------------------------------------------------
   ENROLLMENT   Enrollment activity:  enrolled,
                disenrolled and net                      ECI system data                    Monthly
--------------------------------------------------------------------------------------------------------------------
                Number of patients disenrolled and
                reasons                                  ECI system data                    Monthly
--------------------------------------------------------------------------------------------------------------------
                Average length of enrollment             ECI system data                    Monthly
--------------------------------------------------------------------------------------------------------------------

--------------------------------------------------------------------------------------------------------------------
     CENSUS     Total active membership during the
                period                                   ECI system data                    Monthly
--------------------------------------------------------------------------------------------------------------------

--------------------------------------------------------------------------------------------------------------------
  UTILIZATION   All-cause inpatient admissions PTMPY
                for eligible patients                         Claims                      Semi-annual
--------------------------------------------------------------------------------------------------------------------
                All-cause ER visits PTMPY for
                eligible patients                             Claims                      Semi-annual
--------------------------------------------------------------------------------------------------------------------

--------------------------------------------------------------------------------------------------------------------
   FINANCIAL    Total healthcare costs compared to
                the baseline                                  Claims                       Annually
--------------------------------------------------------------------------------------------------------------------
                Annual net savings                            Claims                       Annually
--------------------------------------------------------------------------------------------------------------------

--------------------------------------------------------------------------------------------------------------------
QUALITY OF LIFE Quality of Life scores (SF-12)            Self-reported                   Semi-annual
--------------------------------------------------------------------------------------------------------------------

--------------------------------------------------------------------------------------------------------------------
  SATISFACTION  Patient:  Overall satisfaction with
                the program                                   Survey                       Annually
--------------------------------------------------------------------------------------------------------------------

--------------------------------------------------------------------------------------------------------------------
                Physician:  Overall satisfaction              Survey                       Annually
--------------------------------------------------------------------------------------------------------------------
</TABLE>

                                      D-9
<PAGE>

<TABLE>
<CAPTION>
====================================================================================================================
<S>                              <C>                      <C>                         <C>
1. Outcomes                      METRICS                  DATA SOURCE                 REPORTING FREQUENCY
--------------------------------------------------------------------------------------------------------------------

                Percent eligible enrolled members
                with Pneumococcal Vaccine                 Self-reported                    Annually
                Percent eligible enrolled members on
                a B-Blocker if post MI                    Self-reported                    Quarterly
                Percent eligible enrolled members
                with Atrial Fibrillation on
                anticoagulation                           Self-reported                    Quarterly
--------------------------------------------------------------------------------------------------------------------
</TABLE>

3.       DATA EXCHANGE AND ANALYSIS

         ALERE DUTIES

a.                Alere shall provide ECI with twenty-four (24) months of
                  medical claims history for the top ten percent (10%) of
                  Enrollees within each participating Tufts Health Plan
                  affiliate.

b.                Alere will also provide similar information to ECI, a minimum
                  of quarterly, in order to enable ECI to identify additional
                  Program Participants. ECI shall meet with the Alere designee
                  to approve all enrollees in the program. ECI with Alere shall
                  timely advise such Program Participants and their primary care
                  and/or treating physicians of the availability of the services
                  described herein. Alere shall use its best efforts to support
                  ECI in the process of maintaining and increasing the number of
                  such Program Participants who may benefit from the Care
                  Management Programs.
c.                Alere will provide ECI with monthly eligibility data for
                  Program Participants (assuming that data is received by Alere
                  from Tufts Health Plan in a timely manner)

         ECI Duties

a)       Assuming the claims data provided to ECI is complete and in the agreed
         upon format, ECI agrees to analyze and identify potential Program
         Participants and provide Alere with a list (in mutually agreed upon
         format) of the identified candidates within 5 business days of receipt
         of the claims data.

b)       ECI will provide Alere with a weekly enrollment status report (in
         mutually agreed upon format) that includes the enrollment status of all
         identified Easy Care Program Participants.

4.       PERFORMANCE STANDARDS.

                                      D-10
<PAGE>

ECI agrees to the following performance standards

o        Nurse accompanies 85% of Program Participants to Physician Visits
o        25 % reduction in hospitalizations over a 1 year period of time
o        80% annual flu  vacination deployment
o        80 % of Program Participants will have an advanced directive on file
85 % of Program Participants with A. Fibrilation on Anticoagulation

5. COMPENSATION. For the Care Management services delivered Alere will pay ECI a
per Program Participant per month fee of $295.00 based on the total number of
Program Participants enrolled. A Program Participant will be considered enrolled
effective upon the date that they agree to participate in the program.

During 2007 the parties anticipate enrolling a minimum of 350 participants in
the care management program provided by ECI. By November 1, 2006 a more
definitive estimated target enrollment number will be mutually established based
upon participating medical groups and Enrollees who meet the participation
criteria. Commencing January 1, 2007 ALERE shall pay ECI a monthly fee based
upon the estimated total fees payable (based upon the estimated active member
months from the estimated target enrollment established above) during the first
six months of 2007 amortized equally over the first six months. See the example
below:

AMORTIZING A PPPPM MODEL FOR START UP
                      PPPPM =          $295.00

<TABLE>
<CAPTION>

<S>                                  <C>              <C>               <C>              <C>              <C>              <C>
                                     Jan              Feb               Mar              Apr              May               Jun
     New Program Participants             0               175              175                0                 0               0
                Total Program
                 Participants             0               175              350              350               350             350
           Cumulative Program
           Participant Months                             175              525              875             1,225           1,575

            "Normal" Payments            $0           $51,625         $103,250         $103,250          $103,250        $103,250
           Amortized Payments       $77,437.50        $77,437.50       $77,437.50       $77,437.50        $77,437.50      $77,437.50
</TABLE>

Training of staff will commence in January, 2007 with Program Participant
enrollment commencing February 1, 2007 with the objective of full enrollment of
350 members by May 31, 2007.

                                      D-11
<PAGE>

By August 31, 2007 ALERE and ECI will reconcile the payments made during the
first six months against actual enrollment and active member months during those
six months. Any credits or debits required to settle the difference will be
applied to the September 2007 invoice (and any "carry-over" to any subsequent
invoices if necessary).

Commencing with September 2007, payment will be based on the actual number of
Program Participants members in the prior month as defined by the active Program
Participant enrollment census as of the 15th day of each month.

ECI will invoice ALERE at the end of each month based on this census and
payments will be due within five (5) business days from the date that ALERE
receives payment from Tufts Health Plan Health Plan for ECI's services.

A minimum of 300 Program Participants after September 2007 will be required. If
such number is not obtained and maintained, ECI may elect to terminate this
under section 13.2.1 of the DMSA.

6. INVOLVED TUFTS HEALTH PLAN AFFILIATES. ECI;s Care Management services will be
provided to Tufts Health Plan Health Plan's Medicare Advantage products.Tufts
Health Plan

ALERE

By:   /s/
      -----------------------------------------------
Name:
      -----------------------------------------------
Title:
       ----------------------------------------------

ECI

By:   /s/
      -----------------------------------------------
Name:
      -----------------------------------------------
Title:
       ----------------------------------------------

                                      D-12

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