Document:

COMMON STOCK PURCHASE AGREEMENT

                  THIS COMMON STOCK PURCHASE AGREEMENT (this "Agreement"),  made
this 4th day of August,  2000,  between Mid Atlantic Medical  Services,  Inc., a
Delaware  corporation  (the  "Seller")  and  The  Bank of New  York,  not in its
individual  or  corporate  capacity,  but solely in its capacity as trustee (the
"Trustee")  of  the  Stock  Compensation  Trust  (the  "Trust")  (the  Trust  is
hereinafter  sometimes  referred to as the "Purchaser")  under a trust agreement
between the Seller and the  Trustee  dated  August 26,  1996,  as most  recently
amended and restated as of August 4, 2000 (the "Trust Agreement").

                              W I T N E S S E T H:

                  WHEREAS, as contemplated by the Trust Agreement, the Purchaser
is to  purchase  from the  Seller,  and the Seller is to sell to the  Purchaser,
shares of the Seller's common stock,  $0.01 par value (the "Common  Stock"),  as
more specifically provided herein;

                  NOW,  THEREFORE,  in consideration of the mutual covenants and
undertakings  contained  herein,  and subject to and on the terms and conditions
herein set forth, the parties hereto agree as follows:

                                    ARTICLE I

                           PURCHASE AND SALE OF SHARES

     1.1  Purchase  and Sale.  Subject  to the terms  and  conditions  set forth
herein,  the Seller will sell to the Purchaser,  and the Purchaser will purchase
from  the  Seller,  at  the  Closing  (as  hereinafter  defined),   two  million
(2,000,000) shares of Common Stock at $14.375 per share which is the Fair Market
Value (as defined in the Trust) of the Common Stock on the last full trading day
prior  to the  Closing.  The  shares  of  Common  Stock to be  purchased  by the
Purchaser  and  sold  by the  Seller  at the  Closing  are  referred  to in this
Agreement as the "Common  Shares." In consideration  for the Common Shares,  the
Purchaser will deliver to the Seller cash in the amount of $20,000, representing
the par value of the Common Stock, and an allonge to the Replacement  Promissory
Note dated  December 20, 1996,  as amended by Allonge dated January 11, 1999 and
Allonge  dated August 20,  1999,  previously  delivered by the  Purchaser to the
Seller in the principal  amount of  $145,814,696.75  (the "Note") in the form of
Exhibit A attached hereto.

     1.2  Closing.  The closing of the sale and  purchase  of the Common  Shares
hereunder (the  "Closing"),  will be held at the offices of the Seller on August
4, 2000 or at such other time, date and place as agreed to by the parties.

     1.3 Delivery and Payment. At the Closing, the Seller will
deliver to the Purchaser a certificate  representing  the Common  Shares,  which
certificate  shall be registered in the name of the Trustee,  or the name of its
nominee,  against  payment  by the  Purchaser  to the  Seller  of the  aggregate
purchase  price  therefor.   Notwithstanding  the  foregoing,   the  Seller  may
accomplish the transfer of shares to the Trustee by book entry, in which event a
cross  receipt  shall be executed by the parties.  The Seller will pay all stamp
and other  transfer  taxes,  if any, which may be payable in respect of the sale
and delivery of the Common Shares.

                                   ARTICLE II

                  REPRESENTATIONS AND WARRANTIES OF THE SELLER

                  The  Seller  represents  and  warrants  to  the  Purchaser  as
follows:

     2.1 Corporate Existence and Authority. The Seller (i) is a corporation duly
organized,  validly existing and in good standing under the laws of the State of
Delaware; (ii) has all requisite corporate power to execute, deliver and perform
this  Agreement;  and  (iii)  has  taken  all  necessary  corporation  action to
authorize the execution, delivery and performance of this Agreement.

     2.2 No Conflict. The execution and delivery of this Agreement does not, and
the consummation of the transactions contemplated hereby will not, conflict with
or constitute a default under (i) the Seller's  certificate of  incorporation or
by-laws,  (ii) any agreement,  indenture or other instrument to which the Seller
is a party or by which the  Seller or its  assets may be bound or (iii) any law,
regulation,  order,  arbitration,  award,  judgment or decree  applicable to the
Seller.

     2.3  Validity.  This  Agreement has been duly executed and delivered by the
Seller and is a valid and binding  agreement of the Seller  enforceable  against
the Seller in accordance with its terms,  except as the  enforceability  thereof
may  be  limited  by  any  applicable  bankruptcy,  insolvency,  reorganization,
moratorium,  fraudulent  conveyance or other laws  affecting the  enforcement of
creditors' rights generally, and by general principles of equity.

     2.4 The Common Shares.  The Common Shares have been duly authorized and are
(or when issued as  contemplated  hereby will be) validly  issued and constitute
fully-paid and  non-assessable  shares of Common Stock,  $0.01 par value, of the
Seller.  No stockholder  of the Seller has any preemptive or other  subscription
right to acquire  any shares of Common  Stock.  The  Seller  will  convey to the
Purchaser,  on the date of Closing,  good and valid  title to the Common  Shares
free and clear of any liens, claims, security interests and encumbrances.

     2.5 Litigation. There are no actions, suits, proceedings or arbitrations or
investigations  pending,  or to the Seller's best  knowledge,  threatened in any
court or before any governmental  agency or instrumentality or arbitration panel
or otherwise against or by the Seller which seek to or could restrain, prohibit,
rescind or declare unlawful, or result in substantial damages in respect of this
Agreement  or  the  performance  hereof  by  the  Seller   (including,   without
limitation, the delivery of the Common Shares).

                                   ARTICLE III

                 REPRESENTATIONS AND WARRANTIES OF THE PURCHASER

                  The Purchaser hereby  represents and warrants to the Seller as
follows:

     3.1  Authority;  Validity.  The  Purchaser  has full power and authority to
execute and deliver this Agreement and the Note as Trustee and to consummate the
transactions contemplated hereby. The Note has been duly executed by the Trustee
on behalf of the Trust and,  upon the  execution  and delivery by the Trustee on
behalf  of the  Trust,  the Note will be a valid and  binding  agreement  of the
Purchaser enforceable in accordance with its terms, except as the enforceability
thereof may be limited by any applicable bankruptcy, insolvency, reorganization,
moratorium,  fraudulent  conveyance or other laws  affecting the  enforcement of
creditors' rights generally, and by general principles of equity.

                                   ARTICLE IV

                RESTRICTIONS ON DISPOSITION OF THE COMMON SHARES

     4.1 Restricted Securities. The Purchaser acknowledges that the Purchaser is
acquiring the Common Shares pursuant to a transaction  exempt from  registration
under the 1933 Act.  The  Purchaser  represents,  warrants  and agrees  that all
Common  Shares  acquired by the Purchaser  pursuant to this  Agreement are being
acquired for investment without any intention of making a distribution  thereof,
or of making any sale or other  disposition  thereof which would be in violation
of the 1933 Act or any applicable  state  securities law, and that the Purchaser
will not dispose of any of the Common Shares except that the Trustee will,  from
time to time,  convey a portion of the Common Shares to the  participants in the
Plans  (as  that  term  is  defined  in the  Trust  Agreement)  to  satisfy  the
obligations of the Seller  thereunder,  and except upon termination of the Trust
to the extent  that the Trust then holds any Common  Shares,  all in  compliance
with all provisions of applicable federal and state law regulating the issuance,
sale and distribution of securities.

     4.2 Legend. Until such time as the Common Shares are registered pursuant to
the provisions of the 1933 Act, any certificate or certificates representing the
Common  Shares  delivered  pursuant  to  Section  1.3,  will  bear a  legend  in
substantially the following form:

                  "The  shares  represented  by this  certificate  have not been
                  registered  under the Securities Act of 1933, as amended,  and
                  may not be sold,  transferred or otherwise  disposed of unless
                  they have  first been  registered  under such Act or unless an
                  exemption from registration is available."

The Seller may place stop transfer  orders against the  registration or transfer
of any shares evidenced by such a certificate or certificates until such time as
the requirements of the foregoing are satisfied.

                                    ARTICLE V

                              CONDITIONS TO CLOSING

     5.1  Conditions to  Obligations  of the  Purchaser.  The  obligation of the
Purchaser to purchase the Common  Shares is subject to the  satisfaction  of the
following conditions on the date of Closing:

                           (a) The  representations and warranties of the Seller
                  set forth in Article II hereof shall be true and correct;  and
                  if the  Closing  shall  occur on a date other than the date of
                  this Agreement, the Purchaser shall have been furnished with a
                  certificate, dated the date of Closing, to such effect, signed
                  by an authorized officer of the Seller; and

                           (b)  All  permits,   approvals,   authorizations  and
                  consents of third parties  necessary for the  consummation  of
                  the transactions herein shall have been obtained, and no order
                  of any court or administrative agency shall be in effect which
                  restrains or prohibits the  transactions  contemplated by this
                  Agreement,  and no suit,  action  or other  proceeding  by any
                  governmental  body or other person shall have been  instituted
                  which  questions the validity or legality of the  transactions
                  contemplated by this Agreement.

     5.2 Conditions to  Obligations of the Seller.  The obligation of the Seller
to issue,  sell and deliver the Common Shares to the Purchaser is subject to the
satisfaction of the following conditions on the date of Closing:

                           (a)  The   representations   and  warranties  of  the
                  Purchaser  set forth in Article  III hereof  shall be true and
                  correct;  and if the Closing  shall occur on a date other than
                  the  date  of this  Agreement,  the  Seller  shall  have  been
                  furnished  with a  certificate  dated the date of Closing,  to
                  such effect,  signed by an  authorized  office of the Trustee;
                  and

                           (b) No order of any  court or  administrative  agency
                  shall  be  in  effect  which   restrains   or  prohibits   the
                  transactions  contemplated  by this  Agreement,  and no  suit,
                  action or other proceeding by any  governmental  body or other
                  person shall have been instituted which questions the validity
                  or  legality  of  the   transactions   contemplated   by  this
                  Agreement.

                                   ARTICLE VI

                                  MISCELLANEOUS

     6.1 Expenses.  The Seller shall pay all of its  expenses,  and it shall pay
the Purchaser's  expenses,  in connection with the  authorization,  preparation,
execution and performance of this Agreement,  including  without  limitation the
reasonable  fees and  expenses  of the  Trustee,  its  agents,  representatives,
counsel, financial advisors and consultants.

     6.2   Survival   of   Seller's   Representations   and   Warranties.    All
representations  and  warranties  made by the  Seller to the  Purchaser  in this
Agreement shall survive the Closing.

     6.3 Notices.  All  notices,  requests or other  communications  required or
permitted to be delivered hereunder shall be in writing, delivered by registered
or certified mail, return receipt requested, as follows:

                           (a)      To the Seller:

                                    Sharon Pavlos, Executive Vice
                                      President and General Counsel

                       Mid Atlantic Medical Services, Inc.

                                    4 Taft Court
                                    Rockville, MD  20850

                           (b)      To the Purchaser:

                                    Richard J. Barry
                                    The Bank of New York
                                    One Wall Street
                                    New York, NY  10286

Any party hereto may from time to time,  by written  notice given as  aforesaid,
designate any other address to which notices,  requests or other  communications
addressed to it shall be sent.

     6.4 Specific Performance. The parties hereto acknowledge that damages would
be an inadequate remedy for any breach of the provisions of this
Agreement  and agree that the  obligations  of the  parties  hereunder  shall be
specifically  enforceable,  and neither party will take any action to impede the
other from seeking to enforce such rights of specific performance.

     6.5  Successors  and Assigns;  Integration;  Assignability.  This Agreement
shall be binding upon and inure to the benefit of and be enforceable
by the parties hereto,  and their respective legal  representatives,  successors
and assigns.  This Agreement (a) constitutes,  together with the Note, the Trust
Agreement, and any other written agreements between the Purchaser and the Seller
executed  and  delivered on the date hereof,  the entire  agreement  between the
parties  hereto and supersedes  all other prior  agreements and  understandings,
both  written and oral,  among the parties,  with respect to the subject  matter
hereof;  (b) shall not confer upon any person other than the parties  hereto any
rights or remedies  hereunder;  and (c) shall not be  assignable by operation of
law or otherwise, except that the Trustee may assign all its rights hereunder to
any corporation or other institution  exercising trust powers in connection with
any such institution assuming the duties of a trustee under the Trust.

     6.6  Governing  Law. This  Agreement  shall be governed by and construed in
accordance with the laws of the state of New York.

     6.7  Further  Assurances.  Subject  to  the  terms  and  conditions  herein
provided,  each of the parties  hereto agrees to use all  reasonable  efforts to
take,  or cause to be taken,  all  action  and to do,  or cause to be done,  all
things  necessary,  proper or advisable to  consummate  and make  effective  the
transactions contemplated by this Agreement.

     6.8 Amendment  and Waiver.  No amendment or waiver of any provision of this
Agreement or consent to departure therefrom shall be effective unless in writing
and signed by the Purchaser and the Seller.

     6.9  Counterparts.  This  Agreement  may  be  executed  in  any  number  of
counterparts  with the same effect as if the  signatures  thereto  were upon one
instrument.

     6.10 Certain Limitations.  The execution and delivery of this Agreement and
the  performance  by the  Trustee of this  Agreement  and under the terms of the
Trust have been or will be,  effected by the Trustee in its capacity as Trustee.
Nothing in this Agreement  shall be interpreted to increase,  decrease or modify
in any  manner any  liability  of the  Trustee to the Seller or to any  trustee,
representative  or other  claimant  by right of the  Seller  resulting  from the
Trustee's  performance  of its duties under the  constituent  instruments of the
Trust, and no personal  liability shall be asserted or enforceable  against said
entity  by  reason  of any  of  the  covenants,  statements  or  representations
contained in this Agreement.

     6.11  Incorporation.  The  terms  and  conditions  of the  Trust  Agreement
relating  to  the  nature  of  the  responsibilities  of  the  Trustee  and  the
indemnification  of the  Trustee  by  the  Seller  are  incorporated  herein  by
reference and made applicable to this Agreement.

                                   [REMAINDER OF PAGE INTENTIONALLY LEFT BLANK]

<PAGE>

         IN WITNESS  WHEREOF,  the undersigned have duly executed this Agreement
on the date and year first above written.

                                     Mid Atlantic Medical Services, Inc.

                                         /S/ Robert E. Foss
                                     By:__________________________________
                                            Sr. EVP & CFO
                                     Title:_________________________________

                            The Bank of New York in its capacity as trustee of
                            the Mid Atlantic Medical Services, Inc. Stock
                            Compensation Trust
                                           /S/ Richard J. Barry
                                     By__________________________________
                                            Vice President
                                     Title:________________________________

<PAGE>

                                    EXHIBIT A

                                     AllongeALLONGE TO REPLACEMENT PROMISSORY NOTE

         This  Allonge  made this 4th day of August,  2000,  to the  Replacement
Promissory Note dated December 20, 1996, as amended by Allonge dated January 11,
1999 and Allonge dated August 20, 1999, made by The Bank of New York, not in its
individual or corporate  capacity,  but solely in its capacity as Trustee of the
Mid Atlantic Medical Services,  Inc. Stock  Compensation  Trust  ("Borrower") in
favor of Mid Atlantic Medical Services, Inc. ("Lender").

         WHEREAS,  Borrower  executed  and  delivered  to  Lender a  Replacement
Promissory  Note dated  December  20, 1996 in the original  principal  amount of
$129,902,500 (the "Original Note").

         WHEREAS,  the Original Note was most recently  amended by an Allonge on
August 20, 1999.

         WHEREAS,  under the terms of such Allonge,  the principal amount of the
Original   Note  due  and  owing  as  of  August  20,  1999  was   increased  to
$127,284,696.75.

         WHEREAS,  $117,084,696.75 of the principal amount of the Original Note,
as amended by such Allonge (the "Amended  Note")  remains  unpaid as of the date
hereof.

         WHEREAS,  in order to finance  the  Borrower's  purchase  of  2,000,000
shares of the  Lender's  common  stock  pursuant  to the  terms of Common  Stock
Purchase  Agreement  of even date  herewith  between  the  Borrower  and Lender,
Borrower  and Lender wish to increase the  principal  amount of the Amended Note
due and owing from  $117,084,696.75 to  $145,814,696.75  while leaving all other
terms of the Amended Note unamended.

         NOW, THEREFORE, for good and valuable consideration and intending to be
legally bound hereby, the parties hereto agree as follows:

                  (1) The  Amended  Note  is  hereby  amended  by  deleting  all
         references  to  "$127,284,696.75"  and by  inserting  in  lieu  thereof
         "$145,814,696.75."

                  (2) The last  sentence of the second  paragraph of the Amended
         Note is hereby  amended by deleting  the date  "August 20, 1999" and by
         inserting in lieu thereof "August 4, 2000."

                  (3) Schedule A attached to the Amended Note is hereby  amended
         and restated in its entirety in the form attached hereto as Exhibit 1.

                  (4) Schedule B attached to the Amended Note is hereby  amended
         and restated in its entirety in the form attached hereto as Exhibit 2.

                  (5)      Except as expressly amended hereby, the Amended Note
         shall remain unamended and in full force and effect.

                      [REMAINDER OF PAGE INTENTIONALLY LEFT BLANK]

<PAGE>

         IN WITNESS  WHEREOF,  this Allonge to  Replacement  Promissory  is made
effective as of the 4th day of August, 2000.

Attest:                            THE BANK OF NEW YORK, not in its individual
                              corporate capacity, but solely in its capacity as
                              Trustee of the Mid Atlantic Medical Services, Inc.
                              Stock Compensation Trust
/S/Paulette S. Bagil, AT              /S/ Richard J. Barry
____________________________      By:_______________________________________
                                          Vice President
                                   Title:_____________________________________

Attest:                               MID ATLANTIC MEDICAL SERVICES, INC.
                                        /S/ Robert E. Foss
______________________________      By:_______________________________________
                                          Sr. EVP & CFO
                                   Title:_____________________________________

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