Document:

EX-10.1

   

  

  Exhibit 4.10 

  Express Scripts, Inc. 2011 Long-Term Incentive Plan 

  (as amended and restated effective April 2, 2012) 

  1. Establishment and Purpose. Express Scripts, Inc. previously established, effective June 1, 2011, an incentive compensation plan
      known as the “Express Scripts, Inc. 2011 Long-Term Incentive Plan” (“Plan”). This document is an amendment and restatement of the Express Scripts, Inc. Long-Term Incentive Plan in effect as of April 2, 2012 and reflects, among other things, the
      assumption of the Plan by Express Scripts Holding Company. The purpose of the Plan is to motivate key personnel to produce a superior return to the stockholders of the Company and its Affiliates by offering such individuals an opportunity to realize
      stock appreciation, by facilitating stock ownership, and by rewarding them for achieving a high level of corporate performance. This Plan is also intended to facilitate recruiting and retaining key personnel of outstanding ability. 

  2. Definitions. The capitalized terms used in this Plan have the meanings set forth below. 

  (a) “Affiliate” means any corporation that is a Subsidiary of the Company and, for purposes other than the grant of Incentive Stock
      Options, any limited liability company, partnership, corporation, joint venture, or any other entity in which the Company or any such Subsidiary owns an equity interest. 

  (b) “Agreement” means a written contract entered into between the Company or an Affiliate and a Participant or, in the discretion of
      the Committee, a written certificate issued by the Company or an Affiliate to a Participant, in either case, containing or incorporating the terms and conditions of an Award in such form (not inconsistent with this Plan) as the Committee approves
      from time to time, together with all amendments thereof, which amendments may be made unilaterally by the Company (with the approval of the Committee) unless such amendments are deemed by the Committee to be materially adverse to the Participant and
      are not required as a matter of law, or such other relevant written contract entered into between the Company or an Affiliate and a Participant and approved by the Committee. 

  (c) “Associate” means any full-time or part-time employee (including an officer or director who is also an employee) of the Company or
      an Affiliate. Except with respect to grants of Incentive Stock Options, “Associate” shall also include any Non-Employee Director serving on the Company’s Board of Directors. References in this Plan to “employment” and related terms (except for
      references to “employee” in this definition of “Associate” or in Section 7(a)(i)) shall include the providing of services as a Non-Employee Director. Except as specifically provided herein with respect to Non-Employee Directors serving on the
      Company’s Board of Directors, the term “Associate” shall not include an individual who is determined in good faith by the Company to be an independent contractor. If, for any period of time, an individual has been determined in good faith by the
      Company not to be a common-law employee, and a court or government agency subsequently makes a determination that the individual was in fact a common-law employee during that period of time, then (i) such determination shall not entitle the
      individual to any retroactive rights under the Plan, and (ii) the individual’s prospective rights under the Plan shall be determined solely in accordance with the terms of the Plan. 

  (d) “Award” means a grant made under this Plan in the form of Options, Stock Appreciation Rights, Restricted Stock, Restricted Stock
      Units, Performance Shares or any Other Award, whether singly, in combination or in tandem.

  (e) “Board” means the Board of Directors of the Company.  

   

    

  
    
      

  

  (f) “Cause” shall mean the willful failure by a Participant to perform his duties with the Company, a Parent or a Subsidiary or the
      willful engaging in conduct which is injurious to the Company, a Parent or any Subsidiary, monetarily or otherwise, as determined by the Committee in its sole discretion. 

  (g) “Change in Control” shall mean any of the following: 

  (i) Individuals who constitute the Incumbent Board cease for any reason to constitute at least a majority of the Board;
    

  (ii) More than 25% of the (x) combined voting power of the then outstanding voting securities of the Company entitled
      to vote generally in the election of directors (“Outstanding Company Voting Securities”) or (y) the then outstanding Shares of Stock (“Outstanding Company Common Stock”) is directly or indirectly acquired or beneficially owned (as defined in Rule
      13d-3 under the Exchange Act, or any successor rule thereto) by any individual, entity or group (within the meaning of Section 13(d)(3) or 14(d)(2) of the Exchange Act), provided, however, that the following acquisitions and beneficial ownership
      shall not constitute Changes in Control pursuant to this paragraph 2(f)(ii); 

  (A) any acquisition or beneficial ownership by the Company or a Subsidiary, or 

  (B) any acquisition or beneficial ownership by any employee benefit plan (or related trust) sponsored or maintained by
      the Company or one of more of its Subsidiaries. 

  (iii) Consummation of a reorganization, merger, share exchange or consolidation (a “Business Combination”), unless in
      each case following such Business Combination, 

  (A) all or substantially all of the individuals and entities who were the beneficial owners, respectively, of the
      Outstanding Company Common Stock and Outstanding Company Voting Securities immediately prior to such Business Combination beneficially own, directly or indirectly, more than 50% of, respectively, the then outstanding shares of common stock and the
      combined voting power of the then outstanding voting securities entitled to vote generally in the election of directors or other governing body, as the case may be, of the entity resulting from such Business Combination (including, without
      limitation, an entity that as a result of such transaction owns the Company through one or more subsidiaries); 

  (B) no individual, entity or group (excluding any employee benefit plan (or related trust) of the Company or such
      corporation resulting from such Business Combination) beneficially owns, directly or indirectly, more than 25% of, respectively, the then outstanding shares of common stock of the corporation resulting from such Business Combination or the combined
      voting power of the then outstanding voting securities of such corporation entitled to vote generally in the election of directors or other governing body of the entity resulting from such Business Combination, except to the extent that such
      individual, entity or group owned more than 25% of the Outstanding Company Common Stock or Outstanding Company Voting Securities prior to the Business Combination; and 

  (C) at least a majority of the members of the board of directors or other governing body of the entity resulting from
      such Business Combination were members of the Incumbent Board at the time of the execution of the initial agreement, or of the action of the Board, approving such Business Combination. 

   

    

  
    
      

  

  (iv) The Company shall sell or otherwise dispose of all or substantially all of the assets of the Company (in one
      transaction or a series of transactions). 

  (v) The stockholders of the Company shall approve a plan to liquidate or dissolve the Company and the Company shall
      commence such liquidation or dissolution. 

  (h) “Change in Control Date” shall mean, in the case of a Change in Control defined in clauses (i) through (iv) of the definition
      thereof, the date on which the event occurs, and in the case of a Change in Control defined in clause (v) of the definition thereof, the date on which the Company shall commence such liquidation or dissolution. 

  (i) “Code” means the Internal Revenue Code of 1986, as amended and in effect from time to time, or any successor statute. 

  (j) “Committee” means the committee of directors appointed by the Board to administer this Plan. In the absence of a specific
      appointment, “Committee” shall mean the Compensation Committee of the Board. 

  (k) “Company” means Express Scripts Holding Company, a Delaware corporation, or any successor to all or substantially all of its
      businesses by merger, consolidation, purchase of assets, share exchange, reorganization or otherwise. 

  (l) “Disability” means that the Participant has suffered physical or mental incapacity of such nature as to prevent him from engaging
      in or performing the principal duties of his customary employment or occupation on a continuing or sustained basis, provided that, if a Participant has entered into an employment agreement with the Company, the Committee, in its sole discretion, may
      determine to substitute the definition set forth in such agreement. All determinations as to the date and extent of disability of any Participant shall be made by the Committee upon the basis of such evidence as it deems necessary or desirable. 

  (m) “Exchange Act” means the Securities Exchange Act of 1934, as amended; “Exchange Act Rule 16b-3” means Rule 16b-3 promulgated by the
      Securities and Exchange Commission under the Exchange Act or any successor regulation. 

  (n) “Fair Market Value” as of any date means, unless otherwise expressly provided in this Plan: 

  (i) (A) the closing sales price of a Share on the composite tape for New York Stock Exchange (“NYSE”) listed shares, or
      if Shares are not quoted on the composite tape for NYSE listed shares, on the Nasdaq Global Select Market or any similar system then in use or, (B) if clause (i)(A) is not applicable, the mean between the closing “bid” and the closing “asked”
      quotation of a Share on the Nasdaq Global Select Market or any similar system then in use, or (C) if the Shares are not quoted on the NYSE composite tape or the Nasdaq Global Select Market or any similar system then in use, the closing sale price of
      a Share on the principal United States securities exchange registered under the Exchange Act on which the Shares are listed, in any case on the specified date, or, if no sale of Shares shall have occurred on that date, on the immediately preceding
      day on which a sale of Shares occurred, or 

   

    

  
    
      

  

  (ii) if clause (i) is not applicable, what the Committee determines in good faith to be 100% of the fair market value
      of a Share on that date. 

  In the case of an Incentive Stock Option, if such determination of Fair Market Value is not consistent with the then current regulations of the Secretary of
      the Treasury, Fair Market Value shall be determined in accordance with said regulations. The determination of Fair Market Value shall be subject to adjustment as provided in Section 13(f) hereof. 

  (o) “Fundamental Change” means a dissolution or liquidation of the Company, a sale of substantially all of the assets of the Company, a
      merger or consolidation of the Company with or into any other corporation, regardless of whether the Company is the surviving corporation, or a statutory share exchange involving capital stock of the Company. 

  (p) “Incentive Stock Option” means any Option designated as such and granted in accordance with the requirements of Section 422 of the
      Code or any successor to such section. 

  (q) “Incumbent Board” means the group of directors consisting of (i) those individuals who, as of the effective date of the Plan,
      constituted the Board of Directors of Express Scripts, Inc.; and (ii) any individuals who become directors subsequent to such effective date whose appointment, election or nomination for election by the stockholders of the Company was approved by a
      vote of at least a majority of the directors then comprising the Incumbent Board. The Incumbent Board shall exclude any individual whose initial assumption of office occurred (i) as a result of an actual or threatened election contest with respect to
      the election or removal of directors or other actual or threatened solicitation of proxies or consents by or on behalf of a Person (other than a solicitation of proxies by the Incumbent Board) or (ii) with the approval of the Incumbent Board but by
      reason of any agreement intended to avoid or settle a proxy contest. 

  (r) “Non-Employee Director” means a director of the Company who is not an employee of the Company, a Parent or a Subsidiary. 

  (s) “Non-Qualified Stock Option” means an Option other than an Incentive Stock Option. 

  (t) “Option” means a right to purchase Stock (or, if the Committee so provides in an applicable Agreement, Restricted Stock), including
      both Non-Qualified Stock Options and Incentive Stock Options. 

  (u) “Other Award” means an Award of Stock, an Award based on Stock other than Options, Stock Appreciation Rights, Restricted Stock,
      Restricted Stock Units or Performance Shares, or a cash-based Award. 

  (v) “Parent” means a “parent corporation,” as that term is defined in Section 424(e) of the Code, or any successor provision. 

  (w) “Participant” means an Associate to whom an Award is made. 

  (x) “Performance Period” means the period of time as specified in an Agreement over which Awards are to vest or be earned. 

  (y) “Performance Shares” means a contingent award of a specified number of Performance Shares, with each Performance Share equivalent
      to one or more Shares or a fractional Share or a Unit expressed in terms of one or more Shares or a fractional Share, as specified in the applicable Agreement, a variable percentage of which may vest or be earned depending upon the extent of
      achievement of specified performance objectives during the applicable Performance Period. 

   

    

  
    
      

  

  (z) “Plan” means this 2011 Long-Term Incentive Plan, as amended and in effect from time to time. 

  (aa) “Restricted Stock” means Stock granted under Section 10 hereof so long as such Stock remains subject to one or more restrictions.
    

  (bb) “Restricted Stock Units” means Units of Stock granted under Section 10 hereof. 

  (cc) “Retirement” shall mean, except as otherwise provided in an Agreement, termination of employment after either (i) attainment of
      age 65, or (ii) the normal retirement age specified in the provisions of a retirement plan maintained by the Company for its employees generally. 

  (dd) “Senior Executive” means any Associate who is an employee of the Company and whose base salary is determined by reference to
      Salary Grades M3 and above (as such salary grades are in effect on the effective date of this Plan), or, if the Company modifies its salary grades after such effective date, in the most nearly comparable salary grades for senior executives of the
      Company under such modified system as determined by the Committee in its sole discretion. 

  (ee) “Share” means a share of Stock. 

  (ff) “Stock” means the Company’s common stock, $0.01 par value per share (as such par value may be adjusted from time to time) or any
      securities issued in respect thereof by the Company or any successor to the Company as a result of an event described in Section 13(f). 

  (gg) “Stock Appreciation Right” means a right, the value of which is determined relative to appreciation in value of Shares pursuant to
      an Award granted under Section 8 hereof. 

  (hh) “Subsidiary” means a “subsidiary corporation,” as that term is defined in Section 424(f) of the Code, or any successor provision.
    

  (ii) “Successor” with respect to a Participant means the legal representative of an incompetent Participant and, if the Participant is
      deceased, the legal representative of the estate of the Participant or the person or persons who may, by bequest or inheritance, or under the terms of an Award or forms submitted by the Participant to the Committee under Section 13(h) hereof, acquire
      the right to exercise an Option or Stock Appreciation Right or receive cash and/or Shares issuable in satisfaction of an Award in the event of a Participant’s death. 

  (jj) “Term” means the period during which an Option or Stock Appreciation Right may be exercised or the period during which the
      restrictions placed on Restricted Stock or any other Award are in effect. 

  (kk) “Unit” means a bookkeeping entry that may be used by the Company or an Affiliate to record and account for the grant of Stock,
      Units of Stock, Stock Appreciation Rights and Performance Shares expressed in terms of Units of Stock until such time as the Award is paid, canceled, forfeited or terminated. 

   

    

  
    
      

  

  (ll) “Vice President” means any Associate who is an employee of the Company or an Affiliate and whose base salary is determined by
      reference to Salary Grades M1 through and including M2 (as such salary grades are in effect on the effective date of this Plan), or, if the Company modifies its salary grades after such effective date, in the most nearly comparable salary grades for
      vice presidents of the Company under such modified system as determined by the Committee in its sole discretion. 

  Except when otherwise indicated by the context, reference to the masculine gender shall include, when used, the feminine gender and any term used in the
      singular shall also include the plural. 

  3. Administration. 

  (a) Authority of Committee. The Committee shall administer this Plan or delegate its authority to do so as provided in Section 3(c)
      hereof. The Committee shall have exclusive power (acting alone or, to the extent the Committee deems appropriate for purposes of Exchange Act Rule 16b-3, in conjunction with the full Board), subject to the limitations contained in this Plan, to make
      Awards and to determine when and to whom Awards will be granted, and the form, amount and other terms and conditions of each Award, subject to the provisions of this Plan. The Committee, subject to the limitations contained in this Plan, may
      determine whether, to what extent and under what circumstances Awards may be settled, paid or exercised in cash, Shares or other Awards or other property, or canceled, forfeited or suspended. The Committee shall have the authority to interpret this
      Plan and any Award or Agreement made under this Plan, to establish, amend, waive and rescind any rules and regulations relating to the administration of this Plan, to determine the terms and provisions of any Agreement entered into hereunder (not
      inconsistent with this Plan), and to make all other determinations necessary or advisable for the administration of this Plan. The Committee may correct any defect, supply any omission or reconcile any inconsistency in this Plan or in any Award in
      the manner and to the extent it shall deem desirable. All determinations of the Committee in the administration of this Plan, as described herein, shall be final, binding and conclusive, including, without limitation, as to any adjustments pursuant
      to Section 13(f). A majority of the members of the Committee shall constitute a quorum for any meeting of the Committee. Notwithstanding the foregoing, in administering this Plan with respect to Awards for Non-Employee Directors, the Board shall
      exercise the powers of the Committee. 

  (b) Limitations. Notwithstanding anything herein to the contrary, the Committee shall not have the right, without stockholder approval,
      to (i) reduce or decrease the purchase price for an outstanding Option or Stock Appreciation Right, (ii) cancel an outstanding Option or Stock Appreciation Right for the purpose of replacing or re-granting such Option or Stock Appreciation Right with
      a purchase price that is less than the original purchase price, (iii) extend the expiration date of an Option or Stock Appreciation Right, (iv) deliver payment in exchange for the cancellation of an Option, the purchase price of which exceeds the
      Fair Market Value of the Shares underlying such Option, (v) modify, amend, or waive the terms and conditions of Awards to persons who are considered “reporting persons” for purposes of Section 16 of the Exchange Act, other than on account of death,
      disability, retirement, Change in Control, or a termination of employment in connection with a business transfer, or (vi) waive or amend any terms, conditions, restrictions, or limitations on an Award to a person who is not a “reporting person” for
      purposes of Section 16 of the Exchange Act, except to the extent that the terms and conditions which are modified, amended, or waived, relate to no more than five percent (5%) of the number of Shares initially available under the Plan. 

  (c) Delegation of Authority. The Committee may delegate all or any part of the administration of this Plan to one or more committees, or
      to senior managers of the Company, and may authorize further delegation by such committees to senior managers of the Company, in each case to the extent permitted by Delaware law; provided that, determinations regarding the timing, pricing, amount
      and terms of any Award to a “reporting person” for purposes of Section 16 of the Exchange Act shall be made only by the Committee; and provided further that, no such delegation may be made that would cause Awards or other transactions under this Plan
      to cease to be exempt from Section 16(b) of the Exchange Act or cause an Award intended to qualify for favorable treatment under Section 162(m) of the Code not to qualify for, or to cease to qualify for, the favorable treatment under Section 162(m)
      of the Code. Any such delegation may be revoked by the Committee at any time. 

   

    

  
    
      

  

  (d) Board Authority. Any authority granted to the Committee may also be exercised by the Board or another committee of the Board, except
      to the extent that the grant or exercise of such authority would cause any Award intended to qualify for favorable treatment under Section 162(m) of the Code to cease to qualify for the favorable treatment under Section 162(m) of the Code. To the
      extent that any permitted action taken by the Board conflicts with action taken by the Committee, the Board action shall control. Without limiting the generality of the foregoing, to the extent the Board has delegated any authority under this Plan to
      another committee of the Board, such authority shall not be exercised by the Committee unless expressly permitted by the Board in connection with such delegation. 

  (e) Awards for Non-Employee Directors. The Board (which may delegate the determination to a Committee of the Board) may from time to
      time determine that each individual who is elected or appointed to the office of director as a Non-Employee Director receive an Award (other than Incentive Stock Options) as compensation, in whole or in part, for such individual’s services as a
      director. In determining the level and terms of such Awards for Non-Employee Directors, the Board may consider such factors as compensation practices of comparable companies with respect to directors, consultants’ recommendations, and such other
      information as the Board may deem appropriate. 

  4. Shares Available; Maximum Payouts. 

  (a) Shares Available. The maximum number of Shares available for Awards under the Plan shall be Thirty Million (30,000,000), including
      Awards made pursuant to the Plan prior to this amendment and restatement. Stock Options and Stock Appreciation Rights awarded shall reduce the number of shares available for Awards by one share for every one share subject to such Award; provided that
      Stock Appreciation Rights that may be settled only in cash shall not reduce the number of Shares available for Awards. Awards of Restricted Stock, Restricted Stock Units, Performance Shares, and Other Awards settled in Shares shall reduce the number
      of Shares available for Awards by one Share for every one Share awarded, up to twenty percent (20%) of the total number of Shares available; beyond that, Restricted Stock Restricted Stock Units, Performance Shares, and Other Awards settled in Shares
      shall reduce the number of Shares available for Awards by three Shares for every one Share awarded. Restricted Stock Units that may be settled only in cash shall not reduce the number of Shares available for Awards. Shares issued under this Plan may
      be authorized and unissued shares or issued shares held as treasury shares. Shares purchased on the open market shall not increase the Shares available under the Plan. 

  (b) Shares Not Applied to Limitations. The following will not be applied to the Share limitations of subsection 4(a) above:
      (i) dividends or dividend equivalents paid in cash in connection with outstanding Awards, (ii) Awards which by their terms may be settled only in cash, (iii) any Shares subject to an Award under the Plan which Award is forfeited, cancelled,
      terminated, expires or lapses for any reason, and (iv) Shares and any Awards that are granted through the settlement, assumption, or substitution of outstanding awards previously granted, or through obligations to grant future awards, as the result
      of a merger, consolidation, or acquisition of the employing company with or by the Company. If a Participant tenders previously owned Shares or has the Company withhold Shares in satisfaction of any tax withholding requirement or payment of the
      purchase price of an Award, such Shares tendered or withheld will not be available again for an Award under the Plan; provided, however, that any Shares so used to satisfy tax withholdings for Restricted Stock, Restricted Stock Units, Performance
      Shares, or Other Awards may again be used for an Award under this Plan. 

   

    

  
    
      

  

  (c) Award Limitations. No Participant may receive any combination of Awards relating to more than 1,000,000 Shares in the aggregate, or
      a cash-based bonus Award with a value that exceeds $10,000,000 in the aggregate, in any fiscal year of the Company under this Plan (subject to adjustment under Section 13(f) hereof). 

  5. Eligibility. Awards may be granted under this Plan to any Associate at the discretion of the Committee. 

  6. General Terms of Awards. 

  (a) Awards. Awards under this Plan may consist of Options (either Incentive Stock Options or Non-Qualified Stock Options), Stock
      Appreciation Rights, Performance Shares, Restricted Stock, Restricted Stock Units, or Other Awards. 

  (b) Amount of Awards. Each Agreement shall set forth the number of Shares of Restricted Stock, Stock, Stock Units, or Performance
      Shares, or the amount of cash, subject to such Agreement, or the number of Shares to which the Option applies or with respect to which payment upon the exercise of the Stock Appreciation Right is to be determined, as the case may be, together with
      such other terms and conditions applicable to the Award (not inconsistent with this Plan) as determined by the Committee in its sole discretion. 

  (c) Term. Each Agreement, other than those relating solely to Awards of Stock without restrictions, shall set forth the Term of the
      Award and any applicable Performance Period, as the case may be, but in no event shall the Term of an Award or the Performance Period be longer than ten years after the date of grant; provided, however, that the Committee may, in its discretion,
      grant Awards with a longer term to Participants who are located outside the United States. An Agreement with a Participant may permit acceleration of vesting requirements and of the expiration of the applicable Term upon such terms and conditions as
      shall be set forth in the Agreement, which may, but, unless otherwise specifically provided in this Plan, need not, include, without limitation, acceleration resulting from the occurrence of the Participant’s death or Disability. Acceleration of the
      Performance Period of Performance Shares and other performance-based Awards shall be subject to Section 9(b) or Section 12 hereof, as applicable. 

  (d) Agreements. Each Award under this Plan shall be evidenced by an Agreement setting forth the terms and conditions, as determined by
      the Committee, that shall apply to such Award, in addition to the terms and conditions specified in this Plan. 

  (e) Transferability. Except as otherwise permitted by the Committee, during the lifetime of a Participant to whom an Award is granted,
      only such Participant (or such Participant’s legal representative) may exercise an Option or Stock Appreciation Right or receive payment with respect to any other Award. Except as otherwise permitted by the Committee, no Award of Restricted Stock
      (prior to the expiration of the restrictions), Restricted Stock Units, Options, Stock Appreciation Rights, Performance Shares or Other Award (other than an award of Stock without restrictions) may be sold, assigned, transferred, exchanged, or
      otherwise encumbered, and any attempt to do so (including pursuant to a decree of divorce or any judicial declaration of property division) shall be of no effect. Notwithstanding the immediately preceding sentence, an Agreement may provide that an
      Award shall be transferable to a Successor in the event of a Participant’s death. 

  (f) Termination of Employment. The extent to which the Participant shall have the right to exercise and/or retain an Award following
      termination of the Participant’s employment with the Company or its Affiliates, shall be as set forth in an Agreement. Such provisions shall be determined in the sole discretion of the Committee, shall be included in the Agreement, need not be
      uniform among Awards issued pursuant to this Plan, and may reflect distinctions based on the reasons for termination. 

   

    

  
    
      

  

  (g) Change in Control. The treatment of Awards upon a Change in Control shall be set forth in an Agreement; provided, however, that in
      no event may the vesting of any Award be accelerated as a result of a Change in Control until on or after the Change in Control Date. In the event the terms of the relevant Agreement and the terms of this Section 6(g) should conflict, the terms of
      this Section shall govern. 

  (h) Rights as Stockholder. A Participant shall have no right as a stockholder with respect to any securities covered by an Award until
      the date the Participant becomes the holder of record. 

  (i) Performance Conditions. The Committee may require the satisfaction of certain performance goals as a condition to the grant or
      vesting of any Award provided under the Plan. 

  7. Stock Options. 

  (a) Terms of All Options. 

  (i) Grants. Each Option shall be granted pursuant to an Agreement as either an Incentive Stock Option or a Non-Qualified
      Stock Option. Only Non-Qualified Stock Options may be granted to Associates who are not employees of the Company or an Affiliate. In no event may Options known as reload options be granted hereunder. 

  (ii) Purchase Price. The purchase price of each Share subject to an Option shall be determined by the Committee and set
      forth in the applicable Agreement, but shall not be less than 100% of the Fair Market Value of a Share as of the date the Option is granted. The purchase price of the Shares with respect to which an Option is exercised shall be payable in full at the
      time of exercise, provided that, to the extent permitted by law and in accordance with rules adopted by the Committee, Participants may simultaneously exercise Options and sell the Shares thereby acquired pursuant to a brokerage or similar
      relationship and use the proceeds from such sale to pay the purchase price of such Shares. The purchase price may be paid in cash or, if the Committee so permits, through delivery or tender to the Company of Shares held, either actually or by
      attestation, by such Participant (in each case, such Shares having a Fair Market Value as of the date the Option is exercised equal to the purchase price of the Shares being purchased pursuant to the Option) or through a net or cashless form of
      exercise as permitted by the Committee, or, if the Committee so permits, a combination thereof, unless otherwise provided in the Agreement. Further, the Committee, in its discretion, may approve other methods or forms of payment of the purchase
      price, and establish rules and procedures therefor. 

  (iii) Exercisability. Each Option shall be exercisable in whole or in part on the terms provided in the Agreement. An
      Option that vests solely on the basis of the passage of time (and not on the basis of any performance standards) shall not vest more rapidly than ratably over a period of approximately three years from the grant date beginning on or about the first
      anniversary of the Option grant date. An Option that vests based on performance standards may, in the discretion of the Committee, vest as rapidly as immediate vesting on or about the first anniversary of the Option grant date. Notwithstanding the
      foregoing, vesting of an Option may be accelerated upon the occurrence of certain events as provided in the applicable Agreement. In no event shall any Option be exercisable at any time after its Term. When an Option is no longer exercisable, it
      shall be deemed to have lapsed or terminated. 

   

    

  
    
      

  

  (b) Incentive Stock Options. In addition to the other terms and conditions applicable to all Options: 

  (i) the aggregate Fair Market Value (determined as of the date the Option is granted) of the Shares with respect to which
      Incentive Stock Options held by an individual first become exercisable in any calendar year (under this Plan and all other incentive stock options plans of the Company and its Affiliates) shall not exceed $100,000 (or such other limit as may be
      required by the Code), if such limitation is necessary to qualify the Option as an Incentive Stock Option, and to the extent an Option or Options granted to a Participant exceed such limit such Option or Options shall be treated as Non-Qualified
      Stock Options; 

  (ii) an Incentive Stock Option shall not be exercisable and the Term of the Award shall not be more than ten years after the
      date of grant (or such other limit as may be required by the Code) if such limitation is necessary to qualify the Option as an Incentive Stock Option; 

  (iii) the Agreement covering an Incentive Stock Option shall contain such other terms and provisions which the Committee
      determines necessary to qualify such Option as an Incentive Stock Option; and 

  (iv) notwithstanding any other provision of this Plan if, at the time an Incentive Stock Option is granted, the Participant
      owns (after application of the rules contained in Section 424(d) of the Code, or its successor provision) Shares possessing more than ten percent of the total combined voting power of all classes of stock of the Company or its subsidiaries, (A) the
      option price for such Incentive Stock Option shall be at least 110% of the Fair Market Value of the Shares subject to such Incentive Stock Option on the date of grant and (B) such Option shall not be exercisable after the date five years from the
      date such Incentive Stock Option is granted. 

  8. Stock Appreciation Rights. 

  (a) Grant. An Award of a Stock Appreciation Right shall entitle the Participant, subject to terms and conditions determined by the
      Committee, to receive upon exercise of the Stock Appreciation Right all or a portion of the excess of (i) the Fair Market Value of a specified number of Shares as of the date of exercise of the Stock Appreciation Right over (ii) a specified price
      which shall not be less than 100% of the Fair Market Value of such Shares as of the date of grant of the Stock Appreciation Right (“purchase price”). A Stock Appreciation Right may be granted in connection with a previously or contemporaneously
      granted Option, or independent of any Option. If issued in connection with an Option, the Committee may impose a condition that exercise of a Stock Appreciation Right cancels the Option with which it is connected and exercise of the connected Option
      cancels the Stock Appreciation Right. Each Stock Appreciation Right may be exercisable in whole or in part on the terms provided in the applicable Agreement. No Stock Appreciation Right shall be exercisable at any time after its Term. When a Stock
      Appreciation Right is no longer exercisable, it shall be deemed to have lapsed or terminated. Except as otherwise provided in the applicable Agreement, upon exercise of a Stock Appreciation Right, payment to the Participant (or to his or her
      Successor) shall be made in the form of cash, Stock or a combination of cash and Stock (as determined by the Committee if not otherwise specified in the Award) as promptly as practicable after such exercise. The Agreement may provide for a limitation
      upon the amount or percentage of the total appreciation on which payment (whether in cash and/or Stock) may be made in the event of the exercise of a Stock Appreciation Right. 

   

    

  
    
      

  

  (b) Exercisability. Each Stock Appreciation Right shall vest in whole or in part on the terms provided in the Agreement. A Stock
      Appreciation Right that vests solely on the basis of the passage of time (and not on the basis of any performance standards) shall not vest more rapidly than ratably over a period of approximately three years from the grant date beginning on or about
      the first anniversary of the Stock Appreciation Right grant date. A Stock Appreciation Right that vests based on performance standards may, in the discretion of the Committee, vest as rapidly as immediate vesting on the first anniversary of the
      Option grant date. Notwithstanding the foregoing, the vesting of a Stock Appreciation Right may be accelerated upon the occurrence of certain events as provided in the applicable Agreement. In no event shall any Stock Appreciation Right be
      exercisable at any time after its Term. When a Stock Appreciation Right is no longer exercisable, it shall be deemed to have lapsed or terminated. 

  9. Performance Shares. 

  (a) Initial Award. An Award of Performance Shares shall entitle a Participant (or a Successor) to future payments based upon the
      achievement of performance targets established in writing by the Committee. Payment shall be made in cash or Stock, or a combination of cash and Stock, as determined by the Committee. Such performance targets shall be determined by the Committee in
      its sole discretion. The Agreement may establish that a portion of the maximum amount of a Participant’s Award will be paid for performance which exceeds the minimum target but falls below the maximum target applicable to such Award. The Agreement
      shall also provide for the timing of such payment. 

  (b) Acceleration and Adjustment. The applicable Agreement may permit an acceleration of the Performance Period and an adjustment of
      performance targets and payments with respect to some or all of the Performance Shares awarded to a Participant, upon such terms and conditions as shall be set forth in the Agreement, upon the occurrence of certain events, which may, but need not,
      include without limitation a Fundamental Change, the Participant’s death or Disability, a change in accounting practices of the Company or its Affiliates, a reclassification, stock dividend, stock split or stock combination, or other event as
      provided in Section 13(f) hereof. Notwithstanding the foregoing, an Award subject to this Section 9 shall vest or be earned no more rapidly than immediate vesting on the first anniversary of the Award grant date, except as may be provided in the
      applicable Agreement. 

  (c) Valuation. To the extent that payment of a Performance Share is made in cash, a Performance Share earned after conclusion of a
      Performance Period shall have a value equal to the Fair Market Value of a Share on the last day of such Performance Period. 

  (d) Voting; Dividends. Participants holding Performance Shares shall have no voting rights with respect to such Awards and shall have no
      dividend rights with respect to Shares subject to such Performances Shares other than as the Committee so provides, in its discretion, in an Agreement; provided, that, any such dividends shall be subject to such restrictions and conditions as the
      Committee may establish with respect to the Performance Shares and shall be payable only at the same time as the underlying Performance Shares may become earned, vested, and payable. 

  10. Restricted Stock and Restricted Stock Unit Awards. 

  (a) Grant. All or any part of any Restricted Stock or Restricted Stock Unit Award may be subject to such conditions and restrictions as
      may be established by the Committee, and set forth in the applicable Agreement, which may include, but are not limited to, continuous service with the Company, a requirement that a Participant pay a purchase price for such Award, the achievement of
      specific performance goals, and/or applicable securities laws restrictions. During any period during which an Award of Restricted Stock or Restricted Stock Units is restricted and subject to a substantial risk of forfeiture, (i) Participants holding
      Restricted Stock Awards may exercise full voting rights with respect to such Shares and shall be entitled to receive all dividends and other distributions paid with respect to such Shares while they are so restricted and (ii) Participants holding
      Restricted Stock Units shall have no voting rights with respect to such Awards and shall have no dividend rights with respect to Shares subject 

   

    

  
    
      

  

   to such Restricted Stock Units other than as the Committee so provides, in its discretion, in an Agreement. Any dividends or dividend equivalents may be paid
      currently or may be credited to a Participant’s account and may be subject to such restrictions and conditions as the Committee may establish. 

  (b) Vesting. An Award of Restricted Stock or Restricted Stock Units that vests solely on the basis of the passage of time (and not on
      the basis of any performance standards) shall not vest more rapidly than ratably over a period of approximately three years from the grant date beginning on or about the first anniversary of the Award grant date, or, in the case of a Restricted Stock
      or Restricted Stock Units Award that vests based on performance standards, such Award may, in the discretion of the Committee, vest as rapidly as immediate vesting on the first anniversary of the Award grant date; provided, however, that up to five
      percent (5%) of the Shares initially available under the Plan may be granted as Restricted Stock Awards that vest more rapidly than ratably over such three-year period or immediately following such one-year period, as applicable. Notwithstanding the
      foregoing, the vesting of a Restricted Stock or Restricted Stock Units Award may be accelerated upon the occurrence of certain events as provided in the applicable Agreement. 

  11. Other Awards. The Committee may from time to time grant Other Awards under this Plan, including without limitation those Awards pursuant to which a
      cash bonus award may be made or pursuant to which Shares may be acquired in the future, such as Awards denominated in Stock, Stock Units, securities convertible into Stock and phantom securities. The Committee, in its sole discretion, shall
      determine, and provide in the applicable Agreement for, the terms and conditions of such Awards provided that such Awards shall not be inconsistent with the terms and purposes of this Plan. The Committee may, in its sole discretion, direct the
      Company to issue Shares subject to restrictive legends and/or stop transfer instructions which are consistent with the terms and conditions of the Award to which such Shares relate. In addition, the Committee may, in its sole discretion, issue such
      Other Awards subject to the performance criteria under Section 12 hereof. 

  12. Performance-Based Awards. 

  (a) Application to Covered Employee. Notwithstanding any other provision of the Plan, if the Committee determines at the time any Award
      is granted to a Participant that such Participant is, or is likely to be as of the end of the tax year in which the Company would claim a tax deduction in connection with such Award, a “covered employee” within the meaning of Section 162(m)(3) of the
      Code, then the Committee may provide that this Section 12 is applicable to such Award. Notwithstanding the foregoing, the Committee may provide, in its discretion, that an Award granted to any other Participant is subject to this Section 12, to the
      extent the Committee deems appropriate, whether or not Section 162(m) of the Code is or would be applicable with respect to such Participant. 

  (b) Performance Goals. Awards under the Plan may be made subject to the achievement of performance goals established by the Committee
      relating to one or more business criteria (“Performance Criteria”) pursuant to Section 162(m) of the Code. Performance Criteria may be applied to the Company, an Affiliate, a Parent, a Subsidiary, division, business unit, corporate group or
      individual or any combination thereof and may be measured in absolute levels or relative to another company or companies, a peer group, an index or indices or Company performance in a previous period. Performance may be measured annually or
      cumulatively over a longer period of time. Performance Criteria that may be used to establish performance goals are: earnings or earnings per share before income tax (profit before taxes), net earnings or net earnings per share (profit after tax),
      compound annual growth in earnings per share, inventory, total or net operating asset turnover, operating income, total stockholder return, compound stockholder return, return on equity, average return on invested capital, pre-tax and pre-interest
      expense return on average invested capital, which may be expressed on a current value basis, sales 

   

    

  
    
      

  

   growth, operating or profit margins, market share or market penetration, successful transition of the Company’s clients to new claim adjudication platforms,
      achievement goals related to of post-merger integrations goals, achievement of goals related to customer service, satisfaction or retention, achievement of employee diversity satisfaction or turnover goals, and achievement of general sales,
      marketing, operating or workplan goals. Performance will be evaluated by excluding the effect of any extraordinary, unusual or non-recurring items that occur during the applicable Performance Period. The performance goals for each Participant and the
      amount payable if those goals are met shall be established in writing for each specified period of performance by the Committee no later than 90 days after the commencement of the period of service to which the performance goals relate and while the
      outcome of whether or not those goals will be achieved is substantially uncertain. However, in no event will such goals be established after 25% of the period of service to which the goals relate has elapsed. The performance goals shall be objective.
      Such goals and the amount payable for each performance period if the goals are achieved shall be set forth in the applicable Agreement. Following the conclusion or acceleration of each Performance Period, the Committee shall determine the extent to
      which (i) Performance Criteria have been attained, (ii) any other terms and conditions with respect to an Award relating to such Performance Period have been satisfied, and (iii) payment is due with respect to a performance-based Award. No amounts
      shall be payable to any Participant for any Performance Period unless and until the Committee certifies that the Performance Criteria and any other material terms were in fact satisfied. 

  (c) Adjustment of Payment. With respect to any Award that is subject to this Section 12, the Committee may adjust downwards, but not
      upwards, the amount payable pursuant to such Award. The applicable Agreement may permit an acceleration of the Performance Period and an adjustment of performance targets and payments with respect to some or all of the performance-based Award(s)
      awarded to a Participant, upon such terms and conditions as shall be set forth in the Agreement, upon the occurrence of certain events, which may, but need not, include without limitation a Fundamental Change, the Participant’s death or Disability, a
      change in accounting practices of the Company or its Affiliates, a reclassification, stock dividend, stock split or stock combination, or other event as provided in Section 13(f) hereof; provided, however, that any such acceleration or adjustment
      shall be made only to the extent and in a manner consistent with Section 162(m) of the Code. Notwithstanding the foregoing, an Award subject to this Section 12 shall vest or be earned no more rapidly than immediate vesting on the first anniversary of
      the Award grant date, except as may be provided in the applicable Agreement. 

  (d) Other Restrictions. The Committee shall have the power to impose such other restrictions on Awards subject to this Section 12 as it
      may deem necessary or appropriate to ensure that such Awards satisfy all requirements for “performance-based compensation” within the meaning of Section 162(m)(4)(C) of the Code, or any successor provision thereto. 

  13. General Provisions. 

  (a) Effective Date of this Plan. This Plan originally became effective as of June 1, 2011 after approval and ratification by the holders
      of common stock of Express Scripts, Inc. at its annual meeting held on May 4, 2011. This amendment and restatement is effective April 2, 2012 and was approved and ratified on March 29, 2012 by the holders of the Company’s common stock. 

  (b) Duration of this Plan; Date of Grant. This Plan shall remain in effect until June 1, 2021 or until all Shares subject to the Plan
      shall have been purchased or acquired according to the Plan’s provisions, whichever occurs first, unless this Plan is sooner terminated pursuant to Section 13(e) hereof. The date and time of approval by the Committee of the granting of an Award shall
      be considered the date and time at which such Award is made or granted, or such later effective date as determined by the Committee, notwithstanding the date of any Agreement with respect to such Award; provided, however, 

   

    

  
    
      

  

   that the Committee may grant Awards other than Incentive Stock Options to Associates or to persons who are about to become Associates, to be effective and
      deemed to be granted on the occurrence of certain specified contingencies, provided that if the Award is granted to a non-Associate who is about to become an Associate, such specified contingencies shall include, without limitation, that such person
      becomes an Associate. 

  (c) Right to Terminate Employment. Nothing in this Plan or in any Agreement shall confer upon any Participant who is an employee of the
      Company the right to continue in the employment of the Company or any Affiliate or affect any right which the Company or any Affiliate may have to terminate or modify the employment of the Participant with or without cause. 

  (d) Tax Withholding. The Company shall withhold from any payment of cash or Stock to a Participant or other person under this Plan an
      amount sufficient to cover any required withholding taxes, including the Participant’s social security and Medicare taxes (FICA) and federal, state and local income tax with respect to income arising from payment of the Award. The Company shall have
      the right to require the payment of any such taxes before issuing any Stock pursuant to the Award. In lieu of all or any part of a cash payment from a person receiving Stock under this Plan, the Committee may, in the applicable Agreement or
      otherwise, permit a person to cover all or any part of the required withholdings, and to cover any additional withholdings up to the amount needed to cover the person’s full FICA and federal, state and local income tax with respect to income arising
      from payment of the Award, through a reduction of the numbers of Shares delivered to such person or a delivery or tender to the Company of Shares held by such person, in each case valued in the same manner as used in computing the withholding taxes
      under applicable laws. 

  (e) Amendment, Modification and Termination of this Plan. Except as provided in this Section 13(e), the Board may at any time amend,
      modify, terminate or suspend this Plan. Except as provided in this Section 13(e), the Committee may at any time alter or amend any or all Agreements under this Plan to the extent permitted by law and subject to the requirements of Section 2(b), in
      which event, as provided in Section 2(b), the term “Agreement” shall mean the Agreement as so amended. Amendments are subject to approval of the stockholders of the Company only as required by applicable law or regulation, or if the amendment
      increases the total number of shares available under this Plan. No termination, suspension or modification of this Plan may materially and adversely affect any right acquired by any Participant (or a Participant’s legal representative) or any
      Successor or permitted transferee under an Award granted before the date of termination, suspension or modification, unless otherwise provided in an Agreement or otherwise or required as a matter of law. It is conclusively presumed that any
      adjustment for changes in capitalization provided for in Sections 9(b), 12(c) or 13(f) hereof does not adversely affect any right of a Participant or other person under an Award. 

  (f) Adjustment for Changes in Capitalization. Appropriate adjustments in the aggregate number and type of securities that may be issued,
      represented, and available for Awards under this Plan, in the limitations on the number and type of securities that may be issued to an individual Participant, in the number and type of securities and amount of cash subject to Awards then
      outstanding, in the Option purchase price as to any outstanding Options, in the purchase price as to any outstanding Stock Appreciation Rights, and, subject to Sections 9(b) and 12(c) hereof, in outstanding Performance Shares and payments with
      respect to outstanding Performance Shares, and comparable adjustments, if applicable, to any outstanding Other Award, automatically shall be made to give effect to adjustments made in the number or type of Shares through a Fundamental Change,
      divestiture, distribution of assets to stockholders (other than ordinary cash dividends), reorganization, recapitalization, reclassification, stock dividend, stock split, reverse stock split, stock combination or exchange, rights offering, spin-off
      or other relevant change, provided that fractional Shares shall be rounded to the nearest whole Share, for which purpose one-half share shall be rounded down to the nearest whole Share. 

   

    

  
    
      

  

  (g) Other Benefit and Compensation Programs. Payments and other benefits received by a participant under an Award shall not be deemed a
      part of a Participant’s regular, recurring compensation for purposes of any termination, indemnity or severance pay laws and shall not be included in, nor have any effect on, the determination of benefits under any other employee benefit plan,
      contract or similar arrangement provided by the Company or an Affiliate, unless expressly so provided by such other plan, contract or arrangement or the Committee determines that an Award or portion of an Award should be included to reflect
      competitive compensation practices or to recognize that an Award has been made in lieu of a portion of competitive cash compensation. 

  (h) Beneficiary Upon Participant’s Death. To the extent that the transfer of a participant’s Award at death is permitted by this Plan or
      under an Agreement, (i) a Participant’s Award shall be transferable to the beneficiary, if any, designated on forms prescribed by and filed with the Committee and (ii) upon the death of the Participant, such beneficiary shall succeed to the rights of
      the Participant to the extent permitted by law and this Plan. If no such designation of a beneficiary has been made, the Participant’s legal representative shall succeed to the Awards, which shall be transferable by will or pursuant to laws of
      descent and distribution to the extent permitted by this Plan or under an Agreement. 

  (i) Unfunded Plan. This Plan shall be unfunded and the Company shall not be required to segregate any assets that may at any time be
      represented by Awards under this Plan. Neither the Company, its Affiliates, the Committee, nor the Board shall be deemed to be a trustee of any amounts to be paid under this Plan nor shall anything contained in this Plan or any action taken pursuant
      to its provisions create or be construed to create a fiduciary relationship between the Company and/or its Affiliates, and a Participant or Successor. To the extent any person acquires a right to receive an Award under this Plan, such right shall be
      no greater than the right of an unsecured general creditor of the Company. 

  (j) Limits of Liability. 

  (i) Any liability of the Company to any Participant with respect to an Award shall be based solely upon contractual obligations
      created by this Plan and the Agreement. 

  (ii) Except as may be required by law, neither the Company nor any member or former member of the Board or the Committee, nor
      any other person participating (including participation pursuant to a delegation of authority under Section 3(c) hereof) in any determination of any question under this Plan, or in the interpretation, administration or application of this Plan, shall
      have any liability to any party for any action taken, or not taken, in good faith under this Plan. 

  (iii) To the full extent permitted by law, each member and former member of the Committee and each person to whom the Committee
      delegates or has delegated authority under this Plan shall be entitled to indemnification by the Company against any loss, liability, judgment, damage, cost and reasonable expense incurred by such member, former member or other person by reason of
      any action taken, failure to act or determination made in good faith under or with respect to this Plan. 

  (k) Compliance with Applicable Legal Requirements. The Company shall not be required to issue or deliver a certificate for Shares
      distributable pursuant to this Plan unless the issuance of such certificate complies with all applicable legal requirements including, without limitation, compliance with the provisions of applicable state securities laws, the Securities Act of 1933,
      as amended and in effect from time to time or any successor statute, the Exchange Act and the requirements of the exchanges, if any, on which the Company’s Shares may, at the time, be listed. 

   

    

  
    
      

  

  (l) Deferrals and Settlements. The Committee may require or permit Participants to elect to defer the issuance of Shares or the
      settlement of Awards in cash under such rules and procedures as it may establish under this Plan. It may also provide that deferred settlements include the payment or crediting of interest on the deferral amounts. 

  14. Substitute Awards. Awards may be granted under this Plan from time to time in substitution for Awards held by employees of other corporations who
      are about to become Associates, or whose employer is about to become a Subsidiary of the Company, as the result of a merger or consolidation of the Company or a Subsidiary of the Company with another corporation, the acquisition by the Company or a
      Subsidiary of the Company of all or substantially all the assets of another corporation or the acquisition by the Company or a Subsidiary of the Company of at least 50% of the issued and outstanding stock of another corporation. The terms and
      conditions of the substitute Awards so granted may vary from the terms and conditions set forth in this Plan to such extent as the Board at the time of the grant may deem appropriate to conform, in whole or in part, to the provisions of the Awards in
      substitution for which they are granted, but with respect to Awards which are Incentive Stock Options, no such variation shall be permitted which affects the status of any such substitute option as an Incentive Stock Option. 

  15. Governing Law. To the extent that federal laws do not otherwise control, this Plan and all determinations made and actions taken pursuant to this
      Plan shall be governed by the laws of Delaware, without giving effect to principles of conflicts of laws, and construed accordingly. 

  16. Severability. In the event any provision of this Plan shall be held illegal or invalid for any reason, the illegality or invalidity shall not
      affect the remaining parts of this Plan, and this Plan shall be construed and enforced as if the illegal or invalid provision had not been included. 

  17. Prior Plans. Notwithstanding the adoption of this Plan by the Board and approval of this Plan by the Company’s stockholders as provided by
      Section 13(a) hereof, the Express Scripts, Inc. 2000 Long-Term Incentive Plan, as amended (the “2000 Plan”), shall remain in effect, but grants pursuant to the 2000 Plan shall not be made after the effective date of this Plan. All grants and awards
      that were made under the 2000 Plan shall be governed by the terms of the 2000 Plan. For the avoidance of doubt, each grant and award that was made under the terms of the Express Scripts, Inc. 2011 Long-Term Incentive Plan outstanding as of April 2,
      2012 has been assumed under this Plan as amended and restated and, to the extent applicable, such grants and awards that represented awards in respect of common stock of Express Scripts, Inc. shall, upon such assumption, represent awards in respect
      of Shares of the Company. 

  18. Deferred Compensation. If any Award would be considered deferred compensation as defined under Code Section 409A and would fail to meet the
      requirements of Code Section 409A, then such Award shall be null and void.EX-10.4

  Exhibit 4.11 

  MEDCO HEALTH SOLUTIONS, INC. 

  2002 STOCK INCENTIVE PLAN 

  (As amended and restated May 15, 2003, March 14, 2011, and April 2, 2012 

  and approved by shareholders on May 31, 2005, May 24, 2011, and March 29, 2012) 

   

  

  1. Purpose 

  The 2002 Stock Incentive Plan (the “Plan”) was previously established effective June 17, 2002. This document is an amendment and restatement of the Medco
      Health Solutions, Inc. 2002 Stock Incentive Plan in effect as of April 2, 2012 and reflects, among other things, the assumption of the Plan by Express Scripts Holding Company (the “Company”). The purpose of the Plan is to encourage employees of the
      Company, its parent, if any, its subsidiaries, its affiliates and its joint ventures to acquire Common Stock in the Company (“Common Stock”). It is believed that the Plan will serve the interests of the Company and its stockholders because it allows
      employees to have a greater personal financial interest in the Company through ownership of, or the right to acquire its Common Stock, which in turn will stimulate employees’ efforts on the Company’s behalf, and maintain and strengthen their desire
      to remain with the Company or one of its related entities. It is believed that the Plan will also assist in the recruitment of employees. 

  2. Administration 

  The Plan shall be administered by the Compensation Committee of the Board of Directors of the Company (the “Committee”). A Director of the Company may serve on
      the Committee only if he or she (i) is a “Non-Employee Director” for purposes of Rule 16b-3 under the Securities Exchange Act of 1934, as amended (the “Exchange Act”), and (ii) satisfies the requirements of an “outside director” for purposes of
      Section 162(m) of the Internal Revenue Code (the “Code”). The Committee shall be responsible for the administration of the Plan including, without limitation, determining which Eligible Persons receive Incentives, the types of Incentives they receive
      under the Plan, the number of shares covered by Incentives granted under the Plan, and the other terms and conditions of such Incentives. Determinations by the Committee under the Plan including, without limitation, determinations of the Eligible
      Persons, the form, amount and timing of Incentives, the terms and provisions of Incentives and the writings evidencing Incentives, need not be uniform and may be made selectively among Eligible Persons who receive, or are eligible to receive,
      Incentives hereunder, whether or not such Eligible Persons are similarly situated. 

  The Committee shall have the responsibility of construing and interpreting the Plan, including the right to construe disputed or doubtful Plan provisions, and
      of establishing, amending and construing such rules and regulations as it may deem necessary or desirable for the proper administration of the Plan including adopting sub-plans and special rules to facilitate compliance or achieve desirable tax
      results or other Company objectives for grants made to employees outside the U.S. and to determine the consequences of termination of employment or other relationships for grants made to non-employee directors, independent contractors, leased
      employees or consultants when the grants are made. In addition, as to any Performance Share Award not intended to constitute “performance-based compensation” under Section 162(m) of the Code, at any time prior to the end of an Award Period (as
      defined in Section 9), the Committee may revise the Performance Goals and the computation of payment if unforeseen events occur which have a substantial effect on the performance of the Company, its parent, subsidiary, division, affiliate or joint
      venture of the Company and which, in the judgment of the Committee, make the application of the Performance Goals (as defined in Section 9) unfair (as determined in the sole discretion of the Committee) unless a revision is made. Any decision or
      action taken or to be taken by the Committee, arising out of or in connection with the construction, administration, interpretation and effect of the Plan and of its 

   

  

   rules and regulations, shall, to the maximum extent permitted by applicable law, be within its absolute discretion (except as otherwise specifically provided
      herein) and shall be final, binding and conclusive upon the Company, all Eligible Persons and any person claiming under or through any Eligible Person. 

  The Committee may delegate any or all of its power and authority hereunder to the Chief Executive Officer or President and such other officers as the
      Committee deems appropriate; provided, however, that the Committee may not delegate its authority with regard to (i) any matter or action affecting an officer subject to Section 16 of the Exchange Act; (ii) any matter related to Incentives intended
      to be qualified under Section 162(m) of the Code; or (iii) any matter or action related to grants of Incentives to Non-Employee Directors. 

  For the purpose of this section and all subsequent sections, the Plan shall be deemed to include this Plan and any sub-plans which, in the aggregate, shall
      constitute one Plan governed by the terms set forth herein. 

  3. Eligibility 

   

  	 	(a)	Employees. Any person employed by the Company, its parent, if any, or its subsidiaries, its affiliates and its joint ventures, including officers, whether or
            not directors of the Company, and employees of a joint venture partner or affiliate of the Company who provide services to the joint venture with such partner or affiliate (each such person, an “Employee”), shall be eligible to participate in
            the Plan if designated by the Committee (“Eligible Persons”). Notwithstanding the foregoing, an individual who was an employee of Express Scripts, Inc. or its subsidiaries as of April 2, 2012 shall not be an Employee eligible to be designated
            as an Eligible Person by reason of such employment or continued employment with the Company thereafter. 

   

  	 	(b)	Non-employees. The term “Employee” shall not include a non-employee director or a person hired as an independent contractor, leased employee or consultant,
            provided, however, that the Committee may determine that any such person is eligible to receive Incentives under the Plan (and, if such a determination is made as to any such person, such person shall be an Eligible Person under the Plan). Such
            person shall not participate in this Plan except to the extent that the Committee so determines, even if such person is subsequently determined to be an “employee” by any governmental or judicial authority. 

   

  	 	(c)	
          No Right To Continued Employment. Nothing in the Plan shall interfere with or limit in any way the right of the Company, its parent, its subsidiaries, its affiliates or its
              joint ventures to terminate the employment of any participant at any time, nor confer upon any participant the right to continue in the employ of the Company, its parent, its subsidiaries, its affiliates or its joint ventures. No Eligible
              Person shall have a right to receive an Incentive or any other benefit under this Plan or having been granted an Incentive or other benefit, to receive any additional Incentive or other benefit. Neither the award of an Incentive nor any
              benefits arising under such Incentives shall constitute an employment contract with the Company, its parent, its subsidiaries, its affiliates or its joint ventures, and accordingly, this Plan and the 

        

   

  

   benefits hereunder may be terminated at any time in the sole and exclusive discretion of the Company without giving rise to liability on the
      part of the Company, its parent, its subsidiaries, its affiliates or its joint ventures for severance (except as otherwise required under applicable local law). Except as may be otherwise specifically stated in any other employee benefit plan, policy
      or program, or as required under applicable local law, neither any Incentive under this Plan nor any amount realized from any such Incentive shall be treated as compensation for any purposes of calculating an employee’s benefit under any such plan,
      policy or program. 

  4. Term of the Plan 

  This Plan was initially adopted by Medco Health Solutions, Inc. effective on June 17, 2002 and originally approved by shareholders of Medco Health Solutions,
      Inc. on July 21, 2003. The Plan was extended pursuant to the amendments and restatements made on March 14, 2011 such that no Incentive shall be granted under the Plan after May 24, 2021, but the term and exercise of Incentives granted theretofore may
      extend beyond that date. This amendment and restatement is effective upon the consummation of that certain merger involving the Company, Express Scripts, Inc. and Medco Health Solutions, Inc. on April 2, 2012 and was approved by Express Scripts, Inc.
      as the sole shareholder of the Company on March 29, 2012. For the avoidance of doubt, each grant and award that was made under the terms of the Medco Health Solutions, Inc. 2002 Stock Incentive Plan outstanding as of April 2, 2012 has been assumed
      under this Plan as amended and restated and, to the extent applicable, such grants and awards that represented awards in respect of common stock of Medco Health Solutions, Inc. shall, upon such assumption, represent awards in respect of Common Stock
      of the Company, appropriately adjusted. 

  5. Incentives 

   

  	 	(a)	Types of Incentives. Incentives under the Plan may be granted in any one or a combination of (i) Incentive Stock Options; (ii) Nonqualified Stock Options;
            (iii) Stock Appreciation Rights; (iv) Restricted Stock Grants, (v) Performance Shares, (vi) Share Awards and (vii) Phantom Stock Awards (Incentive Stock Options and Nonqualified Stock Options shall be referred to collectively as “Stock Options”
            and together with Restricted Stock Grants, Performance Shares, Share Awards and Phantom Stock Awards shall be referred to collectively as “Incentives”) Incentives other than Stock Options and Stock Appreciation Rights are “Full Value Awards.”
            All Incentives shall be subject to the terms and conditions set forth herein and to such other terms and conditions as may be established by the Committee. 

   

  	 	(b)	No Repricing. Except in connection with a corporate transaction involving the company (including, without limitation, any stock dividend, stock split,
            extraordinary cash dividend, recapitalization, reorganization, merger, consolidation, split-up, spin-off, combination, or exchange of shares), the terms of outstanding awards may not be amended to reduce the option price of outstanding Stock
            Options or Stock Appreciation Rights or cancel outstanding Stock Options or in exchange for cash, other awards or Stock Options or with an option price that is less than the option price of the original Stock Options or Stock Appreciation
            Rights without stockholder approval. 

   

  

  6. Shares Available for Incentives 

   

  	 	(a)	Shares Available. Subject to the provisions of Section 6(c), the maximum number of shares of Common Stock of the Company that may be issued under the Plan as of
            April 2, 2012 is thirteen million, nine hundred forty two thousand, eight hundred ninety four (13,942,894) which is the equivalent of the number of shares of common stock of Medco Health Solutions, Inc. that was available under the
            Medco Health Solutions, Inc. 2002 Stock Incentive Plan as of April 2, 2012, adjusted to reflect Common Stock of the Company. 

  For all grants made after December 31, 2010, the share reserve shall be reduced by (1) one common share for each common share issued with
      respect to a Stock Option or Stock Appreciation Right; and (b) 2.16 common shares for each common share issued with respect to Full Value Awards. Upon the exercise of a stock-settled Stock Appreciation Right, the number of shares subject to the Award
      that are then being exercised shall be counted against the maximum aggregate number of shares that may be issued under the Plan, on the basis of one share for every share subject thereto, regardless of the actual number of shares used to settle the
      Stock Appreciation Right upon exercise. 

  In addition to the foregoing, the following shares of Common Stock related to Incentives under this Plan may again be used for the grant of
      Incentives under the Plan: (i) shares related to Incentives paid in cash; (ii) shares related to Incentives that expire, are forfeited or cancelled or terminate for any other reason without issuance of shares of Common Stock; and (iii) any shares of
      Common Stock related to Incentives that are assumed, converted or substituted as a result of the acquisition of another company by the Company or a combination of the Company with another company. Regardless of when Incentives are granted, effective
      January 1, 2011, shares tendered in payment of the option price or grant price for Stock Options and Stock Appreciation Rights or shares withheld from Incentives (including Full Value Awards) for tax payments or withholding for taxes shall not be
      added back into the Plan. 

  Shares under this Plan may be delivered by the Company from its authorized but unissued shares of Common Stock or from issued and reacquired
      Common Stock held as treasury stock, or both. In no event shall fractional shares of Common Stock be issued under the Plan. 

   

  	 	(b)	Limit on an Individual’s Incentives. In any calendar year, no Eligible Person may receive (i) Incentives (including Stock Options and Stock Appreciation Rights)
            covering more than two million, six hundred ninety four thousand, seven hundred seventy three (2,694,773) shares of the Company’s Common Stock (such number of shares shall be adjusted in accordance with Section 6(c)), or
            (ii) any Incentive if such person owns more than ten percent of the stock of the Company within the meaning of Section 422 of the Code, or (iii) any Incentive Stock Option, as defined in Section 422 of the Code, which would result in such
            person receiving a grant of Incentive Stock Options for stock that would have an aggregate fair market value in excess of $100,000, determined as of the time that the Incentive Stock Option is granted, that would be exercisable for the first
            time by such person during any calendar year. 

   

  

  	 	(c)	Adjustment of Shares. In the event of a reorganization, recapitalization, stock split, stock dividend, combination of shares, merger, consolidation, rights
            offering, spin off, split off, split up or other event identified by the Committee, the Committee shall make such adjustments, if any, as it may deem appropriate in (i) the number and kind of shares authorized for issuance under the Plan,
            (ii) the number and kind of shares subject to outstanding Incentives, and (iii) the option price/grant price of Stock Options and Stock Appreciation Rights. For the purposes of (i) and (ii) above, fractions of a share will be rounded down to
            the nearest whole share (other than for Incentive Stock Options). Any such determination shall be final, binding and conclusive on all parties. Without limiting the foregoing, the shares available under this Plan were adjusted effective
            April 2, 2012 as reflected in Section 6(a) hereof, and all other references to numbers of shares, including with respect to previously granted awards, share limits and share reductions, are similarly adjusted effective April 2, 2012 as
            determined by the Committee and such adjustments shall be deemed to be incorporated herein, in each case, to the extent appropriate. 

   

  	 	(d)	Minimum Vesting for Full Value Awards. With respect to at least 95% of Full Value Awards (other than Performance Share Awards) granted after December 31, 2010,
            vesting of such Incentives will occur over a minimum of three years from the grant date. For Performance Share Awards, at least 95% of these Incentives granted after December 31, 2010 will vest over a minimum of one year from the grant date. 

  7. Stock Options 

  The Committee may grant options qualifying as Incentive Stock Options as defined in Section 422 of the Code to employees of the Company or a parent or
      subsidiary corporation within the meaning of Section 424 of the Code, and options other than Incentive Stock Options (“Nonqualified Options”) (collectively “Stock Options”). Such Stock Options shall be subject to the following terms and conditions
      and such other terms and conditions as the Committee may prescribe: 

   

  	 	(a)	Stock Option Price. The option price per share with respect to each Stock Option shall be determined by the Committee, but shall not be less than 100% of the
            Fair Market Value of the Common Stock (as defined below) on the date the Stock Option is granted, as determined by the Committee. Unless the Committee determines otherwise, “Fair Market Value” shall mean the closing stock price of a share of
            Common Stock, as reported on the Nasdaq Global Select Market (or any other reporting system selected by the Committee, in its sole discretion) on the date as of which the determination is being made or, if no sale of shares of Common Stock is
            reported on this date, on the next preceding day on which there were sales of shares of Common Stock reported. 

   

  	 	(b)	Period of Stock Option. The period of each Stock Option shall be fixed by the Committee, provided that the period for all Stock Options shall not exceed ten
            (10) years from the grant. The Committee may, subsequent to the granting of any Stock Option, extend the term thereof, but in no event shall the extended term exceed ten years from the original grant date. 

   

  

  	 	(c)	Exercise of Stock Option and Payment Therefore. No shares shall be issued until full payment of the option price has been made. The option price may be paid in
            cash or, if the Committee determines, in shares of Common Stock or a combination of cash and shares of Common Stock. If the Committee approves the use of shares of Common Stock as a payment method, the Committee shall establish such conditions
            as it deems appropriate for the use of Common Stock to exercise a Stock Option. Stock Options awarded under the Plan shall be exercised through such procedure or program as the Committee may establish or define from time to time, which may
            include a designated broker that must be used in exercising such Stock Options. 

   

  	 	(d)	First Exercisable Date. The Committee shall determine how and when shares covered by a Stock Option may be purchased. The Committee may establish waiting
            periods, the dates on which Stock Options become exercisable or “vested” and, subject to paragraph (b) of this section, exercise periods. The Committee may accelerate the exercisability of any Stock Option or portion thereof. 

   

  	 	(e)	Termination of Employment. Unless determined otherwise by the Committee, upon the termination of a Stock Option grantee’s employment (for any reason other than
            gross misconduct), outstanding Stock Options which were not exercisable at the date of such termination shall be immediately forfeited upon termination. The Committee, however, in its discretion, may provide that any Stock Options outstanding
            but not yet exercisable upon the termination of a Stock Option grantee’s employment may become exercisable in accordance with a schedule determined by the Committee. Such Stock Options shall expire unless exercised within such period of time
            after the date of termination of employment as may be established by the Committee, but in no event later than the expiration date of the Stock Option. 

   

  	 	(f)	Termination Due to Misconduct. If a Stock Option grantee’s employment is terminated for gross misconduct, as determined by the Company, all outstanding Stock
            Options (regardless of whether vested or not upon termination) shall expire upon the date of such termination. 

   

  	 	(g)	Limits on Incentive Stock Options. Except as may otherwise be permitted by the Code, an Eligible Person may not receive a grant of Incentive Stock Options for
            stock that would have an aggregate fair market value in excess of $100,000 (or such other amount as the Internal Revenue Service may decide from time to time), determined as of the time that the Incentive Stock Option is granted, that would be
            exercisable for the first time by such person during any calendar year. All shares that have been authorized to be issued under the Plan may be used for the grant of Incentive Stock Options. 

   

  

  8. Stock Appreciation Rights 

  The Committee may, in its discretion, grant a right to receive the appreciation in the fair market value of shares of Common Stock (“Stock Appreciation Right”)
      either singly or in combination with an underlying Stock Option granted hereunder. Such Stock Appreciation Right shall be subject to the following terms and conditions and such other terms and conditions as the Committee may prescribe: 

   

  	 	(a)	Time and Period of Grant. If a Stock Appreciation Right is granted with respect to an underlying Stock Option, it may be granted at the time of the Stock Option
            grant or at any time thereafter but prior to the expiration of the Stock Option grant. If a Stock Appreciation Right is granted with respect to an underlying Stock Option, at the time the Stock Appreciation Right is granted the Committee may
            limit the exercise period for such Stock Appreciation Right, before and after which period no Stock Appreciation Right shall attach to the underlying Stock Option. In no event shall the exercise period for a Stock Appreciation Right granted
            with respect to an underlying Stock Option exceed the exercise period for such Stock Option. If a Stock Appreciation Right is granted without an underlying Stock Option, the term of the Stock Appreciation Right shall be set by the Committee,
            but in no event shall exceed ten (10) years from the grant. 

   

  	 	(b)	Value of Stock Appreciation Right. If a Stock Appreciation Right is granted with respect to an underlying Stock Option, the grantee will be entitled to
            surrender the Stock Option which is then exercisable and receive in exchange an amount equal to the excess of the fair market value of the Common Stock on the date the election to surrender is received by the Company in accordance with exercise
            procedures established by the Company over the Stock Option price multiplied by the number of shares covered by the Stock Option which is surrendered. If a Stock Appreciation Right is granted without an underlying Stock Option, the grantee will
            receive upon exercise of the Stock Appreciation Right an amount equal to the excess of the fair market value of the Common Stock on the date the election to surrender such Stock Appreciation Right is received by the Company in accordance with
            exercise procedures established by the Company over the fair market value of the Common Stock on the date of grant multiplied by the number of shares covered by the grant of the Stock Appreciation Right. All Stock Appreciation Rights shall have
            a grant price that is not less than 100% of the Fair Market Value of the Common Stock on the date the Stock Appreciation Right is granted. 

   

  	 	(c)	Payment of Stock Appreciation Right. Payment of a Stock Appreciation Right shall be in the form of shares of Common Stock, cash or any combination of shares and
            cash. The form of payment upon exercise of such a right shall be determined by the Committee either at the time of grant of the Stock Appreciation Right or at the time of exercise of the Stock Appreciation Right. 

  9. Performance Share Awards 

  The Committee may grant awards under which payment may be made in shares of Common Stock, cash or any combination of shares and cash if the performance of the
      Company or its parent, if any, or any subsidiary, affiliate or joint venture of the Company or based on an individual grantee’s performance, team, division or group performance or any other defined group that the Committee determines during the Award
      Period meets certain goals established by the Committee (“Performance Share Awards”). Such Performance Share Awards shall be subject to the following terms and conditions and such other terms and conditions as the Committee may prescribe: 

   

  

  	 	(a)	Award Period and Performance Goals. The Committee shall determine and include in a Performance Share Award grant the period of time for which a Performance
            Share Award is made (“Award Period”). The Committee shall also establish performance objectives (“Performance Goals”) to be met by the Company, its parent, if any, subsidiary, affiliate or joint venture of the Company or individual grantee or
            team, division or group determined by the Committee during the Award Period as a condition to payment of the Performance Share Award. The Performance Goals may include any one or more of the following Company measures, as interpreted by the
            Committee, which (to the extent applicable) will be determined in accordance with GAAP: earnings per share; net-new sales; new named sales; client retention; client satisfaction; employee satisfaction; member satisfaction; revenue performance;
            corporate earnings performance; return on assets; return on equity; return on invested capital; cash flow; cash balances; market value added; economic value added; earnings before interest, taxes, depreciation and amortization; mail and total
            prescription volumes; mail penetration rate; cost and expense controls; drug trend management; clinical program effectiveness; generic dispensing rates; specialty segment performance; covered lives; productivity and growth in new markets,
            products and/or services. Performance Measures may be measured before or after taking taxes into consideration, in the discretion of the Committee. The Performance Goals may include minimum and optimum objectives or a single set of objectives.
            In determining attainment of Performance Goals, the Committee will exclude unusual or infrequently occurring items, charges for restructurings (employee severance liabilities, asset impairment costs, and exit costs), discontinued operations,
            extraordinary items and the cumulative effect of changes in accounting treatment, and may determine no later than ninety (90) days after the commencement of any applicable Award Period to exclude other items, each determined in accordance with
            GAAP (to the extent applicable) and as identified in the financial statements, notes to the financial statements or discussion and analysis of management. If the Committee desires that compensation payable pursuant to any Performance Share
            Award be qualified performance-based compensation within the meaning of Section 162(m) of the Code for covered employees, the Performance Goals (i) shall be established by the Committee no later than the end of the first quarter of the Award
            Period (or such other time designated by the United States Internal Revenue Service) and (ii) shall satisfy all other applicable requirements imposed under United States Treasury Regulations promulgated under Section 162(m) of the Code,
            including the requirement that such Performance Goals be stated in terms of an objective formula or standard. 

   

  	 	(b)	
          Payment of Performance Share Awards. The Committee shall establish the method of calculating the amount of payment to be made under a Performance Share Award if the
              Performance Goals are met, including the fixing of a maximum payment. The Performance Share Award shall be expressed in terms of shares of Common Stock and referred to as “Performance Shares.” After the completion of an Award Period, the
              performance of the Company, its parent, if any, subsidiary, 

        

   

  

   affiliate or joint venture of the Company or individual grantee or team, division or group (whichever is relevant under the terms of the
      Performance Share Award) shall be measured against the Performance Goals, and the Committee shall determine, in accordance with the terms of such Performance Share Award, whether all, none or any portion of a Performance Share Award shall be paid.
      The Committee, in its discretion, may elect to make payment in shares of Common Stock, cash or a combination of shares and cash. Any cash payment shall be based on the Fair Market Value of Performance Shares at the end of the Award Period. 

   

  	 	(c)	Requirement of Employment. A grantee of a Performance Share Award must remain in the employ of the Company, its parent, if any, subsidiary, affiliate or joint
            venture until the completion of the Award Period in order to be entitled to payment under the Performance Share Award; provided that the Committee may, in its discretion, provide for a full or partial payment where such an exception is deemed
            equitable. However, to the extent that the Performance Share Award is intended to constitute performance-based compensation, the Committee shall only make exceptions in the event that the covered employee’s employment terminates due to death,
            disability or upon a change of control provided payments are not made until after the completion of the Award Period and certification that the Performance Goals have been attained as required pursuant to Section 162(m). 

   

  	 	(d)	Dividend Equivalents. Dividend equivalents shall not be paid during the Award Period and may only be paid on vested Performance Shares to the extent determined
            by the Committee. 

  10. Restricted Stock Grants 

  The Committee may award shares of Common Stock to an Eligible Person, which shares shall be subject to the following terms and conditions and such other terms
      and conditions as the Committee may prescribe (“Restricted Stock Grant”): 

   

  	 	(a)	Requirement of Employment. A grantee of a Restricted Stock Grant must remain in the employment of the Company or its parent, if any, its subsidiaries, its
            affiliates and its joint ventures during a period designated by the Committee (“Restriction Period”) in order to retain the shares under the Restricted Stock Grant. If the grantee’s employment with the Company or its parent, if any, its
            subsidiaries, its affiliates and its joint ventures terminates prior to the end of the Restriction Period, the Restricted Stock Grant shall terminate and the shares of Common Stock shall be returned immediately to the Company provided that the
            Committee may, at the time of the grant, provide for the employment restriction to lapse with respect to a portion or portions of the Restricted Stock Grant at different times during the Restriction Period. The Committee may, in its discretion,
            also provide for such complete or partial exceptions to the employment restriction as it deems equitable. 

   

  	 	(b)	Restrictions on Transfer and Legend on Stock Certificates. During the Restriction Period, the grantee may not sell, assign, transfer, pledge or otherwise
            dispose of the shares of Common Stock. Each certificate for shares of Common Stock issued hereunder shall contain a legend giving appropriate notice of the restrictions in the grant. 

   

  

  	 	(c)	Escrow Agreement. The Committee may require the grantee to enter into an escrow agreement providing that the certificates representing the Restricted Stock
            Grant will remain in the physical custody of an escrow holder until all restrictions are removed or expire. 

   

  	 	(d)	Lapse of Restrictions. All restrictions imposed under the Restricted Stock Grant shall lapse upon the expiration of the Restriction Period if the conditions as
            to employment set forth above have been met. The grantee shall then be entitled to have the legend removed from the certificates and/or request shares to be transferred to him or her from the escrow holder, if any. 

   

  	 	(e)	Dividends. The Committee shall, in its discretion, at the time of the Restricted Stock Grant, provide that any dividends declared on the Common Stock during the
            Restriction Period shall either be (i) paid to the grantee as soon as practicable after the dividend is declared, or (ii) accumulated for the benefit of the grantee and paid to the grantee only after the expiration of the Restriction Period. 

   

  	 	(f)	Performance Goals. The Committee may designate whether any Restricted Stock Grant is intended to be “performance-based compensation” as that term is used in
            Section 162(m) of the Code. Any such Restricted Stock Grant designated to be “performance-based compensation shall be conditioned on the achievement of one or more Performance Goals (as defined in Section 9(a)), to the extent required by
            Section 162(m). 

  11. Other Share-Based Awards 

   

  	 	(a)	Share Awards. The Committee may grant an award of shares of common stock (a “Share Award”) to any Eligible Person on such terms and conditions as the Committee
            may determine in its sole discretion. 

   

  	 	(b)	Phantom Stock Awards. The Committee may, in its discretion, grant a right representing a number of hypothetical shares, including restricted stock units (a
            “Phantom Stock Award”), to any Eligible Person on such terms and conditions, including whether payment of such Phantom Stock Award will be in cash or shares, as the Committee may determine in its sole discretion. 

  12. Transferability 

  Each Incentive, other than Nonqualified Options, granted under the Plan shall not be transferable or assignable other than by will or the laws of descent and
      distribution and shall be exercisable during the grantee’s lifetime only by the grantee. Nonqualified Options shall not be transferable or assignable by the recipient, and may not be made subject to execution, attachment or similar procedures, other
      than by will or the laws of descent and distribution or pursuant to a domestic relations order within the meaning of Rule 16a-12 under the Exchange Act. Notwithstanding the foregoing, the Committee, in its discretion, may adopt rules permitting the
      transfer, solely as gifts 

   

  

   during the grantee’s lifetime, of Stock Options (other than Incentive Stock Options) to trusts or family partnerships for the benefit of immediate family
      members, but in no event will awards be transferable for value or consideration. For this purpose, immediate family member means the grantee’s spouse, parent, child, stepchild, grandchild and the spouses of such family members. The terms of a Stock
      Option shall be final, binding and conclusive upon the beneficiaries, executors, administrators, heirs and successors of the grantee. 

  13. Discontinuance or Amendment of the Plan 

  The Board of Directors may discontinue the Plan at any time and may from time to time amend or revise the terms of the Plan as permitted by applicable
      statutes, except that it may not, without the consent of the grantees affected, revoke or alter, in a manner unfavorable to the grantees of any Incentives hereunder, any Incentives then outstanding, nor may the Board amend the Plan without
      stockholder approval where the absence of such approval would cause the Plan to fail to comply with Rule 16b-3 under the Exchange Act, or any other requirement of applicable law or regulation. 

  14. No Constraint on Corporate Action 

  Nothing in the Plan shall be construed (i) to limit, impair or otherwise affect the Company’s right or power to make adjustments, reclassifications,
      reorganizations or changes of its capital or business structure, or to merge or consolidate, or dissolve, liquidate, sell or transfer all or any part of its business or assets, or (ii) except as provided in Section 13, to limit the right or power of
      the Company, its parent, or any subsidiary, affiliate or joint venture to take any action which such entity deems to be necessary or appropriate. 

  15. Withholding Taxes 

  The Company and its parent, if any, its subsidiaries, its affiliates and its joint ventures shall be entitled to collect income taxes, social insurance
      contributions, payment on account amounts, any local taxes and any other taxes related to the grant, vesting or exercise of Incentives or acquisition or sale of shares acquired under the Plan legally due by grantee and required to be withheld by the
      Company (or one of its affiliates) or grantee’s employer (“Tax Withholding Amounts”) by any of the following methods: (i) withholding from shares of Common Stock or cash issuable or due under the Incentive; (ii) withholding from compensation, salary,
      bonuses or any other amounts due to grantee; or (iii) forcing shares of Common Stock to be sold that are issued pursuant to Incentives and using the proceeds to cover the Tax Withholding Amounts. In addition and in accordance with any applicable
      administrative guidelines it establishes, the Committee may allow a grantee to pay the Tax Withholding Amounts by withholding from any payment of Common Stock due as a result of such Incentive, or by permitting the grantee to deliver to the Company,
      shares of Common Stock having a fair market value, as determined by the Committee, equal to the amount of the Tax Withholding Amounts. Regardless of when Incentives are granted, effective January 1, 2011, shares tendered in payment of the option
      price or grant price for Stock Options and Stock Appreciation Rights or withheld from Incentives (including Full Value Awards) for tax payments or withholding for taxes shall not be added back into the Plan. 

   

  

  16. Compliance with Section 16 

  With respect to Eligible Persons subject to Section 16 of the Exchange Act (“Section 16 Officers”), transactions under the Plan are intended to comply with all
      applicable conditions of Rule 16b-3 or its successor under the Exchange Act. To the extent that compliance with any Plan provision applicable solely to the Section 16 Officers is not required in order to bring a transaction by such Section 16 Officer
      into compliance with Rule 16b-3, it shall be deemed null and void as to such transaction, to the extent permitted by law and deemed advisable by the Committee and its delegees. To the extent any provision of the Plan or action by the Plan
      administrators involving such Section 16 Officers is deemed not to comply with an applicable condition of Rule 16b-3, it shall be deemed null and void as to such Section 16 Officers, to the extent permitted by law and deemed advisable by the Plan
      administrators. 

  17. Use of Proceeds 

  The proceeds received by the Company from the sale of stock under the Plan shall be added to the general funds of the Company and shall be used for such
      corporate purposes as the Board of Directors shall direct. 

  18. Change in Control 

  Unless otherwise provided in an award agreement, or for Incentives that do not constitute deferred compensation under Section 409A of the Code, unless
      determined by the Committee in its discretion, in the event of a Change in Control (as defined below), each Incentive outstanding as of the Change in Control shall be assumed, continued, or substituted with a new Incentive that has: (i) an intrinsic
      value equivalent to that of the original Incentive; and (ii) terms at least as beneficial to the grantee as those contained in the original award agreement. If within two years following a Change in Control, a grantee is terminated for any reason (or
      constructively terminated as determined by the Committee in its sole discretion) except for “Cause” (as defined below) all of the grantee’s outstanding Incentives which have not vested shall immediately vest and become exercisable (if applicable) and
      all restrictions on such awards or shares shall immediately lapse. 

  For purposes of this Section 18, the term “Cause” shall mean that a grantee: (i) has been convicted of, or entered a plea of nolo contendere to, a crime that
      constitutes a felony under U.S. Federal or state law or equivalent under any applicable foreign law; (ii) has engaged in willful gross misconduct in the performance of the grantee’s duties to the Company or a parent, subsidiary or affiliate; or
      (iii) has committed a material breach of any written agreement with the Company or any parent, subsidiary or affiliate with respect to confidentiality, noncompetition, nonsolicitation or similar restrictive covenant. The Committee shall have the
      discretion of determining whether a grantee has been terminated for Cause for the purposes of this Section 18. 

   

  

  A “Change in Control” shall mean the occurrence during the term of the Plan of any one of the following events: 

   

  	 	(a)	An acquisition (other than directly from the Company) of any shares of Common Stock or other voting securities of the Company by any “Person” (for purposes of this
            Section only, as the term “person” is used for purposes of Section 13(d) or 14(d) of the Exchange Act), immediately after which such Person has “Beneficial Ownership” (within the meaning of Rule 13d-3 promulgated under the Exchange Act) of
            forty percent (40%) or more of either (i) the then outstanding shares of Common Stock or (ii) the combined voting power of the Company’s then outstanding voting securities entitled to vote for the election of directors (the “Voting
            Securities”); provided, however, in determining whether a Change in Control has occurred, shares of Common Stock or Voting Securities which are acquired in a “Non-Control Acquisition” (as hereinafter defined) shall not constitute an acquisition
            which would cause a Change in Control. A “Non-Control Acquisition” shall mean an acquisition by (i) an employee benefit plan (or a trust forming a part thereof) maintained by (A) the Company or (B) any corporation or other Person of which a
            majority of its voting power or its voting equity securities or equity interest is owned, directly or indirectly, by the Company (for purposes of this definition, a “Related Entity”), (ii) the Company or any Related Entity, or (iii) any Person
            in connection with a “Non-Control Transaction” (as hereinafter defined); or 

   

  	 	(b)	The individuals who, immediately after the acquisition or transaction, are members of the Board of Directors of the Company (the “Incumbent Board”), (i) cease for any
            reason to constitute at least a majority of the members of the Board of Directors of the Company, or (ii) following a Merger (as hereinafter defined), do not constitute at least a majority of the board of directors of (x) the Surviving
            Corporation (as hereinafter defined), if fifty percent (50%) or more of the combined voting power of the then outstanding voting securities of the Surviving Corporation is not Beneficially Owned, directly or indirectly by a Parent Corporation,
            or (y) if there is one or more Parent Corporations, the ultimate Parent Corporation (as hereinafter defined); provided, however, that if the election, or nomination for election by the Company’s common stockholders, of any new director was
            approved by a vote of at least a majority of the Incumbent Board, such new director shall, for purposes of this Plan, be considered as a member of the Incumbent Board; provided, further, however, that no individual shall be considered a member
            of the Incumbent Board if such individual initially assumed office as a result of an actual or threatened solicitation of proxies or consents by or on behalf of a Person other than the Board of Directors of the Company (a “Proxy Contest”),
            including by reason of any agreement intended to avoid or settle any Proxy Contest; or 

   

  	 	(c)	The consummation of: 

   

  	 	(i)	A merger, consolidation or reorganization with or into the Company or a direct or indirect subsidiary of the Company or in which securities of the Company are issued
            (a “Merger”), unless the Merger is a “Non-Control Transaction.” A “Non-Control Transaction” shall mean: 

   

  

  	 	(A)	the stockholders of the Company immediately before such Merger own directly or indirectly immediately following the Merger at least fifty percent (50%) of the
            outstanding common stock and the combined voting power of the outstanding voting securities of (x) the corporation resulting from such Merger (the “Surviving Corporation”), if fifty percent (50%) or more of the combined voting power of the then
            outstanding voting securities of the Surviving Corporation is not Beneficially Owned, directly or indirectly by another corporation (a “Parent Corporation”), or (y) if there is one or more Parent Corporations, the ultimate Parent Corporation; 

   

  	 	(B)	the individuals who were members of the Incumbent Board immediately prior to the execution of the agreement providing for the Merger, constitute at least a majority of
            the members of the board of directors of, (x) the Surviving Corporation, if fifty percent (50%) or more of the combined voting power of the then outstanding voting securities of the Surviving Corporation is not Beneficially Owned, directly or
            indirectly by a Parent Corporation, or (y) if there is one or more Parent Corporations, the ultimate Parent Corporation; and 

   

  	 	(C)	no Person other than (1) the Company or another corporation that is a party to the agreement of Merger, (2) any Related Entity, or (3) any employee benefit plan (or
            any trust forming a part thereof) that, immediately prior to the Merger, was maintained by the Company or any Related Entity, or (4) any Person who, immediately prior to the Merger had Beneficial Ownership of forty percent (40%) or more of the
            then outstanding shares of Common Stock or Voting Securities, has Beneficial Ownership, directly or indirectly, of forty percent (40%) or more of the combined voting power of the outstanding voting securities or common stock of (x) the
            Surviving Corporation, if fifty percent (50%) or more of the combined voting power of the then outstanding voting securities of the Surviving Corporation is not Beneficially Owned, directly or indirectly by a Parent Corporation, or (y) if there
            is one or more Parent Corporations, the ultimate Parent Corporation. 

   

  	 	(ii)	A complete liquidation or dissolution of the Company; or 

   

  	 	(iii)	The sale or other disposition of all or substantially all of the assets of the Company and its subsidiaries taken as a whole to any Person (other than a transfer to a
            Related Entity or under conditions that would constitute a Non-Control Transaction with the disposition of assets being regarded as a Merger for this purpose or the distribution to the Company’s stockholders of the stock of a Related Entity or
            any other assets). 

  Notwithstanding the foregoing, a Change in Control shall not be deemed to occur solely because any Person (the “Subject Person”) acquired Beneficial Ownership
      of more than the permitted amount of the then outstanding shares of Common Stock or Voting Securities as a result of the acquisition of shares of Common Stock or Voting Securities by the Company which, by reducing the number of shares of Common Stock
      or Voting Securities then outstanding, increases the 

   

  

   proportional number of shares Beneficially Owned by the Subject Persons; provided, that if a Change in Control would occur (but for the operation of this
      sentence) as a result of the acquisition of shares of Common Stock or Voting Securities by the Company, and after such share acquisition by the Company, the Subject Person becomes the Beneficial Owner of any additional shares of Common Stock or
      Voting Securities which increases the percentage of the then outstanding shares of Common Stock or Voting Securities Beneficially Owned by the Subject Person, then a Change in Control shall occur. 

  Also, notwithstanding the foregoing, to the extent that any Incentive constitutes a deferral of compensation subject to Code Section 409A, and if that
      Incentive provides for a change in the time or form of payment upon a Change in Control, then no Change in Control shall be deemed to have occurred upon an event described in this Section 18 unless the event would also constitute a change in
      ownership or effective control of, or a change in the ownership of a substantial portion of the assets of, the Company under Code Section 409A. 

  19. Governing Law 

  The Plan, and all agreements hereunder, shall be construed in accordance with and governed by the laws of the State of Delaware without giving effect to the
      principles of conflicts of laws. 

   

  

  ADDENDUM 

  TO THE 

  MEDCO HEALTH SOLUTIONS, INC. 

  2002 STOCK INCENTIVE PLAN 

  This addendum is intended to cause the Medco Health Solutions, Inc. 2002 Stock Incentive Plan (the “Plan”) to meet the requirements of a written plan as
      described in Q&A 21 of Internal Revenue Service Notice 2005-1 with respect to restricted stock units, performance shares or other share based awards subject to deferral (“Stock Units”) granted under the Plan. Capitalized terms used herein but not
      defined shall have the meaning ascribed to them in the Plan. 

  1. Deferrals of Stock Units Permitted 

   

  	 	(a)	Receipt of stock or other payment pursuant to the conversion of a Stock Unit granted under the Plan may be deferred at the election of a grantee beyond the taxable
            year in which the Stock Unit vests and becomes non-forfeitable provided permitted by the Committee. 

   

  	 	(b)	This deferral program is intended to meet the requirements of an unfunded “top-hat” plan maintained primarily for the purpose of providing deferred compensation for a
            select group of management or highly compensated employees, within the meaning of Sections 201(2), 301(a)(3) and 401(a)(1) of ERISA. No grantee shall be permitted to make a deferral election if such grantee’s participation in the deferral
            program would cause the Plan to fail to be treated as a top-hat plan. 

   

  	 	(c)	Stock Units granted to members of the Board of Directors are not affected by this Addendum. 

  2. Deferral Period 

   

  	 	(a)	The deferral may be until any of the following: 

   

  	 	(i)	six months after the date of a grantee’s separation from service, 

   

  	 	(ii)	the date the participant becomes disabled (within the meaning of Section 409A(a)(2)(C) of Code), 

   

  	 	(iii)	death, 

   

  	 	(iv)	a specified date (or pursuant to a fixed schedule), 

   

  	 	(v)	to the extent provided in regulations, a change in the ownership or effective control of the Company, or in the ownership of a substantial portion of the assets of the
            Company, or 

   

  	 	(vi)	the occurrence of an unforeseeable emergency (as defined in Section 409A of the Code or the regulations promulgated thereunder). 

   

  

  3. No Acceleration 

  Acceleration of the deferral period elected by the grantee shall not be permitted, except as provided in regulations promulgated under Section 409A of the
      Code. 

  4. Deferral Elections 

  Deferral elections shall be made in compliance with Section 409A of the Code. In accordance with IRS Notice 2005-1, deferral elections with respect to Stock
      Units outstanding but unvested as of March 15, 2005 may be made on or before March 15, 2005. Changes in the time and form of payments with respect to Stock Units for which an initial deferral is in effect shall be permitted in accordance with
      Section 409A(a)(4)(C) of the Code, the terms of which shall be incorporated into this Addendum. 

  5. Compliance with Section 409A 

  Awards granted under the Plans are intended to comply with the requirements of Section 409A of the Internal Revenue Code of 1986, as amended. In order to
      comply with Section 409A, Stock Units granted under the Plans to employees who are not participants in the 2006 Executive Severance Plan at the time of grant shall be administered such that a separation from service of the grantee does not result in
      deferred compensation as defined in Section 409A unless the recipient has made a voluntary deferral election. As a result, Stock Units shall be converted and paid as soon as practicable following the date on which the Stock Units vest and become
      non-forfeitable. Stock Units granted under the Plans to employees who are participants in the 2006 Executive Severance Plan shall be administered such that a separation from service of the grantee does not result in the acceleration of payment of a
      Stock Unit. As a result, Stock Units shall not be converted and paid prior to the “Vesting Date” specified on the Term Sheet issued in respect of the award. The purpose of the prior sentence is to document that, except in the case of death or
      termination Within Two Years following a Change in Control, Stock Units granted to a participant in the 2006 Executive Severance Plan are paid on a date certain unless the recipient has made a specific deferral election in writing. 

  6. Transition Relief 

  Notwithstanding the foregoing, Stock Units that have become vested on or before October 22, 2008 and have not been paid as of such date, shall, if held by an
      employee who is not a participant in the Executive Severance Plan, be paid on or about February 24, 2009. This provision has been added as of October 22, 2008 and is intended to comply with the 409A transition guidance. 

  7. Change in Control Provisions 

  In order to comply with Section 409A in connection with the payment of any Stock Units following or in connection with a “Change in Control,” the following
      applies: 

   

  	 	(a)	The definition of Change in Control in Section 18 of the Plan shall apply for purposes of determining the extent to which an Incentive has vested. 

   

  	 	(b)	Any payment provisions applicable to a Stock Unit that are conditioned upon the occurrence of a Change in Control shall only apply if the Change in Control is also a
            change in the ownership or effective control, or a change in the ownership of a substantial portion of the assets of the Company as defined in Treasury Regulation Section 1.409A-3(i)(5).

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