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Exhibit 4.2

Description of Registrant’s Common Stock

General

Under the Restated Certificate of Incorporation, as amended (the “Charter”), of R1 RCM Inc. (the “Company” or “R1”), R1 is authorized to issue 500 million shares of common stock, par value $0.01 per share (the “Common Stock”), and 5 million shares of preferred stock, par value $0.01 per share. 

Common Stock

Voting Rights

The holders of Common Stock are entitled to one vote for each share held on all matters submitted to a vote of the stockholders and do not have any cumulative voting rights.

Dividend Rights

Subject to the rights of holders of any then outstanding preferred stock, holders of Common Stock are entitled to receive dividends when, as and if declared by the Company’s board of directors out of funds legally available for this purpose.

The Company does not currently pay quarterly cash dividends on shares of Common Stock. The payment of dividends in the future, if any, will be at the discretion of the Company’s board of directors and will depend upon general business conditions, legal and contractual restrictions on the payment of dividends and other factors that the Company’s board of directors may deem to be relevant.

Liquidation Rights

Subject to the rights of any then outstanding preferred stock which ranks senior to the Common Stock, in the event of a liquidation, dissolution or winding up of R1, the holders of Common Stock will be entitled to receive, after payment or provision for payment of all of its debts and liabilities, all of the assets of the Company legally available for distribution to stockholders.

Other Rights

There are no conversion rights or redemption, purchase, retirement or sinking fund provisions with respect to Common Stock.

Anti-Takeover Effects of Delaware Law and the Company’s Charter and Bylaws

Delaware law, the Charter and the Company’s Amended and Restated Bylaws contain provisions that could have the effect of delaying, deferring or discouraging another party from acquiring control of the Company. These provisions, which are summarized below, are expected to discourage coercive takeover practices and inadequate takeover bids. These provisions are also designed to encourage persons seeking to acquire control of the Company to first negotiate with the Company’s board of directors.

Board of Directors; Removal of Directors

The Charter and Amended and Restated Bylaws provide that a director may be removed with or without cause and only by the affirmative vote of the holders of at least two-thirds of the votes that all the stockholders would be entitled to cast in an election of directors. Any vacancy on the Company’s board of directors, including a vacancy resulting from an enlargement of the board of directors, may be filled only by vote of a majority of the directors then in office, although less than a quorum. At each annual meeting, the entire board will stand for election for a one-year term. The limitations on the removal of directors and filling of vacancies could make it more difficult for a third party to acquire, or discourage a third party from seeking to acquire, control of the Company.

Stockholder Action by Written Consent; Special Meetings

The Charter provides that any action required or permitted to be taken by the Company’s stockholders must be effected at a duly called annual or special meeting of such holders and may not be effected by any consent in writing by such holders. The Charter and Amended and Restated Bylaws also provide that, except as otherwise required by law, special meetings of the Company’s stockholders can only be called by the Company’s chairman of the board, chief executive officer or board of directors.

Advance Notice Requirements for Stockholder Proposals

The Amended and Restated Bylaws establish an advance notice procedure for stockholder proposals to be brought before an annual meeting of stockholders, including proposed nominations of persons for election to the board of directors. Stockholders at an annual meeting may only consider proposals or nominations specified in the notice of meeting or brought before the meeting by or at the direction of the board of directors or by a stockholder of record on the record date for the meeting, who is entitled to vote at the meeting and who has delivered timely written notice in proper form to the Company’s secretary of the stockholder’s intention to bring such business before the meeting. This written notice must contain certain information specified in the Amended and Restated Bylaws. These provisions could have the effect of delaying until the next stockholder meeting stockholder actions that are favored by the holders of a majority of the Company’s outstanding voting securities.

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Delaware Business Combination Statute

The Company is subject to Section 203 of the Delaware General Corporation Law. Subject to certain exceptions, Section 203 prevents a publicly-held Delaware corporation from engaging in a “business combination” with any “interested stockholder” for three years following the date that the person became an interested stockholder, unless the interested stockholder attained such status with the approval of the Company’s board of directors or unless the business combination is approved in a prescribed manner. A “business combination” includes, among other things, a merger or consolidation involving the Company and the “interested stockholder” and the sale of more than 10% of the Company’s assets. In general, an “interested stockholder” is any entity or person beneficially owning 15% or more of the Company’s outstanding voting stock and any entity or person affiliated with or controlling or controlled by such entity or person.

Amendment of Certificate of Incorporation and Bylaws

The Delaware General Corporation Law provides generally that the affirmative vote of a majority of the shares entitled to vote on any matter is required to amend a corporation’s certificate of incorporation or bylaws, unless a corporation’s certificate of incorporation or bylaws, as the case may be, requires a greater percentage. The Amended and Restated Bylaws may be amended or repealed by a majority vote of the Company’s board of directors or by the affirmative vote of the holders of at least two-thirds of the votes which all the Company’s stockholders would be entitled to cast in any election of directors. In addition, the affirmative vote of the holders of at least two-thirds of the votes which all the Company’s stockholders would be entitled to cast in any election of directors is required to amend or repeal or to adopt any provisions inconsistent with any of the provisions of the Charter described above under “—Board of Directors; Removal of Directors” and “— Stockholder Action by Written Consent; Special Meetings”.

Transfer Agent and Registrar

The transfer agent and registrar for the Common Stock is American Stock Transfer and Trust Company, LLC.

Exchange Listing

The Common Stock is listed on the NASDAQ Stock Market under the symbol “RCM.”

 3Document

Exhibit 10.70
Execution Version

JOINDER AND AMENDMENT TO AMENDED AND RESTATED 
REGISTRATION RIGHTS AGREEMENT

January 22, 2021
The undersigned is executing and delivering this Joinder and Amendment pursuant to (i) the Amended and Restated Registration Rights Agreement, dated as of January 23, 2018 (as the same may be amended from time to time, the “Registration Agreement”), by and among R1 RCM Inc., a Delaware corporation (the “Company”), TCP-ASC ACHI Series LLLP, a Delaware limited liability limited partnership ("TCP-ASC"), and IHC Health Services, Inc., a Utah non-profit corporation, and (ii) the Securities Purchase Agreement, dated as of the date hereof (the “Purchase Agreement”), by and among the Company and the undersigned.  Capitalized terms used but not defined herein shall have their respective meanings set forth in the Registration Agreement.
The undersigned, the Company and TCP-ASC hereby agree that (i) the undersigned shall become a party to, be bound by and be required to comply with the provisions of the Registration Agreement as an “Investor” and a holder of Registrable Securities, provided that the undersigned shall not have any rights under Section 2 of the Registration Agreement and shall not be bound by or required to comply with Section 9 of the Registration Agreement if the undersigned chooses not to participate in the applicable registered public sale of securities by the Company, (ii) the shares of Common Stock issued by the Company to the undersigned pursuant to the Purchase Agreement shall be deemed Registrable Securities, subject to the exclusions set forth in the definition of Registrable Securities in the Registration Agreement and (iii) any notice required as permitted by the Registration Agreement shall be given to the undersigned at the address below: 
			
	LifePoint Health, Inc.
330 Seven Springs Way
Brentwood, Tennessee
Attention: General Counsel
Email: Jennifer.Peters@lpnt.net 

	
	Sidley Austin LLP
787 Seventh Avenue
New York, New York
Attention: Tony D. Feuerstein
                  Daniel L. Serota 
Email: tfeuerstein@sidley.com;
dserota@sidley.com 

The parties agree that except to the extent of the changes described herein, the Registration Agreement shall remain in full force and effect in accordance with its terms.
* * * * * * * *

Accordingly, the undersigned has executed and delivered this Joinder and Amendment as of the date first set forth above.

SHARED BUSINESS SERVICES, LLC 
By:  /s/ Jason Ross
Name:  Jason Ross
Title:  President

Agreed and Acknowledged:
R1 RCM INC.
By:  /s/ M. Sean Radcliffe
Name:  M. Sean Radcliffe
Title:  EVP, General Counsel

TCP-ASC ACHI SERIES LLLP

By: TCP-ASC GP, LLC, its General Partner

By:  /s/ Glenn F. Miller
Name:  Glenn F. Miller
Title:  Vice President

Signature Page to Joinder and Amendment to Amended and Restated Registration Rights Agreement

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