Document:

AMENDMENT NO. 1 TO THE
                                RIGHTS AGREEMENT

            Amendment No. 1, dated as of March 28, 2000 (this "Amendment"), to
the Rights Agreement, dated as of June 15, 1998 (the "Rights Agreement"),
between IMS Health Incorporated, a Delaware corporation (the "Company"), and
First Chicago Trust Company of New York, as Rights Agent (the "Rights Agent").

            WHEREAS, The TriZetto Group, Inc., a Delaware corporation
("TriZetto") and the Company have proposed to enter into an Agreement and Plan
of Reorganization, to be dated as of March 28, 2000 (the "Merger Agreement");

            WHEREAS, the Company desires to amend the Rights Agreement to render
the Rights (as defined in the Rights Agreement) inapplicable to the Merger (as
defined in the Merger Agreement) and the other transactions contemplated by the
Merger Agreement;

            WHEREAS, the Company deems this Amendment to be necessary and
desirable and in the best interests of the holders of Rights and has duly
approved this Amendment;

            WHEREAS, Section 27 of the Rights Agreement permits the Company to
amend the Rights Agreement in the manner provided herein;

            WHEREAS, Section 27 of the Rights Agreement provides that the Rights
Agent shall execute this Amendment upon delivery of a certificate from an
appropriate officer of the Company which states that this Amendment is in
compliance with the terms of Section 27 of the Rights Agreement (the "Officer's
Certificate"); and

            WHEREAS, the Officer's Certificate is being delivered to the Rights
Agent concurrently with this Amendment;

            NOW, THEREFORE, the Company hereby amends the Rights Agreement as
follows:

            1. Addition of a new Section 35 which shall read as follows:

            "Section 35. Exemption of Specified Transaction. Solely for the
purposes of the transactions contemplated by the Agreement and Plan of
Reorganization, to be dated as of March 28, 2000 (hereinafter referred to as the
"Merger Agreement"), between the Company and The TriZetto Group, Inc., a
Delaware corporation ("TriZetto"), (i) neither TriZetto nor any of its
Affiliates shall be deemed to be an Acquiring Person as a result of the
execution and delivery of the Merger Agreement or the IMS Voting Agreement (as
contemplated by the Merger Agreement) or the consummation of the

<PAGE>

Merger (as contemplated by the Merger Agreement), (ii) the transactions
contemplated by the Merger Agreement, including the Merger, shall not be deemed
to be an event or transaction contemplated by Section 13 hereof, and (iii) a
Distribution Date shall not occur by reason of the approval, execution,
announcement or consummation of the Merger Agreement or the transactions
contemplated thereby. If the Merger Agreement is terminated for any reason in
accordance with its terms or otherwise, this Section 35 shall not apply and
shall have no further force and effect."

            2. The Rights Agreement shall not otherwise be supplemented or
amended by virtue of this Amendment, but shall remain in full force and effect
as amended hereby.

<PAGE>

            IN WITNESS WHEREOF, the Company and the Rights Agent have executed
this Amendment as of the date and year first written above.

                                    IMS HEALTH INCORPORATED

                                    By: /s/ David Stevens
                                        ---------------------------------------
                                        Name: David Stevens
                                        Title: Senior Vice President, General
                                               Counsel and Secretary

                                    FIRST CHICAGO TRUST COMPANY OF NEW YORK

                                    By: /s/ Gerard J. O'Leary
                                        ---------------------------------------
                                        Name: Gerard J. O'Leary
                                        Title: Managing Director[On March 28, 2000, IMS Health entered into letter agreements with its Chairman
and its Chief Executive Officer pursuant to which each of them would receive a
bonus for extraordinary efforts in negotiating a proposed strategic business
combination with TriZetto. Those letter agreements are reproduced below. In
light of the adverse market reaction to the proposed IMS Health-TriZetto merger
announced on March 29, 2000, on April 2, 2000 the Chairman and the Chief
Executive Officer requested IMS Health to terminate these letter agreements as
of that date. The Chairman of the Compensation & Benefits Committee of the Board
of Director's of IMS Health agreed to that request on April 2, 2000, and IMS
Health formalized that agreement by letter agreements dated April 19, 2000 which
are reproduced below.]

IMS HEALTH [LOGO]

Ms. Victoria R. Fash
Chief Executive Officer and President
IMS Health Incorporated
200 Nyala Farms
Westport, CT  06880

March 28, 2000

Mr. Robert E. Weissman
Chairman of the Board
IMS Health Incorporated
200 Nyala Farms
Westport, CT  06880

Re: Transaction Completion Incentive

Dear Bob:

      The Compensation & Benefits Committee of the Board of Directors of IMS
Health Incorporated (the "Company") has authorized and approved a bonus
arrangement intended to reward you for your extraordinary efforts in negotiating
the proposed strategic business combination between the Company and TriZetto or
such other transaction determined by the Board, in its discretion, to be of
comparable magnitude and benefit to shareholders (the "Transaction"), and to
provide you with a substantial incentive to bring the Transaction to a
successful completion. We believe that the Transaction will greatly strengthen
the Company (combined with its Transaction partner) and confer a great benefit
upon the Company's stockholders.

      Therefore, subject to your agreement to the terms of this letter, the
Company hereby provides to you the opportunity to earn a cash bonus (the
"Transaction Completion Incentive") on the terms and conditions set forth as
follows:

      (1)   You will have the opportunity to earn the Transaction Completion
            Incentive if and only if the Board of Directors of the Company has
            approved, and the Company has entered into, a definitive agreement,
            on or before April 1, 2000, binding the Company and TriZetto (or
            such other party determined by the Board to be comparable) to
            consummate the Transaction, subject to customary conditions (the
            "Transaction Agreement").

      (2)   If the Transaction is consummated pursuant to the terms of the
            Transaction Agreement (as that Agreement may be amended from time to
            time, with the approval of the Board of Directors), on or before
            December 31, 2000 (the "Expiration Date"), the Company will pay you,
            at the time of the closing of the Transaction, a cash amount equal
            to $5,500,000.

      (3)   You will be responsible for payment of Federal income and other
            taxes resulting from any payment of the Transaction Completion
            Incentive, except to the extent that Section 9(b) (relating to taxes
            resulting from golden parachute excise taxes) of your Employment
            Agreement, as amended and restated (the "Employment Agreement"),
            applies. The Company will withhold from any payment of the
            Transaction Completion Incentive any such taxes it is required to
            withhold by applicable tax withholding laws and regulations, and you
            may direct the Company to withhold additional amounts to pay taxes
            calculated at your applicable marginal rates.

      (4)   In the event of your termination of employment with the Company for
            any reason prior to the time the Transaction Completion Incentive
            becomes payable and prior to the Expiration Date, other than a
            termination by the Company for Cause (as defined in your

<PAGE>

Mr. Robert E. Weissman
March 28, 2000
Page 2

            Employment Agreement) or your voluntary termination not for Good
            Reason (as defined in your Employment Agreement), the Transaction
            Completion Incentive opportunity will neither be canceled nor deemed
            earned, but will instead remain outstanding according to its terms.
            In the event the Company terminates you for Cause or you voluntarily
            terminate employment not for Good Reason prior to the time the
            Transaction Completion Incentive becomes payable and prior to the
            Expiration Date, the Transaction Completion Incentive will be
            immediately canceled. The provisions of this paragraph (4) override
            any contrary provisions in your Employment Agreement.

      (5)   It is understood that your relinquishing the title of Chairman of
            the Board of the Company and being appointed Vice Chairman of the
            Board of the entity resulting from the Transaction, upon
            consummation of the Transaction, will not constitute "Good Reason"
            within the meaning of your Employment Agreement.

      (6)   The Transaction Completion Incentive shall not represent base salary
            or annual incentive or annual bonus, for purposes of your Employment
            Agreement or otherwise, and shall not be taken into account as
            "compensation" for purposes of the Company's Supplemental Executive
            Retirement Plan, any calculation of a severance benefit, or other
            plans or programs of the Company.

      If you are in agreement with the terms and conditions set forth in this
letter, please sign below (and on the duplicate copy of this letter, which
represents one and the same agreement) and return this letter to me within five
days after your receipt.

                                          Sincerely yours,

                                          IMS Health Incorporated

                                          By: /s/ Victoria R. Fash
                                              ---------------------------------
                                          Victoria R. Fash
                                          Chief Executive Officer and President

I have read, understand and agree to the terms and conditions set forth in this
letter.

/s/ Robert E. Weissman                    March 28, 2000
---------------------------------         -------------------------------------
Robert E. Weissman                        Date

[In connection with discussions with another company about a possible strategic
business combination, which discussions were subsequently terminated, IMS Health
entered into a letter agreement dated February 4, 2000 with Mr. Weissman
substantially identical to that set forth above. The February 4 Agreement, which
is no longer in effect, is not reproduced here because of a confidentiality
agreement with that other company.]

<PAGE>

IMS HEALTH [LOGO]

Mr. Robert E. Weissman
Chairman of the Board
IMS Health Incorporated
200 Nyala Farms
Westport, CT  06880

March 28, 2000

Ms. Victoria R. Fash
Chief Executive Officer and President
IMS Health Incorporated
200 Nyala Farms
Westport, CT  06880

Re: Transaction Completion Incentive

Dear Vickie:

      The Compensation & Benefits Committee of the Board of Directors of IMS
Health Incorporated (the "Company") has authorized and approved a bonus
arrangement intended to reward you for your extraordinary efforts in negotiating
the proposed strategic business combination between the Company and TriZetto or
such other transaction determined by the Board, in its discretion, to be of
comparable magnitude and benefit to shareholders (the "Transaction"), and to
provide you with a substantial incentive to bring the Transaction to a
successful completion. We believe that the Transaction will greatly strengthen
the Company (combined with its Transaction partner) and confer a great benefit
upon the Company's stockholders.

      Therefore, subject to your agreement to the terms of this letter, the
Company hereby provides to you the opportunity to earn a cash bonus (the
"Transaction Completion Incentive") on the terms and conditions set forth as
follows:

      (1)   You will have the opportunity to earn the Transaction Completion
            Incentive if and only if the Board of Directors of the Company has
            approved, and the Company has entered into, a definitive agreement,
            on or before April 1, 2000, binding the Company and TriZetto (or
            such other party determined by the Board to be comparable) to
            consummate the Transaction, subject to customary conditions (the
            "Transaction Agreement").

      (2)   If the Transaction is consummated pursuant to the terms of the
            Transaction Agreement (as that Agreement may be amended from time to
            time, with the approval of the Board of Directors), on or before
            December 31, 2000 (the "Expiration Date"), the Company will pay you,
            at the time of the closing of the Transaction, a cash amount equal
            to $5,500,000.

      (3)   You will be responsible for payment of Federal income and other
            taxes resulting from any payment of the Transaction Completion
            Incentive, except to the extent that Section 9(b) (relating to taxes
            resulting from golden parachute excise taxes) of your Employment
            Agreement, as amended and restated (the "Employment Agreement"),
            applies. The Company will withhold from any payment of the
            Transaction Completion Incentive any such taxes it is required to
            withhold by applicable tax withholding laws and regulations, and you
            may direct the Company to withhold additional amounts to pay taxes
            calculated at your applicable marginal rates.

      (4)   You agree that if, at the time the Transaction Completion Incentive
            becomes payable, there remains any principal or interest outstanding
            under the loan from the Company to

<PAGE>

Ms. Victoria R. Fash
March 28, 2000
Page 2

            you described in Section 5(g) of your Employment Agreement, you will
            pay over to the Company, out of the portion of the Transaction
            Completion Incentive remaining after taxes have been withheld
            (including taxes in excess of mandatory withholding taxes, if so
            directed by you), the amount of such remaining principal or interest
            so as to retire the loan. It is understood that you will not be
            obligated at that time to retire the loan to the extent that the
            remaining principal and interest exceeds the after-tax portion of
            the Transaction Completion Incentive. If any event has occurred
            prior to payment of the Transaction Completion Incentive whereby the
            Company has forgiven your obligation to repay the outstanding
            principal and interest under the loan, the amount of principal and
            interest forgiven shall represent an offset against the Company's
            obligation to pay the Transaction Completion Incentive, so that the
            amount of the Transaction Completion Incentive payable to you will
            be reduced by the amount of the principal and interest forgiven.

      (5)   In the event of your termination of employment with the Company for
            any reason prior to the time the Transaction Completion Incentive
            becomes payable and prior to the Expiration Date, other than a
            termination by the Company for Cause (as defined in your Employment
            Agreement) or your voluntary termination not for Good Reason (as
            defined in your Employment Agreement), the Transaction Completion
            Incentive opportunity will neither be canceled nor deemed earned,
            but will instead remain outstanding according to its terms
            (including the obligation to repay the loan and the loan forgiveness
            offset provision specified in paragraph (4)). In the event the
            Company terminates you for Cause or you voluntarily terminate
            employment for Good Reason prior to the time the Transaction
            Completion Incentive becomes payable and prior to the Expiration
            Date, the Transaction Completion Incentive will be immediately
            canceled. The provisions of this paragraph (5) override any contrary
            provisions in your Employment Agreement.

      (6)   It is understood that your relinquishing the title of Chief
            Executive Officer and being appointed Chairman of the Board of the
            entity resulting from the Transaction (with duties comparable in all
            material respects to those of the Chairman of the company resulting
            from the Transaction immediately following consummation thereof)
            three years after consummation of the transaction will not
            constitute "Good Reason" within the meaning of your Employment
            Agreement.

      (7)   The Transaction Completion Incentive shall not represent base salary
            or annual incentive or annual bonus, for purposes of your Employment
            Agreement or otherwise, and shall not be taken into account as
            "compensation" for purpose of the Company's Supplemental Executive
            Retirement Plan, any calculation of a severance benefit, or other
            plans or programs of the Company.

<PAGE>

Ms. Victoria R. Fash
March 28, 2000
Page 3

      If you are in agreement with the terms and conditions set forth in this
letter, please sign below (and on the duplicate copy of this letter, which
represents one and the same agreement) and return this letter to me within five
days after your receipt.

                                                Sincerely yours,

                                                IMS Health Incorporated

                                                By: /s/ Robert E. Weissman
                                                    -------------------------
                                                Robert E. Weissman
                                                Chairman of the Board

I have read, understand and agree to the terms and conditions set forth in this
letter.

/s/ Victoria R. Fash                            March 28, 2000
----------------------------                    -----------------------------
Victoria R. Fash                                Date

[In connection with discussions with another company about a possible strategic
business combination, which discussions were subsequently terminated, IMS Health
entered into a letter agreement dated February 4, 2000 with Ms. Fash
substantially identical to that set forth above. The February 4 Agreement, which
is no longer in effect, is not reproduced here because of a confidentiality
agreement with that other company.]

<PAGE>

                                          April 19, 2000

IMS HEALTH [LOGO]

Robert E. Weissman
Chairman

IMS HEALTH
200 Nyala Farms
Westport, Connecticut 06880
Tel. 203-222-4242
Fax  203-222-4247
rweissman@imshealth.com

Victoria R. Fash
President and Chief Executive Officer
IMS Health Incorporated
200 Nyala Farms
Westport, CT 06880

            Re: Termination of Transaction Completion Incentive Agreement

Dear Vickie

      On February 4, 2000 and March 28, 2000, we entered into Transaction
Completion Incentive Agreements (the "Agreements"), pursuant to which you would
be awarded a cash bonus of $5.5 million upon the closing of a business
consolidation between the Company and [Name] (under the February 4th Agreement)
or The TriZetto Group, Inc. (under the March 28th Agreement) or upon the
consummation of another transaction of comparable magnitude. The purpose of this
letter is to document our subsequent agreement, which was reached between you
and the Chairman of the Compensation & Benefits Committee of the Board of
Directors on April 2, 2000, to terminate the Agreements as of that date.

      Please sign your name where indicated below and return one copy of this
letter to the undersigned. Keep the other copy for your records.

                                          Sincerely,

                                          /s/ Robert E. Weissman

ACKNOWLEDGED:

/s/ Victoria R. Fash
--------------------------
Victoria R. Fash

ACKNOWLEGED:

/s/ Bernard Puckett
--------------------------
Bernard Puckett
Dated: _____________

<PAGE>

                                          April 19, 2000

IMS HEALTH [LOGO]

Victoria R. Fash
President and
Chief Executive Officer

IMS HEALTH
7 Harewood Avenue
London, NWI 6JB, U.K.
Telephone +44-171-393 5141
Fax +44-171-393 5802
vfash@imshealth.com

Robert E. Weissman
Chairman of the Board
IMS Health Incorporated
200 Nyala Farms
Westport, CT 06880

            Re: Termination of Transaction Completion Incentive Agreement

Dear Bob:

      On February 4, 2000 and March 28, 2000, we entered into Transaction
Completion Incentive Agreements (the "Agreements"), pursuant to which you would
be awarded a cash bonus of $5.5 million upon the closing of a business
consolidation between the Company and [Name] (under the February 4th Agreement)
or The TriZetto Group, Inc. (under the March 28th Agreement) or upon the
consummation of another transaction of comparable magnitude. The purpose of this
letter is to document our subsequent agreement, which was reached between you
and the Chairman of the Compensation & Benefits Committee of the Board of
Directors on April 2, 2000, to terminate the Agreements as of that date.

      Please sign your name where indicated below and return one copy of this
letter to the undersigned. Keep the other copy for your records.

                                          Sincerely,

                                          /s/ Victoria R. Fash

ACKNOWLEDGED:

/s/ Robert E. Weissman
-----------------------------
Robert E. Weissman

ACKNOWLEGED:

/s/ Bernard Puckett
-----------------------------
Bernard Puckett
Dated: _____________

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