Document:

<PAGE>   1
                                                                  EXHIBIT 10.41

                     AMENDMENT NO. 16 TO THE LOAN DOCUMENTS

                  AMENDMENT NO. 16 TO THE LOAN DOCUMENTS dated as of February
3, 2000 to the Amended and Restated Credit Agreement dated as of June 9, 1998
(as amended and otherwise modified by Amendment and Waiver No. 1 to the Loan
Documents dated as of December 4, 1998, Amendment No. 2 to the Loan Documents
dated as of January 13, 1999, Amendment No. 3 to the Loan Documents dated as of
February 9, 1999, Amendment and Waiver No. 4 to the Loan Documents dated as of
March 18, 1999, Amendment and Waiver No. 5 to the Loan Documents dated as of
April 1, 1999, Amendment No. 6 to the Loan Documents dated as of April 14,
1999, Amendment No. 7 to the Loan Documents dated as of June 29, 1999,
Amendment No. 8 to the Loan Documents dated as of August 2, 1999, Amendment No.
9 to the Loan Documents dated as of August 16, 1999, Amendment No. 10 to the
Loan Documents dated as of August 23, 1999, Amendment No. 11 to the Loan
Documents dated as of August 30, 1999, Amendment No. 12 to the Loan Documents
dated as of September 14, 1999, Amendment No. 13 to the Loan Documents dated as
of November 5, 1999, Amendment No. 14 to the Loan Documents dated as of
December 16, 1999 and Amendment No. 15 to the Loan Documents dated as of
January 20, 2000, the "CREDIT AGREEMENT") among Caremark Rx, Inc. (formerly
known as MedPartners, Inc.), a Delaware corporation (the "BORROWER"), the
Lenders party thereto, Bank of America, N.A. (formerly NationsBank, N.A.;
"BOFA"), as the Initial Issuing Bank and the Swing Line Bank thereunder, Credit
Lyonnais New York Branch, The First National Bank of Chicago and Morgan
Guaranty Trust Company of New York, as the Syndication Agents therefor, Banc of
America Securities LLC (formerly NationsBanc Montgomery Securities LLC), as the
Arranger therefor, and BofA, as the Administrative Agent for the Lender Parties
thereunder. Capitalized terms not otherwise defined in this Amendment have the
same meanings as specified therefor in the Credit Agreement.

                             PRELIMINARY STATEMENTS

                  (1)      The Borrower has requested that the Lender Parties
agree to amend the Credit Agreement as provided herein in order to provide for
the issuance of a Letter of Credit for the benefit of MedPartners Provider
Network, Inc. ("MPN") or its authorized representative in respect of certain
obligations under the California Settlement Agreement in the face amount of
$15,000,000 (the "ADDITIONAL LETTER OF CREDIT") and to waive any default under
Section 6.01 (q) in respect thereof.

                  (2)      The Lender Parties have indicated their willingness
to agree to amend the Credit Agreement and to waive such default on the terms
and subject to the satisfaction of the conditions set forth herein.

                  NOW, THEREFORE, in consideration of the premises and of the
mutual covenants and agreements contained herein and in the Loan Documents, the
parties hereto hereby agree as follows:

                  SECTION 1.  Amendments  and Waivers of Certain  Provisions
of the Credit Agreement. (a) The Credit Agreement is, upon the occurrence of
the Amendment Effective Date (as hereinafter defined), hereby amended as
follows:

                  (i)      Section 2.01(e) of the Credit Agreement is amended by
deleting the second parenthetical in the second sentence thereof and to
substitute therefor the following parenthetical: "(other than the Borrower or
any of its Subsidiaries, except for the Letter of Credit in favor of MPN or its
authorized representative as contemplated by Section 5.02(e)(iii)(D) hereof)"
and by deleting the third parenthetical in the second sentence thereof and to
substitute therefor the following parenthetical: "(or,

<PAGE>   2

solely to the extent permitted under Section 5.02(e)(iii)(C) or 5.02(e)(iii)(D)
hereof, or upon adoption of the California Transition Plan, as required under
Section 3.5(c) or 3.6 of the California Settlement Agreement any of the
Unrestricted Subsidiaries)."

                  (ii)     Section 5.02(b)(iii) is amended in full to read as
follows:

                           "(iii) Indebtedness of the Borrower in respect of
                           interest rate Hedge Agreements (A) existing on the
                           date of this Agreement and described in item 1 on
                           Schedule 4.01(y) hereto or (B) entered into from
                           time to time after the date of this Agreement with
                           counterparties that are Lender Parties at the time
                           such interest rate Hedge Agreement is entered into;
                           provided that, in all cases under this clause (iii),
                           all such interest rate Hedge Agreements shall be
                           nonspeculative in nature (including, without
                           limitation, with respect to the term and purpose
                           thereof);"

                  (iii)    Section 5.02(b)(viii) is amended by deleting the
parenthetical in clause (B)(2) thereof and to substitute for such parenthetical
the following parenthetical: "(other that the Letter of Credit issued in favor
of the Special Monitor-Examiner (as defined in the California Settlement
Agreement) in a face amount not to exceed $25,000,000 and the Letter of Credit
in favor of MPN or its authorized representative in a face amount not to exceed
$15,000,000 and, in each case, as otherwise required under the California
Settlement Agreement)".

                  (iv)     Section 5.02(e) is hereby amended to delete the
parenthetical in subclause (iii)(D)(2)(y) thereof and to substitute therefor
the following parenthetical: "(other than the Letter of Credit issued in favor
of the Special Monitor-Examiner (as defined in the California Settlement
Agreement) in the face amount of $25,000,000 and the Letter of Credit in favor
of MPN or its authorized representative in the face amount of $15,000,000, and,
in each case, as otherwise required under the California Settlement
Agreement)".

                  (v)      Section 5.02(e) is hereby further amended to delete
subclause (iii)(E) thereof and to substitute therefor the following: "(E) the
Borrower in MPN and the other California Subsidiaries from time to time after
the adoption of the California Transition Plan with the proceeds of payments
made by the Borrower under the MedPartners Funding Commitment or comprised of
the issuance of the Letter of Credit in favor of the Special Monitor-Examiner
(as defined in the California Settlement Agreement) in a face amount not to
exceed $25,000,000 and the Letter of Credit in favor of MPN or its authorized
representative in a face amount not to exceed $15,000,000 and, in each case, as
otherwise required under the California Settlement Agreement, or, in the case
of MPN, pursuant to the terms of the MPN Management Agreement,"

                  (b)      Upon the occurrence of the Amendment Effective Date,
any Event of Default arising under Section 6.01(q) of the Credit Agreement as a
result of the issuance of the Additional Letter of Credit, or payments
thereunder, is hereby waived.

                  SECTION 2. Conditions Precedent to the Effectiveness of this
Amendment. This Amendment shall become effective as of the first date (the
"AMENDMENT EFFECTIVE DATE") on which, and only if, each of the following
conditions precedent shall have been satisfied:

                  (a)      The Administrative Agent shall have received on or
before 5:00 p.m. (Charlotte time) on February 3, 2000, (i) counterparts of this
Amendment executed by the Borrower and the

                                       2
<PAGE>   3

Required Lenders or, as to any of the Lender Parties, advice satisfactory to
the Administrative Agent that such Lender Party has executed this Amendment and
(ii) counterparts of the Consent attached hereto executed and delivered by each
of the Loan Parties (other than the Borrower).

                  (b)      The representations and warranties set forth in each
of the Loan Documents shall be correct in all material respects on and as of
the Amendment Effective Date, before and after giving effect to this Amendment,
as though made on and as of such date (except (i) for any such representation
and warranty that, by its terms, refers to a specific date other than the
Amendment Effective Date, in which case as of such specific date, (ii) that the
Consolidated financial statements of the Borrower and its Subsidiaries referred
to in Sections 4.01(f) and 4.01(g) of the Credit Agreement shall be deemed to
refer to the Consolidated financial statements of the Borrower and its
Subsidiaries comprising part of the Required Financial Information most
recently delivered to the Administrative Agent and the Lender Parties pursuant
to Sections 5.03(b) and 5.03(c), respectively, on or prior to the Amendment
Effective Date and (iii) that the forecasted Consolidated financial statements
of the Borrower and its Subsidiaries referred to in Section 4.01(h) of the
Credit Agreement shall be deemed to refer to the forecasted Consolidated
financial statements of the Borrower and its Subsidiaries most recently
delivered to the Administrative Agent and the Lender Parties prior to the
Amendment Effective Date).

                  (c)      No event shall have occurred and be continuing, or
shall result from the effectiveness of this Amendment, that constitutes a
Default.

                  (d)      The Administrative Agent shall have received an
amendment, in form and substance satisfactory to it, to the California
Settlement Agreement to delete the requirement of the deposit provided in
Section 3.5(c) thereof and to substitute for such requirement in its entirety
the delivery to MPN or its authorized representative of the Additional Letter
of Credit, which amendment shall be approved by an order of the United States
Bankruptcy Court for the Central District of California having jurisdiction
over the bankruptcy case of MPN and which order shall have been entered and be
in full force and effect.

                  (e)      All of the reasonable fees and expenses of the
Administrative Agent and the Arranger (including the reasonable fees and
expenses of counsel for the Administrative Agent) due and payable on the
Amendment Effective Date shall have been paid in full.

                  The effectiveness of this Amendment is further conditioned
upon the accuracy of all of the factual matters described herein. This
Amendment is subject to the provisions of Section 8.01 of the Credit Agreement.

                  SECTION 3. Reference to and Effect on the Loan Documents. (a)
On and after the Amendment Effective Date, each reference in the Credit
Agreement to "this Agreement," "hereunder," "hereof" or words of like import
referring to the Credit Agreement, and each reference in the Notes and each of
the other Loan Documents to "the Credit Agreement," "thereunder," "thereof" or
words of like import referring to the Credit Agreement, shall mean and be a
reference to the Credit Agreement, as amended by this Amendment.

                  (b)      The Credit Agreement, the Notes and each of the
other Loan Documents, as amended by the amendments specifically provided above
in Section 1, are and shall continue to be in full force and effect and are
hereby in all respects ratified and confirmed. The execution, delivery and
effectiveness of this Amendment shall not, except as expressly provided herein,
operate as a waiver of

                                       3
<PAGE>   4

any right, power or remedy of any of the Guaranteed Parties or the
Administrative Agent under any of the Loan Documents, or constitute a waiver of
any provision of any of the Loan Documents.

                  (c)      This Amendment will constitute any notice required
under Section 5.03(t) of the Credit Agreement in respect of the Additional
Letter of Credit

                  SECTION 4. Costs and Expenses. The Borrower hereby agrees to
pay, upon demand, all of the reasonable costs and expenses of the
Administrative Agent and the Arranger (including, without limitation, the
reasonable fees and expenses of counsel for the Administrative Agent and of
Sugarman & Company LLP) in connection with the preparation, execution,
delivery, administration, modification and amendment of this Amendment and all
of the agreements, instruments and other documents delivered or to be delivered
in connection herewith, all in accordance with the terms of Section 8.04 of the
Credit Agreement.

                  SECTION 5. Execution in Counterparts. This Amendment may be
executed in any number of counterparts and by different parties hereto in
separate counterparts, each of which when so executed shall be deemed to be an
original and all of which taken together shall constitute one and the same
agreement. Delivery of an executed counterpart of a signature page to this
Amendment by telecopier shall be effective as delivery of a manually executed
counterpart of this Amendment.

                  SECTION 6. Governing Law. This Amendment shall be governed
by, and construed in accordance with, the laws of the State of New York.

                                       4
<PAGE>   5

                  IN WITNESS WHEREOF, the parties hereto have caused this
Amendment to be executed by their respective officers, thereunto duly
authorized, as of the date first written above.

                                 THE BORROWER

                                 CAREMARK RX, INC.
                                 (formerly known as MEDPARTNERS, INC.)

                                 By       /s/ James H. Dickerson, Jr.
                                      ---------------------------------
                                      Name:  James H. Dickerson, Jr.
                                      Title: EVP and CFO

                                 THE ADMINISTRATIVE AGENT

                                 BANK OF AMERICA, N.A.

                                 By       /s/ Michael D. Monte
                                      ---------------------------------
                                      Name:  Michael D. Monte
                                      Title: Managing Director

                                    5
<PAGE>   6

                                 THE LENDER PARTIES

                                 BANK OF AMERICA, N.A., as a Lender,
                                 the Swing Line Bank and the Issuing Bank

                                 By         /s/ Michael D. Monte
                                      ---------------------------------
                                      Name:  Michael D. Monte
                                      Title: Managing Director

                                 AMSOUTH BANK

                                 By        /s/ Allison J. Sanders
                                      ---------------------------------
                                      Name:  Allison J. Sanders
                                      Title: Vice President

                                 THE CHASE MANHATTAN BANK

                                 By        /s/ Dawn Lee Lum
                                      ---------------------------------
                                      Name:  Dawn Lee Lum
                                      Title: Vice President

                                 CITIBANK, N.A.

                                 By
                                      ---------------------------------
                                      Name:
                                      Title:

                                 CREDIT LYONNAIS NEW YORK BRANCH

                                 By        /s/ Henry J. Reukauf
                                      ---------------------------------
                                      Name:  Henry J. Reukauf
                                      Title: Vice President

                                 DEBT STRATEGIES FUND, INC.

                                 By
                                      ---------------------------------
                                      Name:
                                      Title:

                                    6
<PAGE>   7

                                 BANK ONE, NA (f/k/a THE FIRST NATIONAL
                                 BANK OF CHICAGO)

                                 By            /s/ L. Richard Schiller
                                      ---------------------------------
                                      Name:  L. Richard Schiller
                                      Title: Vice President

                                 FIRST UNION NATIONAL BANK

                                 By        /s/ Joyce L. Barry
                                      ---------------------------------
                                      Name:  Joyce L. Barry
                                      Title: SVP

                                 FLOATING RATE PORTFOLIO

                                 BY:  INVESCO Senior Secured Management, Inc.,
                                      as attorney in fact

                                 By        /s/ Gregory Stoeckle
                                      ---------------------------------
                                      Name:  Gregory Stoeckle
                                      Title: Authorized Signator

                                 KZH HIGHLAND-2 LLC

                                 By
                                      ---------------------------------
                                      Name:
                                      Title:

                                 MERRILL LYNCH DEBT STRATEGIES
                                   PORTFOLIO, INC.
                                   BY:   MERRILL LYNCH ASSET
                                   MANAGEMENT L.P., as Investment Advisor

                                 By
                                      ---------------------------------
                                      Name:
                                      Title:

                                       7
<PAGE>   8

                                 MERRILL LYNCH GLOBAL INVESTMENT
                                   SERIES: INCOME STRATEGIES PORTFOLIO
                                   BY: MERRILL LYNCH ASSET MANAGEMENT,
                                       L.P., as Investment Advisor

                                 By
                                      ---------------------------------
                                      Name:
                                      Title:

                                 MERRILL LYNCH SENIOR FLOATING
                                   RATE FUND, INC.

                                 By
                                      ---------------------------------
                                      Name:
                                      Title:

                                 MERRILL LYNCH PRIME RATE PORTFOLIO
                                   BY:  MERRILL LYNCH ASSET
                                   MANAGEMENT, L.P., as Investment Advisor

                                 By
                                      ---------------------------------
                                      Name:
                                      Title:

                                 ML CBO IV (CAYMAN) LTD.
                                 BY: HIGHLAND CAPITAL MANAGEMENT L.P.,
                                     as Collateral Manager

                                 By
                                      ---------------------------------
                                      Name:
                                      Title:

                                 ML CLO XX PILGRIM AMERICA
                                   (CAYMAN) LTD.
                                    BY: PILGRIM INVESTMENTS, INC.,
                                        as Investment Manager

                                 By        /s/ Charles E. LeMieux
                                      ---------------------------------
                                      Name:  Charles E. LeMieux, CFA
                                      Title: Assistant Vice President

                                       8
<PAGE>   9

                                 MORGAN GUARANTY TRUST COMPANY
                                   OF NEW YORK

                                 By       /s/ Anna Marie Fallon
                                      ---------------------------------
                                      Name:  Anna Marie Fallon
                                      Title: Vice President

                                 PAM CAPITAL FUNDING, LP
                                   BY: HIGHLAND CAPITAL MANAGEMENT, L.P.,
                                       as Collateral Manager

                                 By
                                      ---------------------------------
                                      Name:
                                      Title:

                                 PAMCO CAYMAN, LTD.
                                   BY: HIGHLAND CAPITAL  MANAGEMENT, L.P.,
                                       as Collateral Manager

                                 By
                                      ---------------------------------
                                      Name:
                                      Title:

                                 PILGRIM PRIME RATE TRUST
                                   BY: PILGRIM INVESTMENTS, INC.,
                                       as Investment Manager

                                 By       /s/ Charles E. LeMieux
                                      ---------------------------------
                                      Name:  Charles E. LeMieux, CFA
                                      Title: Assistant Vice President

                                 SCOTIABANC INC.

                                 By        /s/ Dana Maloney
                                      ---------------------------------
                                      Name:  Dana Maloney
                                      Title: Relationship Manager

                                       9
<PAGE>   10

                                 SRV-HIGHLAND, INC.

                                 By
                                      ---------------------------------
                                      Name:
                                      Title:

                                 STEIN ROE & FARNHAM INCORPORATED,
                                      as Agent for KEYPORT LIFE INSURANCE
                                           COMPANY

                                 By        /s/ Brian W. Good
                                      ---------------------------------
                                      Name:  Brian W. Good
                                      Title: Vice President & Portfolio Manager

                                 TORONTO DOMINION (TEXAS), INC.

                                 By        /s/ Anne C. Favoriti
                                      ---------------------------------
                                      Name:  Anne C. Favoriti
                                      Title: Vice President

                                 TRANSAMERICA LIFE INSURANCE AND
                                      ANNUITY CO.

                                 By
                                      ---------------------------------
                                      Name:
                                      Title:

                                 TRANSAMERICA PREMIER HIGH YIELD FUND

                                 By       /s/ Matthew Kuhns
                                      ---------------------------------
                                      Name:  Matthew Kuhns
                                      Title: Vice President

                                 VAN KAMPEN PRIME RATE INCOME TRUST

                                 By       /s/ Darvin D. Pierce
                                      ---------------------------------
                                      Name:  Darvin D. Pierce
                                      Title: Vice President

1
                                      10
<PAGE>   11

                                 VAN KAMPEN SENIOR INCOME TRUST

                                 By       /s/ Darvin D. Pierce
                                      ---------------------------------
                                      Name:  Darvin D. Pierce
                                      Title: Vice President

                                 VAN KAMPEN CLO II, LIMITED
                                 BY:  VAN KAMPEN MANAGEMENT, INC.,
                                      as Collateral Manager

                                 By       /s/ Darvin D. Pierce
                                      ---------------------------------
                                      Name:  Darvin D. Pierce
                                      Title: Vice President

                                 WACHOVIA BANK, N.A.

                                 By
                                      ---------------------------------
                                      Name:
                                      Title:

                                      11
<PAGE>   12

               CONSENT TO AMENDMENT NO. 16 TO THE LOAN DOCUMENTS

                             As of February 3, 2000

                  Reference is made to Amendment No. 16 to the Loan Documents
dated as of February 3, 2000 (the "AMENDMENT") to the Amended and Restated
Credit Agreement dated as of June 9, 1998 (as amended and otherwise modified by
Amendment No. 1 to the Loan Documents dated as of December 4, 1998, Amendment
No. 2 to the Loan Documents dated as of January 13, 1999, Amendment No. 3 to
the Loan Documents dated as of February 9, 1999, Amendment and Waiver No. 4 to
the Loan Documents dated as of March 18, 1999, Amendment and Waiver No. 5 to
the Loan Documents dated as of April 1, 1999, Amendment No. 6 to the Loan
Documents dated as of April 14, 1999, Amendment No. 7 to the Loan Documents
dated as of June 29, 1999, Amendment No. 8 to the Loan Documents dated as of
August 2, 1999, Amendment No. 9 to the Loan Documents dated as of August 16,
1999, Amendment No. 10 to the Loan Documents dated as of August 23, 1999,
Amendment No. 11 to the Loan Documents dated as of August 30, 1999, Amendment
No. 12 to the Loan Documents dated as of September 14, 1999, Amendment No. 13
to the Loan Documents dated as of November 5, 1999, Amendment No. 14 to the
Loan Documents dated as of December 16, 1999 and Amendment No. 15 to the Loan
Documents dated as of January 20, 2000, the "CREDIT AGREEMENT") among Caremark
Rx, Inc. (formerly known as MedPartners, Inc.), a Delaware corporation, the
Lenders party thereto, Bank of America, N.A. (formerly NationsBank, N.A.), as
the Initial Issuing Bank and Swing Line Bank thereunder, Credit Lyonnais New
York Branch, The First National Bank of Chicago and Morgan Guaranty Trust
Company of New York, as the Syndication Agents therefor, Banc of America
Securities LLC (formerly NationsBanc Montgomery Securities LLC), as Arranger
therefor, and Bank of America, N.A. (formerly NationsBank, N.A.), as the
Administrative Agent for the Lender Parties thereunder. Capitalized terms not
otherwise defined herein shall have the same meanings as specified therefor in
the Credit Agreement.

                  Each of the undersigned, as a guarantor under the
Subsidiaries Guarantee dated as of June 9, 1998 (as modified to the date
hereof, the "SUBSIDIARIES GUARANTEE") in favor of the Guaranteed Parties,
hereby consents to the execution and delivery of the Amendment and the
performance of the Credit Agreement, as amended thereby, and hereby confirms
and agrees that, notwithstanding the effectiveness of the Amendment, the
Subsidiaries Guarantee is, and shall continue to be, in full force and effect
and is hereby in all respects ratified and confirmed, except that each
reference in the Subsidiaries Guarantee to "the Credit Agreement,"
"thereunder," "thereof" or words of like import referring to the Credit
Agreement shall mean and be a reference to the Credit Agreement, as amended by
the Amendment.

                  This Consent may be executed in any number of counterparts
and by different parties hereto in separate counterparts, each of which when so
executed shall be deemed to be an original and all of which taken together
shall constitute one and the same Consent. Delivery of an executed counterpart
of a signature page to this Consent by telecopier shall be effective as
delivery of a manually executed counterpart of this Consent.

                  This Consent shall be governed by, and construed in
accordance with, the laws of the State of New York.
<PAGE>   13

                            MEDPARTNERS ACQUISITION CORPORATION

                            By       /s/ James H. Dickerson, Jr.
                                 ----------------------------------------------
                                 Name:  James H. Dickerson, Jr.
                                 Title: President & Treasurer

                            MEDPARTNERS AVIATION, INC.

                            By       /s/ Sara J. Finley
                                 ----------------------------------------------
                                 Name:  Sara J. Finley
                                 Title: Vice President & Secretary

                            MEDPARTNERS EAST, INC.

                            By       /s/ James H. Dickerson, Jr.
                                 ----------------------------------------------
                                 Name:  James H. Dickerson, Jr.
                                 Title: President & Treasurer

                            MEDPARTNERS INTEGRATED NETWORK-
                            CHANDLER, INC.

                            By       /s/ James H. Dickerson, Jr.
                                 ----------------------------------------------
                                 Name:  James H. Dickerson, Jr.
                                 Title: Vice President & Treasurer

                            MEDPARTNERS PROFESSIONAL
                            MANAGEMENT CORPORATION

                            By       /s/ James H. Dickerson, Jr.
                                 ----------------------------------------------
                                 Name:  James H. Dickerson, Jr.
                                 Title: President & Treasurer

                            HEALTHWAYS, INC.

                            By       /s/ James H. Dickerson, Jr.
                                 ----------------------------------------------
                                 Name:  James H. Dickerson, Jr.
                                 Title: President & Treasurer

                                       2
<PAGE>   14

                            BAY AREA PRACTICE MANAGEMENT
                            GROUP, INC.

                            By       /s/ Sara J. Finley
                                 ----------------------------------------------
                                 Name:  Sara J. Finley
                                 Title: Vice President & Secretary

                            By       /s/ James H. Dickerson, Jr.
                                 ----------------------------------------------
                                 Name:   James H. Dickerson, Jr.
                                 Title:  Vice President & Treasurer

                            CHS MANAGEMENT, INC.

                            By       /s/ James H. Dickerson, Jr.
                                 ----------------------------------------------
                                 Name:   James H. Dickerson, Jr.
                                 Title:  President & Treasurer

                            CAREMARK INTERNATIONAL INC.

                            By       /s/ James H. Dickerson, Jr.
                                 ----------------------------------------------
                                 Name:   James H. Dickerson, Jr.
                                 Title:  President & Treasurer

                            CAREMARK INC.

                            By       /s/ Sara J. Finley
                                 ----------------------------------------------
                                 Name:  Sara J. Finley
                                 Title: Vice President & Secretary

                            By       /s/ Leisa S. Kizer
                                 ----------------------------------------------
                                 Name:   Leisa S. Kizer
                                 Title:  Treasurer

                                       3
<PAGE>   15

                            PRESCRIPTION HEALTH SERVICES, INC.

                            By       /s/ James H. Dickerson, Jr.
                                 ----------------------------------------------
                                 Name:   James H. Dickerson, Jr.
                                 Title:  Vice President & Treasurer

                             By       /s/ Sara J. Finley
                                 ----------------------------------------------
                                 Name:   Sara J. Finley
                                 Title:  Vice President & Secretary

                            CAREMARK INTERNATIONAL HOLDINGS INC.

                            By       /s/ James H. Dickerson, Jr.
                                 ----------------------------------------------
                                 Name:   James H. Dickerson, Jr.
                                 Title:  Vice President & Treasurer

                            MEDPARTNERS PHYSICIAN SERVICES INC.

                            By        /s/ James H. Dickerson, Jr.
                                 ----------------------------------------------
                                 Name:   James H. Dickerson, Jr.
                                 Title:  Vice President & Treasurer

                            FRIENDLY HILLS HEALTHCARE
                            NETWORK INC.

                            By        /s/ Sara J. Finley
                                 ----------------------------------------------
                                 Name:   Sara J. Finley
                                 Title:  Vice President & Secretary

                            MEDPARTNERS NSC LTD.

                            By        /s/ James H. Dickerson, Jr.
                                 ----------------------------------------------
                                 Name:   James H. Dickerson, Jr.
                                 Title:  Vice President & Treasurer

                                       4
<PAGE>   16

                            MEDPARTNERS ADMINISTRATIVE
                            SERVICES, INC.

                            By        /s/ James H. Dickerson, Jr.
                                 ----------------------------------------------
                                 Name:   James H. Dickerson, Jr.
                                 Title:  Vice President & Treasurer

                            MEDPARTNERS MANAGED CARE, INC.

                            By        /s/ Sara J. Finley
                                 ----------------------------------------------
                                 Name:   Sara J. Finley
                                 Title:  Vice President & Secretary

                            ACUTE CARE MEDICAL MANAGEMENT, INC.

                            By        /s/ Sara J. Finley
                                 ----------------------------------------------
                                 Name:   Sara J. Finley
                                 Title:  Vice President & Secretary

                            BGS HEALTHCARE, INC.

                            By        /s/ Sara J. Finley
                                 ----------------------------------------------
                                 Name:   Sara J. Finley
                                 Title:  Vice President & Secretary

                            HOME HEALTH AGENCY OF GREATER
                            MIAMI, INC.

                            By        /s/ Sara J. Finley
                                 ----------------------------------------------
                                 Name:   Sara J. Finley
                                 Title:  Vice President & Secretary

                                       5
<PAGE>   17

                            PACIFIC MEDICAL GROUP, INC.

                            By        /s/ Sara J. Finley
                                 ----------------------------------------------
                                 Name:   Sara J. Finley
                                 Title:  Vice President & Secretary

                            PACIFIC PHYSICIAN SERVICES, INC.

                            By        /s/ James H. Dickerson, Jr.
                                 ----------------------------------------------
                                 Name:  James H. Dickerson, Jr.
                                 Title: President & Treasurer

                            PPS EAST, INC.

                            By        /s/ James H. Dickerson, Jr.
                                 ----------------------------------------------
                                 Name:   James H. Dickerson, Jr.
                                 Title:  President & Treasurer

                            PPS NORTH CAROLINA MEDICAL
                            MANAGEMENT, INC.

                            By        /s/ James H. Dickerson, Jr.
                                 ----------------------------------------------
                                 Name:   James H. Dickerson, Jr.
                                 Title:  President & Treasurer

                            PPS RIVERSIDE DIVISION ACQUISITION
                            AND MANAGEMENT CORP. I

                            By        /s/ James H. Dickerson, Jr.
                                 ----------------------------------------------
                                 Name:   James H. Dickerson, Jr.
                                 Title:  President & Treasurer

                                       6
<PAGE>   18

                            PPS VALLEY MANAGEMENT, INC.

                            By        /s/ James H. Dickerson, Jr.
                                 ----------------------------------------------
                                 Name:   James H. Dickerson, Jr.
                                 Title:  President & Treasurer

                            By        /s/ Sara J. Finley
                                 ----------------------------------------------
                                 Name:   Sara J. Finley
                                 Title:  Vice President & Secretary

                            PACIFIC PHYSICIAN SERVICES
                            ARIZONA, INC.

                            By        /s/ James H. Dickerson, Jr.
                                 ----------------------------------------------
                                 Name:   James H. Dickerson, Jr.
                                 Title:  President & Treasurer

                            PACIFIC PHYSICIAN SERVICES
                            NEVADA, INC.

                            By        /s/ James H. Dickerson, Jr.
                                 ----------------------------------------------
                                 Name:   James H. Dickerson, Jr.
                                 Title:  President & Treasurer

                            PHYSICIANS' HOSPITAL MANAGEMENT
                            CORPORATION

                            By        /s/ James H. Dickerson, Jr.
                                 ----------------------------------------------
                                 Name:   James H. Dickerson, Jr.
                                 Title:  Vice President & Treasurer

                            RELIANT HEALTHCARE SYSTEMS, INC.

                            By        /s/ James H. Dickerson, Jr.
                                 ----------------------------------------------
                                 Name:   James H. Dickerson, Jr.
                                 Title:  President & Treasurer

                            By        /s/ Sara J. Finley
                                 ----------------------------------------------
                                 Name:   Sara J. Finley
                                 Title:  Vice President & Secretary

                                       7
<PAGE>   19

                            MEDPARTNERS/TALBERT MEDICAL
                            MANAGEMENT CORPORATION

                            By        /s/ James H. Dickerson, Jr.
                                 ----------------------------------------------
                                 Name:   James H. Dickerson, Jr.
                                 Title:  Vice President & Treasurer

                            TALBERT MEDICAL MANAGEMENT
                            CORPORATION

                            By        /s/ James H. Dickerson, Jr.
                                 ----------------------------------------------
                                 Name:   James H. Dickerson, Jr.
                                 Title:  Vice President & Treasurer

                            TALBERT HEALTH SERVICES
                            CORPORATION

                            By        /s/ James H. Dickerson, Jr.
                                 ----------------------------------------------
                                 Name:   James H. Dickerson, Jr.
                                 Title:  Vice President & Treasurer

                            MEDPARTNERS ADMINISTRATION, L.P.

                            By        /s/ James H. Dickerson, Jr.
                                 ----------------------------------------------
                                 Name:   James H. Dickerson, Jr.
                                 Title:  Executive Vice President & Treasurer
                                         of Caremark Rx, Inc., the General
                                         Partner

                            MEDPARTNERS PHYSICIAN
                            MANAGEMENT, L.P.

                            By        /s/ James H. Dickerson, Jr.
                                 ----------------------------------------------
                                 Name:    James H. Dickerson, Jr.
                                 Title:   Executive Vice President of
                                          Caremark Rx, Inc., the General
                                          Partner

                                       8
<PAGE>   20

                            MED TENNESSEE, INC.

                            By        /s/ James H. Dickerson, Jr.
                                 ----------------------------------------------
                                 Name:   James H. Dickerson, Jr.
                                 Title:  President & Treasurer

                            MEDPARTNERS PHYSICIAN SERVICES OF
                            ILLINOIS L.L.C.

                            By        /s/ James H. Dickerson, Jr.
                                 ----------------------------------------------
                                 Name:   James H. Dickerson, Jr.
                                 Title:  Vice President & Treasurer of
                                         North Suburban Clinic, Ltd.,
                                         a Member

                            CERRITOS INVESTMENT GROUP

                            By        /s/ James H. Dickerson, Jr.
                                 ----------------------------------------------
                                 Name:   James H. Dickerson, Jr.
                                 Title:  Executive Vice President & Chief
                                         Financial Officer of Caremark Rx, Inc.,
                                         a Partner

                            By        /s/ Sara J. Finley
                                 ----------------------------------------------
                                 Name:   Sara J. Finley
                                 Title:  Corporate Secretary of
                                         Caremark Rx, Inc., a Partner

                            CERRITOS INVESTMENT GROUP II

                            By        /s/ James H. Dickerson, Jr.
                                 ----------------------------------------------
                                 Name:   James H. Dickerson, Jr.
                                 Title:  Executive Vice President & Chief
                                         Financial Officer of Caremark Rx, Inc.,
                                         a Partner

                            By        /s/ Sara J. Finley
                                 ----------------------------------------------
                                 Name:   Sara J. Finley
                                 Title:  Corporate Secretary of
                                         Caremark Rx, Inc., a Partner

                                       9
<PAGE>   21

                            5000 AIRPORT PLAZA, L.P.

                            By        /s/ James H. Dickerson, Jr.
                                 ----------------------------------------------
                                 Name:   James H. Dickerson, Jr.
                                 Title:  Executive Vice President & Chief
                                         Financial Officer of Caremark Rx, Inc.
                                         the General Partner

                            By        /s/ Sara J. Finley
                                 ----------------------------------------------
                                 Name:   Sara J. Finley
                                 Title:  Corporate Secretary of
                                         Caremark Rx, Inc., the General Partner

                                      10<PAGE>   1
                                                                  EXHIBIT 10.42

                                PLEDGE AGREEMENT

                          DATED AS OF NOVEMBER 4, 1999

                                      FROM

                               CAREMARK RX, INC.,
                                   AS GRANTOR

                                       TO

                       LASALLE BANK NATIONAL ASSOCIATION,
                                   AS TRUSTEE

<PAGE>   2

                               TABLE OF CONTENTS

                                                                      PAGE

Section 1.   Grant of Security                                          2

Section 2.   Security for Obligations                                   3

Section 3.   Delivery and Control of Security Collateral
             and Account Collateral                                     3

Section 4.   Maintaining the Trust Account                              4

Section 5.   Investing of Amounts in the Trust Account                  4

Section 6.   Release of Amounts                                         4

Section 7.   Representations and Warranties                             4

Section 8.   Further Assurances                                         5

Section 9.   Place of Perfection; Records                               6

Section 10.  Voting Rights; Dividends; Etc                              6

Section 11.  Transfers and Other Liens; Additional Shares               7

Section 12.  The Trustee's Duties                                       7

Section 13.  Remedies                                                   7

Section 14.  Registration Rights                                        8

Section 15.  Amendments; Waivers; Etc                                   9

Section 16.  Addresses for Notices                                      9

Section 17.  Continuing Security Interest; Release                      9

Section 18.  Governing Law                                             10

<PAGE>   3

                                PLEDGE AGREEMENT

                  PLEDGE AGREEMENT (this "AGREEMENT") dated as of November 4,
1999 made by CAREMARK RX, INC. (formerly MedPartners, Inc.), a Delaware
corporation, with an office at 3000 Galleria Tower, Birmingham, Alabama 35244
(the "GRANTOR"), to LASALLE BANK NATIONAL ASSOCIATION, a national banking
association, as trustee (the "TRUSTEE") for the holders of Secured Debt (as
defined below) under the Trust Agreement (as defined below).

                            PRELIMINARY STATEMENTS:

                  (1) The Grantor has issued $450,000,000.00 of its 7% Senior
Notes due 2006 (the "SENIOR PUBLIC NOTES") pursuant to an Indenture dated as of
October 8, 1996 (the "INDENTURE") among the Grantor, as issuer and U.S. Bank
National Association, as successor trustee for the holders of the Senior Public
Notes.

                  (2) The Grantor has entered into a $1,000,000,000.00 Amended
and Restated Credit Agreement dated as of June 9, 1998, as amended and
otherwise modified by Amendment and Waiver No. 1 to the Loan Documents dated as
of December 4, 1998, Amendment No. 2 to the Loan Documents dated as of January
13, 1999, Amendment No. 3 to the Loan Documents dated as of February 9, 1999,
Amendment and Waiver No. 4 to the Loan Documents dated as of March 18, 1999,
Amendment and Waiver No. 5 to the Loan Documents dated as of April 1, 1999,
Amendment No. 6 to the Loan Documents dated as of April 14, 1999, Amendment No.
7 to the Loan Documents dated as of June 29, 1999, Amendment No. 8 to the Loan
Documents dated as of July 9, 1999, Amendment No. 9 to the Loan Documents
("AMENDMENT NO. 9") dated as of August 16, 1999, Amendment No. 10 to the Loan
Documents dated as of August 23, 1999, Amendment No. 11 to the Loan Documents
dated as of August 30, 1999, and Amendment No. 12 to the Loan Documents dated
as of September 14, 1999, (as so amended and as hereafter amended, restated or
otherwise modified, the "CREDIT AGREEMENT"; the terms defined therein and not
otherwise defined herein being used herein as therein defined; and, together
with the Indenture, the "DEBT INSTRUMENTS") with the financial institutions
party thereto from time to time as lenders, swing line banks and issuing banks
(such lenders, swing line banks and issuing banks, collectively, the "PRIVATE
LENDERS" or the "HOLDERS OF THE BANK DEBT"), Credit Lyonnais New York Branch,
The First National Bank of Chicago and Morgan Guaranty Trust Company of New
York, as syndication agents, Banc of America Securities LLC (formerly known as
NationsBanc Montgomery Securities LLC), as arranger and Bank of America, N.A.
(formerly known as NationsBank, N.A.), as administrative agent.

                  (3) Pursuant to Section 3 of Amendment No. 9, the Borrower
agreed that as promptly as practicable after it was permitted under the terms
of the Credit Agreement it would take all actions necessary to grant a
perfected security interest in all of the capital stock of Caremark, for the
equal and ratable benefit of the Private Lenders and the holders of the Senior
Public Notes (collectively, the "SECURED PARTIES"), to secure, subject to the
terms and conditions of this Agreement and the Trust Agreement (as defined
below), the payment of all of its obligations owing under the Credit Agreement
and the documents delivered in connection therewith (the "BANK DEBT") and the
payment of all of its obligations owning under the Senior Public Notes (the
Bank Debt and the Senior Public Notes being, collectively, the "SECURED DEBT").

<PAGE>   4

                  (4) The Grantor and the Trustee have entered into a Trust
Agreement dated as of the date hereof (said Agreement, as it may hereafter be
amended or otherwise modified from time to time, being the "TRUST AGREEMENT").

                  (5) The Grantor is the owner of 100% of the shares (the
"PLEDGED SHARES") of common stock, par value $1.00, issued by Caremark,
represented by stock certificate #3 for 1,000 shares.

                  (6) The Grantor has opened a trust account (the "TRUST
ACCOUNT") with the Trustee at its office at Chicago, Illinois, Account No.
60-8373-00-7, in the name of "Caremark Rx, Inc. Trust Account" but under the
sole control and dominion of the Trustee and subject to the terms of this
Agreement.

                  (7) Unless otherwise defined in this Agreement or in the
Trust Agreement, terms defined in Article 8 or 9 of the Uniform Commercial Code
in effect in the State of New York ("N.Y. UNIFORM COMMERCIAL CODE") are used in
this Agreement as such terms are defined in such Article 8 or 9.

                  NOW, THEREFORE, in consideration of the premises and in order
to fulfill its obligations under Amendment No. 9 and the Indenture, the Grantor
hereby agrees with the Trustee for its benefit and the equal and ratable
benefit of the Secured Parties as follows:

                  Section 1. Grant of Security. The Grantor hereby assigns and
pledges to the Trustee for its benefit and the equal and ratable benefit of the
Secured Parties, and hereby grants to the Trustee for its benefit and the equal
and ratable benefit of the Secured Parties a security interest in, the
following (collectively, the "COLLATERAL"):

                  (a)      all of the following (the "SECURITY COLLATERAL"):

                           (i) the Pledged Shares and the certificates
                  representing the Pledged Shares, and all dividends, cash,
                  instruments and other property from time to time received,
                  receivable or otherwise distributed in respect of or in
                  exchange for any or all of the Pledged Shares; and

                           (ii) all additional shares of stock of Caremark from
                  time to time acquired by the Grantor in any manner, and the
                  certificates representing such additional shares, and all
                  dividends, cash, instruments and other property from time to
                  time received, receivable or otherwise distributed in respect
                  of or in exchange for any or all of such shares; and

(a)               all of the following (collectively, the "ACCOUNT COLLATERAL"):

(i)               the Trust Account, all funds held therein and all certificates
and instruments, if any, from time to time representing or evidencing the Trust
Account;

(i)               all Collateral Investments (as hereinafter defined) from time
to time and all certificates and instruments, if any, from time to time
representing or evidencing the Collateral Investments;

<PAGE>   5

(ii)              all notes, certificates of deposit, deposit accounts, checks
and other instruments from time to time hereafter delivered to or otherwise
possessed by the Trustee for or on behalf of the Grantor in substitution for or
in addition to any or all of the then existing Account Collateral; and

(i)               all interest, dividends, cash, instruments and other property
from time to time received, receivable or otherwise distributed in respect of
or in exchange for any or all of the then existing Account Collateral; and

(a)               all proceeds of any and all of the foregoing Collateral
(including, without limitation, proceeds that constitute property of the types
described in clauses (a) - (b) of this Section 1).

                  Section 2. Security for Obligations. This Agreement secures
the payment of all obligations of the Grantor now or hereafter existing under
the Debt Instruments, whether for principal, interest, fees, expenses or
otherwise (all such Obligations being the "SECURED OBLIGATIONS").

                  Section 3. Delivery and Control of Security Collateral and
Account Collateral. (a) All certificates or instruments representing or
evidencing Security Collateral or Account Collateral shall be delivered to and
held by or on behalf of the Trustee pursuant hereto and shall be in suitable
form for transfer by delivery, or shall be accompanied by duly executed
instruments of transfer or assignment in blank, all in form and substance
satisfactory to the Trustee. For the better perfection of the Trustee's rights
in and to the Security Collateral and the Account Collateral, the Grantor shall
forthwith, upon the pledge of any Security Collateral or Account Collateral
hereunder, cause such Security Collateral or Account Collateral to be
registered in the name of the Trustee or such of its nominees as the Trustee
shall direct, subject only to the revocable rights specified in Section 10(a).
In addition, the Trustee shall have the right at any time to exchange
certificates or instruments representing or evidencing Security Collateral or
Account Collateral for certificates or instruments of smaller or larger
denominations.

                  (b)       With respect to any Security Collateral that
constitutes a security and is not represented or evidenced by a certificate or
an instrument, the Grantor shall cause the issuer thereof either (i) to
register the Trustee as the registered owner of such security or (ii) to agree
in writing with the Grantor and the Trustee that such issuer will comply with
instructions with respect to such security originated by the Trustee without
further consent of the Grantor, such agreement to be in form and substance
satisfactory to the Trustee.

                  (c)       With respect to any Security Collateral that
constitutes a security entitlement, the Grantor shall cause the securities
intermediary with respect to such security entitlement either (i) to identify
in its records the Trustee as having such security entitlement against such
securities intermediary or (ii) to agree in writing with the Grantor and the
Trustee that such securities intermediary will comply with entitlement orders
(that is, notifications communicated to such securities intermediary directing
transfer or redemption of the financial asset to which the Grantor has a
security entitlement) originated by the Trustee without further consent of the
Grantor, such agreement to be in form and substance satisfactory to the
Trustee.

(a)               With respect to any Security Collateral that constitutes a
securities account, the Grantor will, in the case of a securities account,
comply with subsection (c) of this Section 3 with respect to all security
entitlements carried in such securities account.

<PAGE>   6

                  Section 4. Maintaining the Trust Account. Until the
termination pursuant to Section 17 of the security interest granted herein:

                  (a)       The Grantor will maintain the Trust Account with
         the Trustee.

                  (b) It shall be a term and condition of the Trust Account,
         notwithstanding any term or condition to the contrary in any other
         agreement relating to the Trust Account, and except as otherwise
         provided by the provisions of Sections 6 and Section 13, that no
         amount (including interest on Collateral Investments) shall be paid or
         released to or for the account of, or withdrawn by or for the account
         of, the Grantor or any other Person from the Trust Account.

The Trust Account shall be subject to such applicable laws, and such applicable
regulations of the Board of Governors of the Federal Reserve System and of any
other appropriate banking or governmental authority, as may now or hereafter be
in effect.

Section 1.        Investing of Amounts in the Trust Account. If directed in
writing by the Grantor, the Trustee will, subject to the provisions of Sections
6 and 13 hereof, from time to time invest amounts on deposit in the Trust
Account as permitted by Section 3.3 of the Trust Agreement (such investments
being the "COLLATERAL INVESTMENTS"). Interest and proceeds that are not
invested or reinvested in Collateral Investments as provided above shall be
deposited and held in the Trust Account.

Section 1.        Release of Amounts. If in its sole discretion it elects to do
so, the Trustee may pay and release to the Grantor or at its order and at the
request of the Grantor, the amount, if any, by which the credit balance of the
Trust Account exceeds all amounts then due and payable under the Debt
Instruments together with all accrued and unpaid fees under the Trust
Agreement.

Section 1.        Representations and Warranties.  The Grantor represents and
warrants as follows:

(a)               The principal place of business and chief executive office of
the Grantor is located at the address first specified above for the Grantor.

(a)               The Grantor is the legal and beneficial owner of the
Collateral free and clear of any Lien, except for the security interest created
by this Agreement. No effective financing statement or other instrument similar
in effect covering all or any part of the Collateral is on file in any
recording office, except such as may have been filed in favor of the Trustee
relating to this Agreement. The Grantor has no trade names.

(a)               The Pledged Shares have been duly authorized and validly
issued and are fully paid and non-assessable.

(a)               The Pledged Shares constitute 100% of the issued and
outstanding shares of stock of Caremark.

(a)               (1) The possession by the Trustee of the certificates
representing the Pledged Shares, together with undated stock power executed in
blank, creates a valid and perfected first priority security interest in such
Pledged Shares and (2) the pledge of the Security Collateral pursuant to this
Agreement, the pledge and assignment of the Account Collateral pursuant hereto,
and the filing of a

<PAGE>   7

financing statement in favor of the Trustee with the Secretary of State of the
State of Alabama, create a valid and perfected first priority security interest
in the Collateral, in each case securing the payment of the Secured
Obligations, and all filings and other actions necessary or desirable to
perfect and protect such security interest have been duly taken.

(a)               No consent of any other Person and no authorization, approval
or other action by, and no notice to or filing with, any governmental authority
or regulatory body or other third party is required either (i) for the grant by
the Grantor of the assignment and security interest granted hereby, for the
pledge by the Grantor of the Security Collateral pursuant hereto or for the
execution, delivery or performance of this Agreement by the Grantor, (ii) for
the perfection or maintenance of the pledge, assignment and security interest
created hereby (including the first priority nature of such pledge, assignment
or security interest), except for the filing of financing and continuation
statements under the Uniform Commercial Code, which financing statements have
been or will be duly filed, or (iii) for the exercise by the Trustee of its
voting or other rights provided for in this Agreement or the remedies in
respect of the Collateral pursuant to this Agreement, except as may be required
in connection with the disposition of any portion of the Security Collateral by
laws affecting the offering and sale of securities generally.

(a)               Further Assurances. The Grantor agrees that from time to time,
at the expense of the Grantor, the Grantor will promptly execute and deliver
all further instruments and documents, and take all further action, that may be
necessary or desirable, or that the Trustee may request, in order to perfect
and protect any pledge, assignment or security interest granted or purported to
be granted hereby or to enable the Trustee to exercise and enforce its rights
and remedies hereunder with respect to any Collateral. Without limiting the
generality of the foregoing, the Grantor will: (i) if any Collateral shall be
evidenced by a promissory note or other instrument, deliver and pledge to the
Trustee hereunder such note or instrument duly indorsed and accompanied by duly
executed instruments of transfer or assignment, all in form and substance
satisfactory to the Trustee; and (ii) execute and file such financing or
continuation statements, or amendments thereto, and such other instruments or
notices, as may be necessary or desirable, or as the Trustee may request, in
order to perfect and preserve the pledge, assignment and security interest
granted or purported to be granted hereby.

(a)               The Grantor hereby authorizes the Trustee to file one or more
financing or continuation statements, and amendments thereto, relating to all
or any part of the Collateral without the signature of the Grantor where
permitted by law. A photocopy or other reproduction of this Agreement or any
financing statement covering the Collateral or any part thereof shall be
sufficient as a financing statement where permitted by law.

(a)               The Grantor will furnish to the Trustee from time to time
statements and schedules further identifying and describing the Collateral and
such other reports in connection with the Collateral as the Trustee may
reasonably request, all in reasonable detail.

Section 1.        Place of Perfection; Records. The Grantor shall keep its
principal place of business and chief executive office and the office where it
keeps its records concerning the Collateral, at the location therefor specified
in Section 7(a) or, upon 30 days' prior written notice to the Trustee, at such
other locations in a jurisdiction where all actions required by Section 8 shall
have been taken with respect to the Collateral. The Grantor will hold and
preserve such records and will permit representatives of the Trustee upon
reasonable notice and during normal business hours to inspect and make
abstracts from such records.

<PAGE>   8

(a)               Voting Rights; Dividends; Etc.  So long as no Actionable
Default (as defined in the Trust Agreement) shall have occurred and be
continuing:

(i)               The Grantor shall be entitled to exercise any and all voting
and other consensual rights pertaining to the Security Collateral or any part
thereof for any purpose not inconsistent with the terms of this Agreement or
the other Debt Instruments.

(i)               The Grantor shall be entitled to receive and retain any and
all dividends, interest and other distributions paid in respect of the Security
Collateral; provided, however, that any and all

(A)               dividends, interest and other distributions paid or payable
other than in cash in respect of, and instruments and other property received,
receivable or otherwise distributed in respect of, or in exchange for, any
Security Collateral,

(A)               dividends and other distributions paid or payable in cash
in respect of any Security Collateral in connection with a partial or total
liquidation or dissolution, and

(A)               cash paid, payable or otherwise distributed in exchange for
any Security Collateral

         shall be, and shall be forthwith delivered to the Trustee to hold as,
         Security Collateral and shall, if received by the Grantor, be received
         in trust for the benefit of the Trustee, be segregated from the other
         property or funds of the Grantor and be forthwith delivered to the
         Trustee as Security Collateral in the same form as so received (with
         any necessary indorsement).

(i)               The Trustee shall execute and deliver (or cause to be
executed and delivered) to the Grantor all such proxies and other instruments
as the Grantor may reasonably request for the purpose of enabling the Grantor
to exercise the voting and other rights that it is entitled to exercise
pursuant to paragraph (i) above and to receive the dividends or interest
payments that it is authorized to receive and retain pursuant to paragraph (ii)
above.

(a)               Upon the occurrence and during the continuance of an
Actionable Default (as defined in the Trust Agreement):

(i)               All rights of the Grantor (x) to exercise or refrain from
exercising the voting and other consensual rights that it would otherwise be
entitled to exercise pursuant to Section 10(a)(i) shall, upon notice to the
Grantor by the Trustee, cease and (y) to receive the dividends and other
distributions that it would otherwise be authorized to receive and retain
pursuant to Section 10(a)(ii) shall automatically cease, and all such rights
shall thereupon become vested in the Trustee, which shall thereupon have the
sole right to exercise or refrain from exercising such voting and other
consensual rights and to receive and hold as Security Collateral such dividends
and other distributions.

(i)               All dividends and other distributions that are received by
the Grantor contrary to the provisions of paragraph (i) of this Section 10(b)
shall be received in trust for the benefit of the Trustee, shall be segregated
from other funds of the Grantor and shall be forthwith paid over to the Trustee
as Security Collateral in the same form as so received (with any necessary
indorsement).

<PAGE>   9

(a)               Transfers and Other Liens; Additional Shares. The Grantor
shall not (i) sell, assign (by operation of law or otherwise) or otherwise
dispose of, or grant any option with respect to, any of the Collateral, or (ii)
create or suffer to exist any Lien upon or with respect to any of the
Collateral except for the pledge, assignment and security interest created by
this Agreement.

(a)               The Grantor shall (i) cause Caremark not to issue any stock
or other securities in addition to or in substitution for the Pledged Shares,
except to the Grantor, and (ii) pledge hereunder, immediately upon its
acquisition (directly or indirectly) thereof, any and all additional shares of
stock or other securities of Caremark.

Section 1.        The Trustee's Duties. The powers conferred on the Trustee
hereunder are solely to protect its interest in the Collateral and shall not
impose any duty upon it to exercise any such powers. Except for the safe
custody of any Collateral in its possession and the accounting for moneys
actually received by it hereunder, the Trustee shall have no duty as to any
Collateral, as to ascertaining or taking action with respect to calls,
conversions, exchanges, maturities, tenders or other matters relative to any
Security Collateral, whether or not the Trustee or any Secured Party has or is
deemed to have knowledge of such matters, or as to the taking of any necessary
steps to preserve rights against any parties or any other rights pertaining to
any Collateral. The Trustee shall be deemed to have exercised reasonable care
in the custody and preservation of any Collateral in its possession if such
Collateral is accorded treatment substantially equal to that which the Trustee
accords its own property.

Section 1.        Remedies.  If any Actionable Default (as defined in the
Trust Agreement) shall have occurred and be continuing:

(a)               The Trustee may exercise in respect of the Collateral, in
addition to other rights and remedies provided for herein or otherwise
available to it, all the rights and remedies of a secured party upon default
under the N.Y. Uniform Commercial Code (whether or not the N.Y. Uniform
Commercial Code applies to the affected Collateral) and also may (i) require
the Grantor to, and the Grantor hereby agrees that it will at its expense and
upon request of the Trustee forthwith, assemble all or part of the Collateral
as directed by the Trustee and make it available to the Trustee at a place to
be designated by the Trustee that is reasonably convenient to both parties and
(ii) without notice except as specified below, sell the Collateral or any part
thereof in one or more parcels at public or private sale, at any of the
Trustee's offices or elsewhere, for cash, on credit or for future delivery, and
upon such other terms as the Trustee may deem commercially reasonable. The
Grantor agrees that, to the extent notice of sale shall be required by law, at
least ten days' notice to the Grantor of the time and place of any public sale
or of the time after which any private sale is to be made shall constitute
reasonable notification. The Trustee shall not be obligated to make any sale of
Collateral regardless of notice of sale having been given. The Trustee may
adjourn any public or private sale from time to time by announcement at the
time and place fixed therefor, and such sale may, without further notice, be
made at the time and place to which it was so adjourned.

(a)               All cash proceeds received by the Trustee in respect of any
sale of, collection from, or other realization upon all or any part of the
Collateral shall be deposited into the Trust Account and may, in the discretion
of the Trustee, be held by the Trustee as collateral for, and/or then or at any
time thereafter applied in whole or in part by the Trustee against the Secured
Obligations as provided in Section 3.4 of the Trust Agreement.

<PAGE>   10

(a)               The Trustee may exercise any and all rights and remedies
of the Grantor in respect of the Collateral.

(a)               All payments received by the Grantor in respect of the
Collateral shall be received in trust for the benefit of the Trustee, shall be
segregated from other funds of the Grantor and shall be forthwith paid over to
the Trustee in the same form as so received (with any necessary indorsement).

(a)               The Trustee may, without notice to the Grantor except as
required by law and at any time or from time to time, charge, set-off and
otherwise apply all or any part of the Secured Obligations against the Trust
Account or any part thereof.

Section 1.        Registration Rights.  If the Trustee shall determine to
exercise its right to sell all or any of the Security Collateral pursuant to
Section 13, the Grantor agrees that, upon request of the Trustee, the Grantor
will, at its own expense:

(a)               execute and deliver, and cause each issuer of the Security
Collateral contemplated to be sold, if such issuer is a subsidiary of the
Grantor, and the directors and officers of such issuer to execute and deliver,
all such instruments and documents, and do or cause to be done all such other
acts and things, as may be necessary or, in the opinion of the Trustee,
advisable to register such Security Collateral under the provisions of the
Securities Act of 1933, as from time to time amended (the "SECURITIES ACT"), to
cause the registration statement relating thereto to become effective and to
remain effective for such period as prospectuses are required by law to be
furnished and to make all amendments and supplements thereto and to the related
prospectus that, in the opinion of the Trustee, are necessary or advisable, all
in conformity with the requirements of the Securities Act and the rules and
regulations of the Securities and Exchange Commission applicable thereto;

(a)               use its best efforts to qualify the Security Collateral
under the state securities or "Blue Sky" laws and to obtain all necessary
governmental approvals for the sale of the Security Collateral, as requested by
the Trustee;

(a)               cause each such issuer that is a subsidiary of the Grantor to
make available to its security holders, as soon as practicable, an earnings
statement that will satisfy the provisions of Section 11(a) of the Securities
Act;

(a)               provide the Trustee with such other information and
projections as may be necessary or, in the opinion of the Trustee, advisable to
enable the Trustee to effect the sale of such Security Collateral; and

(a)               do or cause to be done all such other acts and things as may
be necessary to make such sale of the Security Collateral or any part thereof
valid and binding and in compliance with applicable law.

The Trustee is authorized, in connection with any sale of the Security
Collateral pursuant to Section 13, to deliver or otherwise disclose to any
prospective purchaser of the Security Collateral (i) any registration statement
or prospectus, and all supplements and amendments thereto, prepared pursuant to
clause (a) above, (ii) any information and projections provided to it pursuant
to clause (d) above and (iii) any other information in its possession relating
to the Security Collateral.
<PAGE>   11

                  Section 15. Amendments; Waivers; Etc. No amendment or waiver
of any provision of this Agreement, and no consent to any departure by the
Grantor herefrom, shall in any event be effective unless the same shall be in
writing and signed by the Trustee, and then such waiver or consent shall be
effective only in the specific instance and for the specific purpose for which
given. No failure on the part of the Trustee to exercise, and no delay in
exercising any right hereunder, shall operate as a waiver thereof; nor shall
any single or partial exercise of any such right preclude any other or further
exercise thereof or the exercise of any other right.

                  Section 16. Addresses for Notices. All notices and other
communications provided for hereunder shall be in writing (including telecopier
communication) and, mailed, telecopied or delivered to the Grantor or to the
Trustee, as the case may be, in each case addressed to it at its address
specified in the Trust Agreement or, as to either party, at such other address
as shall be designated by such party in a written notice to each other party
complying as to delivery with the terms of this Section. All such notices and
other communications shall be deemed to have been duly given or made, when
delivered by hand or five Business Days after being deposited in the mail,
postage prepaid, or when telecopied, receipt acknowledged; provided, however,
that any notice, request, demand or other communication to the Trustee shall
not be effective until received.

                  Section 17. Continuing Security Interest; Release. This
Agreement shall create a continuing security interest in the Collateral and
shall (a) remain in full force and effect until the release of Collateral as
provided in Section 6.1 of the Trust Agreement, (b) be binding upon the
Grantor, its successors and assigns and (c) inure, together with the rights and
remedies of the Trustee hereunder, to the benefit of the Trustee, the Secured
Parties and their respective successors, transferees and assigns.

                  Section 18. Governing Law. This Agreement shall be governed
by and construed in accordance with the laws of the State of New York.

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<PAGE>   12

                  IN WITNESS WHEREOF, the Grantor has caused this Agreement to
be duly executed and delivered by its officer thereunto duly authorized as of
the date first above written.

                              CAREMARK RX, INC.

                              By         /s/ Peter J. Clemens IV
                                  Title:  SVP Finance & Treasurer

                              LASALLE BANK NATIONAL ASSOCIATION,
                                       AS TRUSTEE

                              By         /s/ Russell C. Bergman
                                  Title:  Vice President

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