Document:

exv4w3

Exhibit 4.3

          Second Supplemental Indenture (this “Second Supplemental Indenture”), dated as of
June 7, 2011, among COVENTRY HEALTH CARE, INC., a Delaware corporation (the “Company”), and
UNION BANK, NATIONAL ASSOCIATION, a national banking association, as trustee with respect
to the series of Securities specified below under the Indenture referred to below (the “New
Trustee”).

WITNESSETH:

          WHEREAS, the Company has heretofore entered into an Indenture, dated as of March 20,
2007 (the “Indenture”), with The Bank of New York Mellon Trust Company, N.A. (successor to
The Bank of New York, N.A.) as trustee (the “Initial Trustee”), providing for the issuance
of Securities of the Company;

          WHEREAS, the Company has heretofore entered into a First Supplemental Indenture, dated
as of August 27, 2007, with Union Bank, National Association (successor to Union Bank of
California, N.A.) as trustee (the “Trustee”), providing for the issuance of Securities of
the Company;

          WHEREAS, Section 301 of the Indenture permits the Company to appoint as trustee for
any series of Securities a Person other than the Initial Trustee, and Section 901 of the
Indenture contemplates such appointment shall be evidenced by a Supplemental Indenture;

          WHEREAS, the Company desires to appoint the New Trustee, and the New Trustee desires
to accept the appointment, to act as Trustee under the Indenture with respect to the
Company’s 5.450% Senior Notes due 2021 (the “Notes”); and

          WHEREAS, all things necessary to make this Second Supplemental Indenture a valid and
legally binding agreement of the Company have been done.

          NOW THEREFORE, in consideration of the foregoing and for other good and valuable
consideration, the receipt of which is hereby acknowledged, the Company, and the New
Trustee mutually covenant and agree as follows:

ARTICLE I

AMENDMENTS TO THE INDENTURE

          1. Appointment of Trustee with respect to the Notes. The Company hereby appoints the
New Trustee, and the New Trustee hereby accepts its appointment, as the Trustee under the Indenture
with respect to the Notes with all rights, powers and obligations as set forth in the Indenture.

 

 

ARTICLE II

MISCELLANEOUS

          1. Ratification of Indenture; Supplemental Indentures Part of Indenture. Except as
expressly amended hereby, the Indenture is in all respects ratified and confirmed and all the
terms, conditions and provisions thereof shall remain in full force and effect. This Second
Supplemental Indenture shall form a part of the Indenture for all purposes, and every Holder of
Notes heretofore or hereafter authenticated and delivered shall be bound hereby.

          2. Governing Law. THIS SECOND SUPPLEMENTAL INDENTURE SHALL BE GOVERNED BY, AND
CONSTRUED IN ACCORDANCE WITH, THE LAWS OF THE STATE OF NEW YORK.

          3. Concerning the Trustee. The recitals contained herein shall be taken as statements
of the Company and the New Trustee assumes no responsibility for their correctness. The New
Trustee assumes no duties, responsibilities or liabilities by reason of this Second Supplemental
Indenture other than as set forth in this Second Supplemental Indenture and the Indenture. In
addition, the New Trustee makes no representation as to the validity or sufficiency of this Second
Supplemental Indenture.

          4. Defined Terms. Unless otherwise defined herein, terms used herein shall have the
meanings set forth in the Indenture.

          5. Separability. In case any provision in this Second Supplemental Indenture shall
for any reason be held to be invalid, illegal or unenforceable in any respect, the validity,
legality and enforceability of the remaining provisions of this Second Supplemental Indenture shall
not in any way be affected or impaired thereby.

          6. Counterparts. This Second Supplemental Indenture may be executed and delivered in
any number of counterparts, each of which when so executed and delivered shall be deemed to be an
original, and all such counterparts shall together constitute but one and the same instrument.

          7. Effect of Headings. The Section headings herein are for convenience only and shall
not effect the construction thereof.

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          IN WITNESS WHEREOF, the parties hereto have caused this Second Supplemental Indenture to be
duly executed as of the date first above written.

	 	 	 	 	 
	 	COVENTRY HEALTH CARE, INC.

 	 
	 	By:  	/s/
Randy P. Giles	 
	 	 	Name:  	Randy P. Giles	 
	 	 	Title:  	Executive Vice President, Chief Financial
Officer and Treasurer	 
	 
	 	UNION BANK, NATIONAL ASSOCIATION,

as Trustee

 	 
	 	By:  	/s/
Fernando Moreyra	 
	 	 	Name:  	Fernando Moreyra	 
	 	 	Title:  	Vice Presidentexv4w4

Exhibit 4.4

COVENTRY HEALTH CARE, INC.

OFFICERS’ CERTIFICATE PURSUANT TO THE INDENTURE

June 7, 2011

          Reference is made to the Indenture (as supplemented, the “Indenture”), dated as of March 20,
2007, between Coventry Health Care, Inc., a Delaware corporation (the “Company”), and The Bank of
New York Mellon Trust Company, N.A. (successor to The Bank of New York, N.A.), as supplemented by
the First Supplemental Indenture, dated as of August 27, 2007 between the Company and Union Bank,
National Association, (successor to Union Bank of California, N.A.) as trustee (the “Trustee”) and
as further supplemented by the Second Supplemental Indenture dated as of June 7, 2011 between the
Company and the Trustee in connection with the issuance of $600,000,000 of the Company’s 5.450%
Senior Notes due 2021 (the “Notes”). Unless otherwise defined herein, capitalized terms used in
this certificate have the meaning assigned to them in the Indenture. This certificate is issued
pursuant to Section 301 of the Indenture.

          We, Allen F. Wise and Randy P. Giles, the duly appointed Chairman and Chief Executive Officer
and Executive Vice President, Chief Financial Officer and Treasurer, respectively, of the Company,
HEREBY CERTIFY that:

               1. We have read the provisions of the Indenture setting forth conditions precedent to
authentication and delivery by the Trustee of the Securities and all definitions in the Indenture
relating thereto;

               2. We have examined (i) the resolutions of the Board of Directors of the Company (the “Board”)
adopted on May 19, 2011; (ii) such agreements, certificates of public officials and certificates of
officers or other representatives of the Company; and (iii) such other documents, certificates and
corporate or other records as we have deemed necessary as a basis for the opinions hereinafter
expressed;

               3. In the opinion of each of the undersigned, he has made such examination or investigation
as is necessary to enable him to express an informed opinion as to whether or not the conditions
referred to below have been complied with;

               4. We are of the opinion that the conditions to be satisfied by the Company as set forth in
the Indenture relating to the authentication and delivery of the Securities have been complied
with; and

               5. Pursuant to Section 301 of the Indenture, the terms and conditions of the Notes are
established and approved to be the following:

          a. Title:

                    “5.450% Senior Notes due 2021”.

 

 

	 	b.	 	Aggregate Principal Amount:
	 
	 	 	 	The Notes are not limited as to the aggregate principal amount of such
series that the Company may issue. The Notes have an aggregate original
principal amount of $600,000,000. The Company may create and issue
additional securities having the same terms and conditions as the Notes in
all respects, except for issue date, issue price and, if applicable, the
first payment of interest on such additional securities. Additional
securities issued in this manner will be consolidated with and will form a
single series with the Notes.
	 
	 	c.	 	Form of Security:
	 
	 	 	 	The Notes will be issued in global form, with the form of the Note attached
hereto as Exhibit A.
	 
	 	d.	 	Principal Repayment Date:
	 
	 	 	 	June 15, 2021.
	 
	 	e.	 	Interest:
	 
	 	 	 	Interest shall be paid at the rate of 5.450% per annum. Interest shall
accrue from June 7, 2011 or from the most recent Interest Payment Date to
which interest has been paid or duly provided for, semi-annually on June 15
and December 15 in each year, commencing December 15, 2011. The Regular
Record Dates shall be June 1 and December 1.
	 
	 	f.	 	Place of Payment of Interest and Principal:
	 
	 	 	 	The Corporate Trust Office of the Trustee.
	 
	 	g.	 	Redemption Provisions:
	 
	 	 	 	The redemption provisions of Article 11 of the Indenture are applicable to
the Notes, provided, however, that Section 1108(b) shall not apply to the
Notes and shall be replaced with the following:

	 	 	 	The Company may redeem Securities of any series, at its option, at
any time in whole, or from time to time in part, provided that (i) if
the Securities are redeemed before March 15, 2021, the Securities
will be redeemed at a price equal to the greater of (1) 100% of the
principal amount of the Securities to be redeemed and (2) the sum of
the present values of the remaining scheduled payments on such series
of Securities to be redeemed consisting of principal and interest,
exclusive of interest accrued to the date of redemption, discounted
to the date of redemption on a semi-annual basis (assuming a 360-day
year consisting of twelve 30-day months) at

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	 	 	 	the applicable Treasury Yield plus 37.5 basis points, plus accrued
and unpaid interest to the date of redemption and (ii) if the
Securities are redeemed on or after March 15, 2021, the Securities
will be redeemed at a price equal to 100% of the principal amount of
the Securities, plus accrued and unpaid interest to the date of
redemption.

	 	h.	 	Sinking Fund Obligations:
	 
	 	 	 	The Notes shall not contain any Sinking Fund provisions and Article 12 of
the Indenture is inapplicable to the Notes.
	 
	 	i.	 	Denominations:
	 
	 	 	 	$2,000 and integral multiples of $1,000 in excess thereof.
	 
	 	j.	 	Additional Principal Payable Upon an Event of Default:
	 
	 	 	 	Not applicable.
	 
	 	k.	 	Inapplicability of, or Additional, Events of Default:
	 
	 	 	 	Not applicable.
	 
	 	l.	 	Trustee Other than The Bank of New York Mellon Trust
Company, N.A. (successor to The Bank of New York, N.A.):
	 
	 	 	 	Union Bank, National Association, with its Corporate Trust Office located
at:
	 
	 		 	1251 Avenue of the Americas, 19th Floor

New York, New York 10020

Attn: Corporate Trust Department
	 
	 	m.	 	Payment of Principal and Interest in Non-U.S. Dollar Currencies:
	 
	 	 	 	Not applicable.
	 
	 	n.	 	Payment of Principal and Interest in Non-U.S. Dollar Currencies at
Election of the Company:
	 
	 	 	 	Not applicable.
	 
	 	o.	 	Currency Determination Agent:
	 
	 	 	 	Not applicable.
	 
	 	p.	 	Satisfaction and Discharge Provisions Other Than as Set Forth in the
Indenture:

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	 	 	 	Not applicable.
	 
	 	q.	 	Date of Global Securities if Other Than Original Issuance Date:
	 
	 	 	 	Not applicable.
	 
	 	r.	 	Guarantees:
	 
	 	 	 	Not applicable.
	 
	 	s.	 	Other Terms:
	 
	 	 	 	Definitions
	 
	 	 	 	The definition of Below Investment Grade Rating Event contained in the
Indenture shall not apply to the Notes and shall be replaced by the
following:

	 	 	 	“Below Investment Grade Rating Event” means the rating on the
Securities is lowered by each of the Rating Agencies and the
Securities are rated below an Investment Grade Rating by each of the
Rating Agencies in either case on any date from the date of the
public notice of an arrangement that could result in a Change of
Control until the end of the 60-day period following public notice of
the occurrence of the Change of Control (which 60-day period shall be
extended so long as the rating of the Securities is under publicly
announced consideration for possible downgrade by any of the Rating
Agencies).

	 	 	 	The following definition of Fitch shall be included in the Indenture and
apply to the Notes:

	 	 	 	“Fitch” means Fitch Ratings, Inc.

	 	 	 	The definition of Independent Investment Banker contained in the Indenture
shall not apply to the Notes and shall be replaced by the following:

	 	 	 	“Independent Investment Banker” means either Citigroup Global Markets
Inc., J.P. Morgan Securities LLC or Merrill Lynch, Pierce, Fenner &
Smith Incorporated as selected by us or, if such firms are unwilling
or unable to select the applicable Comparable Treasury Issue, an
independent investment banking institution of national standing
appointed by us.

	 	 	 	The definition of Investment Grade Rating contained in the Indenture shall
not apply to the Notes and shall be replaced by the following:

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	 	 	 	“Investment Grade Rating” means a rating equal to or higher than Baa3
(or the equivalent) by Moody’s, BBB- (or the equivalent) by S&P and
BBB- (or the equivalent) by Fitch.

	 	 	 	The definition of Rating Agencies contained in the Indenture shall not apply
to the Notes and shall be replaced by the following:

	 	 	 	“Rating Agencies” means (1) each of Moody’s, S&P and Fitch; and (2)
if any or all of Moody’s, S&P or Fitch ceases to rate the Securities
of such series or fails to make a rating of the Securities of such
series publicly available for reasons outside of the Company’s
control, a “nationally recognized statistical rating organization”
within the meaning of Rule 15c3-1(c)(2)(vi)(F) under the Exchange Act
selected by the Company (as certified by a Board Resolution) as a
replacement agency for Moody’s, S&P or Fitch or all of them, as the
case may be.

	 	 	 	The definition of Reference Treasury Dealer contained in the Indenture shall
not apply to the Notes and shall be replaced by the following:

	 	 	 	“Reference Treasury Dealer” means Citigroup Global Markets Inc., J.P.
Morgan Securities LLC and Merrill Lynch, Pierce, Fenner & Smith
Incorporated and their respective successors and at least two other
primary U.S. government securities dealers in New York City (each, a
“Primary Treasury Dealer”) selected by the Independent Investment
Banker; provided, however, that if any of the foregoing shall cease
to be a Primary Treasury Dealer, the Company will substitute therefor
another Primary Treasury Dealer.

	 	 	 	The definition of S&P contained in the Indenture shall not apply to the
Notes and shall be replaced by the following:

	 	 	 	“S&P” means Standard & Poor’s Financial Services LLC, a subsidiary of
The McGraw-Hill Companies, Inc.

	 	 	 	Events of Default
	 
	 	 	 	The Event of Default contained in Section 501(6) of the Indenture shall not
apply to the Notes and shall be replaced by the following:

	 	 	 	[t]he Company or any of its Subsidiaries fails to pay Indebtedness of
the Company or any Subsidiary in an aggregate principal amount of at
least $50,000,000, at the later of final maturity and the expiration
of any related applicable grace period and such defaulted payment
shall not have been made, waived or extended within 30 days after
there has been given to the Company by the Trustee for the Securities
of such series or to the Company and such Trustee by the Holders of
at least 25% in principal amount of

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	 	 	 	the Outstanding Securities of that series a written notice specifying
such default and requiring it to be remedied and stating that such
notice is a “Notice of Default” hereunder or (B) acceleration of the
maturity of Indebtedness of the Company or any Subsidiary in an
aggregate principal amount of at least $50,000,000, if that
acceleration results from a default under the instrument giving rise
to or securing such indebtedness for money borrowed and such
indebtedness has not been discharged in full or such acceleration has
not been rescinded or annulled within 30 days after there has been
given to the Company by the Trustee for the Securities of such series
or to the Company and such Trustee by the Holders of at least 25% in
principal amount of the Outstanding Securities of that series a
written notice specifying such default and requiring it to be
remedied and stating that such notice is a “Notice of Default”
hereunder.

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          IN WITNESS WHEREOF, the undersigned have executed this certificate as of the date first
written above.

	 	 	 	 	 
	 	 	 
	 	By:  	
/s/ Allen F. Wise	 
	 	 	Name:  	Allen F. Wise 	 
	 	 	Title:  	Chief Executive Officer 	 
	 
	 	 	 
	 	By:  	
/s/ Randy P. Giles	 
	 	 	Name:  	Randy P. Giles 	 
	 	 	Title:  	Executive Vice President, Chief Financial
Officer and Treasurer

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