Amendment to Various Agreements - United Healthcare
EX-10.26 8 h22277exv10w26.txt AMENDMENT TO VARIOUS AGREEMENTS - UNITED HEALTHCARE Exhibit 10.26 *** INDICATES MATERIAL HAS BEEN OMITTED PURSUANT TO A CONFIDENTIAL TREATMENT REQUEST FILED WITH THE SECURITIES AND EXCHANGE COMMISSION. A COMPLETE COPY OF THIS AGREEMENT HAS BEEN FILED SEPARATELY WITH THE SECURITIES AND EXCHANGE COMMISSION. AMENDMENT TO VARIOUS AGREEMENTS BETWEEN UNITED HEALTHCARE INSURANCE COMPANY AND ADMINISTAFF OF TEXAS, INC. WHEREAS, United HealthCare Insurance Company ("United HealthCare") and Administaff of Texas, Inc. ("Administaff") entered into certain agreements establishing a minimum premium arrangement ("Minimum Premium Arrangement") for the provision of medical and dental benefits to Administaff Inc.'s employees; and WHEREAS, those agreements were the Security Deposit Agreement (effective December 21, 2001), the Minimum Premium Administrative Services Agreement ("MP Services Agreement") (effective January 1, 2002), and the Minimum Premium Financial Agreement ("MP Financial Agreement") (effective January 1, 2002); and WHEREAS, United HealthCare and Administaff have agreed to amend the Agreements; NOW THEREFORE, the Security Deposit Agreement, the MP Services Agreement and MP Financial Agreement are amended as follows effective as of the dates indicated below: The Security Deposit Agreement 1. Section 1 of the Security Deposit Agreement is amended to delete the third sentence and substitute the following: Effective December 31, 2003, the required Security Deposit shall be Seventeen Million, Five Hundred Thousand and No/100 Dollars ($17,500,000). On or before January 31, 2004, United HealthCare shall remit to Administaff the excess of the actual Security Deposit as of December 31, 2003 over the required $17,500,000. 2. Effective June 20, 2003, Section 1 of the Security Deposit Agreement is amended to add the following as a new paragraph at the end of Section 1. Upon Administaff's request, United HealthCare and Administaff will negotiate in good faith the terms of an agreement under which a premium stabilization reserve or its equivalent ("PSR") held by United HealthCare would be substituted for all or some of the Security Deposit provided for herein. Any such PSR would, when combined with the remaining Security Deposit, if any, provide United HealthCare the same overall level of risk protection as the Security Deposit existing at the time of such PSR negotiation. The MP Financial Agreement 1. Effective April 1, 2002, section 1(s) of the MP Financial Agreement is amended by adding the following sentence at the end: The additions, deletions and substitutions agreed to by the Employer and the Company shall be reflected on Exhibit D. 2. Effective January 1, 2004, the MP Financial Agreement is amended by adding a new section 2(e) to provide as follows: (e) Removal of Dental Benefits. Effective January 1, 2004, the Agreement shall not include or provide dental benefits under the Minimum Premium Arrangement, and shall be construed to be so amended, including the following changes: (i) the definition of "Health Benefits" in section 1(i) shall not include dental benefits, (ii) the Maximum Monthly Employer Benefit Obligation described in section 1(m) shall be calculated without including the Dental Policy, (iii) "Policy" as defined in section 1(s) shall not include the Dental Policy or any other policy providing dental benefits to Employees, (iv) "Non-MP Policy as defined in section 1(p) shall not include the Dental Policy or any other policy providing dental benefits to Employees, and (v) the MP Premium described in section 3(a) shall be calculated without including the Dental Policy. The Company shall cause the dental benefits to be so removed in a manner consistent with funding and accounting actions required upon termination of the Agreement as set forth in Exhibit A, including the Company's (I) funding of dental claims incurred under the Dental Policy prior to January 1, 2004, but paid on or after such date, (II) issuance of a final accumulated surplus/deficit accounting with respect to the Dental Policy as a Final Termination Review within 195 calendar days of December 31, 2003, and (III) adjustment of the IBNR Reserve in a manner consistent with the Final Termination Review with respect to the Dental Policy; provided that the Company shall issue an accumulated surplus/deficit accounting with respect to the Dental Policy as an Initial Termination Review by February 15, 2004. (f) After December 31, 2003, the Dental Policy (or any policy providing dental benefits) shall not be included in any determination of Accumulated Surplus or Accumulated Deficit or in any Initial or Final Termination Review required under Exhibit A, except for the Initial and Final Termination Reviews with respect to the Dental Policy described in section 2(e). 3. Section 1(m) of the MP Financial Agreement is amended effective January 1, 2003, by deleting the provisions of section 1(m) in their entirety and substituting the following provision: 2 (m) "Maximum Monthly Employer Benefit Obligation" for an Arrangement Month shall be the amount determined in Exhibit D hereto. The Maximum Monthly Employer Benefit Obligation for an Arrangement Month (other than the first Arrangement Month of an Arrangement Quarter) shall be increased by the amount by which the Maximum Employer Benefit Obligation in the prior Arrangement Month exceeded the Health Benefits Paid in that Month. 4. Section 3(a) of the MP Financial Agreement is amended effective January 1, 2003, by deleting the provisions of section 3(a) in their entirety and substituting the following: (a) MP Premium. The MP Premium for the Policies for the Arrangement Month shall be the amount determined pursuant to Exhibit D hereto. The MP premium is due on the first day of the Arrangement Month to which it applies. As provided in section 1(v) of the Agreement, the MP Premium may include any adjustments authorized in Exhibit E of the MP Administrative Services Agreement in respect of previous Arrangement Months including any additions, terminations or changes in coverage not known at the beginning of the Arrangement Month to which such MP Premium applies. 5. Effective January 1, 2004, Exhibit A to the MP Financial Agreement is amended by deleting section 1 and substituting the following: The Policies. The Employer has entered into a Minimum Premium Arrangement covering certain of the Company's insurance policies or HMOs. The Arrangement covers those Policies identified in section 1(s) of the Agreement. The Company has also issued Non-MP Policies to the Employer which policies are not subject to the Minimum Premium Arrangement; these policies are identified in Exhibit B. 6. Effective January 1, 2004, Exhibit A to the MP Financial Agreement is amended by adding a new Appendix II, and by deleting the first sentence in section 2.a and substituting the following: A monthly composite rate for the Policies and the Non-MP Policies collectively ("Monthly Payable Rate") is established for each Arrangement Quarter as provided in this Exhibit A, and effective January 1, 2004, as further provided in Appendix II to this Exhibit. 7. Effective January 1, 2004, Exhibit A to the MP Financial Agreement is amended by adding the following provisions after the first paragraph of section 4.a: In addition, effective January 1, 2004, in setting the Monthly Payable Rate, the Company shall take into account an Accumulated Deficit or Accumulated Surplus no earlier than the first Arrangement Quarter beginning 90 days after the 3 Quarterly Review. In the case of an Accumulated Deficit, the Company shall recover such Accumulated Deficit over no fewer than *** successive Arrangement Quarters beginning at least 90 days after the Quarterly Review; provided, however, that if the Accumulated Deficit as of the end of an Arrangement Quarter that is the subject of the Quarterly Review exceeds *** of the "Aggregate Premiums" for such Arrangement Quarter, the Company may recover such Accumulated Deficit over fewer than *** Arrangement Quarters. For this purpose, "Aggregate Premiums" for an Arrangement Quarter shall be the product of (A) the Monthly Payable Rate for such quarter, (B) the number of Employees covered under the Policies and Non-MP Policies as of the 15th of the last month of the preceding Arrangement Quarter, and (C) three (3). 8. Effective October 1, 2003, section 6.h of Exhibit A to the MP Financial Agreement is amended by deleting the second and third sentences thereof and substituting the following sentence: The Expense Percentage for the Policies and the Non-MP Policies is set forth in Exhibit D to the Agreement. 9. Effective January 1, 2003, the MP Financial Agreement is amended by adding new Exhibit D, attached hereto. MP Services Agreement 1. Effective January 1, 2004, the MP Services Agreement is amended by deleting section 6(b)(iii) and substituting the following: except as provided in Exhibit F to the Agreement, each Employee is offered concurrently no more than *** option in addition to the Company's dental benefit plan (where offered); 2. Effective January 1, 2004, section 6 of the MP Services Agreement is amended to add the following sentence at the end of subsection (b). For purposes of this section (6)(b), "the Plan" shall mean the plan of benefits provided by the Employer under both the Policies and the Non-MP Policies. 3. Effective January 1, 2004, the MP Services Agreement is amended by deleting section 8(b) and substituting the following: In the event that a state or other jurisdiction, in accordance with existing or future law, imposes upon the Company the duty to act as agent for collection of any Tax imposed on the Plan or the Employer or with respect to any aspect of the Plan, a Policy, a Non-MP Policy, the MP Financial Agreement, or the Agreement, the Employer will pay over any such amount to the Company when requested to do so by the Company, subject to receipt by the Employer from the Company of 4 prompt notice concerning such matter and exercise by the Employer of its rights as stated under subsection 8(a) above. 4. Effective January 1, 2004, Exhibit F of the MP Services Agreement is amended to add the following to the end of section A: For purposes of this Exhibit F, "Employees" shall include employees of the Employer covered under Non-MP Policies as well as the Policies. 5. Effective June 20, 2003, Exhibit F of the MP Services Agreement is amended by adding the following new section 8: 8. Process for Considering Alternative Vendors in Special Markets a. Effective January 1, 2004, the special procedures for alternate vendors described in this section 8 shall apply to the following markets ("Special Markets"): i. *** ii. *** iii. *** iv. *** v. *** vi. *** b. The Employer and the Company shall discuss in detail whether and upon what terms the offering of vendors other than the Company ("Alternate Vendors") in the Special Markets would be a viable alternative to the current approach in any or all of the Special Markets, including but not limited to, the following: i. pricing, product and other competitive information; ii. the specific advantages expected to be gained from offering an Alternate Vendor; iii. the anticipated process and terms for introducing and offering an Alternate Vendor's product, including price, contribution, product and benefit plan design differences, and employee vs Client selection process; and iv. whether some combination of different or additional Company offerings would best serve the Employer, 5 c. Following these discussions, the Employer may offer an Alternate Vendor in a Special Market without regard to notice and cure provisions of section 5 of this Exhibit F. Any vendor changes made by the Employer pursuant to this section shall be memorialized in an amendment to this Exhibit F. Taking into account the discussions with the Employer, the Company's existing offerings, and the size and product distribution of the existing membership in the Special Market, the Company shall elect one of the following: i. Continue to offer to the Employer an *** and/or *** option at the Client level. (All co-employees of a Client would be offered ***.); ii. Continue to offer to the Employer an *** and/or *** option at the employee level, where Clients may elect more ***. iii. Discontinue offering any option to the Employer in the Special Market. d. If the Employer offers one or more Alternate Vendors in a Special Market, this change in product offering may result in changes in the Monthly Payable Rate, Quoted Premiums or premiums of Non-MP Policies; provided however that any such rate or premium change for a Special Market would not be effective before the later of (i) the date the Alternate Vendor's coverage becomes effective and (ii) the first of the month following 30 days advance written notice of such rate or premium change by the Company to the Employer. UNITED HEALTHCARE ADMINISTAFF OF INSURANCE COMPANY TEXAS, INC. By: /s/ Simeon Schindelman By: /s/ Richard Rawson ------------------------------ ----------------------------- Authorized Signature Authorized Signature Name: Simeon Schindelman Name: Richard Rawson Title: President, Small Business Title: President Date:11/9/04 Date: December 3, 2004 6 EXHIBIT A APPENDIX II METHODOLOGY FOR ESTABLISHING MONTHLY PAYABLE RATES 1. Paragraph 2 of Exhibit A of the MP Financial Agreement provides that the Company will establish for each Arrangement Quarter the Monthly Payable Rate, a monthly *** rate for the Policies and the Non-MP Policies collectively (for purposes of this Appendix II, the "MPR"), which rate will then be used to establish the monthly premiums for the Policies and Non-MP Policies. Certain components of the Company's methodology for determining the MPR for an Arrangement Quarter are reflected in a rate calculation worksheet that is provided by the Company to the Employer when the Company communicates the new MPR to the Employer pursuant to section 4.a of Exhibit A ("Rate Calculation Worksheet"), 2. Effective for the Arrangement Quarter beginning January 1, 2004, the methodology used by the Company for establishing the MPR shall include the following components: a. In estimating future PEPM claims, the Company shall utilize (i) the claims paid in the *** months preceding the month in which the MPR is established, and (ii) the covered Employee headcount for the *** month period beginning two months before the *** month period used in item (i) (such two-month earlier period hereinafter referred to as the "Base Period"). For example, assuming the MPR for the second Arrangement Quarter of 2004 is established by the Company in December 2003, the Company would use the paid claims experience from *** through ***, and the covered Employee headcount for the period *** through ***. b. Any adjustment to the MPR due to changes in health cost risk factors shall be actuarially justifiable (i.e., using credible database and tools agreed upon by Employer and Company). The Company's tabular data used to make the adjustments shall be documented and discussed in the Rate Calculation Worksheet, and the Company shall not change such tabular data more frequently than annually. c. The Company shall apply rate adjustments to reflect changes in the following health cost risk factors between the Base Period and the Arrangement Quarter for which the MPR is being developed. (Continuing the example from subparagraph (a), the base period is *** through *** and Arrangement Quarter for which the MPR is being developed is the second Arrangement Quarter of 2004.) i. Age ii. Gender distribution iii. Family size distribution iv. Geographic distribution v. Enrollment distribution by plan type (HMO, PPO, etc) vi. Plan design changes d. In estimating future PEPM claims, the Company shall apply cost change trend factors for medical claims and prescription drug claims separately. In addition, the trend period will be the period between the mid-point of the Base Period and the mid-point of the Arrangement Quarter for which the MPR is being developed. e. The Company shall establish trend factors based on a reasonable assessment of risk and cost changes in projecting future medical and prescription drug claims. The Company shall limit the change in trend factors used to project medical and prescription drug claims to an increase of *** above the trend factors used to establish the Monthly Payable Rate for the prior Arrangement Quarter. This change in trend factor limitation will not be applicable if: (i) the Employer modifies its management practices such that, for the Arrangement Month in which the trend factor is established, there has been (a) more than a *** increase in the number of Clients (as defined in the MP Services Agreement) with less than *** enrollees over the number of such Clients in the last month of the immediately preceding Arrangement Quarter, or (b) more than a *** increase in the number of COBRA enrollees over the number of COBRA enrollees covered in the last month of the immediately preceding Arrangement Quarter , or (ii) for the Arrangement Month in which the trend factor is established, the age/gender factor has increased more than *** over the factor for the last month of the immediately preceding Arrangement Quarter. In the event the threshold in any of the conditions listed in (i) or (ii) above is exceeded, the trend factors used to project medical and prescription drug claims may be increased up to *** above the trend factors used in the immediately preceding Rate Calculation Worksheet. f. The Company shall reflect administration, profit/risk charge, and premium tax as separate items in the Rate Calculation Worksheet. 3. The Company may change the rate setting methodology described in this Appendix II upon 180 days notice to the Employer. 4. The Company shall report to the Employer in detail on the establishment of the MPR in the Rate Calculation Worksheet. EXHIBIT B - NON-MP POLICIES The insurance policies, HMO contracts and similar arrangements on the following list are considered "Non-MP Policies" for purposes of the Agreement. Such list shall be deemed modified by the Current Policy List provided by the Company as part of the Quarterly Review, unless the Employer objects within 30 calendar days of receipt. UNET POLICY NUMBER MARKET EFFECTIVE DATE TERMINATION DATE - -------------------------------------------------------------------------------------------------- Select HMO - Downstate New York 701648AA ACTIVE 01/01/02 701648AB COBRA 01/01/02 701648B ACTIVE w/o Dental 01/01/04 701648BQ COBRA w/o Dental 01/01/04 - -------------------------------------------------------------------------------------------------- Select HMO - New Jersey 701648AC ACTIVE 01/01/02 701648AD COBRA 01/01/02 701648BR ACTIVE w/o Dental 01/01/04 701648BS COBRA w/o Dental 01/01/04 - -------------------------------------------------------------------------------------------------- Select HMO - Illinois 701648AE ACTIVE 01/01/02 701648AF COBRA 01/01/02 701648BT ACTIVE w/o Dental 01/01/04 701648BU COBRA w/o Dental 01/01/04 - -------------------------------------------------------------------------------------------------- Select HMO - Texas 701648AG ACTIVE 01/01/02 12/31/03 701648AH COBRA 01/01/02 12/31/03 - -------------------------------------------------------------------------------------------------- Select HMO - Upstate New York 701648BJ ACTIVE 01/01/02 701648BK COBRA 01/01/02 701648DS ACTIVE w/o Dental 01/01/04 701648DT COBRA w/o Dental 01/01/04 - -------------------------------------------------------------------------------------------------- Choice HMO - Florida 701648AI ACTIVE 01/01/02 701648AJ COBRA 01/01/04 - --------------------------------------------------------------------------------------------------
UNET POLICY NUMBER MARKET EFFECTIVE DATE TERMINATION DATE - -------------------------------------------------------------------------------------------------- 701648BZ ACTIVE w/o Dental 01/01/04 701648C COBRA w/o Dental 01/01/04 - -------------------------------------------------------------------------------------------------- Choice HMO - Arizona 701648AP ACTIVE 01/01/02 701648AT COBRA 01/01/02 701648CS ACTIVE w/o Dental 01/01/04 701648CT COBRA w/o Dental 01/01/04 - -------------------------------------------------------------------------------------------------- Choice HMO - Ohio 701648AX ACTIVE 01/01/02 701648BA COBRA 01/01/02 701648CU ACTIVE w/o Dental 01/01/04 701648CV COBRA w/o Dental 01/01/04 - -------------------------------------------------------------------------------------------------- Choice HMO - Georgia 701648BB ACTIVE 01/01/02 701648BC COBRA 01/01/02 701648CY ACTIVE w/o Dental 01/01/04 701648CZ COBRA w/o Dental 01/01/04 - -------------------------------------------------------------------------------------------------- Choice HMO - Kentucky 701648BD ACTIVE 01/01/02 701648BE COBRA 01/01/02 701648D ACTIVE w/o Dental 01/01/04 701648DL COBRA w/o Dental 01/01/04 - -------------------------------------------------------------------------------------------------- Choice HMO - Texas 701648BF ACTIVE 01/01/02 701648BG COBRA 01/01/02 701648DN ACTIVE w/o Dental 01/01/04 701648DP COBRA w/o Dental 01/01/04 - -------------------------------------------------------------------------------------------------- Choice HMO - Utah 701648BL ACTIVE 01/01/02 701648BN COBRA 01/01/02 701648DU ACTIVE w/o Dental 01/01/04 701648DV COBRA w/o Dental 01/01/04 - -------------------------------------------------------------------------------------------------- Choice HMO - Missouri - --------------------------------------------------------------------------------------------------
UNET POLICY NUMBER MARKET EFFECTIVE DATE TERMINATION DATE - -------------------------------------------------------------------------------------------------- 701648BP ACTIVE 01/01/02 701648BX COBRA 01/01/02 701648DX ACTIVE w/o Dental 01/01/04 701648DY COBRA w/o Dental 01/01/04 - -------------------------------------------------------------------------------------------------- Choice HMO - Arkansas 701648CA ACTIVE 01/01/02 701648CB COBRA 01/01/02 HMO Choice - Arkansas 701648DZ ACTIVE w/o Dental 01/01/04 701648E COBRA w/o Dental 01/01/04 - ------------------------------------------------------------- ------------------------------------ Choice HMO - Mississippi 701648CC ACTIVE 01/01/02 701648CD COBRA 01/01/02 701648EA ACTIVE w/o Dental 01/01/04 701648EB COBRA w/o Dental 01/01/04 - -------------------------------------------------------------------------------------------------- Choice HMO - District of Columbia 701648CG ACTIVE 01/01/02 701648CH COBRA 01/01/02 701648EE ACTIVE w/o Dental 01/01/04 701648EF COBRA w/o Dental 01/01/04 - ---------------------------------------------------------------- --------------------------------- Choice HMO - Virginia 701648CI ACTIVE 01/01/02 701648CJ COBRA 01/01/02 701648EG ACTIVE w/o Dental 01/01/04 701648EH COBRA w/o Dental 01/01/04 - -------------------------------------------------------------------------------------------------- Choice HMO - Tennessee 701648CE ACTIVE 01/01/02 701648CF COBRA 01/01/02 701648EC ACTIVE w/o Dental 01/01/04 701648ED COBRA w/o Dental 01/01/04 - -------------------------------------------------------------------------------------------------- Choice HMO - Louisiana 701648BH ACTIVE 01/01/02 701648BI COBRA 01/01/02 - --------------------------------------------------------------------------------------------------
- -------------------------------------------------------------------------------------------------- UNET POLICY NUMBER MARKET EFFECTIVE DATE TERMINATION DATE - -------------------------------------------------------------------------------------------------- 701648DQ ACTIVE w/o Dental 01/01/04 701648DR COBRA w/o Dental 01/01/04 - -------------------------------------------------------------------------------------------------- Choice HMO - Colorado 701648AK ACTIVE 01/01/02 701648AN COBRA 01/01/02 701648CQ ACTIVE w/o Dental 01/01/04 701648CR ACTIVE w/o Dental 01/01/04 - -------------------------------------------------------------------------------------------------- Choice HMO - Alabama 701648CN ACTIVE 01/01/02 701648CP COBRA 01/01/02 701648EK ACTIVE w/o Dental 01/01/04 701648EL COBRA w/o Dental 01/01/04 - -------------------------------------------------------------------------------------------------- Select EPO - Wisconsin 701648DI ACTIVE & COBRA 01/01/02 701648DI ACTIVE & COBRA w/o Dental 01/01/04 - -------------------------------------------------------------------------------------------------- Choice HMO - Fairfax VA 701648CK ACTIVE 01/01/02 701648CL COBRA 01/01/02 701648EI ACTIVE w/o Dental 01/01/04 701648EJ COBRA w/o Dental 01/01/04 - -------------------------------------------------------------------------------------------------- Select EPO - South Carolina 701648DH ACTIVE & COBRA 01/01/02 701648DH ACTIVE & COBRA 01/01/04 w/o Dental - -------------------------------------------------------------------------------------------------- Choice HMO - Iowa 701648AS ACTIVE 02/01/03 701648AU COBRA 02/01/03 701648EQ ACTIVE w/o Dental 01/01/04 - --------------------------------------------------------------------------------------------------
UNET POLICY NUMBER MARKET EFFECTIVE DATE TERMINATION DATE - -------------------------------------------------------------------------------------------------- 701648ER COBRA w/o Dental 01/01/04 - -------------------------------------------------------------------------------------------------- Choice HMO - Rhode Island 701648AV ACTIVE 05/01/03 701648AY COBRA 05/01/03 701648ES ACTIVE w/o Dental 01/01/04 701648ET COBRA w/o Dental 01/01/04 - -------------------------------------------------------------------------------------------------- 701648AZ Choice EPO - Indiana ACTIVE & COBRA 08/01/03 - --------------------------------------------------------------------------------------------------
PRIME EFFECTIVE TERMINATION POLICY # POLICYHOLDER DATE DATE - ---------- -------------- ----------- ----------- 247936 *** 1/1/2002 247974 *** 1/1/2002 5/28/2003 247977 *** 1/1/2002 3/1/2002 247989 *** 1/1/2002 5/27/2003 247996 *** 1/1/2002 9/1/2002 248003 *** 1/1/2002 3/1/2003 248006 *** 1/1/2002 1/22/2002 248026 *** 1/1/2002 248030 *** 1/1/2002 248035 *** 1/1/2002 1/1/2002 248041 *** 1/1/2002 2/1/2004 248056 *** 1/1/2002 1/11/2002 248063 *** 1/1/2002 1/1/2004 248110 *** 1/1/2002 248128 *** 1/1/2002 248131 *** 1/1/2002 10/1/2003 248133 *** 1/1/2002 248135 *** 1/1/2002 2/22/2002 248144 *** 1/1/2002 8/15/2003 248151 *** 1/1/2002 8/1/2002
PRIME EFFECTIVE TERMINATION POLICY # POLICYHOLDER DATE DATE - -------- ------------ --------- ----------- 248163 *** 1/1/2002 1/1/2002 248165 *** 1/1/2002 7/1/2002 248180 *** 1/1/2002 6/1/2002 248197 *** 1/1/2002 11/1/2002 248208 *** 1/1/2002 6/16/2002 248241 *** 1/1/2002 248263 *** 1/1/2002 11/22/2002 248271 *** 1/1/2002 248291 *** 1/1/2002 3/4/2003 248306 *** 1/1/2002 5/1/2003 248314 *** 1/1/2002 9/4/2002 248324 *** 1/1/2002 248325 *** 1/1/2002 5/31/2002 248339 *** 1/1/2002 9/8/2003 248346 *** 1/1/2002 248352 *** 1/1/2002 3/30/2002 248370 *** 1/1/2002 6/1/2002 248371 *** 1/1/2002 4/28/2002 248372 *** 1/1/2002 248373 *** 1/1/2002 2/25/2002 248374 *** 1/1/2002 248375 *** 1/1/2002 248376 *** 1/1/2002 11/1/2002 248379 *** 1/1/2002 5/31/2002 248382 *** 1/1/2002 248384 *** 1/1/2002 248388 *** 1/1/2002 248390 *** 1/1/2002 6/26/2002 248396 *** 1/1/2002 4/15/2003 248399 *** 1/1/2002 248404 *** 1/1/2002 7/1/2002 248405 *** 1/1/2002 248407 *** 1/1/2002 12/2/2002 248408 *** 1/1/2002 248409 *** 1/1/2002 248410 *** 1/1/2002 7/1/2002 248411 *** 1/1/2002 248412 *** 1/1/2002 3/1/2002 248413 *** 1/1/2002 6/1/2003 248414 *** 1/1/2002 248415 *** 1/1/2002 248416 *** 1/1/2002 248417 *** 1/1/2002 6/12/2003
PRIME EFFECTIVE TERMINATION POLICY # POLICYHOLDER DATE DATE - -------- ------------ --------- ----------- 248418 *** 1/1/2002 248421 *** 1/1/2002 6/1/2002 248429 *** 1/1/2002 248433 *** 1/1/2002 1/1/2002 248442 *** 1/1/2002 248457 *** 1/1/2002 1/1/2003 248463 *** 1/1/2002 10/26/2002 248466 *** 1/1/2002 248473 *** 1/1/2002 248474 *** 1/1/2002 6/15/2002 248478 *** 1/1/2002 8/8/2002 248480 *** 1/1/2002 248486 *** 1/1/2002 248494 *** 1/1/2002 4/1/2003 248495 *** 1/1/2002 7/1/2002 248497 *** 1/1/2002 248501 *** 1/1/2002 248516 *** 1/1/2002 1/1/2003 248519 *** 1/1/2002 248521 *** 1/1/2002 1/1/2003 248524 *** 1/1/2002 10/16/2002 248528 *** 1/1/2002 248532 *** 1/1/2002 2/1/2003 250136 *** 1/1/2002 7/1/2002 250197 *** 1/7/2002 7/1/2003 250201 *** 1/1/2002 250656 *** 1/1/2002 6/1/2003 250657 *** 1/1/2002 1/1/2003 250658 *** 2/1/2002 250659 *** 2/1/2002 2/1/2004 250660 *** 1/1/2002 250669 *** 2/15/2002 12/9/2002 252657 *** 3/1/2002 252926 *** 3/1/2002 6/1/2002 253683 *** 3/4/2002 3/18/2002 253774 *** 3/1/2002 2/19/2003 253775 *** 3/1/2002 253778 *** 2/27/2002 8/28/2002 254553 *** 4/1/2002 5/21/2002 254678 *** 4/1/2002 5/31/2002 254741 *** 4/1/2002 255675 *** 4/1/2002 10/9/2002 255701 *** 4/1/2002
PRIME EFFECTIVE TERMINATION POLICY # POLICYHOLDER DATE DATE - -------- ------------ --------- ----------- 255709 *** 4/1/2002 4/1/2002 256410 *** 2/4/2002 2/4/2002 256498 *** 2/4/2002 8/12/2002 256505 *** 4/1/2002 1/2/2004 257668 *** 4/15/2002 5/2/2003 261873 *** 6/1/2002 262606 *** 7/1/2002 1/1/2003 262614 *** 6/1/2002 262616 *** 6/1/2002 262666 *** 6/1/2002 3/6/2003 263961 *** 6/7/2002 8/1/2002 264562 *** 7/1/2002 264565 *** 7/1/2002 266459 *** 7/28/2002 5/2/2004 266473 *** 7/28/2002 267825 *** 9/1/2002 3/3/2004 268747 *** 9/1/2002 1/15/2004 271606 *** 10/1/2002 1/1/2003 272924 *** 11/1/2002 5/1/2003 273651 *** 10/16/2002 274488 *** 11/20/2002 1/1/2003 277124 *** 1/1/2003 278257 *** 12/1/2002 279171 *** 1/1/2003 7/1/2003 279197 *** 1/6/2003 2/12/2004 279225 *** 12/15/2002 4/15/2003 281742 *** 1/1/2003 282005 *** 1/1/2003 12/1/2003 282007 *** 1/1/2003 282062 *** 1/6/2003 3/1/2004 286373 *** 2/1/2003 288802 *** 3/1/2003 3/2/2004 303058 *** 7/1/2003 303075 *** 5/1/2003 303083 *** 5/1/2003 310924 *** 5/22/2003 311776 *** 8/11/2003 314764 *** 7/1/2003 314770 *** 7/1/2003 315038 *** 7/1/2003 4/1/2004 326974 *** 9/1/2003 334639 *** 9/14/2003 338429 *** 10/1/2003
PRIME EFFECTIVE TERMINATION POLICY # POLICYHOLDER DATE DATE - -------- ------------ --------- ----------- 345349 *** 9/1/2003 348740 *** 10/1/2003 3/1/2004 348746 *** 10/1/2003 3/1/2004 353316 *** 11/1/2003 369064 *** 1/1/2004 378384 *** 1/1/2004 1/1/2004 391528 *** 3/1/2004 395396 *** 3/1/2004 399283 *** 2/16/2004 400182 *** 2/16/2004 420189 *** 5/3/2004 421616 *** 6/1/2004 250579 *** 1/16/2002 5/1/2002 250671 *** 1/22/2002 3/4/2002 251016 *** 1/13/2002 256129 *** 3/1/2002 7/1/2002 256904 *** 1/1/2002 6/1/2002 256960 *** 3/20/2002 6/1/2002 257422 *** 3/26/2002 6/1/2002 257424 *** 4/9/2002 4/9/2002 259230 *** 4/2/2002 11/1/2002 259740 *** 4/14/2002 7/9/2002 260298 *** 4/2/2002 8/2/2002 260303 *** 4/16/2002 7/16/2002 263976 *** 4/3/2002 6/26/2002 265506 *** 6/20/2002 3/24/2003 265510 *** 6/1/2002 11/1/2002 265515 *** 6/1/2002 9/21/2002 265560 *** 6/1/2002 10/12/2002 268687 *** 7/1/2002 7/1/2002 268689 *** 8/8/2002 11/1/2002 268694 *** 7/24/2002 11/24/2002 269888 *** 8/1/2002 8/1/2002 269896 *** 8/1/2002 8/1/2002 269898 *** 8/1/2002 8/1/2002 269899 *** 7/18/2002 11/17/2002 274864 *** 10/15/2002 4/15/2003 274873 *** 10/16/2002 1/13/2003 274875 *** 10/16/2002 12/1/2002 274880 *** 10/16/2002 11/16/2002 274914 *** 10/16/2002 11/16/2002 275044 *** 9/12/2002 11/30/2002 280221 *** 12/1/2002 3/1/2003
PRIME EFFECTIVE TERMINATION POLICY # POLICYHOLDER DATE DATE - -------- ------------ --------- ----------- 280224 *** 11/1/2002 2/1/2003 280225 *** 1/1/2003 7/1/2003 280327 *** 12/4/2002 6/4/2004 281701 *** 1/1/2003 10/3/2003 282549 *** 12/10/2002 2/10/2004 283649 *** 11/20/2002 2/20/2004 286556 *** 12/27/2002 9/1/2003 288804 *** 1/21/2003 6/4/2004 293814 *** 2/1/2003 5/27/2003 293891 *** 2/27/2003 12/1/2003 310933 *** 5/1/2003 11/1/2003 315060 *** 6/12/2003 7/1/2003 315099 *** 6/12/2003 10/1/2003 315132 *** 6/2/2003 10/1/2003 343286 *** 8/21/2003 12/17/2003 355898 *** 9/15/2003 360528 *** 9/1/2003 2/1/2004 373490 *** 11/11/2003 375159 *** 12/3/2003 386745 *** 2/1/2004 388711 *** 11/26/2003 1/1/2004 390767 *** 2/1/2004 390903 *** 2/6/2004 390937 *** 1/7/2004 397824 *** 3/3/2004 397852 *** 3/3/2004 397859 *** 3/3/2004 397876 *** 3/3/2004 397881 *** 3/3/2004 5/4/2004 398067 *** 3/3/2004 398089 *** 3/15/2004 398122 *** 3/3/2004 398159 *** 3/3/2004 406144 *** 2/19/2004 421429 *** 4/16/2004 421796 *** 5/6/2004
EXHIBIT D - POLICIES, RATES AND FACTORS I. The definition of "Policy" for purposes of section 1(s) shall be as follows: - Effective January 1, 2002: (i) Policy No. 701648 (Medical DA, DB, DC, DD, CX, DK)("Medical Policy") (ii) Policy No. 701648 (Dental DA)("Dental Policy") - Effective April 1, 2002: (i) Policy No. 701648 (Medical DA, DB, DC, DD, CX, DK)("Medical Policy") (iii) Policy No. 701648 (Dental DA)("Dental Policy") - Effective January 1, 2003: (i) Policy No. 701648 (Medical DA, DC, DD, CX, DK, AQ, AR)("Medical Policy") (ii) Policy No. 701648 (Dental DA)("Dental Policy") - Effective January 1, 2004: (i) Policy No. 701648 (Medical DA, DC, DD, CX, DK, AQ, AR)("Medical Policy") II. The "Maximum Monthly Employer Benefit Obligation" shall be the sum of the following: - Effective January 1, 2003: - *** of the Quoted Premium for each Medical Policy - *** of the Quoted Premium for each Dental Policy - Effective October 1, 2003: - *** of the Quoted Premium for each Medical Policy - *** of the Quoted Premium for each Dental Policy - Effective January 1, 2004: - *** of the Quoted Premium for each Medical Policy - Not applicable for any dental policy issued by the Company to the Employer III. The "MP Premium" shall be the sum of the following: - Effective January 1, 2003: - *** of the Quoted Premium for each Medical Policy - *** of the Quoted Premium for each Dental Policy - Effective October 1, 2003: - *** of the Quoted Premium for each Medical Policy - *** of the Quoted Premium for each Dental Policy - Effective January 1, 2004: - *** of the Quoted Premium for each Medical Policy - Not applicable for any dental policy issued by the Company to the Employer IV. Effective October 1, 2003, the "Expense Percentage" shall be *** for the Dental Policies, the Medical Policies and the Non-MP Policies providing medical or dental benefits.
