Common use of Incorporation of Applicable Addenda Clause in Contracts

Incorporation of Applicable Addenda. All addenda checked off and initialed on the cover sheet of this contract by the MA Organization are hereby incorporated by reference. In witness whereof, the parties hereby execute this contract. FOR THE PDP SPONSOR JEFF ROTHENBERGER SR. VP & CORPORATE COO Printxx Xxxx Xxxxx /s/ Jeff Rothenberger 9/7/05 ------------------------------------- Xxte Signature TEXAS HEALTHSPRING I, LLC Organization 2900 NORTH LOOP WEST, SUITE 1300, HOUSTON, TX 77292 Address FOR THE XXXXXXX XXX XXXXXXXX & XXXXXXXX XXXXXXXX /x/ Xxxricia P. Smith 10/12/05 ------------------------------------- Date Patricia P. Smith Director Medicare Advantage Group Center for Benefxxxxxx Xxxxxxx EMPLOYER/UNION-ONLY GROUP PART C ADDENDUM TO CONTRACT WITH APPROVED ENTITY PURSUANT TO SECTIONS 1851 THROUGH 1859 OF THE SOCIAL SECURITY ACT FOR THE OPERATION OF A MEDICARE ADVANTAGE PLAN The Centers for Medicare & Medicaid Services (hereinafter referred to as "CMS") and TEXAS HEALTHSPRING I, LLC, a Medicare Advantage Organization (hereinafter referred to as the "MA Organization") agree to amend the contract H4513 governing the MA Organization's operation of a Medicare Advantage plan described in section 1851(a)(2)(A) or section 1851(a)(2)(C) of the Social Security Act (hereinafter referred to as "the Act"), including all attachments, addenda, and amendments thereto, to include the provisions contained in this Addendum (collectively hereinafter referred to as the "contract"), under which the MA Organization shall offer Employer/Union-Only Group MA-Only Plans (hereinafter referred to as "employer/union-only group health plans") in accordance with the waivers granted by CMS under section 1857(i) of the Act. The terms of this Addendum shall only apply to MA-only health plans offered exclusively to employers/unions. This Addendum is made pursuant to Subpart K of 42 CFR Part 422.

Incorporation of Applicable Addenda. All addenda checked off and initialed on the cover sheet of this contract by the MA Organization are hereby incorporated by reference. In witness whereof, the parties hereby execute this contract. FOR THE PDP SPONSOR JEFF ROTHENBERGER SRMA ORGANIZATION Bxxxxxxx Xxxx, Xx. VP & CORPORATE COO Printxx Xxxx Xxxxx Printed Name President/C.E.O. Title /s/ Jeff Rothenberger 9/7/05 ------------------------------------- Xxte Bxxxxxxx Xxxx, Xx. Signature TEXAS HEALTHSPRING I9/06/05 Date Lxxx Medical Centers Health Plans Organization 10000 XX 00 XX, LLC Organization 2900 NORTH LOOP WESTXxxxx, SUITE 1300, HOUSTON, TX 77292 X0 00000 Address FOR THE XXXXXXX XXX XXXXXXXX CENTERS FOR MEDICARE & XXXXXXXX XXXXXXXX /x/ Xxxricia P. Smith 10/12/05 ------------------------------------- Date Patricia P. Smith MEDICAID SERVICES /s/ Pxxxxxxx X. Xxxxx Pxxxxxxx X. Xxxxx Director Medicare Advantage Group Center for Benefxxxxxx Xxxxxxx EMPLOYER/UNION-ONLY GROUP PART C Beneficiary Choices 10/12/05 Date ADDENDUM TO MEDICARE MANAGED CARE CONTRACT WITH APPROVED ENTITY PURSUANT TO SECTIONS 1851 1860D-1 THROUGH 1859 1860D-42 OF THE SOCIAL SECURITY ACT FOR THE OPERATION OF A VOLUNTARY MEDICARE ADVANTAGE PRESCRIPTION DRUG PLAN The Centers for Medicare & Medicaid Services (hereinafter referred to as "“CMS"”) and TEXAS HEALTHSPRING ILxxx Medical Centers Health Plans, LLCINC H 5410, a Medicare Advantage Organization managed care organization (hereinafter referred to as the "MA Organization"MA-PD Sponsor) agree to amend the contract H4513 (INSERT “H 5410” NUMBER) governing the MA Organization's MA-PD Sponsor’s operation of a Medicare Advantage Part C plan described in section Section 1851(a)(2)(A) or section 1851(a)(2)(C) of the Social Security Act (hereinafter referred to as "“the Act"), including all attachments, addenda, and amendments thereto, ”) or a Medicare cost plan to include the provisions contained in this Addendum (collectively hereinafter referred to as the "contract"), addendum under which the MA Organization shall offer Employer/Union-Only Group MA-Only Plans PD Sponsor shall operate a Voluntary Medicare Prescription Drug Plan pursuant to sections 1860D-1 through 1860D-42 (hereinafter referred to as "employer/union-only group health plans") in accordance with the waivers granted by CMS under exception of section 1857(i1860D-22 and 1860D-31) of the Act. The terms of this Addendum shall only apply to MA-only health plans offered exclusively to employers/unions. This Addendum addendum is made pursuant to Subpart L of 42 CFR Part 417 (in the case of cost plan sponsors offering a Part D benefit) and Subpart K of 42 CFR Part 422422 (in the case of an MA-PD Sponsor offering a Part C plan).

Incorporation of Applicable Addenda. All addenda checked off and initialed on the cover sheet of this contract by the MA Organization are hereby incorporated by reference. In witness whereof, the parties hereby execute this contract. FOR THE PDP SPONSOR JEFF ROTHENBERGER SRMA ORGANIZATION Xxx Xxxxxx CFO Printed Name Title /s/ Xxx Xxxxxx 9/4/08 Signature Date HEALTHSPRING LIFE & HEALTH INSURANCE, INC. VP & CORPORATE COO Printxx Xxxx Xxxxx /s/ Jeff Rothenberger 9/7/05 ------------------------------------- Xxte Signature TEXAS HEALTHSPRING I0000 Xxxxxxxxx Xxxxxxx Franklin, LLC TN 37067 Organization 2900 NORTH LOOP WEST, SUITE 1300, HOUSTON, TX 77292 Address FOR THE XXXXXXX XXX XXXXXXXX CENTER FOR MEDICARE & XXXXXXXX XXXXXXXX /x/ Xxxricia P. Smith 10/12/05 ------------------------------------- MEDICAID SERVICES /s/ Xxxxxx XxXxxx 12/13/08 Xxxxxx XxXxxx, R.N., MS Date Patricia P. Smith Acting Director Medicare Advantage Drug and Health Plan Contract Administration Group Center for Benefxxxxxx Xxxxxxx EMPLOYER/UNION-ONLY GROUP PART C Drug and Health Plan Choice ADDENDUM TO MEDICARE MANAGED CARE CONTRACT WITH APPROVED ENTITY PURSUANT TO SECTIONS 1851 1860D-1 THROUGH 1859 1860D-42 OF THE SOCIAL SECURITY ACT FOR THE OPERATION OF A VOLUNTARY MEDICARE ADVANTAGE PRESCRIPTION DRUG PLAN The Centers for Medicare & Medicaid Services (hereinafter referred to as "“CMS"”) and TEXAS HEALTHSPRING ILIFE & HEALTH INSURANCE COMPANY, LLCINC., a Medicare Advantage Organization managed care organization (hereinafter referred to as the "MA Organization"MA-PD Sponsor) agree to amend the contract H4513 (H7787) governing the MA Organization's MA-PD Sponsor’s operation of a Medicare Advantage Part C plan described in section Section 1851(a)(2)(A) or section 1851(a)(2)(C) of the Social Security Act (hereinafter referred to as "“the Act"), including all attachments, addenda, and amendments thereto, ”) or a Medicare cost plan to include the provisions contained in this Addendum (collectively hereinafter referred to as the "contract"), addendum under which the MA Organization shall offer Employer/Union-Only Group MA-Only Plans PD Sponsor shall operate a Voluntary Medicare Prescription Drug Plan pursuant to sections 1860D-1 through 1860D-42 (hereinafter referred to as "employer/union-only group health plans") in accordance with the waivers granted by CMS under exception of section 1857(i1860D-22 and 1860D-31) of the Act. The terms of this Addendum shall only apply to MA-only health plans offered exclusively to employers/unions. This Addendum addendum is made pursuant to Subpart L of 42 CFR Part 417 (in the case of cost plan sponsors offering a Part D benefit) and Subpart K of 42 CFR Part 422422 (in the case of an MA-PD Sponsor offering a Part C plan).

Incorporation of Applicable Addenda. All addenda checked off and initialed on the cover sheet of this contract by the MA Organization are hereby incorporated by reference. In witness whereof, the parties hereby execute this contract. FOR THE PDP SPONSOR JEFF ROTHENBERGER SR. VP & CORPORATE COO Printxx Xxxx Xxxxx MA ORGANIZATION Chief Executive Officer Printed Name Title /s/ Jeff Rothenberger 9/7/05 ------------------------------------- Xxte September 8, 2005 Signature TEXAS HEALTHSPRING IXxxxxx Healthcare of , LLC Organization 2900 NORTH LOOP WEST, SUITE 1300, HOUSTON, TX 77292 Address Inc. FOR THE XXXXXXX XXX XXXXXXXX CENTERS FOR MEDICARE & XXXXXXXX XXXXXXXX /x/ Xxxricia P. Smith 10/12/05 ------------------------------------- MEDICAID SERVICES /s/ Xxxxxxxx X. Xxxxx 10/17/05 Xxxxxxxx X. Xxxxx Date Patricia P. Smith Director Medicare Advantage Group Center for Benefxxxxxx Xxxxxxx EMPLOYER/UNION-ONLY GROUP PART C Beneficiary Choices Contract #H5628 ADDENDUM TO MEDICARE MANAGED CARE CONTRACT WITH APPROVED ENTITY PURSUANT TO SECTIONS 1851 1860D-1 THROUGH 1859 1860D-42 OF THE SOCIAL SECURITY ACT FOR THE OPERATION OF A VOLUNTARY MEDICARE ADVANTAGE PRESCRIPTION DRUG PLAN The Centers for Medicare & Medicaid Services (hereinafter referred to as "“CMS"”) and TEXAS HEALTHSPRING IXxxxxx Healthcare of , LLCInc., a Medicare Advantage Organization managed care organization (hereinafter referred to as the "MA Organization"MA-PD Sponsor) agree to amend the contract H4513 (H5628) governing the MA Organization's MA-PD Sponsor’s operation of a Medicare Advantage Part C plan described in section Section 1851(a)(2)(A) or section 1851(a)(2)(C) of the Social Security Act (hereinafter referred to as "“the Act"), including all attachments, addenda, and amendments thereto, ”) or a Medicare cost plan to include the provisions contained in this Addendum (collectively hereinafter referred to as the "contract"), addendum under which the MA Organization shall offer Employer/Union-Only Group MA-Only Plans PD Sponsor shall operate a Voluntary Medicare Prescription Drug Plan pursuant to sections 1860D-1 through 1860D-42 (hereinafter referred to as "employer/union-only group health plans") in accordance with the waivers granted by CMS under exception of section 1857(i1860D-22 and 1860D-31) of the Act. The terms of this Addendum shall only apply to MA-only health plans offered exclusively to employers/unions. This Addendum addendum is made pursuant to Subpart L of 42 CFR Part 417 (in the case of cost plan sponsors offering a Part D benefit) and Subpart K of 42 CFR Part 422422 (in the case of an MA-PD Sponsor offering a Part C plan).

Incorporation of Applicable Addenda. All addenda checked off and initialed on the cover sheet of this contract by the MA Organization are hereby incorporated by reference. In witness whereof, the parties hereby execute this contract. FOR THE PDP SPONSOR JEFF ROTHENBERGER SR. VP & CORPORATE COO Printxx Xxxx Xxxxx /s/ Jeff Rothenberger ------------------------------------- 9/7/05 ------------------------------------- Xxte Signature TEXAS Sigxxxxxx Date HEALTHSPRING, INC. D/B/A/ HEALTHSPRING I, LLC OF MISSISSIPPI Organization 2900 NORTH LOOP WEST44 VANTAGE WAY, SUITE 1300300, HOUSTONNASHVILLE, TX 77292 TN 37228 Address FOR THE XXXXXXX CENTXXX XXX XXXXXXXX & XXXXXXXX XXXXXXXX /x/ Xxxricia P. Smith ------------------------------------- 10/12/05 ------------------------------------- Pxxxxxxx X. Xxxxx Date Patricia P. Smith Director Medicare Advantage Group Center Advanxxxx Xxxxx Xxxxxx for Benefxxxxxx Xxxxxxx Beneficiary Choices EMPLOYER/UNION-ONLY GROUP PART C ADDENDUM TO CONTRACT WITH CONTRACTWITH APPROVED ENTITY PURSUANT TO SECTIONS 1851 THROUGH 1859 OF THE SOCIAL SECURITY ACT FOR THE OPERATION OF A MEDICARE ADVANTAGE PLAN The Centers for Medicare & Medicaid Services (hereinafter referred to as "CMS") and TEXAS HEALTHSPRING, INC. D/B/A/ HEALTHSPRING I, LLCOF MISSISSIPPI, a Medicare Advantage Organization (hereinafter referred to as the "MA Organization") agree to amend the contract H4513 H4407 governing the MA Organization's operation of a Medicare Advantage plan described in section 1851(a)(2)(A) or section 1851(a)(2)(C) of the Social Security Act (hereinafter referred to as "the Act"), including all attachments, addenda, and amendments thereto, to include the provisions contained in this Addendum (collectively hereinafter referred to as the "contract"), under which the MA Organization shall offer Employer/Union-Only Group MA-Only Plans (hereinafter referred to as "employer/union-only group health plans") in accordance with the waivers granted by CMS under section 1857(i) of the Act. The terms of this Addendum shall only apply to MA-only health plans offered exclusively to employers/unions. This Addendum is made pursuant to Subpart K of 42 CFR Part 422.

Incorporation of Applicable Addenda. All addenda checked off and initialed on the cover sheet of this contract by the MA Organization are hereby incorporated by reference. In witness whereof, the parties hereby execute this contract. FOR THE PDP SPONSOR JEFF ROTHENBERGER SR. VP & CORPORATE COO Printxx Xxxx Xxxxx /s/ Jeff Rothenberger 9/7/05 ------------------------------------- Xxte MA ORGANIZATION Printed Name Title Signature TEXAS HEALTHSPRING I, LLC Date Organization 2900 NORTH LOOP WEST, SUITE 1300, HOUSTON, TX 77292 Address FOR THE XXXXXXX XXX XXXXXXXX CENTERS FOR MEDICARE & XXXXXXXX XXXXXXXX /x/ Xxxricia P. Smith 10/12/05 ------------------------------------- MEDICAID SERVICES Dxxxx X. Xxxxx Date Patricia P. Smith Acting Director Medicare Advantage Group Center for Benefxxxxxx Xxxxxxx EMPLOYER/UNION-ONLY GROUP PART C Beneficiary Choices ADDENDUM TO MEDICARE MANAGED CARE CONTRACT WITH APPROVED ENTITY PURSUANT TO SECTIONS 1851 1860D-1 THROUGH 1859 1860D-42 OF THE SOCIAL SECURITY ACT FOR THE OPERATION OF A VOLUNTARY MEDICARE ADVANTAGE PRESCRIPTION DRUG PLAN The Centers for Medicare & Medicaid Services (hereinafter referred to as "“CMS"”) and TEXAS HEALTHSPRING I, LLC, a Medicare Advantage Organization managed care organization (hereinafter referred to as the "MA Organization"MA-PD Sponsor) agree to amend the contract H4513 (INSERT “H” OR “R” NUMBER) governing the MA Organization's MA-PD Sponsor’s operation of a Medicare Advantage Part C plan described in section Section 1851(a)(2)(A) or section 1851(a)(2)(C) of the Social Security Act (hereinafter referred to as "“the Act"), including all attachments, addenda, and amendments thereto, ”) or a Medicare cost plan to include the provisions contained in this Addendum (collectively hereinafter referred to as the "contract"), addendum under which the MA Organization shall offer Employer/Union-Only Group MA-Only Plans PD Sponsor shall operate a Voluntary Medicare Prescription Drug Plan pursuant to sections 1860D-1 through 1860D-42 (hereinafter referred to as "employer/union-only group health plans") in accordance with the waivers granted by CMS under exception of section 1857(i1860D-22 and 1860D-31) of the Act. The terms of this Addendum shall only apply to MA-only health plans offered exclusively to employers/unions. This Addendum addendum is made pursuant to Subpart L of 42 CFR Part 417 (in the case of cost plan sponsors offering a Part D benefit) and Subpart K of 42 CFR Part 422422 (in the case of an MA-PD Sponsor offering a Part C plan).

Incorporation of Applicable Addenda. All addenda checked off and initialed on the cover sheet of this contract by the MA Organization are hereby incorporated by reference. In witness whereof, the parties hereby execute this contract. FOR THE PDP SPONSOR JEFF ROTHENBERGER SR. VP & CORPORATE COO Printxx Xxxx Xxxxx /s/ Jeff Rothenberger ------------------------------------- 9/7/05 ------------------------------------- Xxte Signature TEXAS Sigxxxxxx Date HEALTHSPRING IOF ALABAMA, LLC INC. Organization 2900 NORTH LOOP TWO PERIMETER CENTER PARK SOUTH, SUITE 300 WEST, SUITE 1300BIRMINGHAM, HOUSTON, TX 77292 AL 35243 Address FOR THE XXXXXXX XXX XXXXXXXX CENTERS FOR MEDICARE & XXXXXXXX XXXXXXXX /x/ Xxxricia P. Smith 10/12/05 ------------------------------------- 9/30/05 Paxxxxxx X. Xxxxx Date Patricia P. Smith Director Medicare Advantage Group Center Advanxxxx Xxxxx Xxxxxx for Benefxxxxxx Xxxxxxx EMPLOYER/UNION-ONLY GROUP PART C Beneficiary Choices ADDENDUM TO MEDICARE MANAGED CARE CONTRACT WITH APPROVED ENTITY PURSUANT TO SECTIONS 1851 1860D-1 THROUGH 1859 1860D-42 OF THE SOCIAL SECURITY ACT FOR THE OPERATION OF A VOLUNTARY MEDICARE ADVANTAGE PRESCRIPTION DRUG PLAN The Centers for Medicare & Medicaid Services (hereinafter referred to as "CMS") and TEXAS HEALTHSPRING IOF ALABAMA, LLCINC., a Medicare Advantage Organization managed care organization (hereinafter referred to as the "MA Organization"MA-PD Sponsor) agree to amend the contract H4513 (H0150) governing the MA OrganizationMA-PD Sponsor's operation of a Medicare Advantage Part C plan described in section Section 1851(a)(2)(A) or section 1851(a)(2)(C) of the Social Security Act (hereinafter referred to as "the Act"), including all attachments, addenda, and amendments thereto, ) or a Medicare cost plan to include the provisions contained in this Addendum (collectively hereinafter referred to as the "contract"), addendum under which the MA Organization shall offer Employer/Union-Only Group MA-Only Plans PD Sponsor shall operate a Voluntary Medicare Prescription Drug Plan pursuant to sections 1860D-1 through 1860D-42 (hereinafter referred to as "employer/union-only group health plans") in accordance with the waivers granted by CMS under exception of section 1857(i1860D-22 and 1860D-31) of the Act. The terms of this Addendum shall only apply to MA-only health plans offered exclusively to employers/unions. This Addendum addendum is made pursuant to Subpart L of 42 CFR Part 417 (in the case of cost plan sponsors offering a Part D benefit) and Subpart K of 42 CFR Part 422422 (in the case of an MA-PD Sponsor offering a Part C plan).