STOCK PURCHASE AGREEMENT between HUMANA MEDICAL PLAN, INC. and METROPOLITAN HEALTH NETWORKS, INC. June 27, 2008
between
HUMANA
MEDICAL PLAN, INC.
and
METROPOLITAN
HEALTH NETWORKS, INC.
June
27, 2008
TABLE
OF CONTENTS
Page
|
|||
1.
|
DEFINITIONS |
1
|
|
2.
|
SALE AND TRANSFER OF SHARES; CONSIDERATION; CLOSING |
1
|
|
2.1
|
Purchase
and Sale
|
1
|
|
2.2
|
Purchase
Price; Payment at Closing
|
1
|
|
2.3
|
Reductions
Notice
|
2
|
|
2.4
|
Estimated
Excess Net Equity
|
2
|
|
2.5
|
Net
Equity Adjustment Amount; Final Determination of Purchase
Price
|
2
|
|
2.6
|
CMS
Adjustments and Medicare Risk Adjustments
|
5
|
|
2.7
|
Closing
Date
|
7
|
|
2.8
|
Escrow
Fund
|
7
|
|
2.9
|
Section
338(h)(10) Election
|
8
|
|
2.10
|
Items
to be Delivered by Seller at Closing
|
8
|
|
2.11
|
Items
to be Delivered by Purchaser at Closing
|
9
|
|
3.
|
REPRESENTATIONS AND WARRANTIES OF SELLER |
10
|
|
3.1
|
Authorization
|
10
|
|
3.2
|
Binding
Agreement
|
10
|
|
3.3
|
Organization
and Good Standing
|
10
|
|
3.4
|
No
Violation; Consents
|
11
|
|
3.5
|
Capitalization
|
11
|
|
3.6
|
Financial
and Statutory Statements
|
12
|
|
3.7
|
Undisclosed
Liabilities
|
13
|
|
3.8
|
General
Compliance With Laws
|
13
|
|
3.9
|
Insurance
Business and other Governmental and Healthcare Matters
|
13
|
|
3.10
|
Regulatory
Filings and Reports; Accreditation
|
17
|
|
3.11
|
Title
|
17
|
|
3.12
|
Legal
Proceedings
|
17
|
|
3.13
|
Insurance
|
18
|
|
3.14
|
Taxes
|
18
|
|
3.15
|
Intellectual
Property
|
20
|
|
3.16
|
Environmental
|
21
|
-i-
TABLE
OF CONTENTS
(continued)
Page
|
|||
3.17
|
Good
Title, Operating Condition
|
22
|
|
3.18
|
Real
Property; Leases
|
22
|
|
3.19
|
Material
Agreements
|
23
|
|
3.20
|
Providers
and Provider Contracts
|
24
|
|
3.21
|
Employee;
Labor Relations
|
25
|
|
3.22
|
Absence
of Certain Changes or Events
|
26
|
|
3.23
|
Employee
Benefit Plans; ERISA
|
28
|
|
3.24
|
Certain
Business Relationships
|
30
|
|
3.25
|
Accounts
Receivables
|
30
|
|
3.26
|
Relations
and Members
|
30
|
|
3.27
|
Terrorism
Compliance
|
30
|
|
3.28
|
Guarantees
|
30
|
|
3.29
|
Banks
and Depositories
|
31
|
|
3.30
|
Limitation
on Use of Funds
|
31
|
|
3.31
|
Books
and Records
|
31
|
|
3.32
|
Brokers’
Fees
|
31
|
|
4.
|
REPRESENTATIONS AND WARRANTIES OF PURCHASER |
31
|
|
4.1
|
Authorization
|
31
|
|
4.2
|
Binding
Agreement
|
31
|
|
4.3
|
Organization
and Good Standing
|
32
|
|
4.4
|
No
Violation
|
32
|
|
4.5
|
Investment
Representations
|
32
|
|
4.6
|
Restricted
Securities
|
32
|
|
4.7
|
Brokers’
Fees
|
33
|
|
4.8
|
Financing
|
33
|
|
5.
|
PRE-CLOSING COVENANTS |
33
|
|
5.1
|
Access
and Information; Inspections
|
33
|
|
5.2
|
Conduct
of Business
|
34
|
|
5.3
|
Negative
Covenants of Seller
|
34
|
|
5.4
|
No-Shop
|
36
|
-ii-
TABLE
OF CONTENTS
(continued)
Page
|
|||
5.5
|
Efforts
to Close
|
36
|
|
5.6
|
Confidentiality
|
37
|
|
5.7
|
Required
Governmental Approvals
|
37
|
|
5.8
|
Transactions
with Affiliates
|
37
|
|
5.9
|
Certain
Notifications Required
|
38
|
|
5.10
|
Insurance
|
38
|
|
6.
|
POST-CLOSING COVENANTS |
39
|
|
6.1
|
Non-solicitation
|
39
|
|
6.2
|
Non-competition;
Non-solicitation of Members or Providers
|
39
|
|
6.3
|
Employee
Matters
|
40
|
|
6.4
|
Use
of Name and Trademarks
|
42
|
|
6.5
|
Tax
Matters
|
43
|
|
6.6
|
IT
Transition Costs
|
44
|
|
7.
|
CONDITIONS PRECEDENT TO OBLIGATIONS OF SELLER |
45
|
|
7.1
|
Unfavorable
Action or Proceeding
|
45
|
|
7.2
|
Performance
of Covenants
|
45
|
|
7.3
|
Governmental
Authorizations
|
45
|
|
7.4
|
Seller
Third Party Consents
|
45
|
|
7.5
|
Purchase
Price
|
45
|
|
7.6
|
Warranties
True and Correct
|
45
|
|
7.7
|
MHP
Provider Agreement
|
46
|
|
7.8
|
Bring
Down
|
46
|
|
8.
|
CONDITIONS PRECEDENT TO OBLIGATIONS OF PURCHASER |
46
|
|
8.1
|
Unfavorable
Action or Proceeding
|
46
|
|
8.2
|
Performance
of Covenants
|
46
|
|
8.3
|
Governmental
Authorizations
|
46
|
|
8.4
|
Purchaser
Third Party Consents
|
46
|
|
8.5
|
Representations
and Warranties True and Correct
|
47
|
|
8.6
|
Bring
Down
|
47
|
|
8.7
|
MHP
Provider Agreement
|
47
|
-iii-
TABLE
OF CONTENTS
(continued)
Page
|
|||
8.8
|
Material
Adverse Effect
|
47
|
|
9.
|
TERMINATION |
47
|
|
9.1
|
Termination
|
48
|
|
9.2
|
Termination
Consequences
|
48
|
|
10.
|
SURVIVAL AND INDEMNIFICATION |
48
|
|
10.1
|
Survival;
Claims for Indemnification
|
48
|
|
10.2
|
Indemnification
|
49
|
|
10.3
|
Claims
|
51
|
|
10.4
|
Reduction
for Insurance
|
52
|
|
10.5
|
Exclusive
Remedy
|
52
|
|
10.6
|
Additional
Limitations on Recourse
|
52
|
|
11.
|
MISCELLANEOUS PROVISIONS |
53
|
|
11.1
|
Further
Assurances and Cooperation
|
53
|
|
11.2
|
Successors
and Assigns
|
53
|
|
11.3
|
Governing
Law; Venue
|
53
|
|
11.4
|
Amendments
|
53
|
|
11.5
|
Exhibits,
Schedules and Disclosure Schedule
|
53
|
|
11.6
|
Notices
|
53
|
|
11.7
|
Headings
|
54
|
|
11.8
|
Confidentiality
and Publicity; Press Releases
|
54
|
|
11.9
|
Gender
and Number; Construction
|
55
|
|
11.10
|
Third
Party Beneficiary
|
55
|
|
11.11
|
Expenses
and Attorneys’ Fees
|
55
|
|
11.12
|
Counterparts
|
55
|
|
11.13
|
Entire
Agreement
|
56
|
|
11.14
|
No
Waiver
|
56
|
|
11.15
|
Severability
|
56
|
|
11.16
|
Time
is of the Essence
|
56
|
-iv-
LIST
OF EXHIBITS
Description
|
Exhibit
|
Illustration
of Net Equity Adjustment Amount Determination
|
A
|
Escrow
Agreement
|
B
|
Release
of Claims Agreement
|
C
|
Form
of Agreement Not to Compete or Solicit
|
D
|
Form
of Occupancy and Operational License
|
E
|
MHP
Provider Agreements
|
F
|
-v-
LIST
OF SCHEDULES
Description
|
Schedule
|
Material
Contracts Requiring Consent
|
3.4(a)
|
Certain
Material Contracts and Governmental Authorizations Requiring
Notice
|
3.4(b)
|
Financial
Statements
|
3.6(a)
|
Statutory
Statements
|
3.6(b)
|
Certain
Reinsurance Contracts
|
3.6(c)
|
Undisclosed
Liabilities
|
3.7
|
Healthcare
Governmental Authorizations/Service Areas
|
3.9(a)
|
Governmental
Contracts
|
3.9(b)
|
Healthcare
Enrollment Forms
|
3.9(g)
|
Certain
Healthcare Members
|
3.9(h)
|
Reinsurance
Contracts
|
3.9(i)
|
Broker
Contracts
|
3.9(j)
|
Lag
Reports
|
3.9(k)
|
Compliance
with Medicare/Medicaid
|
3.9(l)
|
Delinquent
Regulatory Filings
|
3.10(a)
|
Legal
Proceedings
|
3.12
|
Insurance
Policies
|
3.13(a)
|
Available
Tail Coverage
|
3.13(b)
|
Tax
Sharing Agreements
|
3.14(h)
|
Taxing
Authority Audits
|
3.14(j)
|
Intellectual
Property
|
3.15(a)
|
Needed
Intellectual Property
|
3.15(b)
|
Intellectual
Property Licenses
|
3.15(d)
|
Actions
to Perfect Intellectual Property
|
3.15(e)
|
Environmental
|
3.16
|
Good
Title
|
3.17
|
Real
Property Leases
|
3.18
|
Material
Agreements
|
3.19
|
Provider
Contracts
|
3.20(a)
|
Provider
Contract Liabilities
|
3.20(b)
|
Provider
Contracts with Extraordinary Payments
|
3.20(c)
|
Provider
Contract Defaults and Breaches
|
3.20(d)
|
Current
Employees
|
3.21(a)
|
Labor
Practices
|
3.21(c)
|
Employment
Contracts; Loans to Employees
|
3.21(d)
|
Absence
of Certain Changes or Events
|
3.22
|
Employee
Benefit Plans
|
3.23(a)
|
Non-Qualified
Plans/Investments in Employer Securities
|
3.23(c)
|
Retiree
or Former Employee Health or Welfare Benefits
|
3.23(f)
|
Employee
Benefit Plan Proceedings or Liens
|
3.23(k)
|
Certain
Increased Costs under Employee Benefit Plans
|
3.23(l)
|
Certain
Business Relationships
|
3.24
|
Relations
and Members
|
3.26
|
-vi-
Guarantees
|
3.28
|
Banks
and Depositories
|
3.29
|
Brokers’
Fees
|
3.32
|
No
Violation
|
4.4
|
Debt
Cancellation
|
5.3(m)
|
Transactions
with Affiliates
|
5.8
|
Executive
List for Agreement Not to Compete or Solicit
|
6.2(h)
|
Designated
Employees for Termination
|
6.3(b)
|
Employment
Contracts for Termination
|
6.3(c)
|
Required
Non-Governmental Consents for Closing
|
8.4
|
-vii-
TABLE
OF DEFINED TERMS
Term
Section
|
|
Action
or Proceeding
|
Appendix
|
Actual
Excess Net Equity
|
2.5
|
Acquisition
Balance Sheet
|
3.6(a)
|
Advisors
|
Appendix
|
Affiliate
|
Appendix
|
Agency
Audit
|
Appendix
|
Agreement
|
Preamble
|
AHCA
|
Appendix
|
Annual
Financial Statements
|
3.6(a)
|
Annual
Statement
|
3.6(b)
|
Applicable
Rate
|
Appendix
|
Audit
Reports
|
3.10(a)
|
Base
Purchase Price
|
2.2
|
Basket
Amount
|
10.2(c)
|
Broker
Contracts
|
3.9(j)
|
Business
|
Appendix
|
Business
Day
|
Appendix
|
Cap
|
10.2(d)
|
Claims
Settlement Period
|
Appendix
|
Closing
Net Equity
|
Appendix
|
CMS
|
Appendix
|
CMS
Part D Payment Reconciliation
|
Appendix
|
CERCLA
|
3.16(a)
|
Charter
Documents
|
3.3
|
Closing
|
2.7
|
Closing
Balance Sheet
|
2.4
|
Closing
Date
|
2.7
|
COBRA
|
Appendix
|
Code
|
Appendix
|
Company
|
Recitals
|
Company
Employees
|
6.3
|
Competitive
Business Activity
|
6.2(a)
|
Completion
Amount
|
Appendix
|
Confidential
Information
|
Appendix
|
Contract
or Agreement
|
Appendix
|
Current
Employees
|
3.21(a)
|
Determination
|
2.5(a)
|
DB
Plan
|
Appendix
|
Deferred
Compensation Plan
|
Appendix
|
Effective
Date
|
Preamble
|
Effective
Time
|
2.7
|
Election
|
2.9(a)
|
Enrollment
Forms
|
Appendix
|
-viii-
ERISA
|
Appendix
|
ERISA
Affiliate
|
Appendix
|
Escrow
Agent
|
Appendix
|
Escrow
Agreement
|
Appendix
|
Escrow
Fund
|
Appendix
|
Estimated
Excess Net Equity
|
2.4
|
Estimated
Net Equity
|
Appendix
|
Exchange
Act
|
11.8
|
Federal
HMO Act
|
Appendix
|
Financial
Statements
|
3.6(a)
|
GAAP
|
Appendix
|
Governmental
Authorization
|
Appendix
|
Governmental
Authority
|
Appendix
|
Government
Contracts
|
3.9(b)
|
Hazardous
Materials
|
3.16(a)
|
Health
Benefit Laws
|
Appendix
|
Health
Benefit Plan
|
Appendix
|
HealthFirst
|
6.6
|
HIPAA
|
Appendix
|
Indemnitee
|
10.3(a)
|
Indemnitors
|
10.3(a)
|
Independent
Accountant
|
2.5(a)
|
Intellectual
Property
|
3.15(a)
|
Interim
Statement
|
3.6(b)
|
IPA
Agreement
|
6.2(g)
|
Knowledge
|
Appendix
|
Laws
|
Appendix
|
Leases
|
3.18
|
Liabilities
|
Appendix
|
License
Agreement
|
2.9(j)
|
Lien
|
Appendix
|
Loss
or Losses
|
10.2(a)
|
MAE
Notice
|
5.9
|
Material
Adverse Effect
|
Appendix
|
Material
Agreement
|
3.19
|
Medicaid
|
Appendix
|
Medicare
|
Appendix
|
Medicare
Advantage Contracts
|
Appendix
|
Medicare
Advantage Program
|
Appendix
|
Medicare
Risk Payments
|
2.6(b)
|
Member
|
Appendix
|
Member
Months
|
2.6(a)
|
MHP
Closing Costs
|
Appendix
|
MHP
Provider Agreements
|
Appendix
|
Most
Recent Balance Sheet
|
Appendix
|
Most
Recent Financial Statements
|
3.6(a)
|
-ix-
MRA
Determination Date
|
2.6(b)
|
MRA
Pro Rata Portion
|
2.6(b)
|
Multiemployer
Plan
|
Appendix
|
Net
Equity
|
Appendix
|
Net
Equity Adjustment Amount
|
2.5
|
OIR
|
Appendix
|
Order
|
Appendix
|
Ordinary
Course of Business
|
Appendix
|
Part
D Determination Date
|
2.6(a)
|
Part
D Reconciliations
|
2.6(a)
|
Parties
|
Preamble
|
Party
|
Preamble
|
PBGC
|
Appendix
|
Pension
Plan
|
Appendix
|
Permitted
Liens
|
Appendix
|
Person
|
Appendix
|
Pre-Closing
Tax Deficiency
|
Appendix
|
Pre-Closing
Taxes
|
Appendix
|
Pre-Closing
Tax Period
|
Appendix
|
Provider
Contracts
|
3.20(a)
|
Pro
Rata Portion
|
2.6(a)
|
Purchase
Price
|
2.2
|
Purchase
Price Allocation
|
2.9(a)
|
Purchaser
|
Preamble
|
Purchaser
Indemnified Parties
|
10.2(a)
|
Purchaser
Officer’s Certificate
|
7.8
|
Purchaser
Third Party Consents
|
8.4
|
Purchaser
MRA Determination
|
2.6(b)
|
Purchaser
Part D Determination
|
2.6(a)
|
Quarterly
Statement
|
3.6(b)
|
Real
Property
|
3.18
|
Recalculated
Net Equity
|
2.5(a)
|
Reconciliation
Year 0000
|
Xxxxxxxx
|
Reductions
Notice
|
2.3
|
Regulatory
Filings
|
3.10(a)
|
Reinsurance
Contracts
|
3.9(i)
|
Related
Agreement
|
3.1
|
Restricted
Securities
|
4.6
|
Routine
Communications
|
6.4
|
Sale
|
2.1
|
SAP
|
Appendix
|
Securities
Act
|
3.5
|
Seller
|
Preamble
|
Seller
Indemnified Parties
|
10.2(b)
|
Seller
Officer Certificate
|
8.6
|
Seller
MRA Determination
|
2.6(b)
|
-x-
Seller
Part D Determination
|
2.6(a)
|
Seller
Plan
|
Appendix
|
Seller
Third Party Consents
|
7.4
|
Service
Areas
|
3.9(a)
|
Shares
|
Recitals
|
Specified
Agreements
|
3.19
|
Specified
Proceedings
|
10.2(a)
|
Statutory
Statements
|
3.6(b)
|
Straddle
Period
|
Appendix
|
Straddle
Period Taxes
|
Appendix
|
Statutory
Surplus
|
Appendix
|
Subsidiary
|
Appendix
|
Targeted
Net Equity
|
2.4
|
Tax
|
3.14
|
Taxes
|
3.14
|
Taxing
Authority
|
3.14
|
Tax
Return
|
3.14
|
Termination
Date
|
9.1(b)
|
Third
Party Claim
|
10.3(a)
|
Transactional
Representations and Warranties
|
10.1(a)
|
Transition
Date
|
6.6
|
UR
|
3.9(a)
|
VEBA
|
Appendix
|
WARN
|
6.3
|
Welfare
Plan
|
Appendix
|
-xi-
This
Stock Purchase Agreement
(this
“Agreement”)
is
made and entered into as of the 27th day of June, 2008 (the “Effective
Date”),
by
Humana
Medical Plan, Inc.,
a
Florida corporation (“Purchaser”),
and
Metropolitan
Health Networks, Inc.,
a
Florida corporation (“Seller”).
Purchaser and Seller are sometimes hereinafter referred to individually as
“Party”
and
collectively as “Parties.”
RECITALS:
A. Seller
is
the record and beneficial owner of 18,100,201 shares of outstanding common
stock, having a par value of $0.001 per share (the “Shares”),
of
Metcare Health Plans, Inc., a Florida corporation (the “Company”),
representing all of the outstanding capital stock of the Company.
B. Purchaser
desires to purchase from Seller, and Seller desires to sell to Purchaser, all
of
Seller’s right, title and interest in and to the Shares, for the consideration
and on the terms and subject to the conditions set forth in this
Agreement.
AGREEMENT:
NOW,
THEREFORE,
in
consideration of the foregoing premises and the mutual promises and covenants
contained in this Agreement, and for other good and valuable consideration,
the
receipt and sufficiency of which are hereby acknowledged, the Parties hereby
agree as follows:
1.
Definitions. In
addition to the terms defined in this Agreement, certain other terms used in
this Agreement are defined in the Appendix attached hereto, and, when used
herein, shall have the meaning set forth in the Appendix, which is incorporated
herein by reference.
2.
Sale and Transfer of Shares; Consideration; Closing.
2.1
Purchase and Sale.
Upon
terms and subject to the conditions in this Agreement, at the Closing (defined
in Section 2.7),
Seller
shall sell, transfer, assign, and convey to Purchaser, and Purchaser shall
purchase and acquire from Seller, all of Seller’s right, title and interest in
and to the Shares, free and clear of all Liens, in exchange for the payment
and
delivery by Purchaser of the Purchase Price (defined in Section 2.2)
in
accordance with Section 2.2
(the
“Sale”).
2.2 Purchase
Price; Payment at Closing.
Upon
the terms and subject to the conditions in this Agreement, and in consideration
for the Sale, Purchaser shall pay and deliver to Seller an amount equal to
the
sum of (a) Fourteen Million dollars ($14,000,000.00), (the “Base
Purchase Price”);
and
(b) the Estimated Excess Net Equity (collectively with the Base Purchase Price,
the “Preliminary
Purchase Price”).
The
Preliminary Purchase Price shall be subject to post-closing adjustment by the
Net Equity Adjustment Amount (defined in Section 2.5)
in
accordance with Section 2.5,
the
additional post-closing CMS Part D adjustments as set forth below in Section
2.6(a)
and
the additional post-closing Medicare Risk adjustments as set forth below in
Section 2.6(b) (the Preliminary Purchase Price, as so adjusted, is referred
to
herein as the “Purchase
Price”).
At
Closing, Purchaser shall cause the Preliminary Purchase Price to be paid to
Seller as follows: (i) One Million Four Hundred Thousand dollars
($1,400,000.00),
representing the Escrow Fund to be deposited with Escrow Agent pursuant to
this
Agreement, shall be wire transferred by Purchaser to Escrow Agent to an account
designated by Escrow Agent for receipt thereof; and (ii) the balance of the
Preliminary Purchase Price shall be wire transferred by Purchaser to Seller
to
an account designated by Seller for receipt thereof.
-1-
2.3
Reductions Notice.
At or
prior to the Closing, Seller shall cause the Company to deliver to Purchaser
a
written notice (the “Reductions
Notice”)
setting forth the amount of the MHP Closing Costs, together with (i) the persons
or entities to whom such payments are to be made, if applicable, and (ii) wire
transfer instructions for the recipients of such payments, if
applicable. Purchaser
shall cause the Company to pay in full all MHP Closing Costs in accordance
with
the Reductions Notice.
Notwithstanding anything to the contrary set forth in Section 2.2,
the
Parties hereby acknowledge and agree that the MHP Closing Costs are the sole
responsibility of the Company and that none of the MHP Closing Costs shall
be
deemed to have been assumed by Purchaser, nor shall the payment of the MHP
Closing Costs in accordance with this Section 2.3
be
deemed consideration for the Sale or other transactions contemplated by this
Agreement.
2.4
Estimated
Excess Net Equity.
Within
ten (10) Business Days of the Closing Date, and in no event less than five
(5)
Business Days prior to the Closing Date, Seller shall cause the Company to
deliver to Purchaser a certificate, signed by the Chief Financial Officer of
the
Company, setting forth the excess, if any, as of the Effective Time (the
“Estimated
Excess Net Equity”)
of (i)
the Estimated Net Equity over (ii) $4,500,000 (the “Targeted
Net Equity”).
The
certificate provided for herein shall be accompanied by an unaudited balance
sheet of the Company as of the last calendar day of the month which is two
months prior to the month during which the Effective Time occurs (which amount
is intended to be a reasonable estimate of the Company’s Net Equity as of the
Effective Time) (the “Closing
Balance Sheet”),
prepared in accordance with SAP, including financial information and other
documentation that supports the Company’s determination of the Estimated Excess
Net Equity.
By way
of example, if the Effective Time is September 30, 2008, the Closing Balance
Sheet shall be dated as of July 31, 2008.
2.5
Net
Equity Adjustment Amount; Final Determination of Purchase
Price.
This
Section 2.5
sets
forth the procedure for final determination of the amount of any adjustment,
which amount may be positive or negative, to the Preliminary Purchase Price
for
any difference between (i) the Actual Excess Net Equity (defined below) and
(ii)
the Estimated Excess Net Equity (the “Net
Equity Adjustment Amount”).
For
purposes hereof, “Actual
Excess Net Equity”
shall
mean the excess, if any, as of the Effective Time of Closing Net Equity over
the
Targeted Net Equity. The Preliminary Purchase Price shall be increased by the
absolute value of the Net Equity Adjustment Amount if (i) the Actual Excess
Net
Equity exceeds (ii) the Estimated Excess Net Equity, and shall be decreased
by
the absolute value of the Net Equity Adjustment Amount if (i) the Estimated
Excess Net Equity exceeds (ii) the Actual Excess Net Equity. The Preliminary
Purchase Price, as so adjusted, shall constitute the Purchase Price for purposes
of this Agreement.
-2-
(a)
Within
thirty (30) days following expiration of the Claims Settlement Period, Purchaser
shall prepare and deliver to Seller its written determination (the “Purchaser Determination”)
of the
Company’s Closing Net Equity (the “Recalculated
Net Equity”),
including the basis for such Purchaser Determination. If, within thirty (30)
days after receipt by Seller of the Purchaser Determination, Seller shall not
have given notice to Purchaser setting forth any objection of Seller to the
Purchaser Determination, then the Recalculated Net Equity as set forth in the
Purchaser Determination shall be deemed to be the Closing Net Equity for the
purposes set forth in this Agreement. Any notice of objection shall specifically
(i) state those items or amounts to which Seller objects, (ii) set forth
Seller’s calculation of the Company’s Closing Net Equity (the “Seller
Determination”),
and
(iii) set forth the basis for Seller’s position as to the items or amounts to
which Seller objects, provided, however, that Seller shall not raise as an
objection the existence of any item in the Purchaser Determination, or the
absence of any item in the Purchaser Determination, to the extent that the
existence of such item, or the absence of such item, is accounted for in a
manner consistent with the accounting for such item in the Estimated Net Equity,
unless Purchaser’s adjustments to the Purchaser Determination affect the
accounting of such item or the accounting for such item in the Closing Net
Equity is by definition different than the accounting for such item in the
Estimated Net Equity. Seller shall be deemed to have agreed with all items
and
amounts contained in the Purchaser Determination to which Seller does not
provide specific notice of objection or Seller’s basis for such objection. In
the event Seller gives notice of any objection to such Purchaser Determination
within such thirty (30) day period, Purchaser and Seller shall use all
reasonable efforts to resolve the dispute within thirty (30) days following
the
receipt by Purchaser of such notice from Seller. If Purchaser and Seller are
unable to reach an agreement within such thirty (30) day period as to the
disputed items or amounts, then such disputed items or amounts shall be
submitted to KPMG LLP, certified public accountants (the “Independent
Accountant”),
for
determination. The Independent Accountant shall consider only those items or
amounts that Seller has properly stated in its notice of objection. Each Party
shall be entitled to submit a brief position paper to the Independent
Accountant, not to exceed ten (10) pages in length, setting forth such relevant
information as such Party believes will assist the Independent Accountant in
resolving the dispute, such paper to be submitted within ten (10) days following
the date the matter is submitted to the Independent Accountant. The Independent
Accountant shall deliver to Seller and Purchaser, as promptly as practicable
(but in any case no later than thirty (30) days following the date of delivery
of the position papers to the Independent Accountant), a report (reasonably
detailed in explanation) setting forth its determination as to the disputed
items or amounts and its calculation of the Closing Net Equity, which the
Independent Accountant shall calculate in accordance with SAP except to the
extent such principles are specifically modified by terms of this Agreement.
Such determination shall be final and binding upon the Parties. In the event
that the difference between the Seller Determination and the Purchaser
Determination (the “Disputed
Amount”)
is
less than $50,000, Purchaser shall pay 50%, and Seller shall pay 50%, of the
fees and expenses of the Independent Accountant.
In the
event that the Disputed Amount is equal to or greater than $50,000, (i) Seller
shall pay 100% of the fees and expenses of the Independent Accountant if the
Purchaser Determination is closer in amount to the Closing Net Equity determined
by the Independent Accountant than the Seller Determination; and (ii) Purchaser
shall pay 100% of the fees and expenses of the Independent Accountant if the
Seller Determination is closer in amount to the Closing Net Equity determined
by
the Independent Accountant than the Purchaser Determination.
-3-
(b)
Seller
and Purchaser shall, and shall cause their respective Advisors to, cooperate
with and assist one another in the determination of the Closing Net Equity,
including the making available to each other and to the Independent Accountant,
at reasonable times and upon reasonable advance notice to the extent necessary,
of books, records, work papers and personnel.
(c)
Upon
final determination of the Closing Net Equity in accordance with this Section
2.5,
Seller
or Purchaser, as appropriate, shall cause the Net Equity Adjustment Amount
that
remains due and owing to Purchaser, on the one hand, or Seller, on the other
hand, to be promptly paid in accordance with the terms set forth below in this
Section 2.5(c).
(1)
If the
Actual Excess Net Equity as finally determined pursuant hereto is less than
the
Estimated Excess Net Equity, Seller shall issue written instructions to Escrow
Agent to make payment to Purchaser from the Escrow Fund in an amount equal
to
the Net Equity Adjustment Amount together with interest thereon (determined
as
provided below).
In any
event, Seller shall be liable to Purchaser for any deficiency (together with
interest) due Purchaser hereunder and, if any amount remains due and owing
to
Purchaser after Purchaser has first pursued satisfaction of such deficiency
against the Escrow Fund, Seller shall promptly reimburse and pay to Purchaser
in
cash any such deficiency amount together with interest thereon.
(2)
If the
Actual Excess Net Equity as finally determined pursuant hereto is greater than
the Estimated Excess Net Equity, Purchaser shall promptly pay in cash to Seller
the Net Equity Adjustment Amount together with interest thereon (determined
as
provided below).
(3)
Any
payment to be made by Purchaser or Seller pursuant to this Section 2.5(c)
shall be
made by wire transfer of immediately available funds and shall bear interest
from the Closing Date until satisfaction, but excluding the date of payment,
at
the Applicable Rate. Such interest shall be payable at the same time as the
payment to which it relates and shall be calculated daily on the basis of a
year
of three hundred sixty five (365) days and the actual number of days
elapsed.
Attached
hereto as Exhibit
A
is an
illustration of the determination of the Net Equity Adjustment
Amount.
-4-
2.6
CMS Adjustments and Medicare Risk Adjustments.
(a) On
or
prior to December 31, 2009 (as such date may be adjusted as described below,
the
“Part
D Determination Date”):
(a)
Purchaser shall reconcile (i) the CMS Part D Payment Reconciliation (including
Risk Sharing, Low Income Cost Subsidy, Reinsurance Subsidy and Budget
Neutrality) for services provided prior to the Effective Time to the
corresponding amounts recorded in the final determination of Closing Net Equity
as determined in accordance with Section 2.5 ; and (ii) the amounts
Payable/Receivable related to the CMS Part D, Plan to Plan Reconciliation for
services provided prior to the Effective Time to the corresponding amounts
recorded in the final determination of Closing Net Equity as determined in
accordance with Section 2.5 (collectively, the “Part
D Reconciliations”).
For
purposes of such reconciliation, Seller shall be allocated Seller’s Pro Rata
Portion (defined below) of the Part D Reconciliations. Seller’s “Pro
Rata Portion”
shall
equal (i) for Part D Reconciliations that relate to services provided in years
prior to 2008, 100% and (ii) for Part D Reconciliations that relate to services
provided in 2008, the ratio of the aggregate number of months of healthcare
service the Company provided Members of its Medicare Advantage Plans
(“Member
Months”)
during
the period commencing on January 1, 2008 and ending at the Effective Time to
the
aggregate number of Member Months during the period commencing on January 1,
2008 and ending on the end date of the period covered by the Part D
Reconciliation in 2008. In the event that CMS has not finally determined the
CMS
Part D Payment Reconciliation and/or the amounts Payable/Receivable related
to
the CMS Part D, Plan to Plan Reconciliation to the Company for services provided
by the Company in 2008 by the Part D Determination Date, the Part D
Determination Date shall be extended to the date that is ten (10) Business
Days
following the later of the date CMS provides notice to the Company of the final
determination of the CMS Part D Payment Reconciliation and the date CMS provides
notice to the Company of the amounts Payable/Receivable related to the CMS
Part
D, Plan to Plan Reconciliation. Within ten (10) Business Days of the Part D
Determination Date, Purchaser shall prepare and deliver to Seller its final
determination of the Part D Reconciliations and supporting documentation to
Seller (the “Purchaser
Part D Determination”).
If,
within thirty (30) Business Days after receipt by Purchaser of the Purchaser
Part D Determination, Seller shall not have given notice to Purchaser setting
forth any objection to the Purchaser Part D Determination, then the amounts
as
set forth in the Purchaser Part D Determination shall be deemed to be final.
Any
notice of objection shall specifically set forth Seller’s calculation of the
Part D Reconciliations (the “Seller
Part D Determination”).
In
the event Seller gives notice of any objection to such Purchaser Part D
Determination within such thirty (30) Business Day period, Purchaser and Seller
shall use all reasonable efforts to resolve the dispute within thirty (30)
days
following the receipt by Purchaser of such notice from Seller. If Purchaser
and
Seller are unable to reach an agreement within such thirty (30) day period
as to
the disputed amounts, then such disputed amounts shall be submitted to the
Independent Accountant for determination, which the Independent Accountant
shall
calculate in accordance with SAP except to the extent such principles are
specifically modified by terms of this Agreement. The Independent Accountant
shall deliver to Seller and Purchaser, as promptly as practicable (but in any
case no later than thirty (30) days following the date of delivery of the
disputed amounts to the Independent Accountant), a report (reasonably detailed
in explanation) setting forth its determination as to the Part D
Reconciliations. Such determination shall be final and binding upon the Parties.
In the event that the difference between the Seller Part D Determination and
the
Purchaser Part D Determination (the “Disputed
Part D Amount”)
is
less than $50,000, Purchaser shall pay 50%, and Seller shall pay 50%, of the
fees and expenses of the Independent Accountant. In the event that the Disputed
Part D Amount is equal to or greater than $50,000, (i) Seller shall pay 100%
of
the fees and expenses of the Independent Accountant if the Purchaser Part D
Determination is closer in amount to the Part D Reconciliations determined
by
the Independent Accountant than the Seller Part D Determination; and (ii)
Purchaser shall pay 100% of the fees and expenses of the Independent Accountant
if the Seller Part D Determination is closer in amount to the Part D
Reconciliations determined by the Independent Accountant than the Purchaser
Part
D Determination. The net amount of such Part D Reconciliations, as finally
determined, shall be paid by Purchaser or Seller, as applicable, by wire
transfer or delivery of other immediately available funds within five (5)
Business Days following final determination of such reconciliation.
-5-
(b) On
or
prior to December 31, 2009 (as such date may be adjusted as described below,
the
“MRA
Determination Date”),
Purchaser shall reconcile the change in Medicare payments received by the
Company (the “Medicare
Risk Payments”)
for
services provided prior to the Effective Time to the corresponding amounts
recorded in the final determination of Closing Net Equity as determined in
accordance with Section 2.5. For purposes of such reconciliation, Seller shall
be allocated Seller’s MRA Pro Rata Portion (defined below) of the Medicare Risk
Payments. Seller’s “MRA
Pro Rata Portion”
shall
equal (i) for Medicare Risk Payments that relate to services provided in years
prior to 2008, 100% and (ii) for Medicare Risk Payments that relate to services
provided in 2008, the ratio of the aggregate number of Member Months during
the
period commencing on January 1, 2008 and ending at the Effective Time to the
aggregate number of Member Months during the period covered by the CMS MRA
determination period. The excess or deficit of the Medicare Risk Payments
received versus the amounts recorded on the Closing Balance Sheet will be paid
to (excess) or received from (deficit) the Seller. In the event that CMS has
not
finally determined the amount of Medicare payments to the Company for services
provided by the Company in 2008 by the MRA Determination Date, the MRA
Determination Date shall be extended to the date that is ten (10) Business
Days
following the date CMS provides notice to the Company of such final
determination. Within ten (10) Business Days after the MRA Determination Date,
Purchaser shall prepare and deliver to Seller its final determination of the
Medicare Risk Payments and supporting documentation to Seller (the “Purchaser
MRA Determination”).
If,
within thirty (30) Business Days after receipt by Purchaser of the Purchaser
MRA
Determination, Seller shall not have given notice to Purchaser setting forth
any
objection to the Purchaser MRA Determination, then the amounts as set forth
in
the Purchaser MRA Determination shall be deemed to be final. Any notice of
objection shall specifically set forth Seller’s calculation of the Medicare Risk
Payments (the “Seller
MRA Determination”).
In
the event Seller gives notice of any objection to the Purchaser MRA
Determination within such thirty (30) Business Day period, Purchaser and Seller
shall use all reasonable efforts to resolve the dispute within thirty (30)
days
following the receipt by Purchaser of such notice from Seller. If Purchaser
and
Seller are unable to reach an agreement within such thirty (30) day period
as to
the disputed amounts, then such disputed amounts shall be submitted to the
Independent Accountant for determination, which the Independent Accountant
shall
calculate in accordance with SAP except to the extent such principles are
specifically modified by the terms of this Agreement. The Independent Accountant
shall deliver to Seller and Purchaser, as promptly as practicable (but in any
case no later than thirty (30) days following the date of delivery of the
disputed amounts to the Independent Accountant), a report (reasonably detailed
in explanation) setting forth its determination as to the Medicare Risk
Payments. Such determination shall be final and binding upon the Parties. In
the
event that the difference between the Seller MRA Determination and the Purchaser
MRA Determination (the “Disputed
MRA Amount”)
is
less than $50,000, Purchaser shall pay 50%, and Seller shall pay 50%, of the
fees and expenses of the Independent Accountant. In the event that the Disputed
MRA Amount is equal to or greater than $50,000, (i) Seller shall pay 100% of
the
fees and expenses of the Independent Accountant if the Purchaser MRA
Determination is closer in amount to the Medicare Risk Payments determined
by
the Independent Accountant than the Seller MRA Determination; and (ii) Purchaser
shall pay 100% of the fees and expenses of the Independent Accountant if the
Seller MRA Determination is closer in amount to the Medicare Risk Payments
determined by the Independent Accountant than the Purchaser MRA Determination.
The net amount of such Medicare Risk Payments, as finally determined, shall
be
paid by Purchaser or Seller, as applicable, by wire transfer or delivery of
other immediately available funds within five (5) Business Days following final
determination of such reconciliation.
-6-
2.7
Closing
Date.
Subject
to the terms and conditions set forth in Section 7
and
Section 8,
the
consummation of the transactions contemplated by this Agreement (the
“Closing”)
shall
take place at the offices of Xxxxxxxxxx Xxxx & XxXxxxxx XXXX,
0000
National City Tower, 000 Xxxxx Xxxxx Xxxxxx, Xxxxxxxxxx, XX 00000, at 10:00
a.m.
Eastern Daylight Time on the last Business Day of the calendar month in which
all of the Closing conditions set forth in Section 7
and
Section 8
hereof
(other than conditions which by their terms are required to be satisfied or
waived at the Closing) shall have been satisfied or, if permissible, waived
by
the party entitled to the benefit of the same, or on such other date or at
such
other time and place as the Parties shall mutually agree (the “Closing
Date”).
Unless otherwise mutually agreed upon by the Parties, the Closing will be
effective as of 11:59 P.M., Eastern Standard Time, on the Closing Date (the
“Effective
Time”).
Notwithstanding the order of actions taken or deliveries of the Parties set
forth below in Sections 2.10
and
2.11,
all
actions and deliveries shall be deemed to occur simultaneously and none shall
be
deemed to have been completed until each of the actions and deliveries set
forth
in Sections 2.10
and
2.11
has been
taken and completed or has been duly waived by the Party entitled to make such
waiver.
2.8
Escrow Fund.
At the
Closing, Purchaser and Seller shall enter into an Escrow Agreement with Escrow
Agent in substantially the form of Exhibit
B
attached
hereto, pursuant to which the Escrow Fund will be deposited with Escrow Agent
to
be held, invested and disbursed by Escrow Agent in accordance with the terms
of
the Escrow Agreement. The Escrow Fund, among other purposes, shall constitute
a
fund to secure payment of the following obligations of Seller:
(a)
any Net
Equity Adjustment Amount payable to Purchaser pursuant to Section 2.5(c)(1);
and
(b)
any
Losses of Purchaser as finally determined pursuant to the terms of Section
10
of this
Agreement.
All
claims relating to the obligations or matters set forth above must first be
made
against the Escrow Fund until the escrow provided for in the Escrow Agreement
terminates. On a date which is the second Business Day following the 24-month
anniversary of the Effective Time, all of the Escrow Fund less a reasonable
dollar amount reserved against the Escrow Fund for unresolved claims as of
such
date shall be disbursed from escrow to Seller. The Escrow Fund will not
terminate until all claims against the Escrow Fund have been finally determined
and the Escrow Agent disburses all of the remaining Escrow Fund in accordance
with the terms of the Escrow Agreement.
-7-
2.9 Section
338(h)(10) Election.
(a) In
connection with the Sale, the Parties shall file an election under section
338(h)(10) of the Code and under any comparable provisions of state or local
law
with respect to the purchase of the Shares (collectively called the
“Election”).
As
soon as practicable, on or after the Effective Time, the Parties will timely
file Internal Revenue Service Form 8023 and such other forms as are required
to
effect the Election. The aggregate deemed sales price with respect to the Shares
will be allocated to the assets of the Company in accordance with Section
2.9(b);
such
allocation (the “Purchase
Price Allocation”)
will
be used in filing Form 8023, 8883 and such other forms as are required in
support of the Election. The Parties shall report, on all relevant Tax Returns,
the Sale in a manner consistent with the Election. The Parties shall comply
with
all of the requirements of section 338(h)(10) of the Code. The Parties agree
to
file all relevant Tax Returns in a manner consistent with such Purchase Price
Allocation. Neither Purchaser nor Seller will take any position before any
Taxing Authority or in any judicial proceeding with respect to Income Taxes
that
is inconsistent with such mutually agreed-to allocations without the prior
written consent of the other party, in the consenting party’s sole
discretion.
(b) The
Parties will use their reasonable best efforts prior to the Closing to agree
upon a schedule setting forth the Purchase Price Allocation. If the Parties
cannot agree upon the Purchase Price Allocation prior to the Effective Time,
or
within 20 days after the Closing Date, then such disagreements shall be
submitted for final and binding resolution to the Independent
Accountant.
The
Independent Accountant shall deliver to Seller and Purchaser, as promptly as
practicable (but in any case no later than thirty (30) days following the date
of delivery of the disagreement to the Independent Accountant), a report
(reasonably detailed in explanation) setting forth its determination as to
the
Purchase Price Allocation. The costs of the Independent Accountant for its
determination of the Purchase Price Allocation shall be borne equally by Seller
and Purchaser.
2.10
Items
to be Delivered by Seller at Closing.
At or
before the Closing, Seller shall deliver to Purchaser the following, duly
executed by or on behalf of Seller or the Persons indicated below, as
appropriate:
(a)
one or
more stock certificates evidencing the Shares duly endorsed by Seller in favor
of Purchaser or accompanied by duly executed and completed stock transfers
in
favor of Purchaser, to the extent necessary to transfer and assign the Shares
to
Purchaser;
(b)
original, certified copies of the Company’s Articles of Incorporation, as
amended to date, and a certificate of good standing, or comparable status,
of
the Company, issued by the Secretary of State of the State of Florida, dated
no
earlier than a date that is fifteen (15) calendar days prior to the Closing
Date;
(c)
a
certificate of the Secretary of Seller (i) certifying as complete and in full
force and effect, as of the Effective Date, and attaching, (A) copies of the
Bylaws of Seller and (B) copies of all requisite resolutions or actions of
Seller’s Board of Directors approving the execution and delivery of this
Agreement and the consummation of the Sale and other transactions contemplated
hereby, and (ii) certifying to the incumbency and signatures of the officers
of
Seller executing this Agreement and any Related Agreement (defined in Section
3.1,
below);
-8-
(d)
the
Seller Officer’s Certificate (defined in Section 8.6);
(e)
a
Release of Claims, substantially in the form of Exhibit
C
attached
hereto;
(f)
the
Agreements Not To Compete or Solicit, substantially in the form of Exhibit
D
attached
hereto, as required by Section 6.2(h);
(g)
the
resignation of each director and each officer of the Company effective as of
the
Effective Time, in a form satisfactory to Purchaser;
(h)
all
Seller Third Party Consents (defined in Section 7.4);
(i)
binders
of insurance evidencing the continuation coverages provided for in Section
5.10;
(j)
the
license agreement for use and occupancy by the Company and its Advisors of
portions of Seller’s corporate headquarters, and equipment and furnishings
located therein, in the form of Exhibit
E
attached
hereto (the “License
Agreement”);
(k)
the
Escrow Agreement;
(l)
The MHP
Provider Agreements; and
(m)
such
other instruments, certificates, consents and consents to assignments or other
documents that are required to be delivered at the Closing pursuant to this
Agreement or that are reasonably necessary to effect the Sale and the other
transactions contemplated by this Agreement.
2.11
Items
to be Delivered by Purchaser at Closing.
At or
before the Closing, Purchaser shall deliver to Seller the following, duly
executed by or on behalf of Purchaser or the Persons indicated below, as
appropriate:
(a)
the
Preliminary Purchase Price, in accordance with Section 2.2;
(b)
the
Purchaser Officer’s Certificates (defined in Section 7.8);
(c)
a
certificate of the Secretary of Purchaser (i) certifying as complete and in
full
force and effect, as of the Closing, and attaching, all requisite resolutions
or
actions of Purchaser’s Board of Directors approving the execution and delivery
of this Agreement and the consummation of the Sale and the other transactions
contemplated hereby, and (ii) certifying to the incumbency and signatures of
the
officers of Purchaser executing this Agreement and the Related Agreements;
(d)
the
Escrow Agreement;
(e)
the
License Agreement, executed by Purchaser on behalf of the Company;
-9-
(f)
all
Purchaser Third Party Consents (defined in Section 8.4);
(g)
the
Agreements Not To Compete or Solicit, substantially in the form of Exhibit
D
attached
hereto, as required by Section 6.2(h);
(h)
the MHP
Provider Agreements; and
(i)
such
other instruments, certificates, consents or other documents that are required
to be delivered at the Closing pursuant to this Agreement or that are reasonably
necessary to carry out the transactions contemplated by this Agreement and
to
comply with the terms hereof, in each case, duly executed by or on behalf of
Purchaser or any third party (to the extent execution is required by this
Agreement or in order to make such instruments, certificates, consents, or
other
documents binding).
3.
Representations and Warranties of Seller.
Seller
hereby represents and warrants to Purchaser as follows:
3.1
Authorization.
Seller,
the Company and their Subsidiaries, if any, each has full corporate power and
authority to enter into this Agreement and each agreement, document, certificate
and instrument (each a “Related
Agreement”)
to be
executed and delivered by Seller, the Company or each such Subsidiary pursuant
to, or as contemplated by, this Agreement, to perform its obligations hereunder
and thereunder, and to consummate the Sale and the other transactions
contemplated hereunder and thereunder.
3.2
Binding Agreement.
All
corporate actions and other actions required to be taken by Seller, the Company
and their Subsidiaries, if any, to authorize the execution, delivery and
performance of this Agreement and each Related Agreement to which it is a party,
and Seller’s, the Company’s or each such Subsidiary’s obligations hereunder and
thereunder, as applicable, have been duly and properly taken or obtained by
Seller, the Company and such Subsidiary. This Agreement has been, and each
Related Agreement executed and delivered by Seller, the Company and any of
their
relevant Subsidiaries on or prior to the Closing will be, duly and validly
executed and delivered by Seller, the Company and such Subsidiaries and,
assuming the due and valid execution by Purchaser or other counterparty thereto,
constitutes a legal valid and binding obligation of Seller, the Company and
such
Subsidiaries, as applicable, enforceable against Seller, the Company and such
Subsidiaries, as applicable, in accordance with its terms.
3.3
Organization and Good Standing.
Each of
Seller and the Company is a corporation duly organized, validly existing and
in
good standing under the Laws of the State of Florida. Each of Seller and the
Company is duly qualified to do business as a foreign corporation in each
jurisdiction in which the nature of its business or the character and location
of the properties owned or leased by it makes qualification of it as a foreign
corporation necessary under applicable Laws, excepting only those jurisdictions
where failure to be so qualified would only subject Seller or the Company to
the
obligation to pay nominal filing fees or nominal penalties to be qualified
therein. The Company has the power and authority to own, operate and lease
its
properties and to carry on the Business as now conducted. Seller has delivered
to Purchaser a copy of the Company’s Articles of Incorporation, as amended to
date, certified by the Secretary of State of the State of Florida, and a copy
of
the Company’s Bylaws, as amended to date, (collectively the “Charter Documents”),
and
such documents are true, correct and complete and conform to the originals
thereof.
-10-
3.4
No
Violation; Consents.
(a) Neither
the execution and delivery by Seller, the Company or any of their Subsidiaries
of this Agreement or any Related Agreement, nor the consummation of the
transactions contemplated hereby or thereby by Seller, the Company or any such
Subsidiary, nor compliance with any of the provisions hereof or thereof by
Seller, the Company or any such Subsidiary, will: (i) violate, conflict with
or
result in a breach of any provision of the Charter Documents or the comparable
charter documents of Seller or any such Subsidiary; (ii) violate , in any
material respect, any Order or Law applicable to Seller, the Company or any
such
Subsidiary; (iii) except for those Material Agreements (defined in Section
3.19)
set forth on Schedule
3.4(a)
pursuant
to which the consent of a party other than Seller, the Company or any of their
Subsidiaries is required in connection with the consummation of the transactions
contemplated by this Agreement, conflict with, result in a breach of, constitute
a default under, result in the acceleration or material modification of, create
for any party the right to accelerate, terminate, materially modify or cancel,
or require any notice under any Material Agreement or Governmental Authorization
to which Seller, the Company or any such Subsidiary is a party or by which
Seller, the Company or any such Subsidiary is bound or to which its or their
assets are subject;
or (iv)
result in the imposition of any Lien on the Company’s assets.
(b) No
notice
to, declaration or filing with, or consent or approval of any Governmental
Authority or other third Person is required in connection with the execution
and
delivery of this Agreement or any Related Agreement by Seller, the Company
or
any Subsidiary of Seller or the Company, or for the consummation and performance
by Seller, the Company or any such Subsidiary of the Sale or any other
transactions in accordance with the terms of this Agreement or any Related
Agreement, except for: (i) the filing of a Form A Statement Regarding the
Acquisition of Control of a Domestic Insurer with the OIR and the approval
thereof by the Florida Director of Insurance and (ii) notice to or the approval
of CMS, if required and (iii) notices and/or consents required in accordance
with the Material Agreements and Governmental Authorizations set forth on
Schedule
3.4(b)
hereto.
In furtherance of the foregoing, and not in limitation thereof, Schedule
3.4(b)
sets
forth all Material Agreements and all Governmental Authorizations that require
consent upon a change of control or otherwise require consent or grant the
right
to terminate, modify or accelerate upon the Sale or the other transactions
contemplated in this Agreement or in any Related Agreement.
3.5
Capitalization.
The
authorized capital stock of the Company consists of Forty Million (40,000,000)
shares of common stock, having a par value of $0.001 per share and Ten Million
(10,000,000) shares of Preferred Stock, having a par value of $0.001 per share.
The Shares comprise all of the issued and outstanding shares of capital stock
of
the Company, and all such Shares are owned of record and beneficially by Seller,
free and clear of all Liens. There is not outstanding any options, warrants,
subscription rights, convertible debentures, exchange rights, or other
agreements or instruments for the purchase or acquisition from the Seller or
the
Company, or similar obligations of the Company to issue, or granting conversion
into, any shares of the Company’s capital stock or any other security of the
Company. All of the Shares have been duly authorized and are validly issued,
fully paid and non-assessable. None of the Shares, nor any other securities
of
the Company, was issued in violation of applicable Laws, including the
Securities Act of 1933, as amended (the “Securities
Act”),
or
any preemptive right or similar rights created by Law, Contract or the Charter
Documents. There are no voting trusts, proxies or other agreements or
understandings with respect to the voting of the Shares or any other voting
securities of the Company. The Company does not have any Subsidiaries, and,
except for securities held in the Company’s investment portfolio in the Ordinary
Course of Business, does not own any other capital stock or other equity
interest in any Person.
-11-
3.6
Financial and Statutory Statements.
(a)
Seller
has attached hereto as Schedule
3.6(a),
the
following financial statements (collectively the “Financial
Statements”):
(i)
the Company’s unaudited balance sheet and statements of income as of and for the
years ended December 31, 2006 and December 31, 2007 (collectively, the
“Annual
Financial Statements”
and
the
unaudited balance sheet as of December 31, 2007 referred to herein as the
“Acquisition
Balance Sheet”);
and
(ii) the Company’s interim, unaudited balance sheet and statement of income
(collectively, the “Most
Recent Financial Statements”)
as of
and for the four (4) month period ended April 30, 2008. The Financial Statements
were derived from the books and records regularly maintained by management
of
the Company, have been prepared in accordance with GAAP, and present fairly
in
all material respects the financial condition of the Company as of the
respective dates thereof and the results of operations of the Company for such
respective periods and do not contain any items of special or nonrecurring
nature, other than as set forth therein; provided, that, the Financial
Statements omit the statements of stockholders’ equity and cash flows, footnotes
and other presentation items required
by GAAP for complete financial statements. All adjustments (consisting of normal
recurring accruals) considered necessary for a fair presentation have been
included in the Annual Financial Statements.
(b) Seller
has further delivered to Purchaser a true and correct copy of the Company’s
audited, annual statutory-basis financial statements of the Company for the
year
ended December 31, 2007 (the “Annual Statement”),
the
quarterly statutory-basis financial statements of the Company for the quarter
ended March 31, 2008, (the “Quarterly
Statement”),
in
each case as filed with the OIR. Further, Seller has delivered to Purchaser
a
true and correct copy of the Company’s interim, unaudited balance sheet and
statement of income as of and for the four (4) month period ended April 30,
2008
(the “Interim
Statement”,
together with the Quarterly Statement and the Annual Statement, the
“Statutory Statements”).
The
financial statements included within the Statutory Statements have been prepared
in accordance with SAP, have been derived from the books and records of the
Company, and present fairly the statutory financial position of the Company
at
the respective dates thereof and the statutory results of operations and cash
flows of the Company for the periods then ended, except that the Quarterly
Statement and Interim Statement have not been audited and are subject to normal
year-end adjustments and omit footnotes and other presentation items required
by
SAP. Each of the Annual Statement and Quarterly Statement (i) complied in all
material respects with the requirements of the Florida Insurance Code as of
the
date of its filing, and (ii) was filed with or submitted to the OIR in a timely
manner on forms prescribed or permitted by the OIR at the time of the filing.
Except as set forth in Schedule
3.6(b),
no
material deficiencies have been asserted or, to the Knowledge of Seller,
threatened against the Company with respect to the Statutory Statements that
were filed with the OIR.
-12-
(c)
Notwithstanding anything set forth above in this Section 3.6:
(i) the
claims payable in the Financial Statements and Statutory Statements have been
computed on the basis of methodologies consistent with the past practices of
the
Company; and (ii) the claims payable in the Annual Financial Statements and
the
Annual Statement (x) have been computed in accordance with presently accepted
actuarial standards consistently applied and are fairly stated in accordance
with sound actuarial principles and (y) meet the requirements of any Law
applicable to such reserves. Except as set forth in Schedule
3.6(c),
all
reinsurance receivables payable under Reinsurance Contracts to which the Company
is a party represents an admitted asset or reduction of loss reserves of the
Company in the respective financial statements included in the Statutory
Statements and their carrying values have been described in conformity with
applicable Laws and SAP.
3.7
Undisclosed
Liabilities.
Except
as set forth and to the extent reflected in the Most Recent Financial
Statements, as disclosed in Schedule
3.7,
or as
disclosed in this Agreement or any other disclosure schedule attached to this
Agreement, the Company has no Liabilities (excluding contractual obligations
or
responsibilities requiring performance by the Company of a non-monetary or
non-financial nature), except as disclosed on the Most Recent Financial
Statements, and except for Liabilities (excluding contractual obligations or
responsibilities requiring performance by the Company of a non-monetary or
non-financial nature) that were incurred after the date of the balance sheet
included in the Most Recent Financial Statements in the Ordinary Course of
Business, all of which have been reflected on the regular books of account
of
the Company or have been discharged or paid in full. The
Company does not have any indebtedness for money borrowed from a financial
institution or other commercial lender other than as disclosed in the balance
sheet set forth in the Most Recent Financial Statements.
3.8
General Compliance With Laws.
The
Company and its operations are in compliance in all material respects with
all
applicable Laws and Orders, including the rules and regulations promulgated
by
the OIR, AHCA, CMS and other Governmental Authorities in other jurisdictions
where the Company is conducting its Business, and all Health Benefit Laws.
The
Company has not been charged with, or given notice of, and to the Knowledge
of
Seller, the Company is not under investigation with respect to, any violation
of, or any obligation to take remedial action under, any applicable Law,
Governmental Authorization, or Order entered by any Governmental
Authority.
3.9
Insurance Business and other Governmental and Healthcare
Matters.
(a)
The
Company possesses all material Governmental Authorizations that it is required
to hold in respect of its Business as presently conducted, including the
Company’s Contract with CMS to operate as a Medicare Advantage Organization and
Governmental Authorizations applicable to a HMO, in the State of Florida and
other jurisdictions wherein the Company is presently conducting its Business.
Schedule
3.9(a)
contains
a complete and accurate list of each material Governmental Authorization held
by
the Company and the Governmental Authority issuing each such Governmental
Authorization. The Company is not subject to the Federal HMO Act. Without in
any
manner limiting the foregoing, the Company is duly licensed and authorized
to
operate its Business in the service areas (“Service
Areas”)
in the
State of Florida identified in Schedule
3.9(a).
All
applications, notices or other forms required to have been filed for the renewal
or extensions of such Governmental Authorizations listed on Schedule
3.9(a)
have
been duly filed on a timely basis with the appropriate Governmental Authority,
in accordance with applicable Laws, and the Company has not been notified that
such renewals or extensions will be withheld or delayed in any material
respect.
-13-
(b) Schedule
3.9(b)
contains
a true and complete list of each Contract, including all amendments, with CMS
or
any other Governmental Authority to which the Company is a party (“Governmental
Contracts”).
Except as set forth in Schedule
3.9(b),
the
Company: (i) is in compliance in all material respects with all such Contracts;
(ii) is not in breach or in default of any such Contracts; and (iii) is
currently meeting all conditions of participation for any and all of its
Business.
Further,
Schedule
3.9(b)
contains
a true and complete list of the Health Benefit Plans offered by the Company
to
the public pursuant to its Contracts with CMS, true and correct copies of which
have been furnished to Purchaser.
(c)
Neither
Seller nor the Company or, to the Knowledge of Seller, any officer or director
of same, has ever been excluded or suspended from participation in, had monetary
penalties imposed on, or been sanctioned by, any state or federal health care
program, including the Medicare and Medicaid programs.
(d)
The
Company has not received any written citation, suspension, notice, revocation,
limitation, warning or similar correspondence issued by any applicable
Governmental Authority, including the OIR, AHCA or CMS, which has not been
resolved to such Governmental Authority’s satisfaction. There
is
no investigation or proceeding pending or, to the Knowledge of Seller,
threatened in writing that could result in the termination, revocation,
suspension or restriction of any material Governmental Authorization held by
the
Company or the imposition of any fine, penalty or other sanctions for violation
of any Law relating to any such material Governmental Authorization. Further,
there are no material restrictions placed by a Governmental Authority upon
the
marketing activities of the Company in the Service Areas. To the Knowledge
of
Seller, no event has occurred, nor does any circumstance exist: (i) that
constitutes, or with notice, the lapse of time or both may constitute or result
in, a violation by the Company of, or a failure on the part of the Company
to
comply with, in any material respect, any Health Benefit Law or any Governmental
Authorization held by the Company; (ii) that could reasonably be expected to
result in the revocation, withdrawal, suspension, cancellation or termination
of, or any material modification to, any material Governmental Authorization
held by the Company; or (iii) that could reasonably be expected to give rise
to
an obligation on the part of Purchaser or the Company to undertake, or to bear
all or any portion of the costs of, any remedial action with respect to any
Health Benefit Law or any such material Governmental Authorization, excluding
routine, incidental or other actions involving de minimis costs.
(e)
All
Health Benefit Plans have been submitted to and approved by CMS and, as
applicable, the OIR, AHCA and other Governmental Authorities, and otherwise
comply in all material respects with the applicable requirements of Laws,
including Laws governing the Medicare Advantage Program and other Health Benefit
Laws, as applicable. All forms of Enrollment Forms, benefit forms, evidence
of
coverage forms, policy forms and other materials furnished to Members as
currently in use by the Company in connection with the Health Benefit Plans
have
been submitted to and approved by CMS and, as applicable, the OIR, AHCA and
other Governmental Authorities, and otherwise conform, in all material respects,
to the requirements of Laws, including Law governing the Medicare Advantage
Program and other applicable Health Benefit Laws.
-14-
(f)
The
Company has timely prepared and submitted to CMS its Medicare Advantage bid
proposal for 2009 in accordance with applicable Laws and in form and content
as
necessary and required for the Company to continue its operations in calendar
year 2009 as a Medicare Advantage Organization in the State of Florida and
other
jurisdictions wherein the Company is presently conducting its Business. Seller
has provided to Purchaser a true and correct copy of the Company’s 2009 Medicare
Advantage bid proposal.
(g)
Seller
has made available to Purchaser true and correct copies of all forms of
Enrollment Forms whether standard or not, currently in use by the Company or
that are in force on the date of this Agreement. True and correct copies of
the
standard Enrollment Form of the Company are attached hereto at Schedule
3.9(g).
All
executed Enrollment Forms, whether standard or not, executed or electronically
submitted by Members and accepted for coverage by the Company were accepted
by
the Company in the Ordinary Course of Business, and such acceptance by the
Company created valid, binding and enforceable agreements of the Company and,
to
the Knowledge of Seller, valid, binding and enforceable agreements of the other
parties thereto.
(h)
Set
forth on Schedule
3.9(h)
is the
number of Medicare Advantage Members enrolled in each of the respective Medicare
Advantage plans offered by the Company as of June 12, 2008, and the number
of
Members enrolled in the Medicare Advantage Prescription Drug plans offered
by
the Company as of June 12, 2008. The underwriting standards utilized and ratings
applied by the Company conform with the filings made by the Company with CMS,
OIR and AHCA, as applicable, and , in all material respects, with all applicable
Laws.
Further,
all reports and files submitted by the Company to CMS or any other Governmental
Authority for the purposes of affecting risk scores, premiums or other revenues
due the Company, or any other material information utilized by CMS or any other
Governmental Authority, are and have been correct and complete in all material
respects and comply in all material respects with applicable Laws and Orders,
Governmental Authorizations and Contracts with CMS or such other Governmental
Authority, as applicable.
(i) Schedule
3.9(i)
sets
forth a complete and accurate list of all Contracts to which the Company is
a
party with respect to reinsurance applicable to insurance or Medicare benefits
in force, and all such Contracts under which the Company has any obligation
to
cede insurance (collectively, the “Reinsurance
Contracts”).
The
Reinsurance Contracts are valid, binding and in full force and effect in
accordance with their terms. The Company is in compliance in all material
respects with each provision of the Reinsurance Contracts, the Company has
no
Knowledge of any material breach or default by any other party thereto or of
any
event or circumstance which could reasonably be expected to result in a breach
or default thereunder, and except as set forth in Schedule
3.9(i),
no such
Reinsurance Contract contains any provision providing that the other party
thereto may terminate the same, or requiring any consent, or any other provision
which would be altered or otherwise become applicable, by reason of the
transactions contemplated by this Agreement.
-15-
(j)
All
Contracts with insurance agents, producers or brokers (“Broker
Contracts”)
currently in use by the Company were entered into in the Ordinary Course of
Business and constitute valid, binding and enforceable agreements of the Company
and, to the Knowledge of Company, constitute valid, binding and enforceable
agreements of the other parties thereto. Seller has afforded access to Purchaser
to true, correct and complete copies of all Broker Contracts and has provided
Purchaser with a true, correct and complete copy of any standard form of Broker
Contract used by the Company in the Business. The Company has in all material
respects performed its obligations under each Broker Agreement and, to the
Knowledge of Seller, all other parties to such Broker Contracts have observed
and performed their obligations thereunder, and their duties as an agent,
producer or broker, in compliance in all material respects with all applicable
Laws. All forms of the Broker Contracts which are currently in use by the
Company and its Subsidiaries conform in all material respects to the
requirements of the applicable Health Benefit Laws. Except as set forth on
Schedule
3.9(j),
no
consent or approval is required to be obtained, and no notice required to be
given, under any Broker Contract with a material broker of the Company in
connection with the Sale or the other transactions contemplated in this
Agreement. To the Knowledge of Seller, no material broker has given written
notice to the Company of such broker’s insolvency or of its intention to file a
petition in bankruptcy, and no material broker has given notice to the Company
regarding its intention to terminate, cancel or not renew a Broker
Contract.
The
Company has provided training and training materials and information to its
agents, producers and brokers as required by applicable Law. Except as set
forth
in Schedule
3.9(j),
none of
the Broker Contracts, nor any commission or fees due thereunder, may be
transferred, devised, bequeathed or assigned, whether by operation of Law
(including laws of descent and distribution), Contract or otherwise, by any
agent, producer or broker without the prior consent of the Company.
(k)
Attached
as Schedule
3.9(k)
and made
a part hereof are copies of lag reports setting forth the Company’s payment of
medical claims for services to Members through May 31, 2008.
(l)
Except
as set forth in Schedule
3.9(l),
all
actions taken or failed to have been taken by the Company in connection with
the
issuance or administration of the Health Benefit Plans have been taken or
omitted in compliance in all material respects with the Medicare secondary
payor
rules, the Medicare/Medicaid dual eligibility rules, and all similar Laws
respecting the amount, priority and order of payments of Medicare benefits
in
contrast to other health insurance benefits offered by or through third party
payors or other programs of a Governmental Authority, as supplemented by the
regulations of the Department of Health and Human Services (“Priority
Payment Rules”).
No
Health Benefit Plan administered or insured by the Company has any liability
(including, but not limited to, any liability under the Code, the Social
Security Act, and the Age Discrimination in Employment Act) to the United States
of America or the State of Florida, or any political subdivisions thereof,
or to
any other Person with respect to the Priority Payment Rules.
(m)
To the
extent the Company has implemented a Health Benefit Plan that requires the
beneficiary to pay a percentage coinsurance charge (i.e., a payment to a
provider that is calculated based on a percentage of the provider’s charge,
xxxx, cost or other similar amount), the Company has or had (i) adopted internal
policies and procedures designed to provide reasonable assurances that the
coinsurance charge is calculated at the rate specified pursuant to the
applicable Provider Contract (defined in Section 3.20(a)), and (ii) such
policies and procedures are or have been followed by the Company in all material
respects.
-16-
3.10
Regulatory Filings and Reports; Accreditation.
(a)
Except
as set forth on Schedule
3.10(a),
the
Company has filed all reports, statements, registrations or filings required
to
be filed by it with any Governmental Authority (the “Regulatory
Filings”).
Seller has made available to the Purchaser complete and correct copies of all
such Regulatory Filings. Seller has also made available to Purchaser complete
and correct copies of all audits and examinations performed with respect to
the
Company by any Governmental Authority since August 31, 2001 (the “Audit
Reports”),
along
with the responses thereto of the Company. Other than as set forth in the Audit
Reports: (i) no deficiencies have been asserted against the Company or any
of
its Subsidiaries by any such Governmental Authority with respect to the
Regulatory Filings; (ii) the Regulatory Filings were correct and complete in
all
material respects and in compliance in all material respects with applicable
Laws when filed; (iii) since August 31, 2001, no fine or penalty in excess
of
$25,000 has been imposed on the Company by any Governmental Authority; (iv)
no
deposits have been made by the Company with, or at the direction of, any
Governmental Authority that were not shown, in the Financial Statements
described in Section 3.6;
and (v)
no similar audits or examinations are currently being performed or, to the
Knowledge of Seller, are scheduled to be performed.
The
Company has completed, or is currently in the process of completing, all plans
of correction or other filed responses to any such Government Authority,
including plans of correction or responses to all Audit Reports, and has not
received written notice from any Governmental Authority of any violation or
non-compliance therewith that are pending. The
Company maintains the minimum levels of Statutory Surplus, as required by
Section 641.225 of the Florida Statutes, as modified by Orders of the OIR and
AHCA, and otherwise has the minimum levels of surplus and capital, and has
established statutory reserves, in each circumstance sufficient to satisfy
all
other Laws and Orders applicable to the Company and its Business. The Company
is
in compliance with any other reserve or deposit requirements applicable to
its
Business imposed by the OIR, AHCA CMS and any other Governmental Authority
having jurisdiction over the Company’s Business and it’s
operations.
(b)
Since
January 1, 2005, the Company has not been denied or failed to obtain any
accreditation by any HMO or insurance accreditation agency from which the
Company sought accreditation.
3.11
Title.
Seller
(i) is the sole record and beneficial owner of the Shares, and (ii) has all
right, title, and interest in and to the Shares. Upon delivery of certificates
evidencing the Shares and payment by Purchaser of the Preliminary Purchase
Price
in accordance with this Agreement, Seller will deliver valid title to the
Shares, free of any Liens.
3.12
Legal Proceedings.
Except
as set forth in Schedule
3.12,
there
are no Actions or Proceedings pending against the Company before any
Governmental Authority or, to the Knowledge of Seller, threatened against the
Company by any Governmental Authority or any third Person. Except as set forth
in Schedule
3.12,
the
Company is not subject to any Order specifically (as distinct from generically)
applicable to it or its assets. This Section 3.12
shall
not apply to any Tax matters.
To the
Knowledge of the Seller, no basis of a material nature exists or has been
alleged to exist for any such Action or Proceedings or of any investigation
by a
Governmental Authority relative to the Company, its properties or assets, and
no
event of a material nature has occurred or circumstance of a material nature
exists that may give rise to or serve as a basis for the commencement of any
such Action or Proceeding.
-17-
3.13
Insurance.
(a) Schedule
3.13(a)
contains
a true and complete list of all liability, property, workers’ compensation,
directors’ and officers’ liability, errors and omissions, fidelity bond,
reinsurance, medical malpractice and other material insurance policies
(including all self-insurance policies) maintained by the Company or by Seller
for the benefit of the Company, including an identification of the following
with respect to each such policy: (i) policy number; (ii) all named insureds
and
additional insured parties; (iii) type of coverage; (iv) policy limits; and
(v)
expiration date. Seller has provided to Purchaser correct and complete copies
of
all such policies maintained by the Company (which does not include policies
maintained by Seller for the benefit of the Company). . Each policy listed
in
Schedule
3.13(a)
is valid
and binding and in full force and effect, all premiums due thereunder have
been
paid in full, and neither the Company nor Seller has received any written notice
of cancellation or termination in respect of any such policy. To Seller’s
Knowledge, no event has occurred which constitutes, or with notice or lapse
of
time or both, would constitute, a material breach or a default, or permit the
termination, material modification or acceleration under, any such policy.
Schedule
3.13(a)
further
lists and describes all material claims for payment made by the Company against
its insurance policies since January 1, 2002.
(b) Schedule 3.13(b)
further
sets forth all policies of insurance of a type referenced above in Section
3.13(a)
providing coverage, during the past seven (7) years, on an “occurrence basis” or
on a “claims made basis” for which tail coverage is still available. The Company
has been covered during the past seven (7) years by insurance in scope and
amount customary and reasonable for the business in which it has engaged during
the aforementioned period.
3.14
Taxes.
As used
in this Agreement, “Tax
Return”
means
any return, declaration, report, claim for refund, or information return or
statement relating to Taxes, including any schedule or attachment thereto,
and
including any amendment thereof. “Tax”
or
“Taxes” means any Federal, state, local or foreign net or gross income, gross
receipts, sales, use, ad valorem, transfer, franchise, license, withholding
and
other taxes, including any interest, penalties or additions with respect
thereto. “Taxing
Authority”
means
any government or subdivision, agency, commission or authority thereof, or
any
quasi-governmental or private body having jurisdiction over the assessment,
determination, collection or other imposition of Taxes.
(a)
All Tax
Returns that were required to be filed for or on behalf of the Company have
been
duly prepared, signed and filed on a timely basis pursuant to applicable Laws.
All such Tax Returns were correct and complete in all material respects. The
Company has paid in full all Taxes shown to be payable on the Tax Returns
described in this Section 3.14(a).
All
Taxes incurred by the Company for periods ending on or prior to the date hereof
have been, or ending on or prior to the Effective Time will be, paid or properly
accrued for, in accordance with GAAP, on the books and records of the Company.
Except with respect to the Company’s Tax Return for calendar year 2007 for which
Seller has been granted an extension of time to file, the Company has not
requested or been granted an extension of time to file any Tax Return that
has
not been filed.
-18-
(b)
The
Company has withheld or collected from each payment made to its employees or
other Persons the amount of all Taxes required to be withheld or collected
therefrom and has paid all such amounts to the appropriate Taxing Authorities
when due. The Company has complied in all material respects with all information
reporting and backup withholding requirements, including maintenance of records
with respect thereto, in connection with amounts paid or owing to any employee,
creditor, independent contractor or third party.
(c)
There
are no Tax Liens on the Shares or any assets of the Company, other than Liens
for current ad valorem Taxes not yet due and payable.
(d)
The
Company has not waived any statute of limitations (or is or would be subject
to
a waiver given by Seller) or agreed to any extension of time with respect to
a
Tax assessment or deficiency (or is or would be subject to any extension given
by Seller).
(e)
The
Company has delivered to Purchaser true and complete copies of all Tax Returns
filed and all examination reports and statements of deficiencies assessed
against or agreed to by the Company since January 1, 2004.
(f)
The
Company has not made, agreed to make, nor been required to make, any adjustment
under section 481(a) of the Code by reason of a change in accounting method
or
otherwise.
(g)
The
Company is not, nor has been, a United States real property holding corporation
within the meaning of section 897(c)(2) of the Code during the applicable period
specified in section 897(c)(1)(A)(ii) of the Code.
(h) Except
as
set forth on Schedule
3.14(h),
the
Company is not a party to or bound by any Tax indemnity, Tax sharing or Tax
allocation Agreement. Except as set forth on Schedule
3.14(h),
the
Company (i) has not been a member of an Affiliated group filing a consolidated
federal income tax return and (ii) has no liability for the Taxes of any
corporation or other entity under Treas. Reg. §1.1502-6 (or similar provision of
state, local, or foreign Law), as a transferee or successor, by Contract or
otherwise. Except as set forth on Schedule
3.14(h),
the
Sale will not result in the recognition of income by virtue of any consolidated
return rule.
(i)
The
Company has not entered into any Contract that has resulted in, or would result
in, separately or in the aggregate, the payment of any “excess parachute
payment” within the meaning of section 280G of the Code, or any similar Law, or
result in the imposition of the sanctions imposed under section 4999 of the
Code, or any similar provision of Law.
(j) Except
as
set fort on Schedule
3.14(j),
no Tax
Return of the Company is, or ever has been, under audit or examination by any
Taxing Authority, and no written notice of such an audit or examination has
been
received by the Company or, to the Knowledge of Seller, been threatened
(formally or informally).
(k)
The
Company has not entered into any contract, agreement, understanding, or other
arrangement with respect to deferred compensation (within the meaning of section
409A of the Code and the regulations promulgated thereunder) which does not
comply with the provisions of section 409A of the Code.
-19-
(l) Except
as
set fort on Schedule
3.14(l),
no Tax
Return of the Company is, or ever has been, under audit or examination by any
Taxing Authority, and no written notice of such an audit or examination has
been
received by the Company or, to the Knowledge of Seller, been threatened
(formally or informally).
(m)
The
Company has never been operated as a Tax-exempt entity or solicited or received
charitable contributions from any third party.
3.15
Intellectual Property.
(a)
For
purposes of this Agreement, the term “Intellectual
Property”
means
(i) patents, registered and unregistered trademarks and service marks, brand
names, trade names, domain names, copyrights, designs and trade secrets and
(ii)
applications for and registrations of such patents, trademarks, service marks,
trade names, domain names, copyrights and designs. Schedule
3.15(a)
sets
forth a complete and accurate list of all patents, registered and unregistered
trademarks, registered copyrights, domain names and applications for any of
the
foregoing, in each case owned by the Company and material to the conduct of
the
business of the Company, taken as a whole, as currently conducted.
(b)
Except
as set forth in Schedule
3.15(b),
the
Company is the owner of, or has the right to use, all Intellectual Property,
free and clear of all Liens, as is necessary in connection with the operation
of
the Company, taken as a whole, as currently conducted, subject, however, to
the
restrictions and limitations set forth in any applicable Intellectual Property
License (defined in Section 3.15(d)).
(c)
No
unresolved claims, or to Seller’s Knowledge, threat of claims within the three
years prior to the date of this Agreement, have been asserted by any third
party
against the Company by any other Person challenging or questioning the right
of
Company to use any of the Intellectual Property of the Company or asserting
that
the conduct of the business of the Company infringes, misappropriates or dilutes
any Intellectual Property rights of any third party. To the Seller’s Knowledge,
the conduct of the businesses of the Company does not infringe, misappropriate,
dilute or otherwise violate any Intellectual Property rights of any third party.
To Seller’s Knowledge, no third party is infringing, misappropriating or
diluting any Intellectual Property of the Company.
(d) Schedule
3.15(d)
sets
forth a complete and accurate list of all material licenses, sublicenses and
other agreements (“Intellectual
Property License”)
to
which the Company is a party (i) granting any other Person the right to use
any
of the Intellectual Property of the Company, or (ii) pursuant to which Company
is authorized to use any third party Intellectual Property, which are used
by
the Company in the business of the Company as currently conducted, other than
commercial off-the-shelf software.
The
Company has not exceeded the number of licenses granted by any Person to the
Company pursuant to any license Agreement for the use of any software of other
Intellectual Property. The Company is not in breach of any Intellectual Property
License and, to the Seller’s Knowledge, no other party is in breach of any
Intellectual Property License.
-20-
(e)
All
trademark registrations and applications for registration, patents issued or
pending and copyright registrations and applications for registration owned
by
the Company are valid and subsisting and have not lapsed, expired or been
abandoned, and are not the subject of any opposition filed or, to Seller’s
Knowledge, threatened to be filed with the United States Patent and Trademark
Office or any other intellectual property registry. Except as disclosed in
Schedule
3.15(e),
there
are no actions that must be taken by Purchaser within one hundred twenty (120)
days of the Effective Time, including payment of any registration, maintenance
or renewal fees or the filing of any documents, applications or certificates
for
the purposes of maintaining, perfecting or preserving or renewing any
Intellectual Property
of the
Company set forth on Schedule
3.15(a)
hereto.
(f)
The
Company has promulgated and used its reasonable efforts to enforce a trade
secret protection program sufficient to safeguard and maintain the secrecy
and
confidentiality of the Intellectual Property of the Company. To the Company’s
Knowledge, there has been no material violation of such program by any Person.
The Company does not have any proprietary software.
(g)
All
personnel, including employees, agents, consultants, and contractors, who have
contributed to or participated in the conception and development of the
Intellectual Property on behalf of the Company either (i) have been party to
a
“work-for-hire” arrangement or agreement with the Company, in accordance with
applicable federal and state law, that has accorded the Company full, effective,
exclusive, and original ownership of all tangible and intangible property
thereby arising, or (ii) have executed appropriate instruments of assignment
in
favor of the Company, respectively, as assignee that have conveyed to Company
full and exclusive ownership of all tangible and intangible property thereby
arising.
3.16
Environmental.
(a)
Except
as set forth in Schedule
3.16,
there
have been no disposals, releases or threatened releases of Hazardous Materials
(defined below) on, from or under the Company’s Real Property (defined in
Section 3.18), nor on, from or under the real property that is utilized as
Seller’s corporate headquarters, portions of which are utilized by the Company,
by or on behalf of any Person in violation of applicable Laws. Except as set
forth in Schedule
3.16,
neither
the Company nor, to Seller’s Knowledge, any other Person, has used, generated,
manufactured or stored on, under or about the Company’s premises or transported
to or from the Company’s real property any Hazardous Materials in violation of
applicable Laws. For purposes of this Agreement, (i) the terms “disposal,”
“release,” and “threatened release” shall have the definitions assigned thereto
by the Comprehensive Environmental Response, Compensation and Liability Act
of
1980, 42 U.S.C. Section 9601 et seq., as amended (“CERCLA”),
and
(ii) “Hazardous
Materials”
shall
mean any hazardous, corrosive, ignitable, explosive, infectious, radioactive,
carcinogenic, petroleum-derived, or toxic substance, material or waste that
is
regulated under, or defined as a “hazardous substance,” “hazardous waste,”
“carcinogen,” “toxic substance,” “pollutant,” “contaminant,” “toxic chemical,”
“hazardous materials” or “hazardous chemical” under (1) CERCLA; (2) the Resource
Conservation and Recover Act, 42 U.S.C. Section 6901 et seq.; (3) the Clean
Water Act, 33 U.S.C. Section 1251, et seq.; (4) the Clean Air Act, 42 U.S.C.
Section 7401 et seq.; (5) the Emergency Planning and Community Right-to-Know
Act, 42 U.S.C. Section 1101 et seq.; (6) the Hazardous Materials Transportation
Act, 49 U.S.C. Section 1801, et seq.; (7) the Toxic Substances Control Act,
15
U.S.C. Section 2601 et seq.; (8) the Occupational Safety and Health Act of
1970,
29 U.S.C. Section 651 et seq.; (9) regulations promulgated under any of the
above statutes; or (10) any applicable state or local Law that has a scope
or
purpose similar to those statutes identified above.
-21-
(b)
The
Company is not a party to, or subject to the terms of or bound by, any Order
that imposes a liability or obligation under CERCLA in connection with its
businesses, and there is no present or past circumstances, activities, events,
conditions or occurrences that could reasonably be expected to (i) cause the
Company to be subject to any restriction on its ownership, occupancy or use
of
any material asset in its Business under CERCLA, or (ii) prevent or interfere
with the ability of the Company to operate and conduct the Business in
compliance in all material respects with CERCLA.
(c)
No
cleanup, investigation, corrective or remedial action is currently underway
at
any of the Real Property leased by the Company that has resulted in the
assertion or creation of a Lien on such property and for which the Company
is
responsible, nor has any such assertion of a Lien been made with respect thereto
that has not been removed.
(d)
To the
Knowledge of Seller, the Company is in compliance in all material respects
with
all Laws relating to the regulation and protection of the environment and
natural resources, including those referenced in Section 3.16(a)
above.
There is no environmental claim of which the Company has received written notice
or, to the Knowledge of Seller, has been threatened in writing or filed since
January 1, 2002, against the Company.
3.17
Good Title, Operating Condition.
Except
as set forth in Schedule
3.17,
(i) the
Company has good and valid title to, or the unrestricted right to use, all
of
the assets owned, leased or licensed by it and material to its Business, free
and clear of all Liens, and (ii) all tangible personal property is in good
operating condition for the operation of the Business, normal wear and tear
excepted.
3.18
Real Property; Leases.
The
Company does not own any real property. Schedule
3.18
sets
forth a list of all leases of real property (“Real
Property”)
to
which the Company is a party (“Leases”).
For
purposes of this Agreement, the term “Leases”
does
not include any space the Company utilizes at Seller’s corporate headquarters.
The Company has made available a true, correct and complete copy of each such
Lease to Purchaser. The Company has a valid leasehold interest in all of the
Real Property leased by it as lessee, free and clear of all Liens. Except as
set
forth in Schedule
3.18,
each
Lease is in full force and effect and is the legal, valid and binding obligation
of the Company, enforceable in accordance with its terms, and will continue
to
be the valid and binding obligation of the Company, in full force and effect
on
identical terms following the consummation of the Sale, except that enforcement
of the Leases may be subject to applicable bankruptcy, insolvency,
reorganization, moratorium or other similar Law, now or hereafter in effect,
affecting creditor’s rights generally. Except as set forth in Schedule
3.18,
neither
the Company nor, to Seller’s Knowledge: (i) any other Person is in default or
breach in the observance or performance of any term or obligation to be
performed by it under any Lease, except for defaults or breaches involving
a de
minimis amount or of an incidental nature; (ii) the Real Property leased by
the
Company pursuant to the Leases comprises all of the real property used in the
Company’s Business; (iii) to Seller’s Knowledge, the current use and occupancy
of the Real Property and the operation of the Company’s Business (A) conforms to
the certificates of occupancy applicable thereto, (B) complies with the local
zoning Laws, and (C) does not violate any easement, covenant, condition,
restriction or similar provision in any instrument of record or other unrecorded
agreement or instrument affecting such Real Property; (iv) the Company has
not
subleased, licensed or otherwise granted any Person the right to use or occupy
all or any portion of such Real Property; (v) the Company has not collaterally
assigned or granted any other Lien in any such Lease or any interest therein;
and (vi) to the Knowledge of Seller, there are no condemnation or eminent domain
proceedings pending or threatened against any of the leased Real
Property.
-22-
3.19
Material Agreements.
Schedule
3.19
contains
a true and complete list of the following Contracts or Agreement (other than
Leases, which are disclosed in Section 3.18,
and
Provider Contracts which are disclosed in Section 3.20)
to
which the Company is a party (“Specified
Agreements”):
(a)
any
Agreement creating a partnership or joint venture;
(b)
any
Agreement under which the Company has created, incurred, assumed or guaranteed
any indebtedness for borrowed money or any capitalized lease obligation in
excess of $50,000 or under which it has imposed a Lien on any of its material
assets;
(c)
Contracts for the future acquisition or sale of any assets involving $50,000
or
more individually (or in the aggregate, in the case of any related series of
contracts), other than acquisitions or sales in the Ordinary Course of
Business;
(d)
Contracts containing covenants of the Company prohibiting or limiting the right
to compete in any line of business or prohibiting or restricting its ability
to
conduct business with any Person or in any geographical area;
(e)
Contracts relating to the acquisition by the Company of any operating business,
the capital stock of any other Person or, except in the Ordinary Course of
Business, any other assets or property (real or personal) of any other
Person;
(f)
Contracts requiring the payment by or to the Company of a royalty, “finders’
fee,” brokerage commission, override or similar commission or fee of more than
$50,000 in a year;
(g)
Contracts with third party administrators or other persons for the provision
of
any management, administrative or claims processing service;
(h)
any
Contract that is a power of attorney, proxy or similar instrument;
(i)
any
stock option agreement, restricted stock agreement, phantom stock agreement,
stock appreciation rights, plan of equity compensation, or similar agreement,
arrangement or understanding;
(j)
any
Contract under which the Company has been prepaid in an amount in excess of
$50,000 for goods and services not delivered or requiring the delivery of
services or products over a term extending more than thirty (30) days;
and
(k)
any
other Contract (other than Provider Contracts), the performance of the executory
portion of which involves consideration in excess of $50,000.
-23-
Except
as
set forth in Schedule
3.19,
all
such Specified Agreements are in full force and effect and are the valid and
binding obligations of the Company, enforceable in accordance with their
respective terms, and all such Specified Agreements will continue to be the
valid and binding obligation of the Company, in full force and effect on
identical terms following the consummation of the Sale, except that (i)
enforcement of the Specified Agreements may be subject to applicable bankruptcy,
insolvency, reorganization, moratorium or other similar Laws, now or hereafter
in effect, affecting creditors’ rights generally, and (ii) the remedy of
specific performance and injunctive and other forms of equitable relief may
be
subject to equitable defenses and to the discretion of the court before which
any proceeding therefore may be brought. Except as set forth in Schedule
3.19,
neither
the Company nor, to Seller’s Knowledge, any other Person is in default or breach
in the observance or the performance of any term or obligation to be performed
by it under any Specified Agreement, except for defaults or breaches involving
a
de minimis amount or of an incidental nature.
(For
purposes of this Agreement, “Material
Agreements”
shall
mean, collectively, the Specified Agreements, Provider Contracts, Governmental
Contracts, Reinsurance Contracts, Broker Contracts, Intellectual Property
Licenses, and Leases.)
3.20
Providers and Provider Contracts.
(a) Schedule
3.20(a)
contains
a true and complete list of all Contracts between the Company and any physician,
hospital, pharmacy, pharmacy benefit management, ancillary service provider
or
other health care service provider (“Provider
Contracts”).
Copies of (i) the Company’s standard forms of Provider Contracts (“Form
Provider Contracts”)
and
(ii) each Provider Contract that contain terms that materially deviate from
the
Company’s Form Provider Contracts has been made available to
Purchaser.
(b) Except
as
set forth in Schedule
3.20(b),
none of
the Provider Contracts: (i) has a remaining term of a length greater than one
(1) year without providing the Company the ability to terminate the applicable
Provider Contract without cause prior to the expiration of the current term;
(ii) requires the Company to pay the applicable provider on a most-favored
provider basis; (iii) grants to any provider any exclusive dealing rights and/or
requires the Company to pay a material break-up fee to terminate the contractual
relationship; (iv) obligates the Company to pay material access or
administrative fees; (v) includes any provision for rate escalation based on
factors other than the consumer price index, inflation rates or other economic
indicators; (vi) provides for a guaranty of a minimum level of Members who
are
to have access to a given provider of the Company; (vii) contains terms that
are
binding upon an Affiliate of the Company; (viii) contains change of control
language, including any terms requiring notice or prior consent in the event
of
a change of control of the Company; or (ix) contains non-solicitation or
non-competition provisions. Except as set forth in Schedule
3.20(b),
to the
Knowledge of Seller (i) no provider is insolvent or intends to file a petition
in bankruptcy; and (ii) no provider has given notice to the Company or any
of
its Subsidiaries of its intention to terminate, cancel or not renew its Provider
Contract.
(c) All
Provider Contracts were entered into by the Company in the Ordinary Course
of
Business and constitute legal, valid, binding and enforceable agreements of
the
parties thereto. All Provider Contracts are in full force and effect. All forms
of the Provider Contracts which are currently in use by the Company conform
in
all material respects to the requirements of Laws governing Medicare Advantage
organizations and all other applicable Health Benefit Laws. The Company has
performed in all material respects its obligations under each Provider Contract
and, to the Knowledge of Seller, all other parties to such Provider Contracts
have performed and complied with their respective obligations thereunder in
all
material respects. The Company has paid all non-participating providers
providing services to Members that are not subject to a Provider Contract in
accordance with applicable Laws, including applicable Medicare fee schedules.
None of the Provider Contracts contain any type of bonus, incentive or other
extraordinary compensation arrangement except as set forth on Schedule
3.20(c).
-24-
(d) Except
as
set forth in Schedule
3.20(d),
there
are no current claims or disputes between the Company and any providers, other
than claims for payment due and owing to the providers in the Ordinary Course
of
Business in accordance with the Provider Contracts and applicable Law or other
claims or disputes involving de minimis costs or expenses.
Except
as set forth in Schedule
3.20(d),
the
Company has not received notice from any provider or Governmental Authority
claiming a breach or default in payment of claims or other sums due the
providers under the Provider Contracts or applicable Law, and, to the Knowledge
of Seller, except for non-material claims or payments in the Ordinary Course
of
Business, there exists no facts, circumstances or conditions upon which a claim
or proceeding may be made or supported by any provider or Governmental Authority
against the Company for a breach or default in payment of claims or other sums
due the providers under the Provider Contracts or applicable Law.
3.21
Employee; Labor Relations.
(a) The
Company has made available to Purchaser copies of all written employment
Contracts to which the Company is a party. Schedule
3.21(a)
sets
forth a true, correct and complete list, as of the date hereof, of the Company’s
active and inactive employees (the “Current
Employees”), including
each Current Employee’s: (i) name
(;
(ii)
job title; (iii) date of commencement of employment or engagement; (iv) current
compensation paid or payable and any material change in compensation since
January 1, 2005; (v) sick and vacation leave that is accrued but unused; and
(vi) service credited for purposes of vesting and eligibility to participate
under any Seller Plan.
(b)
The
Company is not a party to or bound by any collective bargaining agreement,
and
has not experienced any strike, slowdown, work stoppage, lockout or other
collective bargaining dispute. To the Knowledge of Seller, no application or
petition for an election of or for certification of a collective bargaining
agent relating to the Company is pending.
(c)
Except
as set forth in Schedule
3.21(c):
(1)
the
Company has complied in all material respects with all Laws relating to
employment, employment practices, equal employment opportunity, immigration,
collective bargaining, payment of social security and similar Taxes, and wages
and hours;
(2)
there is
no unfair labor practice charge or complaint against the Company pending before
the National Labor Relations Board or similar Governmental Authority in the
State of Florida or any other jurisdiction where the Company is engaged in
the
Business, and no such charge or complaint has been made against the Company
with
a Governmental Authority since January 1, 2003;
-25-
(3)
there
has been no charge of discrimination filed against the Company with the Equal
Employment Opportunity Commission or similar Governmental Authority since
January 1, 2003, in the State of Florida or any other jurisdiction where the
Company is engaged in the Business; and
(4)
the
Company has no Contract or relationship with any Person who it characterizes
as
an independent contractor, but who should, under applicable Law, be treated
as
an employee.
(d)
Except
as set forth in Schedule
3.21(d),
the
Company is not a party to any written employment, independent contractor
agreement, consulting agreement, advisory or service agreement, deferred
compensation agreement, bonus agreement (including all Contracts which require
a
payment to any Person upon the consummation of the Sale or any other transaction
contemplated by the Related Agreements), or severance Contract, except for
agreements which may be terminated by the Company without premium or penalty
on
notice of thirty (30) days or less and under which the only monetary obligation
of the Company is to make current and customary wage or salary payments and
provide current and customary employee benefits. Except as set forth in
Schedule
3.21(d),
the
Company has not made any loans or advance (other than travel advances in the
Ordinary Course of Business) to any officer or director of the
Company.
3.22
Absence of Certain Changes or Events.
Except
as set forth in Schedule
3.22,
since
the date of the Acquisition Balance Sheet, the Company has conducted its
business in the ordinary course and has not:
(a)
suffered
any Material Adverse Effect that has not been disclosed pursuant to Section
5.9;
(b)
incurred
any indebtedness, obligation or other liability (contingent or otherwise),
except in the Ordinary Course of Business consistent with its past practice
and,
to Seller’s Knowledge, there does not exist a set of circumstances that could
reasonably be expected to result in any such indebtedness, obligation or
liability;
(c)
failed
to pay any medical claim liability or indebtedness when due (subject to its
right to challenge such liability or indebtedness in good faith);
(d)
created,
permitted or allowed any Lien with respect to the Company assets;
(e)
made any
material increase in the compensation payable by the Company (or for which
the
Company may have any liability) to any provider except as set forth in writing
in a Provider Contract;
(f)
executed, materially amended, or terminated any Material Agreement to which
it
is or was a party or by which any of the Company assets are bound or affected;
amended, terminated or waived any of its material rights thereunder; or received
notice of termination, amendment, or waiver of any Material Agreement or any
material rights thereunder;
-26-
(g)
instituted, settled, or agreed to settle, any litigation, action, or proceeding
before any Governmental Authority;
(h)
sold,
assigned or transferred any material assets outside the Ordinary Course of
Business;
(i)
sold,
assigned or transferred any Intellectual Property;
(j)
made any
capital expenditures or commitments therefore in excess of $50,000 individually
or $150,000 in the aggregate;
(k)
suffered
any theft, damage, destruction or casualty loss to its property in excess of
$50,000 not covered by insurance;
(l)
issued,
sold or transferred any of its equity securities, securities convertible into
its equity securities or warrants, options or other rights to acquire its equity
securities, or any notes, bonds or debt securities of the Company;
(m)
declared
or paid any dividend or made any distribution on its capital stock or redeemed
or purchased any shares of its capital stock;
(n)
reclassified, combined, split, subdivided or redeemed or otherwise repurchased
any securities of the Company, or created, authorized, issued, sold, delivered,
pledged or encumbered any additional capital stock (whether authorized but
unissued or held in treasury) or other securities convertible into or
exchangeable for capital stock of the Company, or granted or otherwise issued
any options, warrants or other rights with respect thereto;
(o)
acquired
or agreed to acquire by merging or consolidating with, or by purchasing any
portion of the capital stock, equity interests or assets of, or by any other
manner, any business or any corporation, partnership, limited liability company,
association or other business organization or division thereof;
(p)
made any
loan or any investment in or capital contribution to, or extended any credit
to,
any Person, except (i) short-term investments pursuant to customary cash
management policies, and (ii) advances made in the Ordinary Course of Business
to employees;
(q)
made any
material election with respect to Taxes, agreed to make any material claim
or
assessment in respect of Taxes, agreed to an extension or waiver of the
limitation period to any claim or assessment in respect of Taxes, or filed
any
claim for a Tax refund or amended any income or other Tax Return;
(r)
made any
change to any accounting principle, method or practice, including any actuarial
practices or methodologies, or any change to any methods of reporting income,
deductions or other items for Tax purposes;
-27-
(s)
had any
cancellation or termination or notice of cancellation or termination by a
provider of its Provider Contract with the Company, or any decrease or change,
or notice of decrease or change, in such Provider Contract;
(t)
waived
or released any debts, claims or rights of value, or written down the value
of
any assets or written down or off any receivable in excess of $50,000 for any
single occurrence or $150,000 in the aggregate; and
(u)
entered
into any Agreement or made any commitment to take any of the types of action
described herein.
3.23
Employee Benefit Plans; ERISA.
(a) Schedule
3.23(a)
contains
a true and complete list and description of each Seller Plan.
(b)
With
respect to each Seller Plan, Seller has furnished to Purchaser true and complete
copies of all plan documents, amendments, Agreements, trust instruments,
insurance Contracts, or other funding arrangements. With respect to any Seller
Plan not reduced to writing, Seller has furnished to Purchaser a true and
complete written description of such Seller Plan. With respect to any such
Seller Plans that are subject to the summary plan description requirements
of
section 102 of ERISA, Seller has furnished to Purchaser true and complete copies
of the most recent summary plan descriptions (and any summary of material
modifications thereto, if applicable). The Seller, the Company and any ERISA
Affiliates have complied with all obligations under section 102 of ERISA and
related regulations. With respect to each Seller Plan subject to annual
reporting under ERISA, Seller has furnished to Purchaser all Forms 5500 Annual
Return/Report of Employee Benefit Plan for the past five years. Seller has
furnished to Purchaser copies of any correspondence with the Internal Revenue
Service, Department of Labor, PBGC, or any other governmental entity relating
to
any Seller Plan.
(c) Each
Seller Plan is in compliance in all material respects, and has been administered
in compliance in all material respects, with applicable Law. No Seller Plan
is
currently under audit by the Internal Revenue Service, Department of Labor,
PBGC, or other governmental entity. Except as set forth in Schedule
3.23(c),
each
Seller Plan that is intended to be a pension, profit-sharing, 401(k), or stock
bonus plan qualified under section 401(a) of the Code is so qualified, has
been
operated and maintained in accordance therewith, is the subject of a favorable
determination letter from the Internal Revenue Service (or an application for
such a determination letter is pending), and has timely been amended in good
faith to extend any applicable remedial amendment period under Rev. Proc.
2005-66; nothing has occurred with respect to the operation of any Seller Plan
that would result in the loss of such qualification. There are no excise or
other Taxes or penalties due or arising out of actions or failures to act with
respect to any Seller Plan. Except as set forth on Schedule
3.23(c),
no
portion of any account balance or assets in any Seller Plan is invested in
employer securities. No asset of any Seller Plan is subject to tax as unrelated
business income.
(d)
All
contributions (including all employer contributions and employee salary
reduction contributions) that were due have been timely made to each Seller
Plan
that is a Pension Plan. Appropriate entries have been made in financial records
and statement for all obligations and liabilities under all Seller Plans. All
contributions to all Seller Plans have been deductible under the Code. All
premiums or other payments that are due have been paid with respect to each
such
Seller Plan that is an Employee Welfare Plan.
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(e)
Neither
Seller nor the Company, nor any ERISA Affiliate, ever has contributed or
currently contributes to any Multiemployer Plan. Neither Seller nor the Company,
nor any ERISA Affiliate, has withdrawn from any Multiemployer Plan or has any
outstanding withdrawal liability or delinquent contributions with respect to
any
such Multiemployer Plan. No event has occurred or circumstance exists that
presents a risk of the occurrence of any withdrawal from, participation in,
or
termination, reorganization, or insolvency of, any Multiemployer Plan that
could
result in any liability to either Seller, the Company or any ERISA Affiliate.
Neither the Seller, the Company, nor any ERISA affiliate thereof has engaged
in
a transaction within the meaning of section 4212(c) of ERISA.
(f) Except
as
set forth on Schedule
3.23(f),
the
Company does not provide, nor has any liability for, health or welfare benefits
with respect to any retired or former employees of Seller, the Company, or
any
ERISA Affiliate (except for any continuation coverage under COBRA or other
applicable state continuation coverage laws, for which such retired or former
employee pays). Except as set forth on Schedule
3.23(f),
the
Company is not obligated to provide any health or welfare benefits to any active
employees of Seller, the Company, or any ERISA Affiliate following such
employee’s retirement or termination of service (except as mandated by COBRA or
other applicable state continuation coverage laws). Neither the Company, Seller
nor any ERISA Affiliate thereof has ever sponsored, participated in or had
any
obligation to contribute to a “multiple employer welfare arrangement” within the
meaning of Section 3(40) of ERISA. Neither the Company, Seller, nor any ERISA
Affiliate thereof has ever sponsored, maintained or had any obligation to
contribute to a VEBA.
(g)
Neither
the Seller, the Company, nor any ERISA Affiliate, ever has sponsored,
maintained, had any obligation to contribute to, or any liability with respect
to, a DB Plan. No facts or circumstances exist that may subject the Seller,
Company or any ERISA Affiliate to any liability under sections 4062, 4063,
or
4064 of ERISA. Neither the Seller, the Company, nor any ERISA Affiliate, has
engaged in a transaction to which section 4069 of ERISA applies.
(h)
With
respect to Seller Plans, Seller or the Company, as applicable, has duly and
timely furnished, in compliance in all material respects with applicable Laws,
all notices required under applicable Laws to be given to Company participants,
beneficiaries, and alternate payees, or to any Governmental Authorities,
including, but not limited to, any notifications required by COBRA, by section
101(i) of ERISA (i.e., blackout notices), or by Field Assistance Bulletin
2006-03 (i.e., periodic benefit statements).
(i)
Each
Seller Plan subject to ERISA has been administered in accordance with its
written terms and ERISA. There has been no breach of fiduciary duty under
section 404 of ERISA with respect to any Seller Plan, nor has any transaction
occurred with respect to a Seller Plan prohibited by section 406 of ERISA for
which there does not exist an applicable exemption under ERISA. With respect
to
any Seller Plan required to file Form 5500, complete and accurate Forms 5500
timely have been filed for all applicable years.
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(j)
With
respect to Deferred Compensation Plans under which Current Employees have
benefited, are benefiting or are eligible to benefit, no such Deferred
Compensation Plans have been “materially modified” after October 3, 2004, and
all such Deferred Compensation Plans have been administered in compliance with
section 409A of the Code (and the published guidance issued thereunder). No
payment that is owed or may become due under any Seller Plan is subject to
tax
under sections 280G, 409A or 4999 of the Code. The Company is under no
obligation to reimburse any service provider or employee for any taxes under
section 409A of the Code.
(k) Except
as
specifically provided in Schedule
3.23(k),
there
are no claims, Proceedings or Liens, other than routine claims for benefits,
pending or, to Seller’s Knowledge, threatened with respect to any Seller Plan as
to which the Company has or could reasonably be expected to have any direct
or
indirect actual or contingent material liability.
(l) Except
as
provided in Schedule
3.23(l),
neither
the execution and delivery of this Agreement nor the consummation of the
transactions contemplated hereby will increase any benefits otherwise payable
under any Seller Plan. Except as provided in Schedule
3.23(l),
there
has been no announcement or commitment by Seller, Company or an ERISA Affiliate
to create any new practice, plan or arrangement that constitutes a Seller Plan
hereunder or to amend any Seller Plan, except for technical amendments required
by applicable law which do not materially increase the costs of the Seller,
Company or ERISA Affiliate.
3.24
Certain Business Relationships.
Except
as set forth in Schedule
3.24,
neither
the Company nor any Affiliate of the Company, nor any director or officer of
the
Company or any Affiliate of the Company, nor any family member of any of the
foregoing, (i) owns, directly or indirectly, in whole or in part, any property,
assets or rights, which are associated with or necessary for the use, operation
or conduct of any of the Business, or (ii) has a Contract to furnish material
services or goods to the Company.
3.25
Accounts Receivables.
All of
the accounts receivable of the Company are properly reflected on the books
and
records of the Company in accordance with GAAP, are valid receivables and arose
in the Ordinary Course of Business from bona fide transactions.
3.26
Relations and Members.
Schedule
3.26
describes each unresolved written complaint that would reasonably be expected
to
result in more than $50,000 of liability to the Company received by the Company
from a Member since January 1, 2005.
3.27
Terrorism Compliance.
The
Company is in compliance with (i) Exec. Order No. 13224, Blocking Property
and
Prohibiting Transactions With Persons Who Commit, Threaten to Commit, or Support
Terrorism, as amended, and (ii) the Uniting and Strengthening America by
Providing Appropriate Tools Required to Intercept and Obstruct Terrorism (USA
Patriot Act) Act of 2001, Pub. L. No. 107-56, as amended.
3.28
Guarantees.
Except
as set forth in Schedule
3.28,
the
Company is not a guarantor or otherwise contractually responsible for any
liability or obligation (including indebtedness) of any other
Person.
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3.29
Banks and Depositories.
Schedule
3.29
sets
forth:
(a)
A list
of the name and address of each bank, savings and loan or other financial
institution in which the Company has an account or safe deposit
box;
(b)
The
identity of each such account or safe deposit box;
(c)
The
names of all Persons authorized to draw on each account and to have access
to
each safe deposit box; and
(d)
The
number of signatures required for any withdrawals therefrom.
3.30
Limitation on Use of Funds.
Pursuant to 31 U.S.C. 1352 and 45 C.F.R. Part 93, no federal appropriated funds
have been paid to any Person by the Company for the purpose of influencing
or
attempting to influence an officer or employee of any agency, a member of
Congress, an officer or employee of Congress, or an employee of a member of
Congress in connection with the award of any federal Contract, the making of
any
federal grant, the making of any federal loan, the entering into of any
cooperative Contract, or the extension, continuation, renewal, amendment, or
modification of any federal Contract, grant, loan, or cooperative Contract
in
violation of such provision.
3.31
Books and Records.
The
minute books of the Company, as previously made available to Purchaser and
its
representatives, contain accurate records of all meetings of and all corporate
actions or written consents by the shareholders and the Board of Directors
of
the Company.
3.32
Brokers’
Fees.
Except
as set forth in Schedule
3.32,
neither
Seller nor the Company has Liability to pay any fees or commissions to any
broker, investment banker, finder or agent with respect to the transactions
contemplated by this Agreement or any Related Agreement for which Purchaser
could become liable or obligated.
4.
Representations and Warranties of Purchaser.
Purchaser
hereby represents and warrants to Seller as follows:
4.1
Authorization.
Purchaser has full corporate power and authority to enter into this Agreement
and the Related Agreements to be executed and delivered by it pursuant to,
or as
contemplated by, this Agreement, to perform its obligations hereunder and
thereunder, and to consummate the Sale and the other transactions contemplated
hereby or thereby.
4.2
Binding Agreement.
All
corporate actions and other actions required to be taken by Purchaser to
authorize the execution, delivery and performance of this Agreement, each
Related Agreement, and Purchaser’s obligations hereunder and thereunder have
been duly and properly taken or obtained by Purchaser. No other corporate action
on the part of Purchaser is necessary to authorize the execution, delivery
and
performance of this Agreement, any Related Agreement, or Purchaser’s obligations
hereunder and thereunder. This Agreement has been, and each Related Agreement
executed and delivered by Purchaser on or prior to the Closing will be, duly
and
validly executed and delivered by Purchaser and, assuming due and valid
execution by Seller, constitutes a legal, valid and binding obligation of
Purchaser enforceable against Purchaser in accordance with its
terms.
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4.3
Organization and Good Standing.
Purchaser is a corporation duly organized, validly existing and in good standing
under the Laws of the State of Florida. Purchaser is duly qualified to do
business as a foreign corporation in each jurisdiction in which the nature
of
its business or the character and location of the properties owned or leased
by
it makes qualification of it as a foreign corporation necessary under applicable
Laws, excepting only those jurisdictions where failure to be so qualified would
only subject Purchaser to the obligation to pay nominal filing fees or nominal
penalties to be qualified therein. Purchaser has the corporate power and
authority to own, operate and lease its properties and to carry on its
businesses as now conducted.
4.4
No Violation.
Neither
the execution and delivery by Purchaser of this Agreement or any Related
Agreement, nor the consummation of the transactions contemplated hereby or
thereby by Purchaser, nor compliance with any of the material provisions hereof
or thereof by Purchaser, will: (i) violate, conflict with or result in a breach
of any material provision of the Purchaser’s Articles of Incorporation, as
amended to date, certified by the Secretary of State of the State of Florida,
and a copy of the Purchaser’s Bylaws, as amended to date; (ii) violate, in any
material respect, any Order or Law applicable to Purchaser; or (iii) except
for
filings and notices required by the OIR, AHCA and CMS, or as set forth in
Schedule
4.4,
require
any consent, approval or authorization of, or notice to, or declaration, filing
or registration with, any Governmental Authority.
4.5
Investment Representations.
(a)
Purchaser has the financial capability to consummate the transactions
contemplated by this Agreement, and Purchaser understands that under the terms
of this Agreement its obligations hereunder are not in any way contingent or
otherwise subject to (i) Purchaser’s consummation of any financing arrangements
or Purchaser obtaining any financing or (ii) the availability of any financing
to Purchaser.
(b)
Purchaser hereby confirms that the Shares are being acquired for investment
for
Purchaser’s own account, not as a nominee or agent, and not with a view to the
resale or distribution of any part thereof, and that Purchaser has no present
intention of selling, granting any participation in, or otherwise distributing
the same.
(c)
Purchaser is an experienced investor, can bear the economic risk of its
investment, and has such Knowledge and experience in financial or business
matters that it is capable of evaluating the merits and risks of the investment
in the Company and the Shares.
(d)
Purchaser is an “accredited investor” as such term is defined in Regulation D
promulgated by the Securities and Exchange Commission.
4.6
Restricted Securities.
Purchaser understands that the Shares: (i) are “Restricted
Securities,”
as
defined in Rule 144 promulgated under the Securities Act; (ii) have not been
registered under the Securities Act or any Laws of any state; (iii) are being
acquired in a transaction not involving a public offering; and (iv) under
applicable Law, such securities may be subject to restrictions or prohibitions
on subsequent sales or transfers.
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4.7
Brokers’ Fees.
Purchaser has no liability or obligation to pay any fees or commissions to
any
broker, finder, or agent with respect to the transactions contemplated by this
Agreement.
4.8
Financing.
Purchaser will at Closing, and at all applicable times after the Closing, have
sufficient available funds to pay the Preliminary Purchase Price and to pay
any
additional amounts required under Section 2.
5.
Pre-Closing Covenants.
5.1
Access and Information; Inspections.
(a)
From the
Effective Date through the Closing Date, Seller shall afford, and shall cause
the Company to afford, to Purchaser and its Advisors, upon reasonable prior
notice to Seller, full and complete access during normal business hours or
other
mutually agreed times to, and the right to inspect, as applicable, the
employees, properties, books, accounts, records, Contracts and all other
relevant documents and information with respect to, the assets, Liabilities
and
operations of the Company and, as necessary, Seller and its Subsidiaries; and
will furnish Purchaser and its Affiliates, officers and agents (including those
described above) with such additional financial and operating data and all
other
information that it or they may reasonably request to investigate all aspects
of
the Company and its businesses, financial condition and operations, and, as
necessary, Seller and its Subsidiaries, and to effect an orderly transition
and
integration of the Company into Purchaser’s group of Affiliated entities.
Purchaser’s right of access and inspection shall be exercised by Purchaser and
its Advisors in such a manner as not to interfere unreasonably with the
operations of the Company, Seller and their Affiliates. Seller acknowledges
and
agrees that it will not unreasonably deny or condition access to the premises
of
the Company by Purchaser or its Advisors prior to and beyond normal business
hours. Seller shall make available to Purchaser a reasonable amount of office
space at the Company’s premises to accommodate Purchaser’s Advisors responsible
for the orderly integration of the Company with Purchaser, including reasonable
access to ports for telephone, computer and other data transmission. No
investigation made by Purchaser as contemplated herein shall affect or diminish
Seller’s representations and warranties contained in this Agreement or
Purchaser’s rights and remedies for any breach of, or inaccuracy in, those
representations or warranties. Seller and its employees, agents and
representatives shall, and shall cause the Company and its employees, agents
and
representatives, to cooperate in a commercially reasonable manner with Purchaser
and its employees, agents and representatives in its conduct of any
investigation contemplated herein.
(b)
In
addition to the covenants set forth in Section 5.1(a),
between
the Effective Date and the Closing Date or the earlier termination of this
Agreement, Seller shall permit Purchaser and its Advisors to meet with the
Controller or Chief Financial Officer of the Company and all other officers
of
the Company responsible for the financial statements and related policies and
practices, and the internal controls, disclosure controls and procedures of
the
Company, to discuss such matters as Purchaser may deem reasonably necessary
or
appropriate for Purchaser or any of its Affiliates to satisfy their respective
obligations under Sections 302 and 906 of the Xxxxxxxx-Xxxxx Act of 2002, as
amended, and all rules and regulations promulgated thereunder.
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(c)
During
the period commencing on the Effective Date and ending on the earlier of the
Closing Date or the earlier termination of this Agreement, within thirty (30)
days of the end of each calendar month, Seller shall provide to Purchaser a
copy
of the Company’s unaudited interim financial statements for such month, prepared
in accordance with GAAP and in accordance with SAP (provided that such
statements may be subject to normal year-end adjustments and omit footnotes
required by GAAP or SAP, as applicable). Further, until the Effective Time
or
the termination of this Agreement, Seller shall deliver to Purchaser within
five
(5) Business Days after they are filed any subsequent interim or annual
financial statutory statements that are filed with the OIR. Purchaser will
hold
all information contained in such financial statements strictly
confidential.
5.2
Conduct of Business.
During
the period commencing on the Effective Date and ending on the earlier of the
Effective Time or the earlier termination of this Agreement, except as otherwise
consented to or approved by an authorized officer of Purchaser in writing or
required by this Agreement, Seller shall cause the Company to:
(a)
use
commercially reasonable efforts to carry on its business operations in
substantially the same manner as presently conducted and shall not make any
change in its policies regarding personnel, operations, finance, or accounting
(unless the Company is required to adopt such changes under GAAP, SAP or
applicable Law);
(b)
use
commercially reasonable efforts, consistent with past practice, to maintain
and
preserve the Company’s Business, including the maintenance and preservation of
all licenses and permits of the Company and all actions in the Ordinary Course
of Business to renew and extend existing Governmental Authorizations of the
Company;
(c)
maintain
the Statutory Surplus of the Company at a level equal to or greater than the
minimum statutory surplus required by Section 641.225 of the Florida Statutes,
as modified by Orders of the OIR and AHCA, and all other applicable Laws or
Orders;
(d)
perform
all of its material obligations under the Material Agreements;
(e)
keep in
full force and effect present insurance policies or other comparable
self-insurance in coverage amounts consistent with past practice;
(f)
use
commercially reasonable efforts to retain the present employees engaged in
providing services to the Company and maintain the Company’s relationships with
Governmental Authorities, suppliers, customers, agents, producers, brokers
and
others having business relationships with the Company; and
(g)
promptly
advise Purchaser in writing of the occurrence of any event or circumstance
having a Material Adverse Effect on the Company.
5.3
Negative Covenants of Seller.
During
the period commencing on the Effective Date and ending on the earlier of the
Effective Time or the earlier termination of this Agreement, Seller shall not
cause or permit the Company to, except as may be required by this Agreement
or
applicable Law or as otherwise consented to or approved by an authorized officer
of Purchaser in writing:
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(a)
adopt
any amendments to the Company’s Articles of Incorporation or
Bylaws;
(b)
materially amend, terminate, fail to renew, or enter into any Material Agreement
or any Governmental Authorization;
(c)
except
in the Ordinary Course of Business, terminate any employee, officer, consultant,
or agent, or hire or retain any new employee, officer, consultant or agent,
or
defer, modify or increase compensation payable or to become payable or make
any
bonus payment to, or otherwise enter into one or more bonus agreements or
arrangements with, any employee, officer, consultant, or agent, other than
customary compensation arrangements, increased compensation or bonus payments
based on merit made in the Ordinary Course of Business;
(d)
allow
transactions between the Company and its Affiliates entered into after the
Effective Date to take place other than on arm’s length terms;
(e)
incur
any indebtedness for borrowed money having a principal balance of $50,000 or
more, or assume, guarantee, endorse or otherwise become responsible for
obligations of any other Person (including an Affiliate), or make loans or
advances to any Person (other than advances to employees made in the Ordinary
Course of Business);
(f)
declare,
set aside or pay dividends and other distributions to Seller;
(g)
fail to
comply in all material respects with applicable Laws and Orders applicable
to
the Company;
(h)
take or
fail to take any other action that is reasonably likely to result in the breach,
default, termination or cancellation of, any Material Agreement;
(i)
transfer, issue or dispose of any shares of capital stock or other securities
of
the Company, or grant options, warrants, calls or other rights to purchase
or
otherwise acquire, directly or indirectly, any shares of capital stock or other
securities of the Company;
(j)
acquire
(whether by purchase or lease), sell, assign, lease, or otherwise transfer
or
dispose of any of the assets of the Company, except in the Ordinary Course
of
Business;
(k)
suffer
any Lien or other restriction on the Shares or any of the material assets or
properties used by the Company in the Business, except for Permitted
Liens;
(l)
adopt,
cease participation in, terminate or amend a Seller Plan, except for the
amendment to the Seller’s Omnibus Equity Compensation Plan anticipated to be
voted upon at the Seller’s 2008 Annual Meeting of Shareholders and any
amendments to a Seller Plan that may be necessitated by section 409A of the
Internal Revenue Code;
-35-
(m) other
than in the Ordinary Course of Business or as set forth on Schedule
5.3(m),
cancel
or compromise any material debt or claim or waive or release any material
right;
(n)
acquire
or agree to acquire, the securities of any other Person other than investment
securities acquired in the Ordinary Course of Business;
(o)
make a
change to any significant business policies relating to marketing, pricing,
underwriting, billing, collection, enrollment functions, reserves, claims
administration, claims processing and claims payment, payment of trade debts
or
purchasing, except changes in the Ordinary Course of Business, administrative
changes involving de minimis cost, or changes required by applicable
Laws;
(p)
make any
capital expenditure or financing in excess of $50,000 individually or $150,000
in the aggregate;
(q)
effect
any recapitalization, reclassification or like change in the capitalization
of
the Company;
(r)
compromise or settle any Proceeding other than in a commercially reasonable
manner the effect of which, alone or together with other compromises or
settlements, would be materially adverse to any Governmental Authorization
of
the Company, any Contract with CMS, or the Business or operations of the Company
after the Effective Time; or
(s)
commit
to do or omit to do any of the foregoing.
5.4
No-Shop. From
and
after the Effective Date until the earlier of the Effective Time or the
termination of this Agreement in accordance with Section 9,
neither
Seller nor Company shall cause its officers, directors, employees,
representatives, and Subsidiaries (including the officers, directors, employees
and representatives of such Subsidiaries) to, directly or indirectly, without
the prior written consent of Purchaser: (i) offer for sale, lease or otherwise
dispose of the Shares or all or substantially all of the Company’s assets; (ii)
solicit offers to buy, or initiate or continue contacts with, or negotiate
with
or aid in the due diligence of, any other Person seeking to acquire all or
any
material portion of the Company; or (iii) enter into any agreement with any
party (other than Purchaser or an Affiliate thereof), or initiate or continue
contacts with, or negotiate with or aid in the due diligence of, any other
Person with respect to the sale or other disposition of any of the Shares or
all
or substantially all of the assets of the Company, in each case, whether by
stock sale, merger, share exchange, consolidation, asset sale, or other
transaction or series of related transactions.
5.5
Efforts to Close.
Except
as provided in Section 5.7(c)
and
subject to the terms and conditions provided herein, the Parties shall use
their
reasonable best efforts to take or cause to be taken, all actions and to do,
or
cause to be done, all things necessary, proper or advisable to consummate the
transactions contemplated by this Agreement and the Related Agreements,
including satisfaction (but not waiver) of all of the conditions precedent
set
forth in Sections 7
and
8
to
Seller’s or Purchaser’s obligations under this Agreement to the extent that the
Party’s action or inaction can control or influence the satisfaction (but not
waiver) of such conditions.
Further,
Seller and Purchaser shall use their respective reasonable best efforts to
obtain and shall cooperate with each other and their respective Affiliates
and
Advisors to obtain all consents, waivers, approvals, authorizations and notices
to or from Persons, other than Governmental Authorities, which are necessary
for
Seller and Purchaser, respectively, to consummate the transactions contemplated
herein or for Purchaser to obtain the rights and benefits of the Material
Agreements or other material assets of the Company from and after the Effective
Time, including those set forth in Schedule
3.4(b).
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5.6
Confidentiality.
The
Parties shall, and shall cause their respective Affiliates and Advisors to
comply in all respects with the terms of that certain Confidentiality Agreement,
dated as of July 26, 2007, by and between the Purchaser and the Seller.
5.7
Required Governmental Approvals.
(a)
Except
as provided in Section 5.7(c),
each of
the Parties, as promptly as reasonably practicable after the date of execution
of this Agreement and to the extent that such Party’s action or inaction is
required or necessary to procure, or may otherwise control or influence the
procurement of, such Governmental Authorizations, shall give any notices to,
make any filings with, and use its reasonable best efforts to obtain any
Governmental Authorizations that are necessary or required to be given, made
or
obtained by Law or in connection with the Sale and the consummation of all
other
transactions contemplated by this Agreement and any Related Agreement, including
those required by the OIR, AHCA, CMS, and any Governmental, Authority of a
jurisdiction wherein the Company is engaged in Business.
(b)
The
Parties shall cooperate with each other and their respective Affiliates and
Advisors to obtain all Governmental Authorizations necessary or required to
carry out the transactions contemplated by this Agreement, including all
Governmental Authorizations required by the OIR, AHCA or CMS, and all other
Governmental Authorizations that Purchaser reasonably deems necessary or
appropriate. Each Party will provide and the Seller will cause the Company
to
provide such other information and communications to Governmental Authorities
as
the other Party or such authorities may reasonably request. The Parties hereto
will not take any action that will have the effect of delaying, impairing or
impeding the receipt of any required approvals and shall promptly respond to
any
requests for additional information from any Governmental Authority or filings
in respect thereof.
(c)
Notwithstanding anything in this Agreement to the contrary, neither Purchaser
nor any Affiliate of Purchaser shall have any obligation to sell, divest, or
otherwise dispose of any of its or their assets or businesses, or to otherwise
take action that would be materially adverse to its or their businesses, assets,
financial condition or operations, (i) to remove any condition to the
Purchaser’s receipt of a Governmental Authorization necessary or required for
the consummation of the transactions contemplated by this Agreement or any
Related Agreement, or (ii) to avoid the entry of, or to effect the dissolution
of, any Order in any Proceeding, that would otherwise have the effect of
preventing or materially delaying the consummation of the transactions
contemplated by this Agreement or any Related Agreement.
5.8
Transactions with Affiliates.
At or
prior to the Closing, (i) Seller shall cause the Company to terminate all
Contracts, transactions and other arrangements with Seller and its Affiliates,
other than the MHP Provider Agreements and any Contract that is otherwise
identified in Schedule
5.8,
at no
cost or expense to the Company or Purchaser, and (ii) Seller shall use its
reasonable best efforts to secure the full release of the Company and Purchaser
from all Liabilities arising under or in connection with any such Contract
or
arrangement terminated in accordance with this Section 5.8.
In
addition, except as set forth in Schedule
5.8,
or for
those payables and receivables included in the determination of the Closing
Net
Equity, all intercompany payables and receivables between the Company and
Seller, or any Affiliate of Seller, shall be fully collected and discharged
or
paid (as applicable) at or prior to the Closing.
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5.9
Certain
Notifications Required.
During
the period commencing on the Effective Date and ending on the earlier of the
Closing Date or the earlier termination of this Agreement, Seller shall give
prompt notice in writing to Purchaser of: (i) any information that to its
Knowledge indicates that any representation or warranty of Seller contained
in
this Agreement was not true and correct in all material respects as of the
Effective Date or will not be true and correct in all material respects as
of
the Closing Date as though made on such date; (ii) the occurrence of any event
that, to its Knowledge, will result, or is likely to result, in the failure
of a
condition in Section 8;
and
(iii) any fact, condition or change that Seller reasonably believes,
individually or in the aggregate, has resulted or is reasonably likely to result
in a Material Adverse Effect. Except as provided in the next sentence, no notice
of the type described above by Seller to Purchaser shall be deemed to affect
or
diminish Seller’s representations or warranties set forth in this Agreement, to
amend or supplement Seller’s disclosure schedules to this Agreement, or to
affect or diminish the remedies and indemnities available to Purchaser or any
other Purchaser Indemnified Parties in this Agreement. Notwithstanding the
immediately preceding sentence, if Seller in good faith gives Purchaser specific
notice (“MAE
Notice”)
of
facts or circumstances that, individually or together with other facts or
circumstances previously disclosed to Purchaser in a MAE Notice, have the effect
that: (i) to its Knowledge, Seller cannot certify at Closing that its
representations and warranties are true and correct as of the Closing Date
in
accordance with Section 8.5;
(ii) it
reasonably believes that the condition to closing set forth in Section
8.5
has
failed, as there has occurred a Material Adverse Effect; and (iii) that
Purchaser has the right to terminate this Agreement as a consequence thereof
absent waiver of the condition to Closing by Purchaser, then Purchaser, if
it
does not terminate this Agreement within ten (10) Business Days after delivery
of such MAE Notice or it otherwise elects to close the transactions contemplated
by this Agreement in spite of such MAE Notice, shall be deemed to have accepted
such MAE Notice as an amendment and/or supplement to Seller’s disclosure
schedules and to have waived all rights to seek indemnification and further
recourse specifically with respect thereto. Each time after a MAE Notice that
Seller shall make an additional disclosure to Purchaser as required by this
Section 5.9,
Purchaser shall be afforded a period of ten (10) Business Days to evaluate
the
cumulative effect of such disclosure together with all previous disclosures,
including the MAE Notice, and may elect to terminate this Agreement and not
close the transactions provided for herein, failing which, it shall be deemed
to
have accepted such disclosure as an amendment and/or supplement to Seller’s
disclosure schedules and to have waived all rights to seek indemnification
and
further recourse specifically with respect thereto.
5.10
Insurance.
Seller
shall use commercially reasonable efforts to procure an
extension or “tail” to the Company’s existing Errors and Omissions Liability
Coverage Policy with The Camden Fire Insurance Association (OneBeacon), Policy
No. MCP-2582-08, which policy (as so extended) shall cover, for a period of
three (3) years
after the Closing Date, errors and omissions that occurred prior to the Closing
Date; it being understood that the costs of such extensions shall be paid by
Seller. Purchaser shall cooperate with Seller and its Affiliates,
representatives and attorneys in Seller’s efforts to obtain such
extension.
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6.
Post-Closing Covenants.
6.1
Non-solicitation.
As an
inducement to Purchaser to enter into this Agreement and to consummate the
transactions contemplated hereby, from the Effective Date until the second
anniversary of the Effective Time, Seller shall not, and shall not cause
or
permit any of its Subsidiaries to, hire any individual who is an employee
of the
Company without the prior written consent of Purchaser; provided, that the
foregoing non-solicitation covenant shall not: (i) apply to those individuals
who have been asked to resign or are terminated in connection with the
consummation of the transactions provided for herein; (ii) prohibit any Seller
or any of its Subsidiaries from hiring any such employee whose employment
has
been terminated by the Company after the Effective Time; or (iii) prohibit
the
hiring of an individual who applies for a job advertised in a publication
or
trade or general circular or on an internet website and who was not otherwise
encouraged or directly enticed by Seller or its respective Affiliates to
make
such application.
6.2
Non-competition;
Non-solicitation of Members or Providers.
(a)
As an
inducement to Purchaser to enter into this Agreement and to consummate the
transactions contemplated hereby, from the Closing Date until the fifth
anniversary of the Closing Date, Seller shall not, and shall not cause or
permit
any of its Subsidiaries to, anywhere within the State of Florida, directly
or
indirectly: (i) own, operate or engage in any business, including any managed
care business or health insurance business, which provides products or services
or engages in businesses or operations that are in competition with the
products, services, Business or operations of the Company, including without
limitation, in the business or operations of owing, managing or operating
a
Medicare Advantage plan or program, a Medicare Advantage Prescription Drug
plan
or program, or a risk based business that contracts with CMS, or its successor,
to provide Medicare Part A and/or Medicare Part B entitlements, whether as
a
HMO, POS plan or product, PPO or Provider Sponsored Organization (each a
“Competitive
Business Activity”);
(ii)
become an agent or consultant of any Competitive Business Activity; or (iii)
obtain
or
hold an interest in any such Competitive Business Activity as a partner,
joint
venturer, shareholder, member or investor; provided, however, that the ownership
of not more than five percent (5%) of the securities of a publicly traded
entity
engaged in a Competitive Business Activity shall not itself be deemed to
be a
violation of this Section 6.
(b)
Without
Purchaser’s prior written consent, Seller shall not, and shall not cause or
permit any of its Subsidiaries to, for a period of five (5) years from and
after
the Closing Date, individually or on behalf of any other Person, directly
or
indirectly, solicit, induce, or attempt to persuade any Member, or any provider
subject to an existing Provider Contract of the Company, to terminate or
fail to
renew its enrollment with the Company or any Affiliate of the Company, or
to
enroll or contract with a Person other than the Company or an Affiliate of
the
Company.
(c)
The
foregoing covenants furnished under this Section 6.2
shall
not, in any way, restrict or limit Seller or its Affiliates from entering
into a
Contract with a payor (e.g. an insurer or HMO or ERISA plan) pursuant to
which
Seller or its Affiliates undertakes to provide physician network services
or
other physician services to or on behalf of the individuals covered by such
payor in the State of Florida.
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(d)
All time
periods referenced in this Agreement shall be computed by excluding from
such
computation any time during which Seller or any of its Affiliates is in
violation of any provision of this Section 6.2
and any
time during which there is pending in any court of competent jurisdiction
any
Action (including any appeal from any final judgment) brought by any Person,
whether or not a Party to this Agreement, in which Action Purchaser seeks
to
enforce the agreements and covenants in this Section 6.2
or in
which any Person contests the validity of such agreements and covenants or
their
enforceability or seeks to avoid their performance or enforcement.
(e)
Seller
acknowledges that the type and period of restriction imposed in the provisions
of this Section 6.2
are fair
and reasonable and are reasonably required for the protection of Purchaser.
If
any of the covenants in this Section 6.2
are
construed to be invalid or unenforceable, that construction shall not affect
the
remainder of the covenants contained in this Section 6.2,
which
shall be given full effect without regard to the invalid portions. If any
of the
covenants contained in this Section 6.2
are held
to be unenforceable because of the duration of the covenant or the area covered
by the covenant, a court of competent jurisdiction shall have the power to
amend
the duration or areas covered and, in its amended form, the provisions shall
then be enforceable.
(f)
If
either Seller or any of its Subsidiaries commits a breach, or are about to
commit a breach, of any of the provisions of this Section 6.2,
Purchaser shall have the right to have the provisions of this Section
6.2
specifically enforced by any court having equity jurisdiction, it being
acknowledged and agreed that any breach or threatened breach of this Section
6.2
may
cause irreparable injury to the non-breaching Party and that money damages
may
not provide an adequate remedy to Purchaser.
(g)
In the
event that on or prior to the fifth anniversary of the Closing Date, Purchaser
and/or its Affiliates terminates that Independent Practice Association
Participation Agreement, dated of even date herewith (the “IPA
Agreement”),
for
any reason other than a reason set forth in Section 6.3 or Section 6.4 of
the
IPA Agreement, the provisions of this Section 6.2 shall automatically terminate
and have no further force and effect.
(h) As
an
additional inducement to Purchaser to enter into this Agreement and to
consummate the transactions contemplated hereby, at or prior to the Closing,
Seller shall cause the executives of Seller identified on Schedule 6.2(h)
to
execute and deliver to Purchaser an Agreement Not to Compete or Solicit in
the
form of Exhibit
D
attached
hereto.
6.3
Employee Matters.
(a) Seller
will cause the Company to furnish to Purchaser an updated employee list,
containing all the information as required by Section 3.21(a),
as of a
date no more than fifteen Business Days prior to the Closing Date. Purchaser
shall use commercially reasonable efforts to continue the employment of the
employees of the Company who can be accommodated and who meet the normal
employment eligibility requirements that Purchaser enforces with respect
to its
employees. Any continuation of employment of the employees of the Company
shall
be on such terms and conditions as Purchaser in its sole discretion determines
to be appropriate, and without guarantee that any such employee shall receive
an
offer of employment for the same or similar position that he currently holds,
or
for the wages and benefits that he currently receives. It is understood and
agreed that any continued employment by an employee of the Company is “at will”
and may be terminated by Purchaser at any time for any reason (subject to
any
written commitments to the contrary made by Purchaser and applicable Laws).
Nothing in this Agreement shall be deemed to prevent or restrict in any way
the
right of Purchaser or the Company, post-closing, to terminate, reassign,
promote
or demote any of the continued employees after the Closing or to change
adversely or favorably the title, powers, duties, responsibilities, functions,
locations, salaries, other compensation or terms or conditions of employment
of
any such employees. Seller shall amend the Metropolitan Health Networks 401(k)
Plan, effective prior to the Closing Date, to provide that the Company's
employees no longer shall be eligible to participate in such retirement plan
from and after the Effective Time. Prior to the Closing Date, Seller shall
furnish to Purchaser a copy of such amendment to the Metropolitan Health
Networks 401(k) Plan, along with appropriate resolutions of Seller and the
Company authorizing and adopting such amendment. Purchaser agrees that the
Company employees whose employment continues from and after the Effective
Time
shall be eligible to participate in the Humana Retirement and Savings Plan
from
and after the Effective Time, subject to the terms and conditions of such
retirement plan. The Humana Retirement and Savings Plan, however, will not
accept any direct transfer or direct rollover of account balances from the
Metropolitan Health Networks 401(k) Plan.
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(b) No
later
than ten Business Days prior to the Closing Date, Purchaser shall provide
to
Seller and the Company a list of all employees of the Company whose employment
with the Company, as determined by Purchaser in its sole discretion, shall
cease
from and after the Closing (such list to be attached hereto and incorporated
herein as Schedule
6.3(b)).
Effective as of the Closing, any and all future rights, obligations and/or
Liabilities in connection with the employment of such employees, if any,
shall
be transferred to Seller from the Company, and Seller shall accept such transfer
and assume from the Company full and complete responsibility for all such
future
rights, obligations or Liabilities held by or owed to such employees from
the
Company, including continued employment obligations, any payment obligations
associated with employment, any severance or change of control payments or
bonuses, or similar compensatory arrangements or termination payment
obligations, which are payable to such employees. Except as provided in this
Section 6.3(b)
below or
in Section 6.3(c)
below,
Seller shall have no responsibility for any rights or Liabilities held by
or
owed to any employees of the Company that are not listed on Schedule
6.3(b).
With
respect to any “M&A qualified beneficiary” of Seller or the Company within
the meaning of Treas. Reg. § 4980B-9 Q&A 4, continuation coverage under
COBRA shall be furnished under the Seller's group health plan. In the event
of
any corporate reorganization or sale of assets or stock of Seller prior to
Seller’s fulfillment of its COBRA obligations to any M&A qualified
beneficiaries hereunder, Seller shall require, as a condition of any such
transaction, that the transferee(s) of any stock or assets assume and fulfill
the remaining COBRA obligations to M&A qualified beneficiaries.
(c) For
those
employees of the Company under a written employment Contract with the Company,
who the Purchaser desires to continue their employment with the Company after
the Closing but requires that their written Contract be terminated at or
prior
to the Effective Time, all of whom are identified on Schedule 6.3(c)
attached
hereto,
Seller
shall assume from the Company full and complete responsibility for all
additional obligations or Liabilities (i) which Seller or the Company agrees
to
pay to induce such employees to terminate their employment Contracts with
the
Company and become at-will employees of the Company at or prior to the Effective
Time or (ii) which are contractual commitments made to such employees of
the
Company that survive the termination of their Contracts and are not waived
by
such employees or cannot be waived by such employees under applicable Law.
If,
following the Closing, Purchaser or the Company terminates any employees
listed
on Schedule
6.3(c)
hereto,
Purchaser shall have full and complete responsibility for all rights or
Liabilities held by or owed to such employees from the Company under the
terms
and conditions for continuation of their employment put into effect by Purchaser
following the Closing, including, as applicable, continued employment
obligations, any payment obligations associated with their post-Closing
employment, any severance or change of control payments or bonuses, or similar
compensatory arrangements or termination payment obligations, which are payable
to such employees under Purchaser’s policies, terms and conditions of
employment.
-41-
6.4
Use of Name and Trademarks.
(a)
No more
than thirty (30) days following the Effective Time, if permitted by the OIR
(or
as soon thereafter as the OIR permits), Purchaser shall take all action
necessary to change the legal name of the Company such that it does not contain
the words “Metcare” or abbreviations or variations thereof, and, except as
provided below, to cease using the name “Metcare” or any other names or symbols
or abbreviations thereof or service marks, symbols or logos related thereto,
or
any promotional material, stationery, supplies or other items of inventory
bearing either such names, symbols or abbreviations or variations thereof;
provided, that the Company may maintain a fictitious name filing with the
Florida Secretary of State for the use of the name “Metcare” for the uses
specifically authorized by Seller below.
Prior to
the Closing, Seller shall take all action as may be required to insure that
the
Company will have, from and after the Effective Time, the full, absolute
and
unrestricted right and authority to use the “AdvantageCare” name.
(b)
The
Company shall be permitted to use in its Ordinary Course of Business, consistent
with past practice, the Company’s signs and brochures, stationery, letterhead,
business cards and other comparable supplies in existence as of the Closing
Date, even if they include the names, symbols, logos and marks otherwise
prohibited by Section 6.4(a),
up to
and including December
31, 2009.
Purchaser and the Company may use any preexisting summary of benefit documents,
plan descriptions or similar forms or documents, even if they include the
names,
symbols, logos and marks otherwise prohibited by Section 6.4(a),
up to
and including December
31, 2009,
or such
longer period reasonably acceptable to Seller.
(c)
Through
December 31, 2009, the Company shall be permitted to communicate or correspond
with existing or potential customers or insureds, beneficiaries or network
providers using the names and other symbols, logos and marks otherwise
prohibited by Section 6.4(a),
provided that (i) Purchaser uses reasonable commercial efforts to inform
such
parties that the Company is now Affiliated with Purchaser and not with Seller,
and (ii) Purchaser shall not use the names, symbols, logos and marks prohibited
by Section 6.4(a)
in any
general or targeted advertising or solicitation without the prior written
consent of Seller, which consent is not to be unreasonably withheld, conditioned
or delayed by Seller.
(d)
The
Company shall have the right to provide membership cards and enrollment kits
to
any Persons who enroll or re-enroll during calendar year 2009, and such
customers or insureds of the Company shall be permitted to use such cards
until
replacement cards are issued by the Company on the next subsequent renewal
date.
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(e)
Promptly
following the Closing Date, Purchaser and Seller shall cooperate in preparing
a
written communication to be mailed to all customers or insureds, vendors
and
others with whom the Company does business advising of the
transaction.
(f)
Seller
and Purchaser acknowledge that the computer operating systems used by Purchaser
and the Company may be either incompatible or incapable of being integrated
in a
manner to allow for the orderly transition and transfer of membership and
provider information and data from the Company’s current operating system to the
Purchaser’s operating system to be utilized by the Company after the Closing.
Seller and Purchaser further agree that the inability to reconcile the two
operating systems would impose an unreasonable burden on Purchaser if Purchaser
was required to cease utilizing the Metcare name
in
connection with any explanation of benefits reports or other routine
communications with customers or insureds of the Company who are enrolled
for
the calendar year 2009 (and any prior calendar year) (the “Routine
Communications”).
Each
of the Parties agree to use commercially reasonable efforts, during the period
from the date of this Agreement through the Closing Date, to reconcile the
differences in the operating systems to allow for Routine Communications
to be
made to the customers and insureds in a manner consistent with Section
6.4(a)
through
6.4(e)
above.
As of the Closing Date, if Purchaser determines in its reasonable discretion
that the systems cannot be reconciled successfully without unreasonable
allocation of resources, cost or expense to Purchaser, Purchaser may use
the
Metcare name
for
Routine Communications through December 31, 2010.
6.5
Tax Matters.
(a)
Seller
shall prepare and file or otherwise furnish in proper form to the appropriate
Governmental Authority, or cause to be prepared and filed or so furnished
in a
timely manner (taking into account timely and valid extensions), all Tax
Returns
relating to Company which are required to be filed on or prior to the Effective
Time and all Tax Returns with respect to the Company which are required to
be
filed on a combined, consolidated, unitary or similar group basis for any
tax
period of the Company that ends on or before the Effective Time. Purchaser
shall
prepare and file or otherwise furnish in proper form to the appropriate
Governmental Authority, or cause to be prepared and filed or so furnished
in a
timely manner (taking into account timely and valid extensions), all other
Tax
Returns relating to Company which are required to be filed after the Closing
Date. With
regards to any Income Tax Returns relating to Pre-Closing Tax Periods that
are
due following the Closing, which are not required to be filed on a combined,
consolidate, unitary or similar group basis, Purchaser shall have control
of the
content, manner and timing of the preparation and filing of such Income Tax
Returns with the appropriate Governmental Authority. Any disputes relating
to
the Taxes due and owing for any Pre-Closing Tax Period, including any Straddle
Period Taxes, shall be reconciled by the parties in the determination of
the
Closing Net Equity and the Net Equity Adjustment Amount.
(b)
Seller
shall not amend any combined, consolidated, unitary or similar group Tax
Return
for any Pre-Closing Tax Period in a manner that negatively impacts the Company
for any Post-Closing Tax Period, without the prior consent of
Purchaser.
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(c)
If,
subsequent to the Closing, Purchaser or Company receives notice of any audit,
examination or other proceeding relating to any Tax Return filed by Company
(a
“Tax
Audit”)
with
respect to any Tax Return for a any Pre-Closing Tax Period,
then
within ten (10) Business Days after receipt of such notice, Purchaser shall
notify Seller of such notice.
(1)
Seller
shall have the right to control the conduct and resolution of such Tax Audit
(other than a Tax Audit of a Tax Return for a Straddle Period), provided,
however, that if any of the issues raised in such Tax Audit could have an
impact
on Taxes of Company for a Post-Closing Tax Period, or any tax accounting
method
or position taken on a Tax Return in any Post-Closing Tax Period, then Seller
shall afford Purchaser the opportunity to control jointly the conduct and
resolution of the portion of such Tax Audit which could have an impact on
Taxes
of Company in any Post-Closing Tax Period. If Seller shall have the right
to
control the conduct and resolution of a Tax Audit but elects not to do so,
then
Purchaser shall have the right to control the conduct and resolution of such
Tax
Audit. Each party shall bear its own costs for participating in such Tax
Audit.
(2)
Purchaser shall control the conduct and resolution of any Tax Audit of Straddle
Period Taxes, and the resolution of such Tax Audit shall be at Purchaser’s sole
risk or for Purchaser’s sole benefit. The costs of such Tax Audit shall be borne
exclusively by Purchaser.
(d)
Following the Closing Date, Seller, on the one hand, and Purchaser and Company,
on the other hand, shall (and shall cause their respective Affiliates
to):
(1)
cooperate fully in responding to any inquiries from or preparing for any
audits
of, or disputes with taxing authorities regarding, any Taxes or Tax Returns
of
Company;
(2)
make
available to the other Party or parties, as the case may be, as reasonably
requested, all information in its possession relating to the Company and
its
Subsidiaries which may be relevant to any Tax Return, Tax claim or assessment
or
to any taxing authority as reasonably requested by Seller or Company;
and
(3)
timely
sign and deliver such certificates or forms as may be necessary or appropriate
to establish an exemption from (or otherwise reduce), or file Tax Returns
or
other reports with respect to, Taxes.
(e)
Unless
otherwise required by a final determination of a Governmental Authority,
the
Parties shall treat all payments made pursuant to this Agreement after the
Closing as adjustments to the Purchase Price, except to the extent any such
payment is classified as interest under applicable Tax law.
6.6
IT Transition Costs.
During
the period commencing at the Effective Time and expiring on the first day
of the
month (the “Transition
Date”)
following the date that Purchaser provides Seller with written notice that
it
has ceased using the information technology systems provided to the Company
by
HF Administrative Services, Inc. (“HealthFirst”)
for
the processing of new claims and the processing of new members, Purchaser
shall
be responsible for the timely payment of all fees and expenses due HealthFirst
under the Administrative Services Agreement between HealthFirst and the Company
(the “HealthFirst
Agreement”).
Commencing on the Transition Date until the termination of such HealthFirst
Agreement in accordance with its terms, Seller shall be responsible for the
timely payment of the minimum monthly fees and expenses due HealthFirst under
the HealthFirst Agreement and Purchaser shall be responsible for all incremental
fees and expenses due HealthFirst under the HealthFirst Agreement.
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7.
Conditions Precedent to Obligations of Seller. Seller’s
obligation to consummate the Sale and the other transactions contemplated
by
this Agreement shall be subject to the satisfaction of each of the following
conditions on or prior to the Closing Date unless specifically waived in
writing
by Seller in whole or in part at or prior to the Closing:
7.1
Unfavorable Action or Proceeding.
On the
Closing Date, no Orders of any Governmental Authority shall be in effect
that
(i) prevent the consummation of the Sale, or (ii) makes the consummation
of the
Sale illegal.
7.2
Performance of Covenants.
Purchaser shall have in all material respects performed or complied with
each
and all of the obligations, covenants, agreements and conditions required
to be
performed or complied with by it on or prior to the Closing Date, including
but
not limited to Section 2.11
(except
to the extent limited or qualified by materiality or Material Adverse Effect,
in
which event such applicable obligations, covenants, agreements and conditions
shall have been performed or complied with in all respects in accordance
with
the terms of the applicable obligations, covenants, agreements and
conditions).
7.3
Governmental Authorizations.
Seller
and Purchaser shall have obtained all material Governmental Authorizations
from
Governmental Authorities that are necessary or required for completion of
the
transactions contemplated by this Agreement and any Related
Agreement.
7.4
Seller Third Party Consents.
Seller
and Purchaser shall have obtained any and all consents, waivers, approvals,
authorizations and notices from Persons, other than Governmental Authorities,
which are necessary for Seller and Purchaser to consummate the transactions
contemplated herein, including those listed in Schedule
3.4(b),
but
excepting any such consents, waivers, approvals, authorizations and notices
if
the failure to obtain the same, individually or in the aggregate, would not
materially negatively impact Purchaser’s or Seller’s ability to consummate this
Agreement and the transactions contemplated hereby (“Seller
Third Party Consents”).
7.5
Purchase Price.
Seller
shall have received the Preliminary Purchase Price in accordance with Section
2.2.
7.6
Warranties True and Correct.
The
representations and warranties of Purchaser set forth in this Agreement shall
be
true and correct in all material respects as of the date of this Agreement
and
shall be true and correct in all material respects at and as of the Closing
Date
as though made on and as of the Closing Date, except for (i) those
representations and warranties which refer to facts existing at a specific
date
which shall be true and correct in all material respects as of such date,
and
(ii) those representations and warranties that are modified or limited in
any
respect by a standard of materiality shall be true and correct in all respects
as of the date hereof and the Closing Date as though made on such
date.
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7.7
MHP Provider Agreement.
At or
before the Closing, the MHP Provider Agreements shall have been executed
and
delivered by MetCare of Florida, Inc., the Company and all of their respective
Affiliates and other Persons who are referenced as a party to such MHP Provider
Agreements.
7.8
Bring Down.
Purchaser shall have delivered to Seller a certificate, dated as of the Closing
Date, duly executed by its Chief Executive Officer, certifying compliance
with
the conditions specified above in Sections 7.2
and
7.6
(the
“Purchaser
Officer’s Certificate”).
8.
Conditions Precedent to Obligations of Purchaser. Purchaser’s
obligation to consummate the Sale and the transactions contemplated by this
Agreement shall be subject to the satisfaction of each of the following
conditions on or prior to the Closing Date unless specifically waived in
writing
by Purchaser in whole or in part at or prior to the Closing.
8.1
Unfavorable Action or Proceeding.
On the
Closing Date, no Orders of any Governmental Authority shall be in effect
that:
(i) prevent the consummation of the Sale; (ii) makes the consummation of
the
Sale illegal; or (iii) require as a condition to the receipt of the consent,
authorization or approval by such Governmental Authority, that Purchaser
or any
of its Affiliates must sell, divest or materially modify any existing line
of
business or any material portion thereof.
8.2
Performance of Covenants.
Seller
shall have in all material respects performed or complied with each and all
of
the obligations, covenants, agreements and conditions required to be performed
or complied with by Seller on or prior to the Closing Date , including but
not
limited to Section 2.10,
(except
to the extent limited or qualified by materiality or Material Adverse Effect,
in
which event such applicable obligations, covenants, agreements and conditions
shall have been performed or complied with in all respects in accordance
with
the terms of the applicable obligations, covenants, agreements and
conditions).
8.3
Governmental Authorizations.
Seller
and Purchaser shall have obtained all Governmental Authorizations from
Governmental Authorities that are necessary or required for completion of
the
transactions contemplated by this Agreement and any Related
Agreement.
8.4
Purchaser
Third Party Consents.
Purchaser and Seller shall have obtained any and all consents, waivers,
approvals, authorizations and notices from Persons, other than Governmental
Authorities, which are listed on Schedule
8.4,
and
shall have obtained any and all such other consents, waivers, approvals,
authorizations and notices from Persons, other than Governmental Authorities,
which are necessary for Purchaser and Seller to consummate the transactions
contemplated herein but excepting such consents, waivers, approvals,
authorizations and notices if the failure to obtain the same, individually
or in
the aggregate, would not have a Material Adverse Effect on the Company or
otherwise materially negatively impact Purchaser’s or Seller’s ability to
consummate this Agreement and the transactions contemplated hereby
(“Purchaser Third
Party Consents”).
-46-
8.5
Representations and Warranties True and Correct.
The
representations and warranties of Seller set forth in this Agreement shall
be
true and correct in all material respects as of the date of this Agreement
and
shall be true and correct in all material respects as of the Closing Date,
as
though made on such date, except for (i) those representations and warranties
which refer to facts existing at a specific date, which shall be true and
correct as of such date and (ii) those representations and warranties that
are
modified or limited in any respect by a standard of materiality shall be
true
and correct in all respects as of the date hereof and the Closing Date as
though
made on such date; provided, that this condition to Closing shall be deemed
satisfied, without prejudice to the right of Purchaser, or any Purchaser
Indemnified Parties, to seek indemnification for any such breach, if Seller
has
breached a representation or warranty, which individually or together with
all
other facts, events or circumstances inconsistent with any representation
or
warranty contained in this Agreement, has not had, or would not reasonably
be
expected to result in, a Material Adverse Effect, or violate any
Law.
8.6
Bring Down.
The
Chief Executive Officer of Seller shall have delivered to Purchaser a
certificate, dated as of the Closing Date, to the effect that each of the
conditions specified above in Sections 8.2
and
8.5
has been
satisfied (the “Seller
Officer’s Certificate”).
8.7
MHP Provider Agreement.
At or
before the Closing, the MHP Provider Agreements shall have been executed
and
delivered by MetCare of Florida, Inc., the Company and all of their respective
Affiliates and other Persons who are referenced as a party to such MHP Provider
Agreements.
8.8
Material Adverse Effect.
There
shall not have occurred a Material Adverse Effect which has not been waived,
or
deemed to have been waived, by Purchaser in accordance with the terms of
Section
5.9.
9.
Termination.
9.1
Termination.
This
Agreement may be terminated at any time prior to Closing:
(a)
by the
mutual written consent of Seller and Purchaser;
(b)
by
Purchaser, pursuant to Section 5.9;
or by
Purchaser if any of the conditions in Section 8
have not
been satisfied as of October 31, 2008 (the “Termination
Date”)
or if
satisfaction of any condition in Section 8
is or
becomes impossible and Purchaser has not waived such condition in writing
on or
before the Termination Date (provided that the failure to satisfy the applicable
condition or conditions has occurred by reason other than through the failure
of
Purchaser to comply with its obligations under this Agreement); or
(c)
by
Seller, if any of the conditions in Section 7
have not
been satisfied as of the Termination Date or if satisfaction of any such
condition in Section 7
is or
becomes impossible and Seller has not waived such condition in writing on
or
before the Termination Date (provided that the failure to satisfy the applicable
condition or conditions has occurred by reason other than through the failure
of
Seller to comply with its obligations under this Agreement).
-47-
9.2
Termination Consequences.
If this
Agreement is terminated pursuant to Section 9.1:
(i) all
further obligations of the Parties under this Agreement shall terminate,
except
that Sections 5.6,
11.3,
11.8
and
11.11,
and
this Section 9.2,
shall
survive; (ii) each Party shall pay the costs and expenses incurred by it
in
connection with this Agreement; and (iii) nothing shall prevent any Party
hereto
from pursuing any of its legal rights or remedies that may be available to
such
Party by Law or in equity against any other Party to this Agreement (including
the rights of any non-breaching Party to this Agreement to pursue its legal
rights or remedies against any breaching Party pursuant to this Agreement
or
otherwise).
10.
Survival and Indemnification.
10.1
Survival; Claims for Indemnification.
(a)
Except
as expressly set forth in this Agreement to the contrary, all representations
and warranties of Purchaser and Seller, respectively, contained in this
Agreement or in any Related Agreement, and as restated in any certificates
delivered at the Closing in connection with this Agreement, shall be deemed
to
be material and to have been relied upon by Purchaser (with respect to the
representations and warranties of Seller), and Seller (with respect to the
representations and warranties of Purchaser), respectively, and shall survive
the Closing, and any claims under Section 10.2
below
shall survive the Closing, and continue to be fully effective and enforceable
following the Effective Time, for twenty four (24) months, and shall thereafter
be of no further force and effect; provided: (i) that the representations
and
warranties set forth in Sections 3.1,
3.2,
3.4(a)(i),
3.5,
3.11,
4.1,
4.2,
and
4.4(i),
and
the time period for making any claim under Section 10.2
in
respect thereof (collectively, the “Transactional
Representations and Warranties”),
shall
survive the Closing and shall not expire; (ii) that the representations and
warranties set forth in Sections 3.14
and
3.23,
and the
time period for making any claim under Section 10.2
in
respect thereof, shall survive the Closing and shall not expire until the
60th
day following the date that the applicable statutes of limitations period
with
respect to the matters covered by such representations and warranties shall
have
expired; (iii) there shall be no time limitation for bringing any claim under
subclauses (iv), (vi) or (vii) of Section 10.2(a);
and
(iv) there shall be no time limit for the bringing of any claim or Action
to
recover any Loss that resulted from any fraudulent acts; provided, further,
that
if there is an outstanding notice of a claim at the end of any such period
of
survival of the representations and warranties, or indemnities, set forth
above,
and such notice was given in compliance with the terms of Section 10.3,
such
applicable period shall not end in respect of such claim until such claim
is
finally resolved. Except as expressly set forth in this Agreement, all covenants
made by the Parties herein shall continue to be enforceable following the
Closing Date in accordance with their terms.
(b)
Except
as set forth in Section 5.9,
each
Party to this Agreement shall have the right to make a claim for indemnification
under this Section 10
irrespective of any such Party’s obligation to close the transactions provided
for herein or any investigation conducted with respect to, or any Knowledge
acquired at any time with respect to, the accuracy or inaccuracy of or
compliance with, any such representation, warranty, covenant or obligation.
Except as set forth in Section 5.9,
the
waiver of any condition to Closing based on the accuracy of any representation
or warranty or on the performance of or compliance with any covenant or
obligation, shall not affect the right to indemnification or other remedy
based
on any misrepresentation, breach or nonperformance of any such representation,
warranty, covenant, and obligation.
-48-
10.2
Indemnification.
(a) Subject
to the limitations set forth in this Section 10,
Seller
shall indemnify, defend and hold harmless Purchaser and Purchaser’s directors,
officers, employees, agents, Affiliates and assigns (collectively, the
“Purchaser
Indemnified Parties”)
from,
against and in respect of any claim, demand, judgment, loss, liability,
Proceeding, assessment, penalty, fee, fine, cost, damage or expense (including
reasonable fees, disbursements and expenses of attorneys, accountants and
other
professional advisors) (collectively, “Losses”
and
individually a “Loss”)
which
any of the Purchaser Indemnified Parties shall suffer, sustain or become
subject
to by virtue of or which arise out of or result from: (i) any breach of,
or
inaccuracy in, the representations and warranties of the Seller set forth
in
this Agreement, in each circumstance without regard to any materiality or
Material Adverse Effect qualifications contained therein for purposes of
determining the amount of any Losses (but not for purposes of determining
any
breach or misrepresentation thereof); (ii) any breach by the Seller of its
or
their covenants contained in this Agreement or any Related Agreement which
are
to be performed prior to the Effective Time; (iii) any breach by the Seller
of
its covenants contained in this Agreement or any Related Agreement which
are to
be performed after the Effective Time; (iv) except to the extent accrued
on the
books and records of the Company as of the Effective Time or in connection
with
the computation of the Net Equity Adjustment Amount, any Pre-Closing Taxes;
(v)
the failure of the Company to timely file a Corrective Action Plan pursuant
to
Rule 69)-191.076; (vi) any Action or Proceeding disclosed, or which should
have
been disclosed, in Schedule
3.12
(collectively, the “Specified
Proceedings”);
or
(vii) failure of the incorporator of the Company, Seller or the Company,
or
Persons acting in capacities as officers or directors of the Company prior
to
the date hereof, to undertake or act in accordance with appropriate legal
and
corporate formalities associated with (v) the due organization of the Company,
(w) appointment of the Company’s board of directors, (x) appointment of
officers, (y) valid issuance of shares under proper authority of a duly
appointed board, and (z) other similar transactions or actions taken for
and on
behalf of the Company where a claim is made that the Company, prior to the
Effective Time, did not have the requisite power and authority to enter into
such transactions or to take such actions.
Notwithstanding the foregoing, the Purchaser Indemnified Parties shall not
be
entitled to indemnification under this Section 10.2(a) to the extent of the
amount of any Losses for which, in accordance with Section 2.5, the Parties
have
taken such amount of such Losses into consideration in the determination
of the
Closing Net Equity and the Net Equity Adjustment Amount. Any Loses payable
in
accordance with this Section 10.2(a)
shall
bear interest from the date such Loss is incurred until satisfaction, but
excluding the date of payment, at the Applicable Rate. Such interest shall
be
payable at the same time as the payment to which it relates and shall be
calculated daily on the basis of a year of three hundred sixty five (365)
days
and the actual number of days elapsed
(b) Subject
to the limitations set forth in Section 10
of this
Agreement, subsequent to the Effective Time, Purchaser shall indemnify, defend
and hold harmless Seller and its directors, officers, employees, agents,
Affiliates and assigns (the “Seller
Indemnified Parties”)
from,
against and in respect of, any Losses which any such Seller Indemnified Party
shall suffer, sustain or become subject to by virtue of or which arise out
of or
result from: (i) any breach of Purchaser’s covenants, representations or
warranties herein which are to be performed after the Closing Date, in each
case
without regard to any materiality or Material Adverse Effect qualifications
contained therein for purposes of determining the amount of any Losses (but
not
for purposes of determining any breach or misrepresentation thereof); (ii)
any
breach by Purchaser of its covenants contained in this Agreement or any Related
Agreement which are to be performed prior to the Effective Time; and (iii)
any
breach by Purchaser of its covenants contained in this Agreement or any Related
Agreement which are to be performed after the Effective Time.
Any
Loses payable in accordance with this Section 10.2(b)
shall
bear interest from the date such Loss is incurred until satisfaction, but
excluding the date of payment, at the Applicable Rate. Such interest shall
be
payable at the same time as the payment to which it relates and shall be
calculated daily on the basis of a year of three hundred sixty five (365)
days
and the actual number of days elapsed.
-49-
(c)
Notwithstanding anything contained in this Agreement to the contrary, the
Purchaser Indemnified Parties shall have no right to indemnification for
any
Losses pursuant to Section 10.2(a)
unless
and until the aggregate amount of all such Losses incurred by the Purchaser
Indemnified Parties, exceeds One Hundred Forty Thousand dollars ($140,000.00)
(the “Basket
Amount”),
and
then only to the extent of such excess; provided, the foregoing limitation
shall
not apply with respect to Losses arising from, in connection with, or relating
to: (i) a breach by the Seller of any representation or warranty contained
in
Sections 3.1
(Authorization), 3.2
(Binding
Agreement), 3.4(a)(i)
(No
Violations), 3.5
(Capitalization), 3.11
(Title),
3.14
(Taxes),
3.23
(Employee Benefit Plans; ERISA) and 3.32
(Broker’s Fees); (ii) the Seller’s breach of any covenant in this Agreement or
any other Related Agreement; and (iii) the indemnity for Taxes and Specified
Proceedings in accordance with the terms of subclauses (iv), (v), (vi), and
(vii), respectively, of Section 10.2(a).
Similarly, notwithstanding anything contained in this Agreement to the contrary,
the Seller Indemnified Parties shall have no right to indemnification for
any
Losses pursuant to Section 10.2(b)
unless
and until the aggregate amount of all such Losses incurred by the Seller
Indemnified Parties exceeds the Basket Amount, and then only to the extent
of
such excess; provided, the foregoing limitation shall not apply with respect
to
Losses arising from, in connection with, or relating to: (i) a breach by
the
Purchaser of any representation or warranty contained in Sections 4.1
(Authorization), 4.2 (Binding Agreement), 4.4(i) (No Violation) and 4.7
(Brokers’ Fees); and (ii) the Purchaser’s breach of any covenant in this
Agreement or any other Related Agreement; and, provided further, that the
foregoing limitation shall not apply to the covenant of Purchaser to pay
the
Purchase Price.
(d)
Notwithstanding any other provision of this Agreement to the contrary, the
Purchaser Indemnified Parties’ right to indemnification for any Losses pursuant
to Section 10.2(a),
shall
not exceed Four Million Two Hundred Thousand dollars ($4,200,000.00) (the
“Cap”);
provided, however, the Cap shall not apply with respect to Losses arising
from,
in connection with, or relating to any of the following matters: (i) a breach
by
the Seller or of any representation or warranty contained in Sections
3.1
(Authorization), 3.2
(Binding
Agreement), 3.4(a)(i)
(No
Violations), 3.5
(Capitalization), 3.11
(Title)
), 3.14
(Taxes)
), 3.23
(Employee Benefit Plans; ERISA) and 3.32
(Broker’s Fees); (ii) a Seller’s breach of any covenant in this Agreement or any
other Related Agreement; and (iii) the indemnity for Taxes and Specified
Proceedings in accordance with the terms of subclauses (iv), (v), (vi), and
(vii), respectively, of Section 10.2(a).
Similarly, notwithstanding any other provision of this Agreement to the
contrary, the Seller Indemnified Parties’ right to indemnification for any
Losses pursuant to Section 10.2(b),
shall
not exceed the Cap;
provided, however, the Cap shall not apply with respect to Losses arising
from,
in connection with, or relating to any of the following matters: (i) a breach
by
the Purchaser of any representation or warranty contained in Sections 4.1
(Authorization), 4.2 (Binding Agreement), 4.4(i) (No Violation) and 4.7
(Brokers’ Fees); and (ii) the Purchaser’s breach of any covenant in this
Agreement or any other Related; provided, the foregoing limitation shall
not
apply to the covenant of Purchaser to pay the Purchase Price.
-50-
10.3
Claims.
(a)
Promptly
after the assertion by any third Person of any claim (a “Third
Party Claim”)
against any Person entitled to indemnification under this Section 10
(the
“Indemnitee”)
that
results or may result in the incurrence by such Indemnitee of any Loss for
which
such Indemnitee would be entitled to indemnification pursuant to this Agreement,
such Indemnitee shall promptly notify the parties from whom such indemnification
could be sought (the “Indemnitors”)
of
such Third Party Claim, in addition to the Escrow Agent; provided, and
notwithstanding anything to the contrary set forth herein, the failure to
give
timely notice in accordance herewith shall not affect or limit the Indemnitor’s
obligations under Section 10.2
unless
and only to the extent such failure materially prejudiced the Indemnitor’s
rights or interests. Any Indemnitee shall have the right to employ separate
counsel in any such Third Party Claim and to participate in the defense thereof,
but the fees and expenses of such counsel shall not be an expense of the
Indemnitor unless: (i) the Indemnitor shall have failed, within a reasonable
time after having been notified by the Indemnitee of the existence of such
Third
Party Claim as provided in the preceding sentence, to assume the defense
of such
Third Party Claim; (ii) the employment of such counsel has been specifically
authorized by the Indemnitor in the case of all Third Party Claims with respect
to which a Purchaser Indemnified Party seeks indemnification under subsection
10.2(a)
above;
or (iii) there is reasonably likely to exist a conflict of interest that
would
make it inappropriate (in the judgment of the Indemnitee in its reasonable
discretion) for the same counsel to represent both the Indemnitee and
Indemnitor. If the Indemnitor assumes the defense of a Third Party Claim,
it
will conduct the defense actively and diligently. The Indemnitor shall not,
without the Indemnitee’s prior written consent (not to be unreasonably
withheld), settle or compromise any Third Party Claim or consent to the entry
of
any judgment with respect to any Third Party Claim, unless the settlement
or
compromise requires solely the payment of monetary damages and the claimant
or
plaintiff unconditionally releases the Indemnitee from all Liability with
respect to the Third Party Claim.
(b)
In the
event that the Indemnitor, within ten (10) days after notice from the Indemnitee
of any such Third Party Claim, does not assume the defense thereof, the
Indemnitee shall have the right to undertake the defense, compromise or
settlement of such action, claim or proceeding for the account of the
Indemnitor, subject to the right of the Indemnitor to assume thereafter the
defense of such action, claim or proceeding at any time prior to the settlement,
compromise or final determination thereof.
(c)
If an
Indemnitee determines in good faith that there is a reasonable probability
that
any such Third Party Claim may adversely and materially affect it or its
Affiliates other than as a result of monetary damages for which it or its
Affiliates would be entitled to indemnification under this Agreement, such
Indemnitee may, at its sole cost and expense, by notice to the Indemnitor,
assume the exclusive right to defend, compromise or settle such Third Party
Claim, but as to Indemnitor’s obligation to the Indemnitee pursuant to this
Section 10
the
Indemnitor will not be bound by any determination of such Third Party Claim
so
defended or any compromise or settlement effected without its consent (which
may
not be unreasonably withheld or delayed).
-51-
(d)
An
Indemnitor assuming the defense of any Third Party Claim shall keep the
Indemnitee reasonably informed at all times of the progress and development
of
Indemnitor’s defense of and compromise efforts related to such Third Party
Claim, and shall furnish the Indemnitee with copies of all relevant pleadings
and correspondence. In addition, Indemnitee and the Indemnitor shall cooperate
with each other, make available personnel for interviews, discovery and court
appearances, and make available to each other and their legal counsel and
other
designated agents and representatives all available relevant records or other
materials required by them for their use in defending, compromising or
contesting any Third Party Claim.
(e)
If the
claim for Losses does not arise from a Third Party Claim (a “Non-Third
Party Claim”),
the
Indemnitor shall have thirty (30) days after receipt of notice of such Non-Third
Party Claim from the Indemnitee to object to such claim by giving notice
to the
Indemnitee specifying the reasons for such objection or objections. If the
Indemnitor has not so objected to the Non-Third Party Claim as of the close
of
business on such thirtieth (30th)
day,
the total amount of the Non-Third Party Claim shall thereupon become chargeable
to and payable by the Indemnitor in accordance with the terms and conditions
of
this Section. If the Indemnitor objects timely to the Non-Third Party Claim
and
the Indemnitor and the Indemnitee(s) are unable to settle any such dispute,
both
Persons shall have all rights and remedies at law or in equity, and either
the
Indemnitor or any Indemnitee may commence an action or proceeding to resolve
such dispute and determine any amounts due hereunder from the
Indemnitor.
10.4
Reduction for Insurance.
The
amount of any payment to any Indemnitee pursuant to this Section 10
shall be
reduced by the amount of any insurance proceeds actually received by or on
behalf of such Indemnitee in reduction of the related indemnifiable Loss.
Any
Indemnitee which subsequently receives insurance proceeds in respect of the
related indemnifiable Loss shall pay to the Indemnitor a refund equal to
the
amount of such insurance proceeds actually received by the Indemnitee (net
of
all direct collection expenses), subject to an aggregate limit on such refund
of
the amount the Indemnitor has paid the Indemnitee in respect of such
indemnifiable Loss.
10.5
Exclusive Remedy.
Except
for claims for injunctive or other equitable relief, fraud or intentional
misconduct or intentional misrepresentation committed in relation to this
Agreement, Purchaser and Seller acknowledge and agree that, after the Effective
Time, the foregoing indemnification provisions shall be the exclusive remedy
with respect to any Losses incurred by a Seller Indemnified Party or Purchaser
Indemnified Party, respectively, in connection with the Sale and the other
transactions contemplated by this Agreement.
10.6
Additional Limitations on Recourse.
Notwithstanding anything to the contrary set forth in this Agreement, any
Purchaser Indemnified Party shall first recover any Losses from the Escrow
Fund
before making any claim against the Seller, but at such point as the aggregate
Losses suffered or incurred by the Purchaser Indemnified Parties exceed the
Escrow Fund, then the Purchaser Indemnified Parties shall be entitled to
recover
such Losses from the Seller subject, however, to the applicable limitations
and
qualifications set forth in Sections 10.2
and
10.4.
-52-
11.
Miscellaneous Provisions.
11.1
Further Assurances and Cooperation.
Except
as otherwise expressly provided in this Agreement, each Party shall execute,
acknowledge and deliver to the other any and all other assignments, consents,
approvals, conveyances, assurances, documents and instruments and shall take
any
and all other actions reasonably appropriate or necessary to effectuate,
carry
out and comply with all of the terms of this Agreement, the Related Agreements
and the transactions contemplated hereby and thereby.
11.2
Successors and Assigns.
All of
the terms and provisions of this Agreement shall be binding upon and shall
inure
to the benefit of and be enforceable by the respective successors and assigns
of
the Parties hereto. No Party hereto may assign any of its rights or delegate
any
of its duties under this Agreement without the prior written consent of the
other Party.
11.3
Governing Law; Venue.
This
Agreement shall be governed by and construed and enforced in accordance with
the
Laws of the State of Florida as applied to Contracts made and performed within
the State of Florida, without giving effect to any choice or conflict of
Law
provision or rule (whether of the State of Florida or any other jurisdiction)
that would cause the application of the Laws of any jurisdiction other than
the
State of Florida. The Parties hereby consent to the exclusive jurisdiction
of
any Federal court sitting in Palm Beach County, Florida in any Action or
Proceeding arising out of or relating to this Agreement and agrees that all
claims in respect of the Action or Proceeding shall be exclusively heard
and
determined in any such court. Each of the Parties hereby waives their right
to
challenge any proceeding involving or relating to this Agreement on the basis
of
lack of jurisdiction over the Person or forum non conveniens.
11.4
Amendments.
This
Agreement may not be amended other than by written instrument signed by the
Parties hereto.
11.5
Exhibits, Schedules and Disclosure Schedule.
The
exhibits, schedules and disclosure schedules referred to in this Agreement
shall
be attached hereto and are incorporated by reference herein.
11.6
Notices.
Any
notice, demand, claim or communication required, permitted, or desired to
be
given hereunder shall be in writing and deemed effectively given when: (i)
on
the date of delivery if personally delivered against a written receipt; (ii)
on
the date of delivery if sent by facsimile with receipt confirmed; (iii) on
the
first Business Day following the date of dispatch if delivered to a reputable
overnight courier service (such as DHL Courier, Federal Express, United Parcel
Service, etc.) for overnight delivery; or (iv) on the third Business Day
if
deposited in the United States mail, with postage prepaid thereon, certified
or
registered mail, return receipt requested, addressed as follows:
-53-
If
to Seller:
|
Metropolitan
Health Networks, Inc.
|
000
Xxxxxxxxxx Xxxxxx, Xxxxx
|
|
Xxxxx
000
|
|
Xxxx
Xxxx Xxxxx, Xxxxxxx 00000
|
|
Attn:
Xxxxxxx Xxxxxx, Chief Executive Officer
|
|
Facsimile:
(000) 000-0000
|
|
With
a copy to:
|
Hunton
& Xxxxxxxx, LLP
|
0000
Xxxxxxxx Xxxxxx, Xxxxx 0000
|
|
Xxxxx,
Xxxxxxx 00000
|
|
Attn:
Xxxxx X. Xxxxx, Esq.
|
|
Facsimile:
(000) 000-0000
|
|
If
to Purchaser:
|
Humana
Medical Plan, Inc.
|
000
Xxxx Xxxx Xxxxxx
|
|
Xxxxxxxxxx,
Xxxxxxxx 00000
|
|
Attention:
Humana Law Department
|
|
Facsimile:
(000) 000-0000
|
|
With
a copy to:
|
Xxxxxxxxxx
Xxxx & XxXxxxxx PLLC
|
3500
National City Tower
|
|
000
Xxxxx Xxxxx Xxxxxx
|
|
Xxxxxxxxxx,
Xxxxxxxx 00000
|
|
Attention:
Xxxxxx X. Xxxxxx, Esq.
|
|
Facsimile:
(000) 000-0000
|
Any
Party
may send any notice, request, demand, claim or other communication hereunder
to
the intended recipient at the address set forth above using any other means
(including messenger service, telecopy, telex, ordinary mail or electronic
mail), but no such notice, request, demand, claim or other communication
shall
be deemed to have been duly given unless and until it actually is received
by
the intended recipient. Any Party may change the address to which notices,
requests, demands, claims and other communications hereunder are to be delivered
by giving the other Party notice in the manner set forth herein.
11.7
Headings.
The
section and other headings contained in this Agreement and in the exhibits
and
disclosure schedules to this Agreement are included for the purpose of
convenient reference only and shall not restrict, modify or otherwise affect
in
any way the meaning or interpretation of this Agreement or the exhibits,
schedules and disclosure schedules hereto.
11.8
Confidentiality and Publicity; Press Releases.
Each
Party shall hold in confidence the terms of this Agreement, and, except as
provided below, such terms shall not be disclosed without the prior written
consent of the other Party. The Parties shall not discuss with, or provide
nonpublic information to, any third Party (except for such Party’s Advisors)
concerning this transaction prior to the Closing Date, except (i) as required
in
governmental filings or judicial, administrative or arbitration proceedings,
or
(ii) pursuant to public releases or announcements either (A) made with the
prior
written approval of Seller and Purchaser (which consent shall not be
unreasonably withheld or delayed), or (B) required by any Law (including
Regulation FD promulgated under the Securities Exchange Act of 1934, as amended
(the “Exchange
Act”))
or
Order or the rules of any stock exchange on which either Party lists securities,
in which case the Party required to make the release or announcement shall
allow
the other Party reasonable time to comment on such release or announcement
in
advance of such issuance, to the extent practicable under the circumstances.
The
Purchaser hereby acknowledges and agrees that the Seller will be required
to
announce the execution of this Agreement on a Current Report on Form 8-K
no
later than four Business Days following the Effective Date and Seller hereby
agrees to use its best efforts to provide Purchaser at least two Business
Days
to comment on the proposed disclosure for the such Form 8-K. Notwithstanding
anything to the contrary set forth in this Agreement, the Seller and Purchaser
each acknowledges and agrees not to disclose any information concerning the
transactions contemplated by this Agreement or any of the Related Agreements
to
any Person that would reasonably give rise to a duty under Regulation FD
under
the Exchange Act for the either Party to publicly disclose such information
or
any other information pertaining to such transactions. The Parties agree
to
prepare and issue mutually acceptable press releases on or promptly after
the
Closing announcing the transactions contemplated hereby.
-54-
11.9
Gender and Number; Construction.
All
references to the neuter gender shall include the feminine or masculine gender
and vice versa, where applicable, and all references to the singular shall
include the plural and vice versa, where applicable. Unless otherwise expressly
provided, the word “including” followed by a listing does not limit the
preceding words or terms and shall mean “including, without limitation.” The
Parties hereto are sophisticated and have been represented by attorneys
throughout the transactions hereby who have carefully negotiated the provisions
hereof. As a consequence, the Parties do not intend that the presumptions
of
Laws or rules relating to the interpretation of contracts against the drafter
of
any particular clause should be applied to this Agreement or any Related
Agreement.
11.10
Third Party Beneficiary.
None of
the provisions contained in this Agreement are intended by the Parties, nor
shall they be deemed, to confer any benefit on any Person not a Party to
this
Agreement other than with respect to Section 10
hereof,
which shall be enforceable by Seller Indemnified Parties and Purchaser
Indemnified Parties.
11.11
Expenses and Attorneys’ Fees.
Except
to the extent otherwise provided in this Agreement, each Party shall bear
and
pay its own costs and expenses relating to the preparation, negotiation,
execution and delivery of this Agreement and the Related Agreements and to
the
transactions contemplated by, or the performance of or compliance with any
condition or covenant set forth in, this Agreement and the Related Agreements,
including without limitation, the disbursements and fees of their respective
Advisors, whether or not the transactions contemplated hereby are consummated.
If any action is brought by any Party to enforce any provision of this
Agreement, the prevailing Party shall be entitled to recover its court costs
and
reasonable attorneys’ fees and costs.
11.12
Counterparts.
This
Agreement may be executed in any number of counterparts, each of which shall
be
deemed an original, but all of which together shall constitute one and the
same
Agreement, binding on all of the Parties hereto. The Parties agree that
facsimile copies of signatures shall be deemed originals for all purposes
hereof
and that a Party may produce such copies, without the need to produce original
signatures, to prove the existence of this Agreement in any proceeding brought
hereunder.
-55-
11.13
Entire Agreement.
Except
as expressly provided herein, this Agreement, the Related Agreements, the
exhibits, schedules and disclosure schedules, and the documents referred
to in
this Agreement contain the entire understanding between the Parties with
respect
to the transactions contemplated hereby and supersede all prior or
contemporaneous agreements, understandings, representations and statements,
oral
or written, between the Parties on the subject matter hereof.
11.14
No Waiver.
Any
term, covenant or condition of this Agreement may be waived at any time by
the
Party that is entitled to the benefit thereof, but only by a written notice
signed by the Party expressly waiving such term or condition. The subsequent
acceptance of performance hereunder by a Party shall not be deemed to be
a
waiver of any preceding breach by any other Party of any term, covenant or
condition of this Agreement, other than the failure of such other Party to
perform the particular duties so accepted, regardless of the accepting Party’s
Knowledge of such preceding breach at the time of acceptance of such
performance. The waiver of any term, covenant or condition shall not be
construed as a waiver of any other term, covenant or condition of this
Agreement.
11.15
Severability.
If any
term, provision, condition or covenant of this Agreement or the application
thereof to any Party or circumstance shall be held to be invalid or
unenforceable to any extent in any jurisdiction, then the remainder of this
Agreement and the application of such term, provision, condition or covenant
in
any other jurisdiction or to Persons or circumstances other than those as
to
whom or which it is held to be invalid or unenforceable, shall not be affected
thereby, and each term, provision, condition and covenant of this Agreement
shall be valid and enforceable to the fullest extent permitted by
Law.
11.16
Time is of the Essence.
Time is
of the essence for all dates and time periods set forth in this Agreement
and
each performance called for in this Agreement.
[Signature
Page Follows]
-56-
In
Witness Whereof,
this
Agreement has been entered into as of the day and year first above
written.
Humana
Medical Plan, Inc.
|
|||
By:
|
|||
Xxxxxxxx
Xxxxxxxxxx,
Vice President
|
|||
and
Assistant Secretary
|
|||
(“Purchaser”)
|
Metropolitan
Health Networks, Inc.
|
|
By:
|
|
Name:
|
|
Title:
|
|
(“Seller”)
|
-57-
APPENDIX
(The
Table of Defined Terms,
which is set forth prior to the body of this Agreement following the Table
of
Contents, is a convenient source for cross-references to the section of this
Agreement or this Appendix where defined terms may be
located.)
For
all
purposes of this Agreement, each of the following terms shall have the meaning
set forth below:
“Action”
or
“Proceeding”
means
any action, hearing, proceeding (public or private), arbitration or suit
(whether civil, criminal, administrative or investigative) commenced, brought
or
conducted by any Person, or any investigation or audit by any Governmental
Authority.
“Advisors”
means,
with respect to any Person, such Person’s directors, officers, employees,
accountants, legal counsel, and financial, actuarial, regulatory and tax
advisors.
“Affiliate”
means
any Person directly or indirectly controlling, controlled by, or under common
control with, another Person. For purposes of this definition “control”
(including the terms “controlled by” and “under common control with”) means the
possession, direct or indirect, of the power to direct or cause the direction
of
the management and policies of a Person, whether through the ownership of
voting
securities, by contract or otherwise
“Agency
Audit”
means
any biennial audit by CMS.
“AHCA”
means
the Florida Agency for Health Care Administration.
“Applicable
Rate”
means
an interest rate of five percent (5%) per annum.
“Business”
means
the business of operating a managed care business in the State of Florida,
including engaging in operations as a Medicare Advantage
Organization.
“Business
Day”
means a
day other than a Saturday or a Sunday or other day on which commercial banks
in
West Palm Beach, Florida are authorized or required by Law to
close.
“Claims
Settlement Period”
means
the period commencing with the Effective Time and expiring the last calendar
day
of the sixth
month
following the Effective Time.
-1-
“Closing
Net Equity”
means
the Company’s Net Equity at the Effective Time, as finally determined at the end
of the Claims Settlement Period pursuant to Section 2.5,
determined in accordance with SAP and otherwise consistent with past practices
and methodologies of the Company, without giving effect to purchase accounting
adjustments or other acquisition-related adjustments that Purchaser may make
in
connection with the Sale and other transactions provided for herein; provided,
notwithstanding the foregoing, that the following items or adjustments shall
,
if not previously done so, be taken into account for purposes of making the
determination of Closing Net Equity: (i) to include in such calculation the
value of intercompany payables and receivables (including any promissory
notes),
if any, between the Company and any of its Affiliates; and (ii) to reflect
the
value (including, any increase or diminution thereof) of any assets or
liabilities of the Company related to or resulting from: (A) any amounts
due a
current or past director, officer, employee or consultant of the Company
for
severance, compensation or other amounts due such director, officer, employee
or
consultant arising or resulting from the termination of their employment,
appointment or engagement with the Company at or prior to the Closing; (B)
any
severance, retention or change of control payments or bonuses, or similar
compensatory arrangements, paid or payable to directors, officers, employees
or
consultants of the Company, or any payments due any employee listed on
Schedule
6.3(c)
upon
termination of their employment Contract, as a result of the consummation
of the
Sale or any other transaction described in this Agreement (excluding any
such
payments or compensation of the type referred to above for which Purchaser
or
the Company is responsible under the terms of this Agreement for or on account
of actions taken, or policies, terms or conditions put into effect, by Purchaser
or the Company after the Effective Time); (C) any recoveries, rebates, refunds,
collections or reimbursements collected within the Claims Settlement Period
to
the Company relating to the Company’s operations prior to the Effective Time
(including any pharmacy rebates and recoveries related to: insurance losses,
coordination of benefits, subrogation, reinsurance, and hospital audits,
irrespective of whether such items were reflected or understated on the Closing
Balance Sheet delivered by the Chief Financial Officer of the Company in
accordance with Section 2.4);
(D)
the MHP Closing Costs; and (E) any changes in estimates as of the Effective
Time
of an asset or a liability or expense included in the determination of Estimated
Net Equity, including, but not limited to, any changes in (x) premium receivable
from CMS related to calendar year 2007 Medicare member risk score changes
above
or below the accrued receivable and (y) premiums received from CMS after
the
Effective Time as a result of CMS Medicare member risk score changes enacted
after the Effective Time that are retroactive to time periods prior to the
Effective Time; provided, further, that the liabilities for medical claims
payable and incurred but not reported medical claims as of the Effective
Time
shall be an amount equal to the sum of (A) all amounts actually paid with
respect to medical claims or settlements of medical claims during the Claims
Settlement Period for covered services relating to Members where the date
of
service preceded the Effective Time, and (B) the Completion Amount (defined
below), and (C) a loss adjustment expense of three percent (3%) of the sum
of
(A) and (B) above. Further, the Parties shall include in the determination
of
Closing Net Equity: in lieu of any estimates in the Closing Balance Sheet,
(x)
the net amount of the actual reconciliations with CMS for all Reconciliation
Years prior to the Reconciliation Year 2008 that remain open and unreconciled
attributable to (1) the CMS Part D Payment Reconciliation (including Risk
Sharing, Low Income Cost Subsidy, Reinsurance Subsidy and Budget Neutrality)
and
(2) the CMS Part D Plan to Plan Reconciliation; plus (y) the estimates reflected
in the Closing Balance Sheet of the same two amounts for the portion of the
Reconciliation Year 2008 ending at the Effective Time, the final payment
for
which shall be made pursuant to Section 2.6(a).
Further, the Parties shall include in the determination of Closing Net Equity
the estimates reflected in the Closing Balance Sheet of any payments to be
received from CMS regarding the Medicare Risk Payments, the final payment
for
which shall be made pursuant to Section 2.6(b).
Notwithstanding anything to the contrary contained in this definition, to
the
extent any expense is otherwise satisfied by Seller, the payment of such
expense
shall not be deemed a liability for purposes of determining the Closing Net
Equity.
-2-
“CMS”
means
the Centers for Medicare and Medicaid Services, a division of the United
States
Department of Health and Human Services.
“CMS
Part D Payment Reconciliation”
means
all retroactive payments, adjustments and reconciliations between CMS and
the
Company pursuant to 42 CFR Part 423, Subpart G.
“COBRA”
shall
refer to Provisions relating to the continuation of coverage under group
medical
plans set forth in Part 6, Subtitle B, Title I of ERISA, and section 4980B
of
the Code.
“Code”
means
the Internal Revenue Code of 1986, as amended, and the regulations promulgated
thereunder.
“Completion
Amount”
means a
good faith estimate, based on the application of actuarial standards and
principles consistent with past practices of the Company, of all remaining
medical service expenses for the period preceding the Effective Time which
have
not been paid prior to expiration of the Claims Settlement Period.
“Confidential
Information”
shall
mean all information of any kind concerning Purchaser, Seller the Company
or
their Affiliates, in connection with the transactions contemplated by this
Agreement except information: (i) ascertainable or obtained from public or
published information, or is otherwise in the public domain at the time
disclosed or obtained; (ii) received from a third party not known by such
party
to be under an obligation to keep such information confidential; (iii) that
is
or becomes known to the public (other than through a breach of this Agreement);
or (iv) that was in such party’s possession prior to disclosure thereof to such
party in connection herewith.
“Contract”
or
“Agreement”
means
any contract, agreement, subcontract, indenture, note, bonds (including surety
bond), loan, instrument, lease, mortgage, franchise, license, assignment,
purchase order, sale order, proposal, bid, undertaking, arrangement,
understanding, commitment, whether written or oral, that is legally
binding.
“DB
Plan”
shall
refer to any employee benefit plan sponsored by Seller or an ERISA Affiliate
subject to Title I, Subtitle B, Part 3 or ERISA or Title IV of
ERISA.
“Deferred
Compensation Plan”
shall
refer to any “nonqualified deferred compensation plan” within the meaning of
section 409A(d)(1) of the Code.
“Enrollment
Forms”
means
all applications and other documents which are or have been submitted by
Members
or prospective Members for enrollment in a Health Benefit Plan and which
have
been accepted by the Company.
“ERISA”
shall
refer to the Employee Retirement Income Security Act of 1974, as
amended.
“ERISA
Affiliate”
shall
refer to any other person or entity that, together with the Company or the
Seller, would be treated as a single employer under section 414 of the
Code.
“Escrow
Agent”
means
the mutually acceptable escrow agent retained to serve as such pursuant to
the
Escrow Agreement.
-3-
“Escrow
Agreement”
means
the Escrow Agreement among Purchaser, the Seller and Escrow Agent, in
substantially the form attached hereto as Exhibit
B.
“Escrow
Fund”
means
$1,400,000.00, deposited with the Escrow Agent in accordance with the Escrow
Agreement and Sections 2.5
and
2.8
of this
Agreement.
“Estimated
Net Equity”
means
the Company’s Net Equity as of the last calendar day of the month which is two
months prior to the month during which the Closing occurs (which amount is
intended to be a reasonable estimate of the Company’s Net Equity as of the
Effective Time), determined in accordance with SAP and otherwise consistent
with
past practices and methodologies of the Company as more fully described in
Schedule
2.4,
but
without giving any effect to purchase accounting adjustments or other
acquisition-related adjustments that Purchaser may make in connection with
the
Sale and the other transactions provided for in this Agreement; provided,
notwithstanding the foregoing, that the following items or adjustments shall
,
if not previously done so, be taken into account for purposes of making the
determination of Estimated Net Equity: (i) to include in such calculation
the
value of intercompany payables and receivables (including any promissory
notes),
if any, between the Company and any of its Affiliates; and (ii) to reflect
the
value (including, any increase or diminution thereof) of any assets or
liabilities of the Company related to or resulting from: (A) any amounts
due a
current or past director, officer, employee or consultant of the Company
for
severance, compensation or other amounts due such director, officer, employee
or
consultant arising or resulting from the termination of their employment,
appointment or engagement with the Company at or prior to the Closing; (B)
any
severance, retention or change of control payments or bonuses, or similar
compensatory arrangements, paid or payable to directors, officers, employees
or
consultants of the Company, or any payments due any employee listed on
Schedule
6.3(c)
upon
termination of their employment Contract, as a result of the consummation
of the
Sale or any other transaction described in this Agreement (excluding any
such
payments or compensation of the type referred to above for which Purchaser
or
the Company is responsible under the terms of this Agreement for or on account
of actions taken, or policies, terms or conditions put into effect, by Purchaser
or the Company after the Effective Time); (C) a good faith estimate of medical
expenses payable determined by the Company; (D) a loss adjustment expense
of
three percent (3%) of subclause (C) above; and (E) the MHP Closing Costs.
Notwithstanding anything to the contrary contained in this definition, to
the
extent any liability of the Company will be paid at or after closing by the
Sellers, the payment of such expense shall not be deemed a liability for
purposes of determining the Estimated Net Equity.
“Federal
HMO Act”
means
the federal Health Maintenance Organization Act of 1973, codified at 42 U.S.C.
§
300e.
“GAAP”
means
United States generally accepted accounting principles as in effect from
time to
time applied on a consistent basis.
“Governmental
Authorization”
means
any consent, license, or certificate of need, registration, authorization
or
permit issued, granted, given or otherwise made available by or under the
authority of any Governmental Authority or pursuant to any Law or
Order.
-4-
“Governmental
Authority”
means,
collectively, any: (i) nation, state, county, city, town, village, district
or
other jurisdiction of any nature; (ii) federal, state, local, municipal or
other
governmental organization or body; (iii) governmental or quasi governmental
authority of any nature (including any governmental agency, branch, department,
official or entity and any court or other tribunal); or (iv) body exercising,
or
entitled to exercise, any administrative, executive, judicial, legislative,
regulatory or Taxing authority of any nature.
“Health
Benefit Laws”
shall
mean all Laws of the State of Florida and all other jurisdictions wherein
the
Company is conducting its Business, and federal Laws of the United States
of
America, relating to the licensure, certification, qualification or authority
to
transact business relating to the provision of, payment for, arrangement
of, or
administration or utilization of health or medical benefits, insurance or
provider claims, including ERISA, the Consolidated Omnibus Budget Reconciliation
Act of 1985, as amended, the HIPAA, the Laws governing the Medicare Advantage
Program, the Insurance Code of the State of Florida, and other Laws relating
to
the regulation of workers compensation, managed care organizations, insurance
companies, third-party administrators, utilization review agents, certificates
of need, utilization review coordination of benefits, hospital reimbursement,
Medicare and Medicaid participation, fraud and abuse, patient referrals and
provider incentives.
“Health
Benefit Plan”
means
all of the health and medical care benefit plans and products, and all of
the
prescription drug plans and products, and any evidence of coverage form,
summary
of benefits form, or other policy forms reflecting the benefits or coverage
under such plans, offered, sold, administered or maintained by the Company
for
the benefit of its Members.
“HIPAA”
means
the Health Insurance Portability and Accountability Act of 1996.
“Knowledge”
means
(i) when referring to Seller’s Knowledge, the actual knowledge of the Seller’s
Chief Executive Officer, the Seller’s Chief Financial Officer, the Seller’s
General Counsel and the President of Metcare of Florida, Inc., and in each
such
case, the knowledge that a reasonably prudent person would be expected to
have
acting in such person’s capacity in the conduct of the Company’s business and
operations; and (ii) when referring to Purchaser’s knowledge, the actual
knowledge of Xxxxxx X. Xxxxxx, Xxxxxxx Xxxxxxx, Xxxxxxx Xxxxxxx and Xxxxx
X.
Xxxxxx, and in each such case, the knowledge that a reasonably prudent person
would be expected to have acting in such person’s capacity in the conduct of the
Purchaser’s business and operations.
“Law”
means
any law, statute, rule, regulation, ordinance and other pronouncement having
the
effect of law of the United States of America, the State of Florida, any
foreign
country or any domestic or foreign state, county, city or other political
subdivision of any Governmental Authority.
“Liabilities”
means
any direct or indirect liability, indebtedness, claim, loss, damage, deficiency,
obligation, penalty, responsibility, cost or expense, fixed or unfixed, xxxxxx
or inchoate, liquidated or unliquidated, secured or unsecured, accrued,
absolute, known or unknown, contingent or otherwise.
-5-
“Lien”
shall
mean any mortgage, security interest, pledge, hypothecation, assignment,
lease,
encumbrance, lien, or restriction on transfer, other than restrictions on
transfer imposed by applicable securities Laws, including the Securities
Act.
“Material
Adverse Effect”,
with
respect to any Person, means any effect that individually or taken together
with
other effects is materially adverse to (i) the condition, properties, assets,
liabilities, business, operations, or results of operations of such Person
and
its subsidiaries, taken as a whole, or (ii) the ability of such Person to
consummate the transactions contemplated by this Agreement; provided, however,
that no Material Adverse Effect shall be deemed to have occurred as a result
of
(A) general economic conditions affecting generally the industry in which
such
Person competes, (B) general market conditions in the United States or (C)
any
effect resulting from or arising in connection with the announcement of this
Agreement or the transactions contemplated hereby, except that a Material
Adverse Effect shall be deemed to have occurred as a result of any announcement
of this Agreement or transactions contemplated hereby that result in any
Affiliated physician organizations, associations or groups terminating its
relationship with the Company.
“Medicaid”
means
Title XIX of the Social Security Act, as amended, or any successor Law, and
all
regulations issued pursuant thereto and any successor Law, and the Laws of
the
State of Florida and any other States in which the Company does business
passed
or promulgated in connection with programs administered under Title XIX of
the
Social Security Act.
“Medicare”
means
Title XVIII of the Social Security Act, as amended, or any successor Law
and all
regulations issued pursuant thereto and any successor Law.
“Medicare
Advantage Contracts”
means
the Company’s Contracts ## H5426 with CMS (including any successor Contracts)
that authorize the Company to participate in the Medicare Advantage Program
and
offer, sell and administer the Health Benefit Plans in the Service Area.
“Medicare
Advantage Program”
means
the program enacted under Part C of Title XVIII of the Social Security Act
as
succeeded and superceded by Title II of the Medicare Prescription Drug,
Improvement and Modernization Act of 2003, or any successor Law and all
regulations issued pursuant thereto or any successor Law.
“Member”
means
an individual enrolled in any Health Benefit Plan.
“MHP
Closing Costs”
means
the sum of all fees and expenses payable by the Company in connection with
or
related to the transactions contemplated hereby to the Advisors (other than
directors, officers and employees) of Seller and the Company, incurred in
connection with the Sale, this Agreement or the transactions contemplated
hereby, including any and all investment banking, accounting, advisory, brokers,
finders, escrow agent or legal fees set forth in the Reductions Notice delivered
by Seller to Purchaser pursuant to Section 2.2.
“MHP
Provider Agreements”
means
all agreements in the form of Exhibit
F
attached
hereto between the Purchaser and Metcare of Florida, Inc..
-6-
“Most
Recent Balance Sheet”
means
the balance sheet contained within the Most Recent Financial
Statements.
“Multiemployer
Plan”
shall
refer to any “multiemployer plan” within the meaning of section 3(37) of
ERISA.
“Net
Equity”
shall
mean the net equity of the Company as determined in accordance with SAP,
applied
on a consistent basis with past practices of the Company.
“OIR”
means
the Office of Insurance Regulation of the State of Florida.
“Order”
means
any decision, award writ, judgment, decree, ruling, verdict, injunction,
assessment, penalty, or similar order made, issued or entered by, or settlement
with, any Governmental Authorities or arbitrator.
“Ordinary
Course of Business”
means an
action taken by a Person will be deemed to have been taken in the “Ordinary
Course of Business” only if:
(a)
such an
action is consistent with the past practices of such Person and is taken
in the
ordinary course of the normal day-to-day operations of such Person;
(b)
such
action is not required to be authorized by the board of directors of such
Person
(or by any Person or group of Persons exercising similar authority) and is
not
required to be specifically authorized by the parent company (if any) of
such
Person; and
(c)
such
action is similar in nature and magnitude to actions customarily taken, without
any authorization by the board of directors (or by any Person or group of
Persons exercising similar authority), in the ordinary course of the normal
day-to-day operations of other Persons that are in the same line of business
as
such Person.
“PBGC”
shall
refer to the Pension Benefit Guaranty Corporation.
“Pension
Plan”
shall
refer to any “employee pension benefit plan” within the meaning of section 3(2)
of ERISA.
“Permitted
Liens”
means
(i) materialmen's, mechanics', carriers', workmen's, repairmen's or other
like
Liens arising in the Ordinary Course of Business for amounts not yet due
or
which are being contested in good faith by appropriate proceedings, (ii)
Liens
for current Taxes or special assessments not yet due or any Taxes being
contested in good faith by appropriate proceedings, (iii) Liens, easements,
rights of way, encroachments, restrictions or similar conditions affecting
or
burdening the Company's assets which individually or in the aggregate do
not
detract materially from the use or value of the assets, (iv) purchase money
Liens and Liens securing rental payments under capital lease arrangements,
and
(v) statutory landlord's Liens related to the rental of real property.
“Person”
means
an individual, a partnership, a corporation, a limited liability company,
an
association, a joint stock company, a trust, a joint venture, an unincorporated
organization or a governmental entity (or any department, agency or political
subdivision thereof).
-7-
“Pre-Closing
Tax Deficiency”
shall
mean any obligation of Company or its Subsidiaries to pay Pre-Closing Taxes
that
are not reserved for, or with respect to which a liability has not been
recorded, on the Closing Balance Sheet.
“Pre-Closing
Taxes”
shall
mean all Liabilities for Taxes of the Company and its Subsidiaries for
Pre-Closing Tax Periods, including all Liabilities for Straddle Period Taxes
allocated to any Pre-Closing Period. For purposes hereof, Liabilities for
Straddle Period Taxes shall be allocated as follows: (i) for Straddle Period
Taxes that are either (w) based upon or related to income or receipts or
(x)
imposed in connection with any sale or other transfer or assignment of property
(real or personal, tangible or intangible), the portion of such Straddle
Period
Taxes allocated to the Pre-Closing Period shall be deemed to be an amount
which
would be payable if the taxable period began or ended at the Effective Time;
and
(ii) for Straddle Period Taxes imposed on a periodic basis with respect to
the
assets of the Company or any of its Subsidiaries, or otherwise measured by
the
level of any item, the portion of such Straddle Period Taxes allocated to
the
Pre-Closing Period shall be an amount equal to the product of (y) the amount
of
such Straddle Period Taxes for the entire period multiplied by
(z) a
fraction, the numerator of which is the number of calendar days in the portion
of such period ending on the Closing Date and the denominator of which is
the
number of calendar days in the entire period.
“Pre-Closing
Tax Period”
shall
mean any Tax period beginning before the Effective Time and ending at the
Effective Time, including the portion of any Straddle Period preceding and
ending at the Effective Time.
“Reconciliation
Year 2008”
means
calendar year 2008.
“SAP”
means
statutory accounting principles prescribed by the National Association of
Insurance Commissioners for the preparation of financial statements, as modified
by the Laws of the State of Florida or other applicable State wherein the
financial statements of the Company are to be or have been filed, applied
on a
consistent basis.
“Seller
Plan”
shall
refer to any Pension Plan, Welfare Plan, Multiemployer Plan, Deferred
Compensation Plan, VEBA, stock option plan, phantom stock plan, stock
appreciation right, severance plan, life insurance, disability insurance,
fringe
benefit plan, or any other arrangement sponsored by Seller, the Company or
an
ERISA Affiliate pursuant to which any Company Employee has any present or
future
right to any benefits, incentive, bonus, or compensation (other than salary
or
wages), or under which the Company has or may have any present or future
liability.
“Straddle
Period” means
a
period that begins before the Effective Time and ends after the Effective
Time,
including any such period to which a periodic or recurring assessment of
property or other Taxes relates.
“Straddle
Period Taxes”
means
Taxes due and payable with respect to a Straddle Period.
“Statutory
Surplus”
means
the surplus as defined in §641.19 of the Florida Statutes, as amended,
determined in accordance with SAP, which amount is used to determine compliance
with the minimum surplus requirements under the Laws of the State of
Florida.
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“Subsidiary”
means
any corporation more than fifty percent (50%) of whose outstanding voting
securities, or any partnership, joint venture or other entity more than fifty
percent (50%) of whose total equity interest, is directly or indirectly owned
by
the Company.
“VEBA”
shall
refer to any voluntary employees’ beneficiary association under section
501(c)(9) of the Code.
“Welfare
Plan”
shall
refer to any “employee welfare benefit plan” within the meaning of section 3(1)
of ERISA.
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