0000754009-04-000297 Sample Contracts

ADDENDUM TO EMPLOYMENT AGREEMENT
Employment Agreement • December 16th, 2004 • Sierra Health Services Inc • Hospital & medical service plans

This Addendum to the November 16, 2000 Employment Agreement between Sierra Health Services, Inc., a Nevada Corporation (hereinafter referred to as "Employer"), and Anthony M. Marlon, M.D. (hereinafter referred to as "Employee"), attached hereto and incorporated herein by reference is effective as of December 13, 2004 . This Addendum shall modify, amend and supersede any conflicting or inconsistent language contained in the previously executed Employment Agreement.

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ADDENDUM TO EMPLOYMENT AGREEMENT
Employment Agreement • December 16th, 2004 • Sierra Health Services Inc • Hospital & medical service plans

This Addendum to the December 10, 1999 Employment Agreement between Sierra Health Services, Inc., a Nevada Corporation (hereinafter referred to as "Employer"), and William R. Godfrey (hereinafter referred to as "Employee"), attached hereto and incorporated herein by reference is effective as of December 13, 2004 . This Addendum shall modify, amend and supersede any conflicting or inconsistent language contained in the previously executed Employment Agreement.

ADDENDUM TO EMPLOYMENT AGREEMENT
Employment Agreement • December 16th, 2004 • Sierra Health Services Inc • Hospital & medical service plans

This Addendum to the January 1, 2003 Employment Agreement between Sierra Health Services, Inc., a Nevada Corporation (hereinafter referred to as "Employer"), and Michael A. Montalvo (hereinafter referred to as "Employee"), attached hereto and incorporated herein by reference is effective as of December 13, 2004 . This Addendum shall modify, amend and supersede any conflicting or inconsistent language contained in the previously executed Employment Agreement.

ADDENDUM TO EMPLOYMENT AGREEMENT
Employment Agreement • December 16th, 2004 • Sierra Health Services Inc • Hospital & medical service plans

This Addendum to the November 16, 2000 Employment Agreement between Sierra Health Services, Inc., a Nevada Corporation (hereinafter referred to as "Employer"), and Marie H. Soldo (hereinafter referred to as "Employee"), attached hereto and incorporated herein by reference is effective as of December 13, 2004 . This Addendum shall modify, amend and supersede any conflicting or inconsistent language contained in the previously executed Employment Agreement.

ADDENDUM TO EMPLOYMENT AGREEMENT
Employment Agreement • December 16th, 2004 • Sierra Health Services Inc • Hospital & medical service plans

This Addendum to the December 1, 2001 Employment Agreement between Sierra Health Services, Inc., a Nevada Corporation (hereinafter referred to as "Employer"), and Paul H. Palmer (hereinafter referred to as "Employee"), attached hereto and incorporated herein by reference is effective as of December 13, 2004 . This Addendum shall modify, amend and supersede any conflicting or inconsistent language contained in the previously executed Employment Agreement.

ADDENDUM TO EMPLOYMENT AGREEMENT
Employment Agreement • December 16th, 2004 • Sierra Health Services Inc • Hospital & medical service plans

This Addendum to the February 1, 2003 Employment Agreement between Sierra Health Services, Inc., a Nevada Corporation (hereinafter referred to as "Employer"), and Jonathon W. Bunker (hereinafter referred to as "Employee"), attached hereto and incorporated herein by reference is effective as of December 13, 2004 . This Addendum shall modify, amend and supersede any conflicting or inconsistent language contained in the previously executed Employment Agreement.

ADDENDUM TO EMPLOYMENT AGREEMENT
Employment Agreement • December 16th, 2004 • Sierra Health Services Inc • Hospital & medical service plans

This Addendum to the December 10, 1999 Employment Agreement between Sierra Health Services, Inc., a Nevada Corporation (hereinafter referred to as "Employer"), and Laurence S. Howard (hereinafter referred to as "Employee"), attached hereto and incorporated herein by reference is effective as of December 13, 2004 . This Addendum shall modify, amend and supersede any conflicting or inconsistent language contained in the previously executed Employment Agreement.

ADDENDUM TO EMPLOYMENT AGREEMENT
Employment Agreement • December 16th, 2004 • Sierra Health Services Inc • Hospital & medical service plans

This Addendum to the February 12, 2001 Employment Agreement between Sierra Health Services, Inc., a Nevada Corporation (hereinafter referred to as "Employer"), and Erin E. MacDonald (hereinafter referred to as "Employee"), attached hereto and incorporated herein by reference is effective as of December 13, 2004 . This Addendum shall modify, amend and supersede any conflicting or inconsistent language contained in the previously executed Employment Agreement.

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