0001193125-05-114703 Sample Contracts

FORM OF NON QUALIFIED STOCK OPTION AGREEMENT UNDER THE PACIFICARE HEALTH SYSTEMS, INC.
Non-Qualified Stock Option Agreement • May 25th, 2005 • Pacificare Health Systems Inc /De/ • Hospital & medical service plans • Delaware

THIS AGREEMENT, dated , (“Agreement”), is made by and between PACIFICARE HEALTH SYSTEMS, INC., a Delaware corporation (the “Company”), and (the “Optionee”):

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