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REGISTRATION RIGHTS AGREEMENT

Registration Rights Agreement

REGISTRATION RIGHTS AGREEMENT | Document Parties: ABN AMRO INCORPORATED | BANC OF AMERICA SECURITIES LLC | BNY CAPITAL MARKETS, INC | COVENTRY HEALTH CARE, INC | Lehman Brothers Inc, CIBC World Markets Corp | PIPER JAFFRAY & CO You are currently viewing:
This Registration Rights Agreement involves

ABN AMRO INCORPORATED | BANC OF AMERICA SECURITIES LLC | BNY CAPITAL MARKETS, INC | COVENTRY HEALTH CARE, INC | Lehman Brothers Inc, CIBC World Markets Corp | PIPER JAFFRAY & CO

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Title: REGISTRATION RIGHTS AGREEMENT
Governing Law: New York     Date: 1/28/2005
Law Firm: Simpson Thacher;Shearman Sterling    

REGISTRATION RIGHTS AGREEMENT, Parties: abn amro incorporated , banc of america securities llc , bny capital markets  inc , coventry health care  inc , lehman brothers inc  cibc world markets corp , piper jaffray & co
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<PAGE>

EXHIBIT 4.4

EXECUTION COPY

5-7/8% SENIOR NOTES DUE 2012

REGISTRATION RIGHTS AGREEMENT

DATED AS OF JANUARY 28, 2005

BY AND AMONG

COVENTRY HEALTH CARE, INC.,

AS ISSUER,

AND

LEHMAN BROTHERS INC.,

CIBC WORLD MARKETS CORP.,

ABN AMRO INCORPORATED,

BANC OF AMERICA SECURITIES LLC,

WACHOVIA SECURITIES,

BNP PARIBAS,

BNY CAPITAL MARKETS, INC.

AND

PIPER JAFFRAY & CO.,

AS THE INITIAL PURCHASERS

<PAGE>

This Registration Rights Agreement (this "AGREEMENT") is dated as of

January 28, 2005, by and among Coventry Health Care, Inc., a Delaware

corporation (the "COMPANY") and Lehman Brothers Inc., CIBC World Markets Corp.,

ABN AMRO Incorporated, Banc of America Securities LLC, Wachovia Securities, BNP

Paribas, BNY Capital Markets, Inc. and Piper Jaffray & Co. (each an "INITIAL

PURCHASER" and, collectively, the "INITIAL PURCHASERS"), each of whom has agreed

to purchase the Company's 5-7/8% Senior Notes due 2012 (the "NOTES") pursuant to

the Purchase Agreement (as defined below).

This Agreement is made pursuant to the Purchase Agreement, dated

January 21, 2005 (the "PURCHASE AGREEMENT"), by and among the Company and the

Initial Purchasers. In order to induce the Initial Purchasers to purchase the

Notes, the Company has agreed to provide the registration rights set forth in

this Agreement. The execution and delivery of this Agreement is a condition to

the obligations of the Initial Purchasers set forth in Section 6 of the Purchase

Agreement. Capitalized terms used herein and not otherwise defined shall have

the meanings assigned to them in the Indenture, dated the date hereof (the

"INDENTURE"), among the Company and Wachovia Bank, National Association, as

Trustee (the "TRUSTEE"), relating to the Notes and the Exchange Notes (as

defined below).

The parties hereby agree as follows:

SECTION 1. DEFINITIONS

As used in this Agreement, the following capitalized terms shall

have the following meanings:

ACT: The U.S. Securities Act of 1933, as amended.

AFFILIATE: As defined in Rule 144 of the Act.

BROKER-DEALER: Any broker or dealer registered under the Exchange

Act.

CERTIFICATED SECURITIES: Definitive Notes, as defined in the

Indenture.

CLOSING DATE: The date of this Agreement.

COMMISSION: The U.S. Securities and Exchange Commission.

CONSUMMATE: An Exchange Offer shall be deemed "Consummated" for

purposes of this Agreement upon the occurrence of (a) the filing and

effectiveness under the Act of the Exchange Offer Registration Statement

relating to the Exchange Notes to be issued in the Exchange Offer, (b) the

maintenance of such Exchange Offer Registration Statement continuously effective

and the keeping of the Exchange Offer open for a period not less than the period

required pursuant to Section 3(b) hereof and (c) the delivery by the Company to

the Registrar under an Indenture of Exchange Notes in the same aggregate

principal amount as the aggregate principal amount of Notes tendered by Holders

thereof pursuant to the Exchange Offer.

CONSUMMATION DEADLINE: As defined in Section 3(b) hereof.

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2

EFFECTIVENESS DEADLINE: As defined in Section 3(a) hereof.

EXCHANGE ACT: The U.S. Securities Exchange Act of 1934, as amended.

EXCHANGE NOTES: The Company's 5-7/8% Senior Notes due 2012,

registered under the Act, to be issued pursuant to the Indenture (a) in the

Exchange Offer or (b) as contemplated by Section 4 hereof.

EXCHANGE OFFER: The exchange and issuance by the Company of a

principal amount of Exchange Notes (which shall be registered pursuant to the

Exchange Offer Registration Statement) equal to the outstanding principal amount

of Notes that are tendered by such Holders in connection with such exchange and

issuance.

EXCHANGE OFFER REGISTRATION STATEMENT: The Registration Statement

relating to the Exchange Offer, including the related Prospectus.

EXEMPT RESALES: The transactions in which the Initial Purchasers

propose to sell the Notes to certain "qualified institutional buyers," as such

term is defined in Rule 144A under the Act, and pursuant to Regulation S under

the Act.

FILING DEADLINE: As defined in Sections 3(a) and 4(a) hereof.

HOLDERS: As defined in Section 2 hereof.

INTEREST PAYMENT DATE: As defined in the Notes and the Exchange

Notes.

PERSON: As defined in the Indenture.

PROSPECTUS: The prospectus included in a Registration Statement at

the time such Registration Statement is declared effective, as amended or

supplemented by any prospectus supplement and by all other amendments thereto,

including post-effective amendments, and all material incorporated by reference

into such Prospectus.

RECOMMENCEMENT DATE: As defined in Section 6(e) hereof.

REGISTRATION DEFAULT: As defined in Section 5 hereof.

REGISTRATION STATEMENT: Any registration statement of the Company

relating to (a) an offering of Exchange Notes pursuant to an Exchange Offer or

(b) the registration for resale of Transfer Restricted Securities pursuant to

the Shelf Registration Statement, in each case (i) that is filed pursuant to the

provisions of this Agreement and (ii) including the Prospectus included therein,

all amendments and supplements thereto (including post-effective amendments) and

all exhibits and material incorporated by reference therein.

REGULATION S: Regulation S promulgated under the Act.

RULE 144: Rule 144 promulgated under the Act.

SHELF REGISTRATION STATEMENT: As defined in Section 4(a) hereof.

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3

SUSPENSION NOTICE: As defined in Section 6(e) hereof.

TIA: The U.S. Trust Indenture Act of 1939 (15 U.S.C. Section

77aaa-77bbbb) as in effect on the date of the Indenture.

TRANSFER RESTRICTED SECURITIES: (a) Each Note, until the earliest to

occur of (i) the date on which such Note has been exchanged by a Person other

than a Broker-Dealer for an Exchange Note in the Exchange Offer and is entitled

to be resold to the public by such Person without complying with the prospectus

delivery requirements of the Act, (ii) the date on which such Note has been

effectively registered under the Act and disposed of in accordance with the

Shelf Registration Statement, or (iii) the date on which such Note is eligible

to be distributed to the public pursuant to Rule 144 under the Act, and (b) each

Exchange Note acquired by a Broker-Dealer in the Exchange Offer of a Note for

such Exchange Note, until the date on which such Exchange Note is sold to a

purchaser who receives from such Broker-Dealer on or prior to the date of such

sale a copy of the Prospectus contained in the Exchange Offer Registration

Statement.

SECTION 2. HOLDERS

A Person is deemed to be a holder of Transfer Restricted Securities

(each, a "HOLDER") whenever such Person owns Transfer Restricted Securities.

SECTION 3. REGISTERED EXCHANGE OFFER

(a) Unless the Exchange Offer shall not be permitted by applicable

federal law (after the procedures set forth in Section 6(a)(i) below have been

complied with), the Company shall (i) cause the Exchange Offer Registration

Statement to be filed with the Commission no later than 120 days after the

Closing Date (such 120th day being the "FILING DEADLINE"), (ii) use their best

efforts to cause such Exchange Offer Registration Statement to become effective

no later than 180 days after the Closing Date (such 180th day being the

"EFFECTIVENESS DEADLINE"), (iii) in connection with the foregoing, (A) file all

pre-effective amendments to such Exchange Offer Registration Statement as may be

necessary in order to cause it to become effective, (B) file, if applicable, a

post-effective amendment to such Exchange Offer Registration Statement pursuant

to Rule 430A under the Act and (C) cause all necessary filings, if any, in

connection with the registration and qualification of the Exchange Notes to be

made under the Blue Sky laws of such jurisdictions as are necessary to permit

Consummation of the Exchange Offer, and (iv) upon the effectiveness of such

Exchange Offer Registration Statement, commence and use all commercially

reasonable efforts to Consummate the Exchange Offer. The Exchange Offer shall be

on the appropriate form permitting (I) registration of the Exchange Notes to be

offered in exchange for the Notes that are Transfer Restricted Securities and

(II) resales of Exchange Notes by Broker-Dealers that tendered into the Exchange

Offer Notes that such Broker-Dealer acquired for its own account as a result of

market making activities or other trading activities (other than Notes acquired

directly from the Company or any its Affiliates) as contemplated by Section 3(c)

below.

(b) The Company shall use its best efforts to cause the Exchange

Offer Registration Statement to be effective continuously, and shall keep the

Exchange Offer open for

<PAGE>

4

a period of not less than (i) 20 business days or more than 45 days or (ii) if

longer, the minimum period required under applicable federal and state

securities laws to Consummate the Exchange Offer. The Company shall cause the

Exchange Offer to comply with all applicable federal and state securities laws.

No securities other than the Exchange Notes shall be included in the Exchange

Offer Registration Statement. The Company shall use all commercially reasonable

efforts to cause the Exchange Offer to be Consummated on or prior to 30 Business

Days after the Exchange Offer Registration Statement has become effective, but

in no event later than 30 business days thereafter (such 30th business day being

the "CONSUMMATION DEADLINE").

(c) The Company shall include a "Plan of Distribution" section in

the Prospectus contained in the Exchange Offer Registration Statement and

indicate therein that any Broker-Dealer who holds Transfer Restricted Securities

that were acquired for the account of such Broker-Dealer as a result of

market-making activities or other trading activities (other than Notes acquired

directly from the Company or any Affiliate of the Company), may exchange such

Transfer Restricted Securities pursuant to the Exchange Offer. Such "Plan of

Distribution" section shall also contain all other information with respect to

such sales by such Broker-Dealers that the Commission may require in order to

permit such sales pursuant thereto, but such "Plan of Distribution" shall not

name any such Broker-Dealer or disclose the amount of Transfer Restricted

Securities held by any such Broker-Dealer, except to the extent required by the

Commission as a result of a change in policy, rules or regulations after the

date of this Agreement.

Because such Broker-Dealer may be deemed to be an "underwriter"

within the meaning of the Act and must, therefore, deliver a prospectus meeting

the requirements of the Act in connection with its initial sale of any Exchange

Notes received by such Broker-Dealer in the Exchange Offer, the Company shall

permit the use of the Prospectus contained in the Exchange Offer Registration

Statement by such Broker-Dealer to satisfy such prospectus delivery requirement.

To the extent necessary to ensure that the prospectus contained in the Exchange

Offer Registration Statement is available for sales of Exchange Notes by

Broker-Dealers, the Company agrees to use its best efforts to keep the Exchange

Offer Registration Statement continuously effective, supplemented, amended and

current as required by and subject to the provisions of Section 6(a) and (c)

hereof and in conformity with the requirements of this Agreement, the Act and

the policies, rules and regulations of the Commission as announced from time to

time, for a period of one year from the date on which the Exchange Offer is

Consummated or such shorter period as will terminate when all Transfer

Restricted Securities covered by such Registration Statement have been sold

pursuant thereto. The Company shall provide sufficient copies of the latest

version of such Prospectus to such Broker-Dealers, promptly upon request, and in

no event later than one day after such request, at any time during such period.

SECTION 4. SHELF REGISTRATION

(a) Shelf Registration. If (i) due to applicable law or

interpretations thereof by the Commission's staff, the Company determines upon

advice of its outside counsel that it is not permitted to effect the Exchange

Offer as contemplated by Section 3 hereof (after the Company has complied with

the procedures set forth in Section 6(a)(i) hereof); (ii) for any other reason

the Exchange Offer Registration Statement is not declared effective within 180

days

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5

following the date of the original issuance of the Notes or the Exchange Offer

is not consummated within 210 days following the date of the original issuance

of the Notes; (iii) any Initial Purchaser so requests with respect to Notes that

are not eligible to be exchanged for Exchange Notes in the Exchange Offer and

that are held by it following consummation of the Exchange Offer; (iv) any

Holder (other than an Initial Purchaser) of Transfer Restricted Securities is

not eligible to participate in the Exchange Offer or does not receive freely

tradeable Exchange Notes in the Exchange Offer other than by reason of such

Holder being an Affiliate of the Company (it being understood that the

requirement that a participating Broker-Dealer deliver the Prospectus contained

in the Exchange Offer Registration Statement in connection with sales of

Exchange Notes shall not result in such Exchange Notes being not "freely

tradeable"); or (v) in the case of any Initial Purchaser that participates in

the Exchange Offer or acquires Exchange Notes from the Company as a result of

its determination that it is not eligible to participate in the Exchange Offer

with respect to any unsold Notes, such Initial Purchaser does not receive freely

tradeable Exchange Notes in exchange for Notes constituting any portion of an

unsold allotment (it being understood that (x) the requirement that an Initial

Purchaser deliver a Prospectus containing the information required by Item 507

or 508 of Regulation S-K under the Act in connection with sales of Exchange

Notes acquired in exchange for such Notes shall result in such Exchange Notes

being not "freely tradeable"; and (y) the requirement that a participating

Broker-Dealer delivers a Prospectus in connection with sales of Exchange Notes

acquired in the Exchange Offer in exchange for Notes acquired as a result of

market-making activities or other trading activities shall not result in such

Exchange Notes being not "freely tradeable"), the Company shall effect a Shelf

Registration Statement in accordance with subsection (b) below.

(b) If required pursuant to subsection (a) above,

(I) the Company shall, as promptly as practicable, file with

the Commission and thereafter shall use its best efforts to cause to be

declared effective under the Act a Shelf Registration Statement relating

to the offer and sale of the Notes or the Exchange Notes, as applicable,

by the Holders thereof from time to time in accordance with the methods of

distribution elected by such Holders and set forth in such Shelf

Registration Statement; provided, however, that no Holder (other than an

Initial Purchaser) shall be entitled to have the Notes or Exchange Notes

held by it covered by such Shelf Registration Statement unless such Holder

agrees in writing to be bound by all of the provisions of this Agreement

applicable to such Holder; and provided further, that with respect to

Exchange Notes received by an Initial Purchaser in exchange for Notes

constituting any portion of an unsold allotment, the Company may, if

permitted by current interpretations by the Commission's staff, file a

post-effective amendment to the Exchange Offer Registration Statement

containing the information required by Item 507 or 508 of Regulation S-K,

as applicable, in satisfaction of its obligations under this subsection

with respect thereto, and any such Exchange Offer Registration Statement,

as so amended, shall be referred to herein as, and governed by the

provisions herein applicable to, a Shelf Registration Statement.

(II) the Company shall use its best efforts to keep the Shelf

Registration Statement continuously effective, supplemented and amended as

required by the Act, in order to permit the Prospectus forming part

thereof to be usable by Holders for a period of two years (as extended

pursuant to Section 6(c)(i)hereof) from the date the

<PAGE>

6

Shelf Registration Statement is declared effective by the Commission or

such shorter period that will terminate when all the Notes or Exchange

Notes, as applicable, covered by the Shelf Registration Statement have

been sold pursuant to the Shelf Registration Statement (in any such case,

such period being called the "SHELF REGISTRATION PERIOD"). The Company

shall be deemed not to have used its best efforts to keep the Shelf

Registration Statement effective during the requisite period if it

voluntarily takes any action that would result in Holders of Notes or

Exchange Notes covered thereby not being able to offer and sell such Notes

or Exchange Notes during that period, unless (A) such action is required

by applicable law; or (B) such action is taken by the Company in good

faith and for valid business reasons (not including avoidance of the

Company's obligations hereunder), including the acquisition or divestiture

of assets, so long as the Company promptly thereafter complies with the

requirements of Section 5(k) hereof, if applicable; provided, however,

that in any case if such Registration Default occurs for a continuous

period in excess of 30 days, Additional Interest shall be payable in

accordance with Section 5 hereof from the day such Registration Default

occurs until such Registration Default is cured.

(III) the Company shall cause the Shelf Registration Statement

and the related Prospectus and any amendment or supplement thereto, as of

the effective date of the Shelf Registration Statement or such amendment

or supplement, (A) to comply in all material respects with the applicable

requirements of the Act and the rules and regulations of the Commission;

and (B) not to contain any untrue statement of a material fact or omit to

state a material fact required to be stated therein or necessary in order

to make the statements therein, in the light of the circumstances under

which they were made, not misleading.

(c) Provision by Holders of Certain Information in Connection with

the Shelf Registration Statement. No Holder of Transfer Restricted Securities

may include any of its Transfer Restricted Securities in any Shelf Registration

Statement pursuant to this Agreement unless and until such Holder furnishes to

the Company in writing, within 20 days after receipt of a request therefor, the

information specified in Item 507 or 508 of Regulation S-K, as applicable, of

the Act for use in connection with any Shelf Registration Statement or

Prospectus or preliminary Prospectus included therein. No Holder of Transfer

Restricted Securities shall be entitled to Additional Interest pursuant to

Section 5 hereof unless and until such Holder shall have provided all such

information. By its acceptance of Transfer Restricted Securities, each Holder

agrees to promptly furnish additional information required to be disclosed in

order to make the information previously furnished to the Company by such Holder

not materially misleading.

SECTION 5. ADDITIONAL INTEREST

If (a) on or prior to the 120th day following the original issue

date of the Notes, neither the Exchange Offer Registration Statement nor the

Shelf Registration Statement has been filed with the Commission, (b) on or prior

to the 180th day following the original issue date of the Notes, neither the

Exchange Offer Registration Statement nor the Shelf Registration Statement has

been declared effective, (c) on or prior to the 210th day following the original

issue date of the Notes, neither the Exchange Offer has been consummated nor the

Shelf

<PAGE>

7

Registration Statement has been declared effective, or (d) after either the

Exchange Offer Registration Statement or the Shelf Registration Statement has

been declared effective, except as provided in Section 4(b)(II) hereof, such

Registration Statement thereafter ceases to be effective or usable in connection

with resales of Notes or Exchange Notes in accordance with and during the

periods specified in this Agreement (each such event referred to in clauses (a)

through (d), a "REGISTRATION DEFAULT"), interest ("ADDITIONAL INTEREST") will

accrue on the principal amount of the Notes and the Exchange Notes (in addition

to the stated interest on the Notes and Exchange Notes) from and including the

date on which any such Registration Default shall occur to but excluding the

date on which all Registration Defaults have been cured. Additional Interest

will accrue at a rate of 0.25% per annum during the 90-day period immediately

following the occurrence of such Registration Default and shall increase by

0.25% per annum at the end of each subsequent 90-day period, but in no event

shall such rate exceed 1.00% per annum.

All accrued Additional Interest shall be paid to the Holders

entitled thereto, in the manner provided for the payment of interest in the

Indenture, on each Interest Payment Date, as more fully set forth in the

Indenture and the Notes and the Exchange Notes. Notwithstanding the fact that

any securities for which Additional Interest are due cease to be Transfer

Restricted Securities, all obligations of the Company to pay Additional Interest

with respect to securities shall survive until such time as such obligations

with respect to such securities shall have been satisfied in full.

SECTION 6. REGISTRATION PROCEDURES

(a) Exchange Offer Registration Statement. In connection with the

Exchange Offer, the Company shall (i) comply with all applicable provisions of

Section 6(c) below, (ii) use its best efforts to effect such exchange and to

permit the resale of Exchange Notes by any Broker-Dealer that tendered Notes in

the Exchange Offer that such Broker-Dealer acquired for its own account as a

result of its market making activities or other trading activities (other than

Notes acquired directly from the Company or any of its Affiliates) being sold in

accordance with the intended method or methods of distribution thereof, and

(iii) comply with all of the following provisions:

(A) If, following the date hereof there has been announced a change

in Commission policy with respect to exchange offers such as the Exchange

Offer, that in the reasonable opinion of counsel to the Company raises a

substantial question as to whether the Exchange Offer is permitted by

applicable federal law, the Company hereby agrees to seek a no-action

letter or other favorable decision from the Commission allowing the

Company to Consummate an Exchange Offer for such Transfer Restricted

Securities. The Company hereby agrees to pursue the issuance of such a

decision to the Commission staff level. In connection with the foregoing,

the Company hereby agrees to take all such other actions as may be

requested by the Commission or otherwise required in connection with the

issuance of such decision, including without limitation (I) participating

in telephonic conferences with the Commission staff, (II) delivering to

the Commission staff an analysis prepared by counsel to the Company

setting forth the legal bases, if any, upon which such counsel has

concluded that such an Exchange Offer should be permitted and (III)

diligently pursuing a resolution (which need not be favorable) by the

Commission staff.

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8

(B) As a condition to its participation in the Exchange Offer, each

Holder of Transfer Restricted Securities (including, without limitation,

any Holder who is a Broker-Dealer) shall furnish, upon the request of the

Company, prior to the Consummation of the Exchange Offer, a written

representation to the Company (which may be contained in the letter of

transmittal contemplated by the Exchange Offer Registration Statement) to

the effect that (I) it is not an Affiliate of the Company, (II) it is not

engaged in, and does not intend to engage in, and has no arrangement or

understanding with any person to participate in, a distribution of the

Exchange Notes to be issued in the Exchange Offer and (III) it is

acquiring the Exchange Notes in its ordinary course of business. Each

Holder using the Exchange Offer to participate in a distribution of the

Exchange Notes will be required to acknowledge and agree that, if the

resales are of Exchange Notes obtained by such Holder in exchange for

Notes acquired directly from the Company or an Affiliate thereof, it (1)

could not, under Commission policy as in effect on the date of this

Agreement, rely on the position of the Commission enunciated in Morgan

Stanley and Co., Inc. (available June 5, 1991) and Exxon Capital Holdings

Corporation (available May 13, 1988), as interpreted in the Commission's

letter to Shearman & Sterling dated July 2, 1993, and similar no-action

letters (including, if applicable, any no-action letter obtained pursuant

to clause (A) above), and (2) must comply with the registration and

prospectus delivery requirements of the Act in connection with a secondary

resale transaction and that such a secondary resale transaction must be

covered by an effective Registration Statement containing the selling

security holder information required by Item 507 or 508, as applicable, of

Regulation S-K

(C) Prior to effectiveness of the Exchange Offer Registration

Statement, the Company shall provide a supplemental letter to the

Commission (I) stating that the Company is registering the Exchange Offer

in reliance on the position of the Commission enunciated in Exxon Capital

Holdings Corporation (available May 13, 1988), Morgan Stanley and Co.,

Inc. (available June 5, 1991) as interpreted in the Commission's letter to

Shearman & Sterling dated July 2, 1993, and, if applicable, any no-action

letter obtained pursuant to clause (A) above, (II) including a

representation that the Company has not entered into any arrangement or

understanding with any Person to distribute the Exchange Notes to be

received in the Exchange Offer and that, to the best of the Company's

information and belief, each Holder participating in the Exchange Offer is

acquiring the Exchange Notes in its ordinary course of business and has no

arrangement or understanding with any Person to participate in the

distribution of the Exchange Notes received in the Exchange Offer and

(III) any other undertaking or representation required by the Commission

as set forth in any no-action letter obtained pursuant to clause (A)

above, if applicable.

(b) Shelf Registration Statement. In connection with the Shelf

Registration Statement, the Company shall:

(i) comply with all the provisions of Section 6(c) an


 
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