CONNECTICUT GENERAL LIFE INSURANCE
COMPANY
UNITED STATES PHARMACEUTICAL GROUP,
LLC and
NATIONSHEALTH, INC.
CONFIDENTIAL MATERIALS OMITTED AND FILED SEPARATELY WITH THE
SECURITIES AND EXCHANGE COMMISSION. ASTERISKS DENOTE SUCH
OMISSION.
This STRATEGIC
AGREEMENT (this “Agreement”), dated as of May 4,
2005 (the “Effective Date”), is made and entered into
by and between Connecticut General Life Insurance Company, a
Connecticut corporation, (“CIGNA”), and UNITED STATES
PHARMACEUTICAL GROUP, LLC, a Delaware limited liability company,
(“USPG”) and NATIONSHEALTH, INC., a Delaware
corporation and the indirect owner of all of the membership
interest of USPG (“NationsHealth”).
WHEREAS, the
Medicare Prescription Drug Benefit program was established by
Section 101 of the Medicare Prescription Drug, Improvement,
and Modernization Act of 2003 (the “MMA”) and is
codified in Sections 1860D-1 through 1860D-41 of the Social
Security Act (the “Act”) and created a new Part D,
known as the Voluntary Prescription Drug Benefit Program
(hereinafter referred to as “Part D”);
WHEREAS, CIGNA has
submitted an application to the Centers for Medicare and Medicaid
Services (“CMS”) under Part D to become a
Prescription Drug Plan (“PDP”) sponsor in each of the
thirty-four Part D regions designated by CMS;
WHEREAS, subject
to such approvals by CMS as may be necessary, CIGNA, USPG and
NationsHealth desire to enter into an agreement in the nature of a
strategic alliance, pursuant to which USPG would provide certain
marketing, distribution, and enrollee service activities and
expertise in connection with CIGNA’s activities as a PDP
sponsor and Medicare contractor;
WHEREAS, in
entering into the relationship contemplated herein, CIGNA is
desirous of becoming a shareholder and warrantholder of
NationsHealth as contemplated in sections 3.02 and 3.03 of this
Agreement.
NOW, THEREFORE, in
consideration of the covenants set forth in this Agreement, and for
other good and valuable consideration, the receipt and sufficiency
of which are hereby acknowledged, the Parties agree as
follows:
ARTICLE I
SERVICES AND OBLIGATIONS OF USPG
SECTION 1.01
General Responsibilities . USPG shall provide to CIGNA the
services (collectively, the “Services”) set forth in
this Article I. The Services shall consist of the activities
enumerated in Sections 1.02 through 1.06, below. The Services
shall be performed, at a minimum, consistent with the timeliness,
accuracy and quality standards set forth in CMS instructions and
guidelines, provided, however , that the Parties may agree
to standards in addition, or in excess of, those established by
CMS.
SECTION 1.02
Part D Capabilities . USPG will develop the systems and
infrastructure required to perform the Services in conformance with
CMS regulations and guidance, as described in
Exhibit 1.02 .
SECTION 1.03
Marketing and Beneficiary Communication . USPG will provide
marketing and beneficiary communication services in conformance
with CMS regulations and guidance, as described in
Exhibit 1.03 and consistent with the standards of
performance described therein.
SECTION 1.04
Enrollment Billing and Premium Collection . USPG will
provide Enrollee billing and collection services, including, but
not limited to, Enrollee-specific premium billing, and collection
information in support of financial reporting and reconciliation
processes, all in conformance with CMS regulations and guidance, as
described in Exhibit 1.04 and consistent with the
standards of performance described therein.
SECTION 1.05
Enrollment and Eligibility . USPG will provide Enrollee
management entry point and servicing in conformance with CMS
regulations and guidance, as described in Exhibit 1.05 and
consistent with the standards of performance described therein.
USPG will also provide disenrollment management in conformance with
CMS regulations and guidance, as described in
Exhibit 1.05 and consistent with the standards of
performance described therein.
SECTION 1.06
Enrollee Inquiries and Grievance Processing . USPG will be
responsible for Enrollee inquiries and grievance processing in
conformance with CMS regulations and guidance, as described in
Exhibit 1.06 and consistent with the standards of
performance described therein.
SECTION 1.07.
NationsHealth *** . NationsHealth and/or USPG will fund the
NationsHealth *** described in Exhibit 1.07
.
ARTICLE II
REPRESENTATIONS AND WARRANTIES OF CIGNA;
*** OF CIGNA
SECTION 2.01 CIGNA
hereby represents and warrants to USPG and NationsHealth as
follows:
(a)
Corporate Status; Authorizations . CIGNA is a corporation
duly incorporated, validly existing and in good standing under the
Laws of the State of Connecticut. CIGNA has the corporate power and
authority, and all licenses, permits or other authorizations
required for CIGNA to carry on its business as now conducted and as
contemplated by this Agreement, except where the failure to possess
any such authority, authorization, licenses, permits or other
authorizations would not have a Material Adverse Effect. The
execution, delivery and performance of this Agreement by CIGNA have
been duly authorized by all necessary corporate action of CIGNA and
this Agreement constitutes the valid and binding obligations of
CIGNA enforceable against it in accordance with their terms, except
as may be limited by bankruptcy, insolvency, moratorium or other
similar Laws affecting creditors’ rights generally, and
subject to general principles of equity (regardless of whether
enforcement is considered in a proceeding in equity or at
law).
(b)
Part D Qualification . CIGNA is a risk bearing entity
licensed to provide health insurance benefits in each of the fifty
states and the District of Columbia; has, or will develop, a
pharmacy network that meets, or will meet, CMS access standards for
a PDP sponsor; and otherwise qualifies for one or more Part D
contracts.
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(c)
Part D Contract Requirements . CIGNA will comply with
all of the requirements imposed by any Part D Contract it
executes with CMS, provided, however , that CIGNA’s
failure to comply with any Part D Contract requirements will
not be grounds for termination of this Agreement unless CMS
terminates the Part D Contract based on CIGNA’s failure
to comply.
(d)
State Licensure . CIGNA will continuously maintain all
appropriate state insurance licenses, permits, or qualifications
for the provision of its services to Enrollees under the
PDP.
SECTION 2.02
*** . CIGNA will develop the systems and infrastructure
described in Exhibit 2.02 .
ARTICLE III
COMPENSATION AND INVESTMENT
SECTION 3.01
Determination of Compensation . The compensation to USPG for
its Services as described in this Agreement shall be determined as
described in Exhibit 3. 01 .
SECTION 3.02
Common Stock Purchase . Fourteen (14) days after the
NationsHealth Funding Date, CIGNA shall purchase from
NationsHealth, and NationsHealth shall issue to CIGNA, 303,030
shares of the common stock of NationsHealth (the “NHRX Common
Shares”) at a purchase price of Six Dollars and Sixty Cents
($6.60) per share, for a total aggregate purchase price of One
Million Nine Hundred Ninety-nine Thousand Nine Hundred Ninety-eight
Dollars ($1,999,998.00). The purchase of the Common Shares and the
Warrant (as defined below) shall be governed by a Securities
Purchase Agreement by and between NationsHealth and CIGNA,
substantially in the form attached hereto as
Exhibit 3.02 , and which is being executed
contemporaneously herewith.
SECTION 3.03
Issuance of Warrants to CIGNA . Fourteen (14) days
after the NationsHealth Funding Date, NationsHealth shall issue to
CIGNA a Warrant (the “Warrant”) to purchase 2,936,450
shares of the common stock of NationsHealth (the “Warrant
Shares”) at an exercise price of Six Dollars and Sixty Cents
($6.60) per share, in accordance with the terms and conditions of a
Warrant Agreement, substantially in the form attached hereto as
Exhibit 3.03 (the “Warrant Agreement”), and
which is being executed contemporaneously herewith.
SECTION 3.04
Registration Rights . The NHRX Common Shares and the Warrant
Shares (when issued) shall become subject to a Registration Rights
Agreement between NationsHealth and CIGNA, substantially in the
form attached hereto as Exhibit 3.04 , which
NationsHealth and CIGNA shall execute upon the purchase and
issuance of the NHRX Common Shares.
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ARTICLE IV
ADDITIONAL AGREEMENTS
SECTION 4.01
Legal and Regulatory Compliance .
(a) Each
Party shall carry out its duties and obligations under this
Agreement in material compliance with all applicable Laws. USPG
shall provide Services under this Agreement to Enrollees in
accordance with the terms and conditions of this Agreement and in a
manner consistent with the requirements of the Medicare statutes,
regulations, CMS guidance and CIGNA policies, including but not
limited to CIGNA’s CMS-required compliance programs with
respect to Medicare Part D, as amended from time to time, and
training thereon, provided, however , that such policies and
compliance programs, as amended, shall have been furnished in
writing to USPG which shall have a reasonable period of time for
their implementation. With respect to CIGNA policies other than
CIGNA’s CMS-required compliance program, CIGNA shall not
require compliance by NationsHealth in excess of that required from
CIGNA’s other Part D subcontractors. USPG shall maintain
all applicable licenses required to carry out its business
activities and shall further comply with CIGNA policies and
procedures and all applicable laws and regulations to ensure that
its Services are provided in a culturally competent manner to
Enrollees, including those with limited English proficiency or
reading skills, diverse cultural and ethnic backgrounds, and
physical or mental disabilities.
(b) In the
event that USPG is required by regulatory authorities to obtain
additional licenses necessary to permit it to perform the Services,
or USPG determines that it is required to obtain such licenses, or
in the event that CIGNA concludes in good faith after reasonable
investigation that USPG is required to obtain such licenses, and
USPG does not possess such licenses, then USPG shall have a period
of ninety (90) days within which to file applications for such
licenses. If, after one hundred twenty (120) days from the
last day of such ninety (90) day period USPG does not possess
at least seventy-five (75%) percent of such licenses, then CIGNA
shall be entitled to terminate this Agreement For Cause pursuant to
Section 6.05(a), provided, however , that in such
instance the notice requirement and cure period contained in
Section 6.05(a) shall not apply.
(c) In the
event that USPG is ordered or otherwise formally requested by
regulatory authorities to cease performing any of the Services,
then USPG shall cease performing such Services in accordance with
such order or formal request.
(d) If either
of the events described in subsections (b) or (c), above,
occurs, CIGNA may, pursuant to Section 7.04(a)(iv), directly
or through a third party, solicit and/or service Part D
Enrollees in the state(s) or jurisdictions(s) with respect to which
USPG is unable to so solicit and/or service because of its lack of
licensure or the application of a governmental order or formal
request that it cease such activities in such state(s) or
jurisdiction(s).
(e) To the
extent that USPG seeks to obtain applicable licenses, even if it is
uncertain whether Governmental Authorities require, or will require
such licenses, then USPG’s *** in obtaining such licenses
shall be *** under this Agreement.
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SECTION 4.02
Inspection, Audit and Acceptance .
(a) CIGNA,
its Affiliates, and CMS shall have the right, directly or through
their designated auditors, at all reasonable times to inspect,
audit, or otherwise evaluate the work performed or being performed
by USPG, its supporting policies and procedures, including those
related to data security, disaster recovery and back-up, as well as
all data supplied, in the performance of this Agreement. If any
inspection or evaluation is made by CIGNA or CMS on the premises of
USPG or any of USPG’s suppliers, USPG or its suppliers shall
provide at no additional charge all reasonable facilities and
assistance for the safety and convenience of the personnel
conducting the inspection or evaluation. The Secretary of Health
and Human Services, the Comptroller General of the U.S. Government
Accountability Office, or their designees shall have the right
during the term of this Agreement and for a period of ten
(10) years after termination of this Agreement or the date of
the audit completion, whichever is later, to audit, evaluate, or
inspect any books, contracts, medical records, documents, papers,
enrollee documentation, and other records of USPG, related entity,
subcontractor, or transferee that pertain to any aspect of the
Services provided under this Agreement, or as the Secretary may
deem necessary to enforce the applicable Medicare Contract between
CMS and CIGNA. Any audit, evaluation, or inspection covered by this
Section 4.02(a) shall be at no additional charge to CIGNA, but
each Party will be responsible for its own labor and out of pocket
expenses. USPG and NationsHealth further represent, warrant, and
covenant to CIGNA that, in connection with the performance of the
Services hereunder, USPG and/or NationsHealth will not hold
Enrollees liable for fees that are the responsibility of
CIGNA.
(b) All
Services provided by USPG for CIGNA, its Affiliates, and the
Enrollees shall be in accordance with the requirements of this
Agreement, including all schedules, annexes, exhibits and
attachments, and shall be subject to rejection if such Services are
nonconforming. No inspection or evaluation performed by CIGNA, its
Affiliates, or CMS shall in any way relieve USPG of its obligation
to furnish all required Services in strict accordance with the
requirements of this Agreement. If any of the Services do not
conform to the requirements of this Agreement, CIGNA shall have the
right to require USPG to take such steps as are reasonably
necessary to bring its performance into compliance including, but
not limited to, requiring USPG to perform the work or services
again in conformity with the applicable requirements at no cost to
CIGNA or CMS.
SECTION 4.03
Representations and Covenants of USPG and NationsHealth
.
(a)
Contracting Capacity . USPG and NationsHealth represent,
warrant and covenant that (1) as to themselves and their
principals within the last five years, and (2) their employees
and subcontractors that will be assigned to perform Services
hereunder within the five-year period preceding their initial
performance hereunder, to USPG and NationsHealth’s Knowledge:
(i) are not debarred, suspended, proposed for debarment or
suspension, or otherwise excluded or declared ineligible for the
award of contracts by or participation in any Federal program,
department or agency; (ii) have not been charged with,
convicted of or had a civil judgment rendered against them for:
commission of a fraud or a criminal offense in connection with
obtaining, attempting to obtain, or performing a public (Federal,
state, or local) contract or subcontract; dishonesty or breach of
trust including but not limited to violation of Federal or state
antitrust statutes, commission of a fraud including but not limited
to mail fraud or false repre
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sentations,
violation of fiduciary relationship, securities offenses,
embezzlement, theft, forgery, bribery, falsification or destruction
of records, making false statements, tax evasion, or receiving
stolen property; (iii) have not been indicted for, or
otherwise criminally or civilly charged by a government entity
(Federal, state, or local) with, commission of any of the offenses
enumerated in this Section; (iv) have not had one or more
public agreements or transactions (Federal, state, or local)
terminated for cause or default; and (v) have not been
excluded from participation for a federal program, including but
not limited to, Medicare, Medicaid, federal health care programs or
federal behavioral health care programs pursuant to Title XI of the
Social Security Act, 42 U.S.C. § 1320a-7 and other applicable
federal statutes. USPG and NationsHealth also represent, warrant,
and covenant to CIGNA that USPG and/or NationsHealth have or will
duly obtain all intellectual property rights necessary to perform
its obligations under this Agreement. USPG and
NationsHealth’s certification in this Section is a material
representation of fact upon which CIGNA relied when this Agreement
was entered into by the Parties. USPG and/or NationsHealth shall
provide immediate written notice to CIGNA if, at any time during
the term of this Agreement, USPG and/or NationsHealth learns that
its certification in this Section was erroneous on the Effective
Date of this Agreement or has become erroneous by reason of new or
changed circumstances. If the circumstances causing such
certification to be erroneous are curable, then USPG and
NationsHealth shall have forty-five (45) days to cure such
circumstances. Furthermore, if the circumstances causing such
certification to be erroneous relate to a non-compliant employee or
subcontractor in connection with Section 4.03(a)(2), above,
then USPG and NationsHealth shall be deemed to have timely cured
such circumstances, so long as USPG and/or NationsHealth completely
removes such employee or subcontractor from performing any Services
hereunder immediately upon learning that such employee or
subcontractor is non-compliant with this Section. Subject to the
foregoing cure provisions, if it is later determined that
USPG’s and/or NationsHealth’s certification in this
Section was erroneous on the Effective Date of this Agreement or
has become erroneous by reason of new or changed circumstances, in
addition to other remedies available to CIGNA, CIGNA may terminate
this Agreement for convenience, at its sole discretion.
(b)
Corporate Status; Authorizations . NationsHealth and USPG,
respectively, are a corporation and a limited liability company
duly incorporated or organized, validly existing and in good
standing under the Laws of the state of Delaware. NationsHealth and
USPG have the corporate power and authority, and all licenses,
permits or other authorizations required to carry on their
businesses as now conducted and as contemplated by this Agreement,
except where the failure to possess any such authority,
authorization, licenses, permits or other authorizations would not
have a Material Adverse Effect and except as set forth on
Exhibit 4.03(b) . The execution, delivery and
performance of this Agreement by NationsHealth and USPG have been
duly authorized by all necessary corporate action and this
Agreement constitutes the valid and binding obligations of
NationsHealth and USPG enforceable against them in accordance with
their terms, except as may be limited by bankruptcy, insolvency,
moratorium or other similar Laws affecting creditors’ rights
generally, and subject to general principles of equity (regardless
of whether enforcement is considered in a proceeding in equity or
at law).
SECTION 4.04
Warranting and Certification of Data . Certain of the data
(the “CMS data”) furnished by USPG or NationsHealth in
connection with its performance of its obligations under this
Agreement will be used by CIGNA to obtain payments from CMS, to
support
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CIGNA’s
bids for Medicare Program renewals and contracts with CMS in future
years, or both. CIGNA and CMS will be acting in reliance on the
accuracy, completeness, and truthfulness of any CMS data USPG or
NationsHealth provides. USPG and NationsHealth agree to warrant the
accuracy, completeness, and truthfulness of the CMS data it
furnishes pursuant to this Agreement to CMS and to indemnify and
hold CIGNA harmless for any payments made by CIGNA and any damages
or liabilities caused by the negligence or willful misconduct of
USPG or NationsHealth or that of their employees or agents in
connection with providing inaccurate, incomplete, or untruthful CMS
data. Any CMS data that are provided pursuant to this Agreement on
a monthly, quarterly, or annual basis shall be certified by the
duly authorized Chief Executive Officer, the Chief Financial
Officer or other officer of USPG who reports directly to
NationsHealth’s Chief Executive Officer or Chief Financial
Officer. With respect to any data furnished by USPG and/or
NationsHealth that CIGNA or its Affiliates will incorporate into
data certified to CMS such certification shall state:
“I hereby
certify that the data, information and statements set forth herein
are accurate, complete, truthful and current to the best of my
knowledge, information, and belief after reasonable investigation
with respect thereto, and are made in good faith.
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Signed:
Certifying Officer”
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SECTION 4.05
Compliance with Grievance Requirements . If and to the
extent that USPG processes Enrollee grievances, then USPG shall
cooperate and comply with all requirements of Medicare and CIGNA
regarding the processing of Enrollee grievances as defined under
Part D and accompanying CMS regulations, including the
obligation to provide information (including medical records and
other pertinent information) to CIGNA within the time frame
reasonably requested for such purpose, and shall process such
grievances in accordance with Exhibit 1.06 .
SECTION 4.06
Privacy and Security of Certain Data .
(a) The
Parties expect to be responsible for obtaining, analyzing, storing,
transmitting, and reporting Protected Health Information, as
defined in regulations, 45 CFR Parts 160 and 164, implementing the
Health Insurance Portability and Accountability Act of 1996, Pub.
L. 104-191 (“HIPAA”). The Parties agree to comply with
all applicable Federal and State privacy and security laws
including but not limited to the requirements of HIPAA and its
implementing regulations and 42 CFR § 423.136 as more fully
described in the Business Associate Agreement in the form attached
as Exhibit 4.06 to be executed by the Parties with
respect to Enrollee data and other protected
information.
(b) The
parties recognize that USPG and NationsHealth are able to provide
important health-related products and services that may add value
for Enrollees, but which may not be part of CIGNA’s plan of
benefits, that may be part of an Enrollee’s treatment, or
provide a kind of alternative treatment or therapy that may be
helpful to Enrollees. Accordingly, and in a manner consistent with
applicable state and federal law, including HIPAA, CIGNA agrees
that it will work with USPG and NationsHealth over the next one
hundred twenty (120) days to develop a plan that: (i) directly
provides Enrollees with information concerning USPG and
NationsHealth
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Part B
Supplies in a form approved by USPG and NationsHealth, and
(ii) seeks to obtain appropriate authorizations from Enrollees
authorizing CIGNA to share Protected Health Information with USPG
and NationsHealth such that USPG and NationsHealth may provide
appropriate information to Enrollees regarding USPG and
NationsHealth Part B Supplies. Any plan to directly provide
Enrollees with information concerning USPG and NationsHealth
products shall be subject to any applicable regulatory and
marketing requirements, including but not limited to those set
forth in 42 C.F.R. § 423.50 that may require the approval of
CMS, as determined in the reasonable discretion of CIGNA. In the
event that CMS disapproves any plan to directly provide Enrollees
with information concerning USPG and NationsHealth products, such
disapproval shall not affect or change any of the Parties’
respective rights and obligations under the Agreement, and such
disapproval shall not constitute a breach of the Agreement by
CIGNA, or give rise to any right of termination or rescission or
amendment of the Agreement in any manner by any Party.
SECTION 4.07
Assignment and Subcontracting . Except as described on
Exhibit 4.07 , USPG and NationsHealth are solely responsible
for the provision of the Services and their other obligations under
this Agreement. Neither USPG nor NationsHealth may assign or
transfer, in whole or in part, these obligations, any interest in
this Agreement or any claim under this Agreement. Neither the
entirety nor any part of this Agreement or any task order may be
further subcontracted by USPG or NationsHealth without the prior
written consent of CIGNA.
SECTION 4.08
Advance Consent to Assignment Among Affiliates of CIGNA .
USPG and NationsHealth consent in advance to CIGNA’s
assignment or transfer of all or part of its rights and obligations
of under this Agreement to any CIGNA subsidiary or Affiliate
(including any successor company of CIGNA pursuant to a
reorganization by CIGNA and one or more of its Affiliates). Any
such assignment and transfer shall be effective upon delivery of a
written notice of assignment by CIGNA to USPG or NationsHealth and
shall be subject to Section 11.05 of this
Agreement.
SECTION 4.09
Delegation of Duties . The parties acknowledge that CIGNA
oversees and is accountable to CMS for any functions or
responsibilities described in CMS’ Medicare Program
regulations and, upon becoming a sponsor of the PDP, will monitor
the performance of USPG on an ongoing basis. USPG and NationsHealth
shall perform their obligations under this Agreement in a manner
consistent with and in compliance with CIGNA’s contractual
obligations under CIGNA’s Medicare contract with CMS. In the
event that CIGNA delegates to USPG or NationsHealth any function or
responsibility imposed pursuant to CIGNA’s contract with CMS,
such delegation shall be subject to the requirements set forth in
42 C.F.R.§ 423.505(i)(4), as they may be amended over time. In
addition, any delegation by USPG or NationsHealth of functions or
responsibilities imposed pursuant to this Agreement shall be
subject to the prior written approval of CIGNA and shall also be
subject to the requirements set forth in 42 C.F.R. §
423.505(i)(4), as they may be amended over time. USPG and
NationsHealth shall promptly supplement and amend their permitted
subcontracts to include CMS’ requirements applicable to
subcontractors. USPG and NationsHealth agree that CIGNA or its
Affiliates may, at their option, outsource various functions of its
Medicare contract with CMS.
SECTION 4.10
Document Retention, Audit Rights . Each Party shall retain,
in accordance with standard and accepted practices, such financial,
accounting, and administrative re
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cords related
to the services it is obligated to provide under this Agreement for
such period as is necessary to comply with applicable Law, but in
no event less than ten (10) years after the date such
documents and information are created or obtained, or longer under
the conditions enumerated in 42 CFR§ 423.505(e)(4). Subject to
applicable Law, during the term of this Agreement CIGNA, on one
hand, and USPG and NationsHealth, on the other hand, may reasonably
conduct (or have conducted on its behalf), at its own expense, one
audit each year of the other Party with respect to relevant
documents and data in the possession of such other Party and with
reasonable access to relevant personnel of such other Party upon
reasonable notice solely for the purposes of confirming compliance
with obligations undertaken pursuant to this Agreement including
those that are required to be reported to an applicable government
agency; provided , however , that such audits may be
performed more frequently to the extent necessary to respond to a
request by CMS or another government agency. The terms of the
confidentiality provisions set forth in Article VII hereof
shall apply to any such audits. Such audit rights will be available
following termination of this Agreement to the extent necessary to
respond to a request by a customer, Governmental Authority,
provider or other relevant party and for a Party’s need to
manage litigation and to determine compliance with this Agreement
or applicable Laws.
SECTION 4.11
Ownership of Assets . Notwithstanding any other provision of
this Agreement, each Party shall maintain ownership of its own
assets.
SECTION 4.12
Organization of Committee . The parties shall organize the
Committee to facilitate the implementation and operating efficiency
of the activities described in this Agreement, which Committee
shall meet monthly or at such intervals as the Parties may
agree.
ARTICLE V
SEPARATE PRODUCT OFFERINGS: FUTURE ENDEAVORS
SECTION 5.01
Sale of Other Products and Services by USPG or NationsHealth
. CIGNA acknowledges that NationsHealth and USPG are in the
business of selling other services and supplies including, but not
limited to, Part B Supplies reimbursable by the Medicare
Program. Nothing in this Agreement is intended to foreclose USPG or
NationsHealth from conducting such other businesses or offering
such products and services, including, but not limited to,
Part B Supplies. Notwithstanding the foregoing in no event
shall NationsHealth or USPG market any service or supply on a
targeted basis directly to Enrollees of CIGNA Employer Groups.
Notwithstanding anything in this Agreement to the contrary, except
as provided for in Section 5.03, in no event shall
NationsHealth or USPG, in the course of providing services under
this Agreement or in connection with an Enrollee interaction
initiated with or by NationsHealth or USPG concerning coverage or
services under the PDP, solicit, refer, recommend or direct
Enrollees to utilize NationsHealth or USPG for any Medicare
Part B goods or services or other goods or services. Nothing
contained in this Agreement shall apply to current or prospective
enrollees in the CIGNA Healthcare of Arizona Medicare Advantage
Prescription Drug Plan or to any other Medicare Advantage
Prescription Drug Plan that CIGNA or its Affiliates, or
NationsHealth and USPG, may acquire, offer, administer, insure or
otherwise provide, or to non-Part D products or services
offered by CIGNA or NationsHealth and/or USPG, provided,
however , that CIGNA agrees that it will not directly, or
through a contract on CIGNA’s behalf, market the Part B
Supplies of a Part B supplier other than NationsHealth to
Persons who are enrolled in Medicare Part B, except as such
activities are conducted by CIGNA as of the Effective
Date.
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SECTION 5.02
Prohibition on Discount Card Marketing to Part D-Eligible
Enrollees . From *** through *** NationsHealth and USPG shall
not market any drug discount card directly to Part D-eligible
individuals.
SECTION 5.03
Future Endeavors . The Parties agree that there may be
additional opportunities to jointly offer products and services ***
such products and services, in a manner that capitalizes on the
strengths and efficiencies of each Party. In connection with
potential future endeavors, the Parties agree to the undertakings
described in Exhibit 5.03 .
ARTICLE VI
AGREEMENT CONTINGENT;
TERM AND TERMINATION
SECTION 6.01
Agreement Contingent on CMS Acceptance of CIGNA Applications
. This Agreement is expressly contingent upon CMS’ acceptance
of the applications submitted by CIGNA and the award of Part D
contracts to CIGNA.
SECTION 6.02
Agreement Contingent on NationsHealth Funding of *** and
NationsHealth *** .
(a)
Required NationsHealth Funding . By the later of
(i) the date that is *** after the Effective Date or
(ii) the date that is *** after CMS approves the PDP (the
“NationsHealth Funding Date”) NationsHealth and/or USPG
will have received *** in funds available to support the Services,
or NationsHealth and/or USPG will have entered into a binding
credit agreement or loan agreement with a term of at least twelve
(12) months with a lender or other financial institution
providing NationsHealth and/or USPG with total proceeds or
borrowing availability, together with any funds realized from the
sale of equity or from other sources, of at least *** (exclusive of
financing expenses) to fund the *** and the NationsHealth *** as
necessary to make the PDP fully operational. The proceeds of such
loan agreement or credit agreement shall be available to be drawn
down by USPG and/or NationsHealth on the NationsHealth Funding
Date. The *** to be provided by NationsHealth and/or USPG on the
NationsHealth Funding Date shall be evidenced by either of the
following:
(i) the deposit by
NationsHealth or USPG of the sum of at least *** in an escrow
account subject to an escrow agreement, control agreement, or
similar arrangement limiting withdrawals to the funding of ***
and/or NationsHealth ***; or
(ii) the execution
by NationsHealth and/or USPG of a binding credit agreement or loan
agreement with MHR Capital Partners LP, or any of its Affiliates,
or a financial institution rated “A” or better by
Standard and Poor’s, or by another financing source
reasonably acceptable to CIGNA, which credit agreement or loan
agreement shall expressly permit the draw down of proceeds of at
least *** (less any proceeds realized by NationsHealth or USPG from
the sale of equity or from other sources) to pay for the *** and
the NationsHealth ***.
(b) Elections
Available to CIGNA in the Absence of Funding by NationsHealth .
If, on the NationsHealth Funding Date, NationsHealth and/or USPG,
for any reason, have not obtained
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cash proceeds
or borrowing availability, together with any funds realized from
the sale of equity or from other sources, of at least ***
(exclusive of financing expenses) or are not able to commence
actual payment of the *** and the NationsHealth *** as necessary to
make the PDP fully operational, then CIGNA shall be entitled to, in
its sole discretion, elect one or more of the following items (i),
(ii), (iii) or (iv):
(i) terminate this
Agreement pursuant to Section 6.05(a), below, provided,
however , that the notice requirement and cure period contained
therein shall not apply;
(ii) remove all
exclusivity obligations by CIGNA to NationsHealth and/or USPG,
including, without limitation, the commitment described in
Section 7.04(a), below;
(iii) terminate,
without any liability to CIGNA, that certain Securities Purchase
Agreement dated May 4, 2005, by and between NationsHealth and
CIGNA, which termination shall not affect the Warrant Agreement
dated May 4, 2005 executed by NationsHealth for the benefit of
CIGNA or the Warrants issued by NationsHealth to CIGNA pursuant
thereto; or,
(iv) modify the
terms of this Agreement to provide all of the following:
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(A)
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CIGNA shall be responsible for ***
of the first *** of the *** for 2005.
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(B)
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CIGNA may reduce the monthly
settlement payment due to NationsHealth as described in
Exhibit 3.01 by a fee reduction equal to *** until such
time as NationsHealth and/or USPG’s portion of the 2005 ***
is recovered, and for an additional *** thereafter. Such fee
reduction shall be applied until the earlier of the date described
in the preceding sentence or the termination of this
Agreement.
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(C)
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The
Advanced Expense Payment to NationsHealth shall increase from ***
of the estimated *** for the month in question to *** of the
estimated *** for such month.
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SECTION 6.03
Term of this Agreement . The initial term of this Agreement
shall be from the Effective Date until December 31,
2009.
SECTION 6.04
Termination . Each Party may terminate this Agreement For
Cause by providing written notice to the other Party, provided,
however , that neither of USPG or NationsHealth may cause a
termination of this Agreement by providing a notice of termination
to the other. If For Cause notice is given regarding any of the
events set forth in Section 6.05(a), (b), (c), (d), and
(h) the effective date of termination shall be either
(i) the expiration of the applicable cure period, or
(ii) if there is no applicable cure period, forty-five
(45) days after the date written notice of termination is
received by the other Party. In the event a For Cause notice is
given regarding any of the events set forth in
Section 6.05(e), (f) or (g), the effective date of
termination will be the date that such notice is received by the
other Party.
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SECTION
6.05 For Cause . “For Cause” termination shall
mean the following:
(a) As
to a nonbreaching Party, the other Party’s breach of any of
the terms
and
conditions of this Agreement that causes a Material Adverse Effect
on the non-breaching Party, and remains uncured following written
notice and a reasonable opportunity to cure, which shall not be
less than ninety (90) days from the date of written notice of
such breach.
(b) As
to any Party, if the PDP, at the end of then most recent CMS
contract year, has fewer than *** Enrollees (excluding CIGNA
Employer Group members and Dual Eligibles).
(c) As
to any Party, if the then-most recently completed two CMS contract
years cumulative experience results in a Net Loss.
(d) As
to a nonbreaching Party, if a default occurs on a payment required
to
be
made by the breaching Party relating to the PDP.
(e) As
to a nonbreaching Party, if a Party is adjudicated to have
committed fraud in a civil proceeding or otherwise settles a civil
fraud action involving the United States for a material amount, or
a criminal action is filed by a governmental agency against a Party
arising out of, or relating to, the PDP, or a Party is excluded or
debarred from participation in any federal or state health care
program pursuant to 42 U.S.C. § 1320a-7.
(f) As
to a nonbreaching Party, if a Party: (i) is unable to pay its
debts generally as they become due; (ii) makes a voluntary
assignment for the benefit of creditors; (iii) is declared
insolvent in any proceeding; (iv) commences a voluntary case
or other proceeding seeking liquidation, reorganization or other
relief with respect to itself, any of its property, assets or debts
under any bankruptcy, insolvency or other similar laws now or
hereafter in effect or petitions or applies to any tribunal for the
appointment of a receiver, liquidator, custodian or trustee for
such Party under any bankruptcy, reorganization, arrangement,
insolvency, readjustment of debt, liquidation, or dissolution law
of any jurisdiction now or hereafter in effect; or (v) is
named as a debtor party in such petition, application, case or
proceeding and it indicates its approval thereof, consents thereto,
acquiesces therein or acts in furtherance thereof, or if such
petition, application, case or proceeding is not dismissed or
stayed for a period of sixty (60) days after it is commenced, or is
the subject of any order appointing any such receiver, liquidator,
custodian or trustee or approving the petition in any such case or
proceeding.
(g) If
a Party undergoes a change in control which shall be defined as a
transfer of all, or substantially all, of the Party’s assets,
or a transfer of more than (i) *** as to CIGNA, or (ii) *** as to
NationsHealth or USPG, of the voting control of their respective
securities, in a single transaction or a series of transactions
intended to effect a change in control of such Party then the Party
not undergoing such change in control may deem a For Cause
termination to have occurred, provided, however that a
reorganization by a Party and one or more of its Affiliates for
administrative or similar purposes shall not be deemed a change in
control and provided further that as to USPG and/or
NationsHealth this provision shall be limited to a change in
control such
12
that USPG
and/or NationsHealth would be substantially controlled by a health
plan or pharmacy benefit provider or another entity that
substantially competes with, or operates a business that
substantially conflicts with, CIGNA.
(h) As
to any Party, as to which any existing Law governing the
Part D program is changed, or if a new Law relating to
Part D is enacted or promulgated, and the effect of such
changed or new Law would cause a Material Adverse Effect on such
Party.
SECTION 6.06
Optional Extension of Counter-Party Performance in Connection
With Early Termination .
(a)
Early Termination for Failure to Meet Enrollee Threshold, Net
Loss . Following the termination of this Agreement prior to the
initial term described in Section 6.03 pursuant to
Section 6.05 (b) or (c) above, either party shall,
at the election of the other party, agree to honor the terms and
conditions of this Agreement through December 31 of the year
following the year in which the termination is effective, or such
shorter time as the party requesting performance may specify,
provided however , that if such a continuation of
performance creates a substantial financial hardship to USPG, then
the parties shall meet and confer in good faith concerning
potential compensation to ***.
(b)
Early Termination for Other Reasons . Following the
termination of this Agreement prior to the initial term described
in Section 6.03 pursuant to Section 6.05 (a), (d),(e),
(f),(g) and (h), above, the party subject to a termination For
Cause shall, at the election of the other party, agree to honor the
terms and conditions of this Agreement through December 31 of
the year following the year in which the termination is effective,
or such shorter time as the party requesting performance may
specify, provided however , that if such a continuation of
performance creates a substantial financial hardship to USPG, then
the parties shall meet and confer in good faith concerning
potential compensation to ***.
SECTION 6.07
Effect of Termination or Expiration of Agreement Upon Enrollees;
Contingent Financial Settlement; Option to Acquire Servicing
Assets; No Loss of Rights in Cardholder Data; No Preclusion on
Marketing by USPG and NationsHealth .
(a)
Post-Termination Re-Enrollment . Upon termination or
expiration of this Agreement other than with respect to a
termination by CIGNA of NationsHealth and/or USPG pursuant to
Sections 6.05(a),(d), (e) (except that for purposes of this
Subsection 6.07(a) the criminal action referred to in (e) must
result in a conviction of NationsHealth) and (f), if NationsHealth
or USPG (or NationsHealth or USPG and a third party or parties) is
the sponsor or is a contractor, in a material capacity, for a
CMS-approved PDP (the “NationsHealth PDP”) and ***
within thirty (30) days of termination of this Agreement (or
such longer period as the Parties may agree) *** that otherwise
would be automatically *** for the then-next open ***, then the
Parties will effect such *** and any other activities necessary to
support such *** in accordance with terms of such approval and
applicable Law, including, without limitation, HIPAA, pursuant to
which, CIGNA shall provide NationsHealth and/or USPG with *** to
the extent necessary to enable NationsHealth and/or USPG to *** the
NationsHealth PDP *** as of the date of termination of this
Agreement. ***:
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(i) *** a
prescription card program offered or operated by NationsHealth
and/or USPG prior to October 1, 2005, or *** Part B
Supplies from NationsHealth prior to October 1, 2005, *** of
the Parties no later than June 30, 2006.
(ii) *** (***
through a procedure agreed upon by the Parties, except where *** is
impracticable or inappropriate, such as where it would result in
*** Part D plans) *** of CIGNA Employer Groups.
(b)
Contingent Financial Settlement . If the NationsHealth PDP
is precluded by CMS or by applicable Law from ***, above, or CMS
does not grant its express authorization or approval as described
in (a), above, then, at the end of each calendar quarter ***
following the termination of ***:
(i) NationsHealth
shall pay CIGNA *** of CIGNA’s Employer Groups *** in any
NationsHealth PDP.
(ii) CIGNA shall
pay NationsHealth or USPG ***:
(1) *** otherwise
would have been *** the NationsHealth PDP under subsection ***,
above;
(2) *** where USPG
and/or NationsHealth *** pursuant to Section 4.01(b), above;
and,
(3) *** in the
CIGNA PDP for ***.
(iii) For (A) ***
not identified in subsections *** and ***, above,(for example, ***
as a consequence of ***) and (B) excluding CIGNA Employer
Group *** NationsHealth shall consist of *** for those *** (as to
which CIGNA shall exercise reasonable diligence, but no less effort
than it would with respect to ***) in CIGNA’s PDP for such
plan year, less *** (as to which NationsHealth and/or USPG shall
exercise reasonable diligence, but no less effort than it would
with respect to ***) in the NationsHealth PDP. In the event that
*** in the NationsHealth PDP *** in CIGNA’s PDP, then
NationsHealth shall ***.
(c)
Option to Acquire Servicing Assets . In the event of a
termination of this Agreement by CIGNA For Cause pursuant to
subsections (a), (d), (e), (f) and (g) of
Section 6.05, above, or in the event that USPG and
NationsHealth change their business operations such that they no
longer offer the Services, then CIGNA shall have the option to
acquire, which option must be exercised within thirty
(30) days of the final date on which USPG renders Services
pursuant to this Agreement, the assets required to deliver all or
part of the Services described in Exhibits 1.02,
1.03, 1.04, 1.05 , and 1.06 . CIGNA
shall have the option to acquire such physical assets from USPG
and/or NationsHealth at their fair market value. NationsHealth may
decline to sell such physical assets to CIGNA, in which instance
CIGNA may acquire similar assets from third party vendors.
NationsHealth and/or USPG will provide know how, expertise, and
personnel resources to assist CIGNA, without cost to CIGNA, in
replicating the functionality of such assets. Prior to the
effective date of such termination, CIGNA may notify USPG or
NationsHealth of CIGNA’s intent to exercise such option so
that the transfer of such assets will occur
14
simultaneously
with the termination. Further, in the event of such termination,
CIGNA shall have the option to acquire from USPG and/or
NationsHealth, without cost to CIGNA, the intangible assets
required to deliver all or part of the Services, including system
specifications and configurations, software code, training and
policy manuals, marketing plans and other information used by USPG
or NationsHealth in the performance of the Services described in
the foregoing exhibits through a grant by USPG and/or NationsHealth
to CIGNA of a royalty-free perpetual license for such intangible
assets to the extent of the authority of USPG and/or NationsHealth
to grant such a license.
(d)
No Loss of Rights in Cardholder Data; No Preclusion on Marketing
by USPG and NationsHealth . No termination of this Agreement
shall be deemed by CIGNA to constitute a transfer or assignment by
USPG or NationsHealth to CIGNA of data developed by USPG or
NationsHealth concerning participants in NationsHealth’s
prescription card program or to constitute a prohibition on
marketing activities by NationsHealth or USPG with respect to such
participants.
(e)
Inapplicability of Post-Termination *** Arrangements and
Contingent Financial Settlement to CIGNA as a Result of a
Termination For Cause by NationsHealth . Upon the termination
of this Agreement by NationsHealth pursuant to Sections 6.05(a),
(d), (e) (except that for purposes of this Subsection 6.07(e) the
criminal action referred to in (e) must result in a conviction
of CIGNA) and (f), then those provisions of subsections 6.07
(a) and (b), above, entitling CIGNA to post-termination ***
and a contingent financial settlement, shall not apply to
CIGNA.
ARTICLE VII
CONFIDENTIALITY; USE OF INTELLECTUAL PROPERTY;
ENROLLEE DATA; EXCLUSIVITY
SECTION 7.01
Confidentiality . Prior to entering into this Agreement the
Parties have each committed substantial resources to developing the
arrangements described in this Agreement. The Parties specifically
acknowledge that to induce each other to enter into this Agreement
each Party specifically confirms that all Confidential Information
received from the other party at any time shall remain confidential
during the term of this Agreement and shall be used only in
furtherance of the business relationships contemplated by the
provisions of this Agreement. In this regard, each Party agrees
that any Confidential Information provided to it will only be
provided to its employees on a “need to know” basis,
and will be treated with at least as much care as the receiving
party provides for its own Confidential Information (and in no
event treated with any less than a high degree of
confidentiality.)
SECTION 7.02
Use of Proprietary Information .
(a) Notwithstanding
anything to the contrary in this Agreement, NationsHealth and USPG
reserves all right, title and interest in and to, and all control
of the use of NationsHealth or USPG’s copyrights, patents,
service marks, trademarks, designs, logos, brand names, Internet
“URL” addresses, World Wide Web sites and all right,
title and interest in and to any trade names, fictitious business
names, and all other intellectual property rights (collectively,
“NationsHealth/USPG Intellectual Property”), including
all right, title and interest, including any
15
license rights
it has, in and to the name of NationsHealth or USPG, and any
derivation thereof and including NationsHealth/USPG New
Intellectual Property (as defined below). CIGNA shall not, and
shall ensure that CIGNA’s Affiliates do not, use any of
NationsHealth/USPG Intellectual Property in materials supplied to
Employer Groups, prospective Employer Groups, Enrollees or
otherwise without NationsHealth’s and USPG’s express
and specific prior written consent. To the extent applicable, CIGNA
hereby assigns, transfers and conveys irrevocably and perpetually
to NationsHealth or USPG all of its worldwide right, title and
interest in and to any and all NationsHealth/USPG Intellectual
Property. “NationsHealth/USPG New Intellectual
Property” means all developed materials and other
intellectual property that (a) are conceived, created or
developed in connection with or in the course of providing the
Services and are modifications, enhancements, adaptations or
derivative works of or derived from or based on the NationsHealth
Data or any NationsHealth/USPG Intellectual Property in all cases,
regardless of who makes such modifications, enhancements,
adaptations and derivative works but specifically excluding
modifications, enhancements, adaptations or derivative works of or
derived from or based on the CIGNA Data or any CIGNA Intellectual
Property, or (b) are conceived, created or developed to
address, execute or embody a NationsHealth/USPG-specific product,
service, business process, including any modifications,
enhancements, adaptations and/or derivative works of or based on
any of the foregoing, in all cases, regardless of who conceives,
creates, develops or makes any of the foregoing. For the avoidance
of doubt, “NationsHealth/USPG New Intellectual
Property” does not include CIGNA Intellectual Property
generally applicable to CIGNA’s business.
(b) Notwithstanding
anything to the contrary in this Agreement, CIGNA and its
Affiliates reserve all right, title and interest in and to, and all
control of the use of, CIGNA’s copyrights, patents, service
marks, trademarks, designs, logos, brand names, Internet
“URL” addresses, World Wide Web sites and all right,
title and interest in and to any trade names, fictious business
names and all other intellectual property rights (collectively
“CIGNA Intellectual Property”) including all right,
title and interest, including any license rights it has, in and to
the names “CIGNA,” “CIGNA HealthCare,”
“CIGNA Companies,” “Connecticut General Life
Insurance Company,” and any derivation thereof and including
CIGNA New Intellectual Property. USPG and NationsHealth shall not,
and shall ensure that USPG’s and NationsHealth’s
Affiliates do not, use any CIGNA Proprietary Information in
materials supplied to Employer Groups, prospective Employer Groups,
Enrollees or otherwise without CIGNA’s prior express and
specific prior written consent. To the extent applicable, USPG and
NationsHealth hereby assign, transfer and convey irrevocably and
perpetually to CIGNA all of their worldwide right, title and
interest in and to any and all CIGNA Intellectual Property.
“CIGNA New Intellectual Property” means all developed
materials and other intellectual property that (a) are
conceived, created or developed in connection with or in the course
of providing the Services and are modifications, enhancements,
adaptations or derivative works or derived from or based on the
CIGNA Data or CIGNA Confidential Information or any CIGNA
Intellectual Property in all cases, regardless of who makes such
modifications, enhancements, adaptations and derivative works of or
derived from or based on the CIGNA Data or any CIGNA Intellectual
Property but specifically excluding modifications, enhancements,
adaptations and derivative works derived from or based on the
NationsHealth Data or any NationsHealth /USPG Intellectual
Property, or (b) are conceived, created or developed to address,
execute or embody a CIGNA-specific product, service, business
process, including any modifications, enhancements, adaptations
and/or derivative works of or based on any of the foregoing, in all
cases, regardless of who conceives, creates, develops or makes any
of
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the foregoing.
For the avoidance of doubt, “CIGNA New Intellectual
Property” does not include NationsHealth/USPG Intellectual
Property generally applicable to USPG’s or
NationsHealth’s business.
SECTION 7.03
Data . The use and management of CIGNA Data by USPG and/or
NationsHealth shall be as described in Exhibit 7.03 .
The use and management of NationsHealth Data by CIGNA shall be as
described in Exhibit 7.03 .
SECTION 7.04
Exclusivity .
(a)
Exclusive Rights of USPG . USPG shall be CIGNA’s
exclusive provider of the Services described in Article I of
this Agreement that pertain to Part D Enrollees, provided,
however , that this shall not prevent CIGNA from engaging in,
or acquiring capabilities, to engage in the following:
(i) CIGNA
shall have the option to service its Part D Enrollees in
CIGNA’s Employer Groups through its own servicing operations
or through servicing operations provided by a third
party;
(ii) CIGNA
may provide its pharmacy benefit management capability to third
parties on a “leased” or fee basis;
(iii) CIGNA
may provide its pharmacy benefit management capability and risk
taking capacity to third parties who market and service products
within discrete local markets and which may include a
direct-to-consumer Part D program as described under
Section 101 the MMA; and
(iv) CIGNA
may, directly or through a third party, solicit and/or service
Part D Enrollees if USPG is legally prohibited from marketing
the PDP to enrollees of its non-endorsed prescription card and
Medicare Part B programs, or is unable to perform the Services
described in Article I of this Agreement, or experiences (or
NationsHealth experiences) a change in control as described in
Section 6.05(g), or in connection with circumstances described
in Section 4.01(d) (relating to USPG’s failure to
possess certain licenses or the issuance to USPG of a cease and
desist order or similar formal regulatory request.)
(v) CIGNA
may use a third party to market the CIGNA PDP to prospective
Enrollees provided that CIGNA offers to USPG the opportunity to
perform, and USPG agrees to perform, all Services under this
Agreement with respect to such prospective Enrollees except for the
marketing services that are provided by such third party. If USPG
agrees to perform the Services, then such prospective Enrollees, to
the extent that they become Enrollees, will be counted in the
Parties’ calculations as described in
Exhibit 3.01 . If USPG rejects CIGNA’s offer as
described above, then USPG shall not perform Services for CIGNA
with respect to such Enrollees and such Enrollees shall not be
counted in the Parties’ calculations as described in
Exhibit 3.01 .
(b)
Exclusive Rights of CIGNA CIGNA shall be the exclusive PDP
sponsor for which USPG or NationsHealth provides any Services as
described in Article I of this Agreement.
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ARTICLE VIII
SURVIVAL; INDEMNIFICATION
SECTION 8.01
Survival of Representations and Warranties . Notwithstanding
any investigation made by or on behalf of the Parties hereto, the
results of any such investigation, or the Knowledge of USPG or
NationsHealth or Knowledge of CIGNA (regardless of how obtained),
the representations and warranties contained in Articles II and IV
hereof and the indemnification obligations of the Parties with
respect thereto, and the provisions of Article IX, shall
survive the expiration or termination of this Agreement for a
period of one (1) year following such expiration or
termination, subject to the terms and conditions of this
Article VIII.
SECTION 8.02
Mutual Indemnification .
(a) Subject
to the terms and conditions of this Article VIII, USPG and
NationsHealth shall hold harmless and indemnify CIGNA and its
Affiliates from any claims, losses, damages, liabilities, costs,
expenses or obligations, including reasonable attorney’s fees
and expenses related to the performance of this Agreement
(collectively, “Losses”) that arise out of or result
from (i) the breach of any representation or warranty of USPG
under this Agreement, or (ii) the negligence or willful
misconduct of USPG, its officers, employees and agents in the
performance of USPG’s obligations under this
Agreement.
(b) Subject
to the terms and conditions of this Article VIII, CIGNA shall
hold harmless and indemnify USPG and NationsHealth from any Losses
that arise out of or result from (i) the breach of any
representation or warranty of CIGNA under this Agreement, or
(ii) the negligence or willful misconduct of CIGNA, its
officers, employees and agents in the performance of CIGNA’s
obligations under this Agreement.
SECTION 8.03
Method of Asserting Third-Party Claims .
(a) As
used in this Agreement, “Notifying Party” refers to any
Party who claims entitlement to indemnification under
Section 8.02 for losses resulting from a third-party claim.
The “Indemnifying Party” refers to the Party obligated
to indemnify the Notifying Party under Section 8.02.
(b) In
the event any Notifying Party is made a defendant in or party to
any claim instituted by any third party for which the Notifying
Party may be entitled to indemnification under Section 8.02, the
Notifying Party shall give the Indemnifying Party prompt notice
thereof. The failure to give such notice shall not affect any
Notifying Party’s ability to seek reimbursement unless, and
only to the extent that, such failure has a detrimental effect on
the Indemnifying Party’s ability to defend successfully the
claim. The Indemnifying Party shall be entitled to contest and
defend such claim, provided that the Indemnifying Party:
(i) has a reasonable basis for concluding that such defense
may be successful; and (ii) diligently contests and defends
such claim.
(c) Notice
of the intention so to contest and defend shall be given by the
Indemnifying Party to the Notifying Party within fifteen
(15) business days after the Notifying Party’s notice of
such claim. The Indemnifying Party shall use reputable attorneys of
its choosing
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to conduct such
contest and defense. The Notifying Party shall be entitled at any
time, at its own cost and expense (which expense shall not
constitute a Loss for which the Notifying Party can be indemnified
under Section 8.02), to participate in such contest and
defense and to be represented by attorneys of its own choosing. The
Notifying Party shall give the Indemnifying Party notice that it
intends to participate in such contest and defense.
(d) If
the Notifying Party elects to participate in such defense, the
Notifying Party shall cooperate with the Indemnifying Party in the
conduct of the defense. Whether or not the Notifying Party elects
to participate in such defense, neither the Notifying Party nor the
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