MID ATLANTIC MEDICAL SERVICES INC
DEF 14A, 1999-03-29
HOSPITAL & MEDICAL SERVICE PLANS
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                                  SCHEDULE 14A

                            SCHEDULE 14A INFORMATION
           Proxy Statement Pursuant to Section 14(a) of the Securities
                              Exchange Act of 1934
                               (Amendment No. __)

Filed by Registrant [X]

Filed by a Party other than the Registrant [   ]

Check the appropriate box:

         [   ]    Preliminary Proxy Statement
         [   ]    Confidential, for Use of the Commission Only (as permitted by
                  Rule 14a-6(e)(2))
         [X  ]    Definitive Proxy Statement
         [   ]    Definitive Additional Materials
         [   ]    Soliciting Material Pursuant to 240.14a-11(c) or 240.14a-12


                       Mid Atlantic Medical Services, Inc.
               __________________________________________________
                (Name of Registrant as Specified In Its Charter)

             _______________________________________________________
      (Name of Person(s) Filing Proxy Statement, if other than Registrant)

Payment of Filing Fee (Check the appropriate box):

   [X  ]    No fee required.
   [   ]    Fee computed on table below per Exchange Act Rules 14a-6(i)(1)
            and 0-11:

            1)       Title of each class of securities to which transaction 
                     applies:                                 

            2)       Aggregate number of securities to which transaction 
                     applies:                                 

            3)       Per unit price or other underlying value of transaction
                     computed pursuant to Exchange Act Rule 0-11 (set
                     forth the amount on which the filing is calculated
                     and state how it was determined):____________________ 

            4)       Proposed maximum aggregate value of transaction:_________

            5)       Total fee paid:_______________________________  
  
   [   ] Fee paid previously with preliminary materials.

   [   ] Check  box if any part of the fee is offset  as  provided  by
         Exchange  Act Rule  0-11(a)(2)  and identify the filing for which
         the  offsetting  fee was paid  previously.  Identify the previous
         filing by registration  statement number, or the Form or Schedule
         and the date of its filing.
<PAGE>

         1)       Amount Previously
                  Paid:                                                       

         2)       Form, Schedule or Registration Statement No.:____           
         3)       Filing
                  Party:                                                      

         4)       Date
                  Filed:                                                      

<PAGE>






                       MID ATLANTIC MEDICAL SERVICES, INC.
                                  4 Taft Court
                            Rockville, Maryland 20850
                                 (301) 762-8205

                    NOTICE OF ANNUAL MEETING OF STOCKHOLDERS
                            TO BE HELD APRIL 26, 1999

         NOTICE IS HEREBY GIVEN that the annual meeting of stockholders ("Annual
Meeting") of Mid Atlantic  Medical  Services,  Inc.  ("Company") will be held on
April 26, 1999 at 10:00 a.m.,  Rockville time, at the Company's  offices located
at 10 Taft Court, Rockville, Maryland 20850 for the following purposes:

         1. To elect five directors for a three year term and one director
 for a two year term (Proposal 1);

         2. To ratify the adoption of the 1999  Non-Qualified  Stock Option Plan
(Proposal 2);

         3. To ratify the  adoption  of the 1999  Senior  Management  Bonus Plan
(Proposal 3); and

         4. To transact  such other  business and other matters and proposals 
as may properly come before the meeting or any adjournment or adjournments 
thereof.

         Pursuant to the Company's Bylaws,  the Board of Directors has fixed the
close of business on March 4, 1999, as the record date for the  determination of
stockholders  entitled  to notice  of and to vote at the  Annual  Meeting.  Only
record  holders of the  Company's  Common Stock at the close of business on that
date will be  entitled  to notice of and to vote at the  Annual  Meeting  or any
adjournments thereof.


         In the event that there are not sufficient  votes to approve any one or
more of the foregoing  proposals at the time of the Annual  Meeting,  the Annual
Meeting may be adjourned in order to permit further  solicitation  of proxies by
the Company.

                                    By Order of the Board of Directors,

                                    /s/Sharon C. Pavlos


                                    Sharon C. Pavlos
                                    Secretary

Rockville, Maryland
March 31, 1999

         IT IS  IMPORTANT  THAT THE  PROXIES BE  RETURNED  PROMPTLY.  THEREFORE,
WHETHER OR NOT YOU PLAN TO BE PRESENT  IN PERSON AT THE ANNUAL  MEETING,  PLEASE
COMPLETE,  DATE, AND SIGN THE ENCLOSED PROXY CARD(S) AND RETURN IT (THEM) IN THE
ENCLOSED ENVELOPE, WHICH REQUIRES NO POSTAGE IF MAILED IN THE UNITED STATES.


<PAGE>


                       MID ATLANTIC MEDICAL SERVICES, INC.
                                  4 Taft Court
                            Rockville, Maryland 20850
                                 (301) 762-8205

                                 PROXY STATEMENT
                         ANNUAL MEETING OF STOCKHOLDERS
                                 APRIL 26, 1999


         This Proxy  Statement  is  furnished  to  stockholders  of Mid Atlantic
Medical Services, Inc., a Delaware corporation  ("Company"),  in connection with
the  solicitation by the Board of Directors of the Company of proxies to be used
at the 1999 annual meeting of stockholders of the Company ("Annual Meeting"), to
be held on April 26,  1999,  at 10:00 a.m.,  Rockville  time,  at the  Company's
offices  located  at 10  Taft  Court,  Rockville,  Maryland  20850  and  at  any
adjournments thereof. It is anticipated that the mailing of this Proxy Statement
and the form of proxy to stockholders will commence on or about March 31, 1999.


                SOLICITATION, VOTING AND REVOCABILITY OF PROXIES

         If the enclosed form of proxy is properly  executed and returned to the
Company  in time to be voted  at the  Annual  Meeting,  the  shares  represented
thereby  will be  voted in  accordance  with the  instructions  marked  thereon.
Executed  but  unmarked  proxies  will be voted (1) FOR  Proposal 1 to elect the
designated nominees for directors; and (2) FOR Proposal 2 to ratify the adoption
of the 1999 Non-Qualified  Stock Option Plan ("1999 Plan"); and (3) FOR Proposal
3 to ratify the adoption of the 1999 Senior  Management Bonus Plan. If any other
matters  are  properly   brought  before  the  Annual  Meeting  that  require  a
stockholder's  vote, the persons named in the  accompanying  proxy will vote the
shares  represented  by such  proxies  on such  matters in  accordance  with the
determination of a majority of the Board of Directors.

         The  presence  of  a  stockholder   at  the  Annual  Meeting  will  not
automatically revoke such stockholder's proxy. However, a stockholder may revoke
a proxy at any  time  prior to its  exercise  by  filing  a  written  notice  of
revocation with, or by delivering a duly executed proxy bearing a later date to,
the  Secretary of the Company or by attending  the Annual  Meeting and voting in
person.

     The cost of  solicitation  of  proxies  will be borne  by the  Company.  In
addition  to the  solicitation  of  proxies by mail,  the  Company or one of its
subsidiaries,  MD-Individual Practice Association,  Inc. ("MD-IPA"),  Physicians
Health Plan of Maryland,  Inc. ("PHP-MD"),  Optimum Choice, Inc. ("OCI"), MD-IPA
Surgicenter,  Inc.  ("Surgicenter"),   HomeCall,  Inc.  ("HomeCall"),   HomeCall
Pharmaceutical  Services,  Inc.  ("HPS,"  formerly  known as  HomeCall  Infusion
Services,   Inc.),  HomeCall  Hospice  Services,   Inc.  ("HHS"),  Mid  Atlantic
Psychiatric Services, Inc. ("MAPSI"), Alliance PPO, LLC ("Alliance"), MAMSI Life
and Health Insurance Company ("MLH"),  FirstCall,  Inc.  ("FirstCall"),  Optimum
Choice, Inc. of Pennsylvania  ("OCIPA"),  Optimum Choice of the Carolinas,  Inc.
("OCCI"),  MAMSI  Insurance  Agency  of the  Carolinas,  Inc.  ("MIACI"),  MAMSI
Insurance  Resources,  LLC ("MIRI,"  formerly known as MAMSI  Insurance  Agency,
Inc.), or Frederick Associates, LLC (collectively,  "Subsidiaries"), through its
directors,  officers and regular employees,  may also solicit proxies personally
or by telephone or telegraph.  The Company will also request persons,  firms and
corporations  holding  shares in their names or in the names of their  nominees,
which are  beneficially  owned by others,  to send proxy materials to and obtain
proxies from such  beneficial  owners and will  reimburse such holders for their
reasonable expenses in doing so.

         The  securities  that can be voted at the  Annual  Meeting  consist  of
shares of Common Stock of the Company. Each share entitles its owner to one vote
on each matter  presented at the Annual Meeting.  The close of business on March
4, 1999 has been fixed by the Board of  Directors  as the record  date  ("Record
Date") for  determination  of stockholders  entitled to receive notice of and to
vote at the Annual Meeting.  There were 775 record holders of Common Stock as of
such date.  The number of shares of Common Stock  outstanding on the Record Date
was 51,134,162.  The presence,  in person or by proxy, of at least a majority of
the  total  number  of  outstanding  shares  of  Common  Stock is  necessary  to
constitute  a quorum  at the  Annual  Meeting.  In the  event  that  less than a
majority of the outstanding shares are present at the Annual Meeting,  either in
person or by proxy, a majority of the shares so represented  may vote to adjourn
the Annual Meeting from time to time without further notice.  A plurality of the
total  number of shares  present or  represented  by proxy will be  necessary to
elect directors (Proposal 1) and a simple majority of the total number of shares
present or  represented  by proxy will be  necessary  to approve  Proposal 2 and
Proposal 3.

                  On March 9, 1999, the Company's Board of Directors unanimously
voted to clarify and amend the Company's By-laws to not require any director who
is being  elected to fill a vacancy in the Board  resulting  from an increase in
the number of authorized  directors to be elected by the vote of  three-quarters
of the votes cast at a meeting of shareholders unless the increase in the number
of authorized  directors is a result of an action of the  stockholders.  Section
2.5(b) of the  Company's  By-laws  as amended  March 9, 1999 now  reads:  "(b) A
majority  of the votes cast at a duly held  meeting of  stockholders  at which a
quorum is present  (stockholders  represented by proxy shall be deemed  present)
shall be  sufficient  to take or  authorize  action  upon any  matter  which may
properly  come before the meeting,  unless a greater vote, or voting by classes,
is required by law or by the Certificate of Incorporation or by these By-Laws on
any question,  and except that, in elections of directors,  those  receiving the
greatest  number of votes shall be deemed  elected  even though not  receiving a
majority.  Notwithstanding  the above, at all meetings of the stockholders,  any
newly created directorship  resulting from any increase in the authorized number
of directors by action of the stockholders may be filled by the affirmative vote
of  three-quarters  (3/4) of the votes cast at the  meeting.  Any vacancy in the
Board of Directors resulting from the resignation of a director or for any other
cause other than the removal of a director by the  stockholders may be filled by
the affirmative vote of the plurality of the votes cast at the meeting."

         A copy  of the  Annual  Report  to  Stockholders,  including  certified
financial statements,  for the fiscal year ended December 31, 1998,  accompanies
this Proxy  Statement.  The Company is required to file an Annual Report on Form
10-K for its  fiscal  year  ended  December  31,  1998 with the  Securities  and
Exchange Commission ("SEC").  Stockholders may obtain, free of charge, a copy of
such  Annual  Report by writing to Sharon C.  Pavlos,  Secretary,  Mid  Atlantic
Medical Services, Inc., 4 Taft Court, Rockville, Maryland 20850.

                            STOCK OWNED BY MANAGEMENT

         The following  table sets forth  information as of February 25, 1999 or
with respect to the shares of the Company's Common Stock  beneficially  owned by
each  current  director of the Company,  by each nominee who is not  currently a
director,  by each executive  officer listed in the Summary  Compensation  Table
below and by all current  directors and  executive  officers of the Company as a
group. There are no arrangements  known to the Company,  including any pledge by
any  person  of  securities  of the  Company,  the  operation  of which may at a
subsequent  date  result in a change in control of the  Company.  All  ownership
consists of sole voting and dispositive power, except as noted.
<TABLE>
<CAPTION>

Name                                                      Amount and Nature                      Percent of
                                                          of Beneficial                          Common Stock
                                                          Ownership(1)                           Outstanding
<S>                                                       <C>                                    <C>                     
Thomas P. Barbera*                                        62,800     (2)                         **

Francis C. Bruno, M.D.*                                   49,788     (3)                         **

John H. Cook, III, M.D.                                     9,245    (4)                         **

Raymond H. Cypess, D.V.M., Ph.D.                            8,048    (5)                         **

Stanley M. Dahlman, Ph.D.                                   7,256    (6)                         **

J. Stevens Dufresne                                       178,310    (7)    **

Robert E. Foss                                             51,400    (8)                         **

Mark D. Groban, M.D.                                      160,246    (9)                         **

Joseph L. Guarriello                                      127,556    (10)                        **

George T. Jochum                                        1,728,142    (11)  3.5%

John P. Mamana, M.D.                                       15,056    (12)                        **

William M. Mayer, M.D.                                     52,176    (13)                        **

Edward J. Muhl                                              7,056    (14)                        **

Gretchen P. Murdza                                          8,578    (15)                        **

Janet L. Norwood*                                                  0                             **

John A. Paganelli*                                                 0                             **

Ivan R. Sabel*                                                     0                             **

James A. Wild*                                              9,394    (16)                        **

All current directors, and                              2,677,629    (17)  5.4%
executive officers as a group (27 persons)
</TABLE>

         *Nominee for director
         **Represents less than 1% of the outstanding shares of Common Stock.

     (1)  This number includes shares of Common Stock over which the director or
          officers  has voting power under the Amended and Restated Mid Atlantic
          Medical Services,  Inc. Stock Compensation Trust Agreement  ("Trust").
          Under the Trust, each of the persons who holds an option granted under
          the Company's 1990 Non-Qualified Stock Option Plan, 1991 Non-Qualified
          Stock  Option  Plan,  1992  Non-Qualified   Stock  Option  Plan,  1993
          Non-Qualified Stock Option Plan, 1994 Non-Qualified Stock Option Plan,
          1995 Non-Qualified  Stock Option Plan, 1996 Non-Qualified Stock Option
          Plan,  or 1998  Non-Qualified  Stock  Option Plan  (collectively,  the
          "Plans")  has the right to one equal vote of the Common  Stock held in
          the  Trust.  As the Trust  held  8,523,950  shares of Common  Stock on
          February 25, 1999 and there were 1,208 option  holders under the Plans
          as of such date, each option holder has the right to vote 7,056 shares
          of Common Stock held by the Trust. Shares for which the trustee of the
          Trust  does  not  receive  voting  instructions  will be  voted by the
          trustee of the Trust for,  against or withheld in the same proportions
          as those  shares of Common  Stock for which the trustee  does  receive
          voting  instructions.  As the number of shares  held by the Trust that
          each option  holder has the right to vote (7,056  shares) is less than
          the  number of  presently  exercisable  options  held by each  current
          director,  executive  officer or nominee  (other than Dr.  Bruno,  Dr.
          Cook, Dr. Cypess,  Dr. Dahlman,  Mr.  Dufresne,  Mr.  Guarriello,  Dr.
          Mamana, Dr. Mayer, Mr. Muhl, Ms. Murdza, and Mr. Wild), the beneficial
          ownership of each person (other than Dr. Bruno,  Dr. Cook, Dr. Cypess,
          Dr. Dahlman, Mr. Dufresne, Mr. Guarriello,  Dr. Mamana, Dr. Mayer, Mr.
          Muhl, Ms.  Murdza,  and Mr. Wild ) did not increase as a result of the
          Trust.

     (2)  Represents presently  exercisable options to purchase 60,000 shares of
          Common Stock.

     (3)  Includes  2,306  shares of Common  Stock  held by his spouse and 7,056
          shares that he has the right to direct the voting of under the Trust.

     (4)  Includes  434  shares of Common  Stock  held by his  spouse  and 7,056
          shares that he has the right to direct the voting of under the Trust.

     (5)  Includes  7,056  shares  that he has the right to direct the voting of
          under the Trust.  (6)  Includes  7,056 shares that he has the right to
          direct the voting of under the Trust.  (7) Includes  7,056 shares that
          he has the  right to  direct  the  voting  of  under  the  Trust.  (8)
          Represents 51,000 presently  exercisable options to purchase shares of
          Common Stock.

     (9)  Represents 60,000 presently  exercisable options to purchase shares of
          Common  Stock and 9,500  Shares of Common Stock held by his spouse and
          children.

     (10) Includes  30,000  shares of Common  Stock  held by his  spouse,  7,056
          shares that he has the right to direct the voting of under the Trust.

     (11) Includes  11,640  shares of Common  Stock  held by his  spouse,  3,420
          shares  held in his IRA,  3,582  shares held in the  Company's  401(k)
          Plan, and presently  exercisable options to purchase 879,500 shares of
          Common Stock.

     (12) Includes  7,056  shares  that he has the right to direct the voting of
          under  the  Trust  and  7,000  shares  owned  by a  partnership  and a
          corporation in which Dr. Mamana has an ownership interest.

     (13) Includes  7,056  shares  that he has the right to direct the voting of
          under the Trust. (14) Represents 7,056 shares that he has the right to
          direct the voting of under the Trust.

     (15) Includes  7,056  shares that she has the right to direct the voting of
          under the Trust and 302 shares  held as part of the  Company's  401(K)
          Plan.

     (16) Includes  7,056  shares  that he has the right to direct the voting of
          under the Trust.

     (17) This number also  includes  80,680  shares of Common Stock held by the
          spouses of executive  officers,  13,250 shares held in executives  IRA
          accounts, 6,259 shares held in the Company's 401(K) Plan, 4,800 shares
          held  for the  benefit  of  minor  children  and  1,111,508  presently
          exercisable options to purchase shares of Common Stock.

                             PRINCIPAL STOCKHOLDERS


         As of February  25,  1999,  no persons or groups  within the meaning of
Section  13(d)(3) of the  Securities  Exchange  Act of 1934,  as amended  ("1934
Act"),  were known by management to  beneficially  own more than five percent of
the Company's Common Stock except as follows:
<TABLE>
<CAPTION>


Name and Address                                     Number of Shares                   Percent of Outstanding
                                              of Common Stock Common Stock
<S>                                           <C>                                       <C>
Crabbe Huson Group, Inc.                             4,925,100       (1)                9.63%
     121 S.W. Morrison, Suite 1400
     Portland, OR  97204

Massachusetts Financial Services Company             4,391,828       (2)                8.59%
MFS Series Trust II - MFS Energy Growth Fund
     500 Boylston Street
     Boston, Massachusetts 02116

SG Cowen Securities Corporation                      4,982,870       (3)                9.74%
     1221 Avenue of the Americas
     New York, NY  10020


Franklin Resources, Inc.                             4,246,400       (4)                8.3%
Charles B. Johnson
Rupert H. Johnson, Jr.
     777 Mariners Island Blvd.
     San Mateo, California 94404
Franklin Mutual Advisors, Inc.
     51 John F. Kennedy Parkway
     Short Hills, New Jersey 07078

</TABLE>

     (1)  Crabbe Huson Group, Inc. reports that it has shared voting power
         and shared  dispositive  power with respect to 4,499,200  and 4,925,100
         shares, respectively, as an investment adviser registered under Section
         203 of the Investment  Advisers Act of 1940. This  information is based
         on Amendment No. 1 to Schedule 13G dated February 12, 1999.

     (2)  Of  these  shares  of  Common  Stock,  2,359,888  of  the  shares  are
          beneficially owned by MFS Series Trust II MFS Emerging Growth Fund and
          4,391,828 are beneficially  owned by Massachusetts  Financial Services
          Company ("MFS") and 2,031,940 shares are beneficially owned by certain
          other non-reporting  entities. This information is based on a schedule
          13G dated February 11, 1999.

     (3)  SG Cowen  Securities  Corporation  reports that it has sole voting and
          dispositive power with respect to 133,220 shares,  shared voting power
          with respect to 3,814,800  shares,  and shared  dispositive power with
          respect to 4,849,650  shares.  This information is based on a Schedule
          13G dated February 8, 1999.


     (4)  Franklin  Mutual  Advisers,  Inc.  reports that it has sole voting and
          dispositive   power  with  respect  to  4,246,400   shares.   Franklin
          Resources,  Inc.  reports  that it is the  parent  holding  company of
          Franklin  Mutual  Advisers,  Inc. and Charles B. Johnson and Rupert H.
          Johnson,  Jr. report that they are principal  shareholders of Franklin
          Resources,  Inc. This  information is based on Amendment 2 to Schedule
          13G dated January 27, 1999.




                              ELECTION OF DIRECTORS

                                  (Proposal 1)

     The terms of office of Thomas P. Barbera,  Francis C. Bruno,  M.D., Stanley
M. Dahlman,  Ph.D., and James A. Wild expire at the Annual Meeting.  Dr. Francis
C. Bruno, James A. Wild, John A. Paganelli,  Ivan R. Sabel, and Janet L. Norwood
have been nominated by the Board of Directors for election to the Board, each to
serve for a three-year  term. Mr. Thomas Barbera has been nominated by the Board
of Directors for election to the Board to serve for a two-year  term.  The terms
of approximately  one-third of the Board expire each year at the Annual Meeting.
Directors serve until their successors are duly elected and qualified. Following
the Annual  Meeting,  the size of the Board of Directors  will be 14 and, if the
nominees are elected, there will be no vacancies on the Board.

     In  connection  with the  settlement  of certain  litigation  among Francis
Bruno, M.D., Stanley Dahlman,  Mark D. Groban, M.D., Gretchen Murdza and William
M. Mayer,  M.D.,  current  directors of the Company,  and George T. Jochum,  the
Company's  former  Chairman,  President  and Chief  Executive  Officer,  and the
Company,  the  parties  appointed  a  Transition  and  Search  Committee.   This
Committee,  composed of Dr. Bruno, Mr. Dahlman,  John P. Mamana, M.D. and Edward
J. Muhl,  is to identify  and  recommend  to the Board  nominees for election as
directors at the Annual  Meeting.  This  Committee  identified  and proposed Dr.
Bruno,  Mr.  Wild,  John A.  Paganelli,  Ivan R.  Sabel and Janet L.  Norwood as
nominees for director at the Annual Meeting.

     Except as stated above, there are no arrangements or understandings between
the  Company  and any person  pursuant  to which such person has been or will be
elected as a director.  If any nominee becomes  unavailable for election for any
reason,  or if any other  vacancy in the class of directors to be elected at the
Annual Meeting should occur before the election,  the shares  represented by the
proxy will be voted by any of the  persons  serving  as  proxies  for the person
designated by the Company's Board of Directors to replace the nominee or to fill
such other vacancy on the Board. The Board of Directors has no reason to believe
that any of the nominees will be  unavailable  or that any other such vacancy on
the Board will occur.  Each nominee has  consented to be named and has indicated
his or her  intent  to serve if  elected.  Except as noted  below,  there are no
family  relationships  among any  director,  nominee for  director or  executive
officer of the Company.

         THE BOARD OF DIRECTORS RECOMMENDS THAT YOU VOTE FOR THE ELECTION OF ALL
NOMINEES TO THE COMPANY'S BOARD OF DIRECTORS.

                        DIRECTORS AND EXECUTIVE OFFICERS

         The  following  table  sets  forth  the names of the six  nominees  for
election as director and of those  directors  who will continue to serve as such
after  the  Annual  Meeting,  as  well  as the  executive  officers  who are not
directors. Also set forth is certain other information with respect to each such
person's age, the periods during which he or she has served as a director of the
Company and positions currently held with the Company and its Subsidiaries.
<TABLE>


Name and Age (1)                               Director    Term of    Directorships; Positions with the Company
                                               Since       Office
                                                           Expires
                                                           Annual 
                                                           Meeting                                               
<S>                                            <C>         <C>        <C>                
Continuing Directors:


John H. Cook III, M.D., 62                       1990        2001(6)  Director of the Company, MLH and PHP-MD.

Raymond H. Cypess, D.V.M., Ph.D., 57             1998        2001     Director of the Company and MLH.

Robert E. Foss, 48                               1998        2001     Director of the Company,  MLH,  HomeCall,  FirstCall,  HPS,
                                                                      HHS and  Surgicenter;  Senior  Executive Vice President and
                                                                      Chief  Financial  Officer of the  Company,  MLH,  Alliance,
                                                                      MAPSI,    MD-IPA,    HomeCall,    FirstCall,    HPS,   HHS,
                                                                      Surgicenter, OCI, OCIPA, OCCI, MIRI, PHP-MD and MIACI.

Mark D. Groban, M.D., 57                         1990        2000(3)  Director  of  the  Company,   MLH,  PHP-MD,  MAPSI,  MIACI,
                                                                      MD-IPA,   Surgicenter,    OCI,   OCCI,   OCIPA,   HomeCall,
                                                                      FirstCall,  HPS,  HHS;  President of Alliance,  MAPSI,  and
                                                                      MIACI;   Chairman  of  the  Company,   MLH,  MAPSI,  MIACI,
                                                                      MD-IPA,   Surgicenter,    OCI,   OCCI,   OCIPA,   HomeCall,
                                                                      FirstCall,  HPS, HHS;  Chief  Executive  Officer of PHP-MD;
                                                                      Executive  Vice  President and Medical  Director of Quality
                                                                      Improvement  of  the  Company,   MLH,  PHP-MD,   FirstCall,
                                                                      HomeCall,  HPS, HHS,  MDIPA,  Surgicenter,  OCI,  OCCI, and
                                                                      OCIPA.

John P. Mamana, M.D., 56                         1997        2000     Director of the Company, MLH and PHP-MD.

William M. Mayer, M.D., 51                       1993        2000(4)  Director of the Company, MLH
                                                                      and PHP-MD.

Edward J. Muhl, 53                               1998        2001     Director of the Company and MLH.

Gretchen P. Murdza, 51                           1997        2000     Director of the Company,  HomeCall,  FirstCall,  HPS,  HHS,
                                                                      and  MLH;   Chief   Executive   Officer  of  FirstCall  and
                                                                      HomeCall; President of HPS and HHS.


Nominees (for a three-year term expiring in 2002):

Francis C. Bruno, M.D., 57                       1986        1999(2)  Director  of the  Company,  MLH  and  PHP-MD;  Chairman  of
                                                                      PHP-MD;Co-Medical Director of HHS.

Janet L. Norwood, 75

John A. Paganelli,  64

Ivan R. Sabel, 53

James A. Wild,  47                                1989        1999(5)  Director of the Company, MLH,
MD-
IPA and Surgicenter.


Nominee (for a two-year term expiring in 2001)

Thomas P. Barbera, 48                             1996        1999     Director  of  the  Company,  MLH,  MIACI,  and  MIRI;  Vice
                                                                       Chairman,   Chief   Executive   Officer,    President   and
                                                                       Executive  Vice  President,  Governmental  Services  of the
                                                                       Company and MLH; Chief  Executive  Officer and President of
                                                                       MIRI,  OCCI, OCI; Chief Executive  Officer of HPS,  MD-IPA,
                                                                       MIACI,  OCIPA,  HHS and MAPSI;  Executive  Vice  President,
                                                                       Governmental  Services  and  Assistant  Secretary  of  HPS,
                                                                       HHS, MIRI, OCCI,  FirstCall,  and HomeCall;  Executive Vice
                                                                       President,  Governmental  Services of the Company,  MD-IPA,
                                                                       OCI, OCIPA, Alliance, and  MAPSI.




Executive  Officers Who Are Not Current  Directors or Nominees or Whose Terms as Director Will Not Continue After the 1999 
Shareholders Meeting:


Paul E. Dillon, 47                                                      Director of MD-IPA;  Senior Vice  President,  and Treasurer
                                                                        of  the   Company,   MLH,   Alliance,   MAPSI,   FirstCall,
                                                                        HomeCall,  HPS,  HHS,  Surgicenter,   MD-IPA,  OCI,  OCIPA,
                                                                        OCCI, and PHP-MD.

J. Stevens Dufresne, 43                                                 Director of Alliance,  MAPSI,  PHP-MD,  OCI,  OCCI,  OCIPA,
                                                                        Surgicenter,  MIACI, and MIRI; Chief Executive  Officer and
                                                                        President of  Surgicenter;  President  of OCIPA;  Executive
                                                                        Vice  President,  Provider  Networks of the  Company,  MLH,
                                                                        Alliance,  FirstCall,  HomeCall,  HPS, HHS,  MAPSI,  MDIPA,
                                                                        OCI, OCCI and PHP-MD.

Vera C. Dvorak, M.D., 52                                                Director of PHP-MD,  HomeCall, and FirstCall;  President of
                                                                        PHP-MD;  Executive Vice  President and Medical  Director of
                                                                        the Company,  Alliance,  MAPSI, HomeCall,  FirstCall,  HPS,
                                                                        HHS, MD-IPA, OCI, OCCI, OCIPA and Surgicenter.


Catherine M. Fridell, 41                                                Director of MD-IPA,  OCI, OCCI,  and OCIPA;  Executive Vice
                                                                        President  of Claims and Chief  Operating  Officer of OCIPA
                                                                        and  OCCI;  Executive  Vice  President  of  Claims  of  the
                                                                        Company,  MLH,  Alliance,  FirstCall,  HomeCall,  HPS, HHS,
                                                                        MAPSI, MD-IPA, Surgicenter, OCI, OCCI, OCIPA and PHP-MD.


Susan D. Goff, 53                                                       Director  of  Alliance,  MAPSI,  MD-IPA,  MIACI  and  MIRI;
                                                                        President   of  MD-IPA;   Senior  Vice   President  of  the
                                                                        Company, MLH, OCI, OCIPA and OCCI.

Debbie J. Hulen, 39
                                                                        Director of OCI,OCCI, and OCIPA. Senior Vice President of
                                                                        the Company, MLH, MIRI,OCCI, OCI,and OCIPA.

Christopher E. Mackail, 40                                              Senior Vice  President and  Controller of the Company,  and
                                                                        MLH.  
                                                                            


Sharon C. Pavlos, 40                                                    Executive  Vice  President,  General  Counsel and Secretary
                                                                        of   the   Company,   MLH,   Alliance,   MAPSI,   HomeCall,
                                                                        FirstCall,  HPS, HHS,  MD-IPA,  Surgicenter,  MIACI,  MIRI,
                                                                        OCI, OCCI, OCIPA and PHP-MD.

Mary E. Shocklee, 36                                                    Vice  President,   Accounting  Operations,  MLH,  Alliance,
                                                                        MAPSI,  HPS, HHS, MD-IPA,  Surgicenter,  MIACI,  MIRI, OCI,
                                                                        OCCI, OCIPA and PHP-MD.

</TABLE>

(1)      Signifies age as of December 31, 1998.

(2) Dr. Bruno was not a Director of the Company from April 1991 to April 1992 or
from April 1994 to April 1995.  (3) Dr. Groban was not a Director of the Company
from April 1993 to April 1994.  (4) Dr.  Mayer was not a Director of the Company
from April 1995 to April  1996.  (5) Mr.  Wild was not a Director of the Company
from April 1992 to April  1993.  (6) Dr.  Cook was not a Director of the Company
from April 1993 to April 1995 or from April 1997 to April 1998.

         Information  concerning the principal  occupations or employment of the
directors,  nominees for director and executive  officers of the Company for the
past five years and other biographical data are set forth below.

Continuing Directors and Nominees:

     Thomas P. Barbera was elected interim President and Chief Executive Officer
on January 8, 1999.  He was elected Vice Chairman of the Company on May 6, 1996.
Mr.  Barbera  became  Executive  Vice  President  of  Government  Relations  and
Assistant  Secretary for the Company and MLH in May of 1993.  From December 1987
until May 1993,  Mr.  Barbera  was a partner at  Weinberg  and Green,  a general
practice law firm in Baltimore, Maryland.

     Francis C. Bruno,  M.D.  received a B.S.  from Kings  College in 1964 and a
M.D.  from New York  Medical  College in 1968.  He is Board  certified in family
practice and has practiced medicine since 1972.

     John H.  Cook III,  M.D.  is a board  certified  practitioner  of  internal
medicine.  From June 1957 to July 1973,  Dr.  Cook  served in the United  States
Navy. In 1977, Dr. Cook received an M.D. from Yale University School of Medicine
and, in 1957, Dr. Cook received a B.S. from the United States Naval Academy. Dr.
Cook has been in private practice since 1980.

     Raymond H. Cypess,  D.V.M.,  Ph.D.  is President  and CEO of American  Type
Culture Collection,  Rockville,  Maryland. Dr. Cypess was an Associate Professor
of  Epidemiology  and  Microbiology  at the  University of Pittsburgh  School of
Public  Health from 1970 to 1973,  Professor  and Chairman at the New York State
College of  Veterinary  Medicine  from 1977 to 1987,  and Dean of the College of
Graduate Health Sciences, as well as Professor of Microbiology,  Immunology, and
Comparative  Medicine,  and Vice Provost for Research and Research Training,  at
the  University of Tennessee,  Memphis from 1989 to 1993. Dr. Cypess is a fellow
of the  Infectious  Disease  Society and a Member of the  American  Epidemiology
Society.  Dr. Cypess received a B.S. in biology from Brooklyn College in 1961, a
B.Agri.  from  the  University  of  Illinois  in  1965,  and a  D.V.M.  from the
University  of  Illinois  in 1967.  In 1970,  Dr.  Cypess  received  a Ph.D.  in
Parasitology from the University of North Carolina.

     Robert  E. Foss was  elected  Senior  Executive  Vice  President  and Chief
Financial  Officer on January 8, 1999.  Mr.  Foss  joined the Company on July 1,
1994 as its Executive Vice President and Chief Financial Officer.  For more than
five years  prior to July 1,  1994,  Mr.  Foss was a partner  with Ernst & Young
LLP's  Washington,  D.C.  office.  Ernst & Young LLP has served as the Company's
independent  public  accountants  since June 2, 1989 and Mr.  Foss was the audit
partner on the Company's  account.  Mr. Foss received a BSBA from the University
of Colorado in 1971 and became a CPA in 1972.

     Mark D. Groban,  M.D. was elected interim  Chairman of the Board on January
8, 1999.  Dr. Groban is a Board  certified  psychiatrist  who joined the Company
full time on December 1, 1990 after being in full time practice  since 1973. Dr.
Groban  served as a consultant  from  February 1988 to October 1989 for MD-IPA's
managed mental health program.  He became President of MAPSI in October 1989. In
May 1991, he became  President of Alliance.  In October 1996, Dr. Groban assumed
the  responsibility  for  the  Quality  Improvement  Department  and  was  named
Executive Vice  President and Medical  Director of Quality  Improvement  for the
Company.


     John P. Mamana, M.D. received his B.A. from Harvard University and his M.D.
degree from Boston  University  School of Medicine.  Dr. Mamana is a Director of
American  Health  Properties  as well as a member of the Audit and  Compensation
Committee of that entity. Dr. Mamana is also Chief Executive  Officer,  Chairman
of the Board and a Director of American  Health  Sciences  Inc.  Dr.  Mamana has
practiced  internal  medicine in  Springfield,  Virginia since 1974. In 1978, he
founded Virginia Medical Associates, P.C., a multi-specialty group practice, and
served as the  President,  Chief  Executive  Officer,  and Chairman of the Board
until December 1997.  During 1998,  Virginia Medical  Associates,  P.C. declared
bankruptcy. Dr. Mamana served as the Chief Executive Officer and Chairman of the
Board for Gateway Physicians Services (formerly Virginia Health Partners) and as
the Chief Medical Officer of Health Partners, Inc. in Norwalk,  Connecticut from
1994 until January 1998. Dr. Mamana has been a Clinical  Associate  Professor of
Medicine at Georgetown  University Medical School since 1987. He has served as a
member of the Board of Directors of American Health  Properties,  since May 1997
and as the Chairman and Chief  Executive  Officer of American  Health  Sciences,
Inc. since January 1998.


     William M. Mayer, M.D.  received a B.S. from Georgetown  University in 1967
and his M.D.  degree from New York  Medical  College in 1971.  He  completed  an
internal medicine internship at the Cornell Cooperating  Hospitals and completed
his Ob-Gyn  residency at New York Medical College.  Following  completion of his
residency,  he was the chief of Ob-Gyn at Kimbrough Army Hospital,  serving as a
major in the U.S. Army.  Upon completion of his tour of duty, he entered private
practice  in the field of Ob-Gyn in  Columbia,  Maryland  and has  practiced  in
Columbia since 1977.

     Edward J.  Muhl is  Executive  Vice  President  and  Member of the Board of
Directors of Peterson Consulting,  LLC a business and insurance consulting firm.
Mr. Muhl was  Superintendent of Insurance for the State of New York from 1995 to
1997.  He is a  former  President  of  the  National  Association  of  Insurance
Commissioners,  and a  previous  Commissioner  of  Insurance  for the  State  of
Maryland.  From  1991 to  1995,  Mr.  Muhl was a Senior  Vice  President  of the
Reliance  Insurance Group. Mr. Muhl received his B.A. in Social Science from the
University of Baltimore in 1973.

     Gretchen  P.  Murdza  was  employed  by  the  Company  as the  Director  of
Professional  Recruitment  in  October  1989,  became  the  Senior  Director  of
Professional  Recruitment in April 1990,  Vice President,  Provider  Networks in
July 1991 and Senior Vice  President  responsible  for the  development  of Home
Health  Service on March 9, 1994.  In October 1994,  she became Chief  Executive
Officer of HomeCall,  Inc. and subsequently President of HomeCall Pharmaceutical
Services,  Inc.  and  HomeCall  Hospice  Services,  Inc. She was educated at the
College of Notre Dame of Maryland located in Baltimore, Maryland.

     Janet L.  Norwood  is an  economist  and a  Senior  Fellow  with the  Urban
Institute  since  1991.  She  served as the  Chair of the  Advisory  Council  on
Unemployment  Compensation  from 1993 to 1996.  She was  appointed by Presidents
Carter and Reagan to be the U.S.  Commissioner of Labor  Statistics from 1979 to
1991.  From 1993 to 1996,  she was appointed by  Presidents  Bush and Clinton as
Chair, Advisory Council on Unemployment Compensation.  Ms. Norwood received a BA
from Douglas  College,  Rutgers  University  and holds an MA and Ph.D.  from the
Fletcher  School of Law and Diplomacy from Tufts  University as well as an LL.D.
Honorary from Harvard University and Carnegie Mellon University.

     John A. Paganelli was President and Chief Executive Officer of Transamerica
Life Insurance  Company of New York from 1992 to 1997. Mr. Paganelli holds an AB
from Virginia Military Institute. Mr. Paganelli is currently retired.

     Ivan R.  Sabel has been  Chairman  and Chief  Executive  Officer  of Hanger
Orthopedics  Group  Inc.  (a New  York  Stock  Exchange  company  that is in the
orthotics  and  prosthetics  market)  since August 1995.  From  November 1987 to
August  1995,  Mr. Sabel was  President  and Chief  Operating  Officer of Hanger
Orthopedics  Group,  Inc. He is also a clinical  instructor  in  orthopedics  at
Georgetown  University  Medical School since 1969. Mr. Sabel holds a Bachelor of
Science in Orthotics and Prosthetics from New York University.

     James A. Wild  received a B.A. in  accounting  from  Franklin  and Marshall
College in 1973. He has been Vice President and Director of Waterview Investment
Corporation (a holding  company whose 100% owned  subsidiary,  Almag, is a metal
finishing company) since February 1988.

Executive Officers:

     Paul E. Dillon became the Company's  Senior Vice President and Treasurer in
April 1994.  From January 1994 through  April 1994,  he served as the  Company's
Senior Vice President, Quality Assurance and Quality Improvement.  From November
1990 through January 1994, he served as the Company's Vice President, Enrollment
and Billing; from April 1990 to November 1990, he served as the Company's Senior
Director,  Enrollment  and Billing;  and from  November  1989 to April 1990,  he
served as the Company's  Director of Enrollment.  Mr. Dillon  graduated from St.
Francis  College  in  Loretto,  Pennsylvania  in 1973  and  received  his MBA in
International  Business  and Finance  from Pace  University  in New York City in
1983.

     J. Stevens Dufresne was employed by the Company as Senior Vice President of
Provider Networks effective February 1989. He became Executive Vice President of
Provider Networks for the Company,  MLH and PHP-MD in April 1993. From June 1987
to February 1989, he served as Senior Director of Professional Recruitment.  Mr.
Dufresne  graduated  from  Florida  Southern  College in 1977 and  received  his
Masters of Health Services  Administration from George Washington  University in
1982.

     Vera C.  Dvorak,  M.D.  joined the Company in August  1994 as an  Associate
Medical  Director.  She became Senior Vice President and Medical Director of the
Company,  MLH,  PHP-MD,  HomeCall,  FirstCall and HPS in April 1996. In November
1996, Dr. Dvorak was promoted to Executive  Vice President and Medical  Director
of the  Company.  Dr.  Dvorak  is  Board  certified  in  Internal  Medicine  and
Geriatrics.  She was  recertified by the American Board of Internal  Medicine in
1987 and 1993. Dr. Dvorak was a practicing  physician for 18 years  (1976-1994);
the last 6 years she  served as Chief of  Department  of  Internal  Medicine  of
Kaiser  Permanente.  Dr. Dvorak received her M.D. degree from Charles University
in Prague,  Czechoslovakia  and  trained in  internal  medicine  and  infectious
diseases at the University of Oklahoma and the University of Pennsylvania.

     Catherine M. Fridell  (formerly  Tyser) joined the Company in February 1992
as Senior Supervisor in Claims  Production.  Subsequently,  Ms. Fridell has held
the  following  positions  within  the  Claims  Department:   Manager  beginning
September 1992,  Director  beginning  November 1993,  Senior Director  beginning
November  1994,  Vice  President  beginning  March 1995,  Senior Vice  President
beginning  July 1995 when she also assumed the  additional  responsibilities  of
managing the Alliance PPO Claims  Department.  In November 1996, Ms. Fridell was
promoted to Executive Vice President  assuming  responsibility for Operations in
North  Carolina  and  Pennsylvania.  Prior to joining the Company,  Ms.  Fridell
worked at NationsBank for 15 years holding various positions within the Consumer
Credit Division.  Her last position held was Assistant Vice President,  Consumer
Credit Automation  Manager  responsible for the functioning of an automated loan
processing system and related support personnel for the Metropolitan  Washington
Consumer Credit Division.

     Susan D. Goff was  employed  by  Alliance  and MAPSI as Vice  President  on
August 1, 1989,  became  Executive  Vice  President of MD-IPA on April 26, 1993,
responsible  for large group sales  activities  in all states and  President  of
MD-IPA  on  November  15,  1993.  Ms.  Goff  graduated  from the  University  of
California  at Los Angeles in 1967 with a B.S. in Nursing and received a Masters
of Science in  Administration  with a concentration  in Health Care from Central
Michigan  University  in 1989.  Ms. Goff is a director of Sandy Spring  National
Bank.

     Debbie J. Hulen joined the Company in August 1993 as a Regional Director of
Sales for OCI. Ms. Hulen was promoted to Senior Director in July 1995 and became
a Senior Vice  President in charge of sales for OCI and MLH effective  September
1997. Ms. Hulen is currently responsible for all small group sales activities in
Maryland,  Northern  Virginia,  Delaware,  Pennsylvania,  and  the  District  of
Columbia.  Prior to joining the Company, Ms. Hulen worked at Esprit de Corps for
ten years, leaving with a final title of Regional Director of Sales.

     Christopher  E.  Mackail  joined the  Company  in October  1996 as the Vice
President of Finance.  He became Senior Vice President and Controller on January
25, 1999.  Prior to joining the Company,  Mr.  Mackail was a Senior Manager with
Ernst & Young LLP's Washington, D.C. office. Ernst & Young LLP has served as the
Company's  independent public accountants since June 2, 1989 and Mr. Mackail was
the audit Senior Manager on the Company's  account.  Mr. Mackail  graduated from
the University of Richmond in 1981 with a B.S. in accounting and became a CPA in
1983.


     Sharon C. Pavlos was elected  Executive Vice President and General  Counsel
of the Company on January 15, 1999.  Ms. Pavlos  became  Senior Vice  President,
General Counsel and Secretary of the Company effective September 8, 1998. Before
joining the Company,  Ms. Pavlos was the Vice  President,  Regulatory  Affairs &
Network  Development for United HealthCare of the  Mid-Atlantic,  Inc. since May
1996. Prior to her position with United  HealthCare of the  Mid-Atlantic,  Inc.,
Ms. Pavlos was the Vice President,  General  Counsel of Chesapeake  Health Plan,
Inc. since February 1994. From March 1994 to May 1996, Ms. Pavlos also served as
the Vice  President,  Legal Affairs of  HealthWise  of America,  Inc. Ms. Pavlos
received her B.A.  summa cum laude from the  University  of Maryland in 1980 and
her J.D. from Georgetown University in 1983.


     Mary E. Shocklee is Vice  President of Accounting  Operations.  She was the
Controller of the Company from January 1993 to January  1999.  She became a Vice
President of the Company  effective  April 1996.  From September 1988 to January
1993, Ms. Shocklee  managed the Accounting  Department of the Company and served
as the Director of Accounting since September 1990. Ms. Shocklee graduated magna
cum laude from  Georgetown  University with a BS/BA degree in Accounting in 1983
and became a CPA in 1985.

Board Meetings and Committees


     The Company's  Board of Directors met 6 times in fiscal 1998.  The standing
committees of the Board include the Executive Committee,  the Finance Committee,
the Audit Committee, the Stock Option Committee, the Compensation Committee, the
Employment  Practices Committee,  and the Select Committee.  During fiscal 1998,
the Executive  Committee held 6 meetings,  the Finance Committee held 1 meeting,
the Audit Committee held 3 meetings, the Stock Option Committee held 3 meetings,
the Compensation  Committee held 4 meetings,  the Employment Practices Committee
held 5 meetings  and the Select  Committee  held 3 meetings.  The Board does not
have a standing Nominating Committee.

     All  Directors  attended at least 75 percent of the  aggregate of the total
number of meetings of the  Company's  Board of Directors and the total number of
meetings held by all committees on which they served.

     The  Executive  Committee of the Board of Directors  has general  oversight
functions  relating to the  operation  of the Company and its  Subsidiaries  and
functions as the  Company's  Board when the  Company's  Board is not in session,
with all powers of the Company's  Board,  except those of removing or nominating
Directors, filling vacancies on the Board of Directors, and as otherwise limited
by the Delaware General  Corporation  Law. Its members are Mark D. Groban,  M.D.
(Interim  Chairman),  Thomas P. Barbera,  Francis C. Bruno,  M.D., John H. Cook,
III, M.D. and James A. Wild.


     The  Finance   Committee  of  the  Company  oversees  the  projections  and
assumptions of the Company in preparing its financial goals each year. The Audit
Committee  interfaces  with the  Company's  independent  public  accountants  to
determine if the financial accounting practices of the Company are in compliance
with generally accepted accounting  principles.  The Finance Committee's members
are James A. Wild (Chairman),  Raymond H. Cypess, D.V.M., Ph.D., Robert E. Foss,
Mark D. Groban, M.D., and John P. Mamana, M.D. The Audit Committee's members are
James A. Wild (Chairman), Stanley M. Dahlman, Ph.D., and Edward J. Muhl.


     The Stock Option  Committee  grants options under and otherwise  implements
the 1989, 1990, 1991, 1992, 1993, 1994, 1995, 1996 and 1998 Non-Qualified  Stock
Option  Plans.  The  members  of the Stock  Option  Committee  are James A. Wild
(Chairman), Stanley M. Dahlman, Ph.D. and Edward J. Muhl.

     The Select  Committee  grants options in the 1989,  1990, 1991, 1992, 1993,
1994, 1995, 1996, and 1998 Non-Qualified  Stock Option Plans for employees below
Vice  President  (Level 17).  The Select  Committee  was formed in 1998.  It has
authority to grant  options to officers and key  employees  who are not "covered
employees"  within the meaning of Section 162(m) of the Internal Revenue Code of
1986,  as amended  ("Code"),  and who are not  subject to Section 16 of the 1934
Act. If there is a conflict  between the Select  Committee  and the Stock Option
Committee,  the  determination of the Stock Option  Committee will control.  The
members of the Select Committee are Thomas P. Barbera and Mark D. Groban, M.D.

     The Compensation  Committee  oversees the development and implementation of
the Company's  compensation program for executive officers, the Chairman and the
President and Chief Executive Officer. Its members are James A. Wild (Chairman),
Stanley M. Dahlman, PhD. and Edward J. Muhl.


     The Employment  Practices  Committee oversees the Company's  maintenance of
equal  opportunity  for all  employees  regardless  of  race,  national  origin,
religion, gender, physical disability,  sexual orientation,  or age. The members
of the Employment  Practices Committee are James A. Wild (Chairman),  Stanley M.
Dahlman, Ph.D., Gretchen P. Murdza, and William M. Mayer, M.D.


     In January 1999 the Board  established the Transition and Search  Committee
to (1)  propose  1999  Board  nominees  and (2)  recommend  individuals  for the
positions of Chairman, Chief Executive Officer and President.


Section 16(a) Beneficial Ownership Reporting Compliance


     Thomas P. Barbera,  Paul E. Dillon,  J. Stevens  Dufresne,  Vera C. Dvorak,
M.D., Robert E. Foss, Susan D. Goff, Mark D. Groban, M.D., Joseph L. Guarriello,
Debbie J. Hulen,  Gretchen P. Murdza and Alfred  Talamantes  failed to file on a
timely basis one Form 4 Report,  Statement of Changes in  Beneficial  Ownership,
reporting one transaction as required by Section 16(a) of the 1934 Act.  Raymond
H.  Cypess  and Mary E.  Shocklee  failed to  timely  file two such  forms  each
reporting one  transaction,  and George T. Jochum failed to timely file one such
form  reporting 4  transactions.  Dr.  Mamana failed to timely file 3 such forms
reporting three transactions.  All of the aforementioned forms have subsequently
been filed.



Directors' Compensation

     For the fiscal year ended  December 31, 1998,  the directors of the Company
were compensated according to the following table:


                                                      Per Person Compensation(1)
Chairman & Vice
Chairman of the Board                                         $52,000/yr(2)

Director  Attendance  at
Board Meeting                                                   1,250

Director  Attendance  as
Chairman  of a Committee Meeting                                1,250

Director  Attendance  at
a Committee Meeting                                               750



     (1)  Employees  of the Company  receive no annual fees and no  compensation
          for  Board  or  Committee   meeting   attendance.   (2)  Any  director
          compensated as a Chairman or Vice Chairman does not receive additional
          compensation from the Company or any of its Subsidiaries for attending
          Board or Committee meetings. If the position is held by an employee of
          the  Corporation,  no  compensation in addition to his or her employee
          compensation is paid.


         Under the Company's 1996 and 1998 Non-Qualified Stock Option Plan ("the
Plans"),  each  person  who  was a  director  of  the  Company  or  one  of  its
Subsidiaries  on May 1, 1996 or May 1,  1998,  respectively,  but who was not an
employee of the Company or one of its  Subsidiaries on such date  ("Non-Employee
Director") received a Non-Employee  Director Option to purchase shares of Common
Stock at an  exercise  price of $20.00 per share or $13.00 per share  (which was
the fair market value of a share of Common Stock on May 1, 1996 and May 1, 1998,
respectively). The number of shares of Common Stock covered by each Non-Employee
Director Option was based on a formula specified in the Plan.

         Each Non-Employee  Director Option becomes exercisable  cumulatively in
three equal  installments  starting on May 3, of the year  following the year of
the grant and has a five year term. If a  Non-Employee  Director's  service with
the  Company  terminates  (other  than as a result of a removal for cause) or if
such person ceases to be a  Non-Employee  Director,  the option will continue to
become  exercisable and may be exercised until the stated term of the option. If
a Non-Employee  Director is removed for cause, the Non-Employee  Director Option
held by such person will cease to continue to become exercisable on or after the
date of such removal.


         Set forth  below is the number of shares  covered by each  Non-Employee
Director  Options  received by current Company  directors and nominees on May 1,
1996 and May 1, 1998 under the 1996 and 1998 Plans.



                                         Number of Shares      Number of Shares
                                            1996 Plan             1998 Plan
                                            May 1, 1996           May 1, 1998


Francis C. Bruno, M.D.*                       4,980                4,950

John L. Cook, III, M.D.                       4,380                4,350

Raymond H. Cypess, D.V.M., Ph.D.              2,814                3,450

Stanley M. Dahlman, Ph.D.                     5,430                5,400

John P. Mamana, M.D.                          3,264                3,900

William M. Mayer, M.D.                        3,564                4,200

Edward J. Muhl None                           None                 3,000

Janet L.  Norwood*                            None                 None

John A.  Paganelli*                           None                 None 

Ivan R. Sabel*                                None                 None

James A. Wild*                                4,380                4,350


  *Nominee

                        EXECUTIVE MANAGEMENT COMPENSATION


Report of the Compensation Committee on Executive Compensation

         The role of the Compensation Committee is to set salary for individuals
who  are  Senior  Vice  Presidents  and  above,  and to  review  any  employment
agreements or revisions thereto entered into with the Company's officers; and to
establish the bonus goal for the Chief Executive Officer and other employees.

     The Committee uses a common set of criteria for evaluating all  executives.
The criteria are:

     Individual performance

     Individual responsibility

     Corporate performance

     Potential for growth

     In  evaluating  the  executive's  individual  performance,   the  following
criteria is reviewed:

     Selection,  placement  and  evaluation of personnel  under the  executive's
supervision;

     Education of personnel under the executive's supervision;

     Control of corporate expenditures;

     Customer service;

     Job performance;

     Acceptance of and ability to accomplish special tasks, and

     Establishment and completion of specific goals.

     Salary. During 1998, George T. Jochum was the Chairman, President and Chief
Executive  Officer of the  Company.  His  employment  contract  was  executed on
December 18, 1990 after  approval of the Board of  Directors of the Company.  In
1992,  the term of Mr.  Jochum's  contract was extended by the Board to December
31, 1998. For 1998, the Board  established  Mr.  Jochum's  salary at $1,350,000.
This amount was the same as his 1997 salary. 

     With respect to those executive  officers other than Mr. Jochum, Mr. Jochum
presented a recommendation  to the Committee  regarding such  individuals'  1998
salary  based on his  evaluation  of each  individual's  performance,  using the
criteria stated above.  The Committee  discussed these  recommendations  and the
Committee   set  1998   salary   levels   in   accordance   with  Mr.   Jochum's
recommendations.

     As of January 8, 1999, Mr. Jochum  resigned his positions with the Company.
As of this same date, the Board of Directors elected Mark D. Groban,  M.D. to be
interim Chairman of the Board and Thomas P. Barbera to be interim  President and
Chief  Executive  Officer.  The  Board of  Directors  also  approved  employment
agreements  for Dr. Groban and Mr.  Barbera,  and Robert E. Foss,  the Company's
Senior  Executive  Vice  President and Chief  Financial  Officer.  The Company's
employment  agreements with Dr. Groban and Mr. Barbera are effective  January 8,
1999, and will continue for a period of one year from the date of the conclusion
of the search effort and the acceptance of the selected  individual(s)  to serve
as Chairman of the Board,  President and Chief Executive  Officer unless earlier
terminated  as provided in the  agreement.  In the event that Dr.  Groban or Mr.
Barbera are  selected  and agree to serve as Chairman of the Board or  President
and Chief Executive Officer,  the Company and the selected executive would enter
into a new  employment  agreement.  Dr.  Groban  and  Mr.  Barbera's  employment
agreements provide for a base salary of a minimum of $475,000 per year.

     Mr.  Foss'  employment  agreement  is  effective  January  8, 1999 and will
continue  for a period of three  years  from the date of the  conclusion  of the
search  effort and the  acceptance  of the selected  individuals(s)  to serve as
Chairman of the Board,  President and Chief  Executive  Officer  unless  earlier
terminated as provided in the agreement. Mr. Foss' minimum base salary under the
agreement  is  $400,000  with a provision  that  allows for an annual  change in
salary  directly  related to the earnings of the Company.  Mr. Foss'  employment
agreement  provides  that his base  salary will  increase or decrease  each year
beginning in the year 2000 by an amount equal to 50% of the percentage change in
the Company's  consolidated  net after tax income during the previous  year. The
employment  agreement  also provides that his salary cannot be increased by more
than 20% or decreased by more than 10% in any one year.


     Bonus.  Bonus  compensation  for  management is based on the ability of the
Company to attain a  predetermined  net income goal. The 1998 Senior  Management
Bonus Plan includes a minimum net income (prior to the return of amount withheld
by PHP-MD as part of the claims  reserve  risk pool and  payment of  physicians'
bonuses  and before  deductions  for income tax and  expansion  and  acquisition
costs) goal. For 1998, the minimum net income goal was $33.750 million. The goal
was not achieved and no bonuses have been paid under the 1998 Senior  Management
Bonus  Plan.  The  goal  was  established  at  the  beginning  of  1998  by  the
Compensation Committee and was approved by the stockholders.


     Some  executive  officers and other  salaried  employees do not receive the
full amount of their bonus even if the minimum net income level is achieved. For
these individuals,  a portion of their bonus compensation is determined based on
other measurable criteria.


     Stock Options.  The total compensation program for executives also includes
equity-based compensation.  The Company's stockholders have approved a series of
non-qualified stock option plans. These plans encourage and create ownership and
retention of the Company's stock by the vast majority of salaried employees. The
equity portion of the  executives'  compensation  provides a tool to recruit and
retain  employees,  as well as to align the interest of the employees with those
of the non-employee stockholders.  The individuals constituting the Compensation
Committee also constitute the Stock Option Committee and, as such,  administered
these stock  option plans in 1998 with respect to the  executive  officers.  The
Stock  Option  Committee  determines  the  amount of stock  options  awarded  to
individual  executives and the Select  Committee  determines the amount of stock
options  awarded to  employees  below Vice  President  (Level  17).  In general,
options  are  granted to  executives  annually.  Although,  under the  Company's
existing  stock  option  plans  (other  than  the  1994,  1995,  1996,  and 1998
Non-Qualified Stock Option Plans),  there is no limitation,  either a minimum or
maximum, on the number of options that can be granted to an individual,  usually
individuals of the same salary grade level receive approximately the same number
of options.  Variations from this standard are based upon individual performance
using the criteria stated above. Mr. Jochum recommended the number of options to
be  granted  to  each  executive  officer,   including  himself,   during  1998,
considering the criteria for  performance  listed above, as well as such factors
as the potential of the recipient and prior grants.  The Stock Option  Committee
granted  options in the amounts  recommended by Mr. Jochum.  In general,  during
1998,  executive  officers  were only  granted  additional  options if they were
promoted during the year.


     On April 15, 1998,  the Stock Option  Committee  authorized  the  voluntary
exchange of all options whose then current  exercise  price was in excess of $16
per share for newly issued options with an exercise price of $16 per share.  The
repricing  program  acknowledged  the importance to the Company of its employees
and of the incentive to employees  represented by stock  options,  especially in
considering alternative employment opportunities.  The Committee considered such
factors as the  competitive  environment  for obtaining and retaining  qualified
employees and the overall benefit to the  stockholders  from a highly  motivated
group of employees.

     As a  condition  of the  exchange,  options  holders  agreed to an extended
vesting.  Options  that were  vested  on the date of the  exchange,  became,  on
exchange, unvested for a period of one year. Additionally,  the new options were
exercisable  for an  additional  year beyond the current  expiration  date.  The
Company's  Board of Directors and Mr.  Jochum's  options were not subject to the
repricing program.


     Section  162(m).  Section  162(m) of the Internal  Revenue Code of 1986, as
amended ("Code"),  limits the ability of a public company,  such as the Company,
to deduct, in 1994 and subsequent years, compensation paid to executive officers
who are named in its  "Summary  Compensation  Table" in excess of $1 million per
year unless certain conditions are met. What the requirements are vary depending
on the type of  compensation  paid.  One  requirement  applicable  to both stock
option and bonus plans is that the material  terms of the plan must be disclosed
to, and  approved  by, the public  company's  stockholders  in a separate  vote.
Accordingly,  the Company is soliciting  stockholder approval of its 1999 Senior
Management Bonus Plan. The Company  generally  intends to take steps so that its
stock option and bonus programs generally available to all employees comply with
the requirements of Section 162(m).


James A. Wild (Chairman)
Edward J. Muhl
Stanley   M.    Dahlman,
Ph.D.

Stock Performance Graph

         The following  graph  compares the change in the  Company's  cumulative
total return on its Common Stock [
    ] with (a) the change in the cumulative  total return on the stocks included
in the New York Stock  Exchange  Stock  Market Index [ ], and (b) the Standard &
Poors MidCap Health Care Managed Care Index [ - - - - ].


         These  comparisons  assume an  investment  of $100 made on December 31,
1993 and  compares  relative  values  on an annual  basis  for the years  ending
December 31, 1994,  1995,  1996,  1997 and 1998. All of these  cumulative  total
returns are computed  assuming the  reinvestment  of dividends at the  frequency
with which  dividends  were paid  during  this  period.  The Common  Stock price
performance  shown  below  should  not be viewed as being  indicative  of future
performance.



(Stock Performance Graph is Shown here containing plot points below.)
<TABLE>
<CAPTION>



                                   Dec-93        Dec-94       Dec-95        Dec-96         Dec-97         Dec-98
 <S>                               <C>           <C>          <C>           <C>            <C>            <C>
- --------------------------------------------------------------------------------------------------------------------
Mid-Atlantic Medical Svcs.         $100          $179         $189          $104           $100           $77
- --------------------------------------------------------------------------------------------------------------------
- --------------------------------------------------------------------------------------------------------------------
HealthCare (Mgd. Care)-Mid         $100          $118         $144          $116           $78            $63
- --------------------------------------------------------------------------------------------------------------------
- --------------------------------------------------------------------------------------------------------------------
NY Stock Exchange-Comp.            $100          $97          $127          $151           $197           $230
- --------------------------------------------------------------------------------------------------------------------
</TABLE>



Compensation Committee Interlocks and Insider Participation


     During 1998, the members of the Company's Compensation Committee were James
A. Wild  (Chairman),  Stanley M. Dahlman,  Ph.D and Edward J. Muhl. No member of
the Committee is a former employee of the Company or any of its Subsidiaries.

     As a result of the nature of the business conducted by the Company, certain
members of the Board of Directors and nominees of the Company have received fees
for physician  services  rendered on behalf of persons enrolled in the HMO plans
run by the Company and its Subsidiaries  ("Enrollees").  Such persons, except as
noted below, were compensated at the same rate as were non-director primary care
and specialist physicians ("Participating Physicians"). Compensation from PHP-MD
for medical services rendered by all  Participating  Physicians (or corporations
or partnerships of which they were partners,  affiliates or stockholders) ranged
from $0 to  $4,537,355  approximately  in  1998.  MD-IPA  also  provides  health
coverage to members of the Board of  Directors of the Company who are members of
the Board of Directors of PHP-MD or MD-IPA at reduced rates. The following table
sets  forth the total 1998  compensation  from  PHP-MD  earned by members of the
Board of Directors  and nominees for director for medical  services  rendered to
Enrollees,   for  services   rendered  as  directors  of  the  Company  and  its
Subsidiaries  and for health  coverage  where such amounts  exceeded  $60,000 in
1998.  Certain other  directors serve on the Board of Directors of the Company's
Subsidiaries;  however,  the fees for such  services  did not exceed  $60,000 in
1998.


                                Medical Services             Total Compensation
Francis C. Bruno, M.D. (1)            $99,612                      $157,701
William M. Mayer M.D. (2)             $848,267                     $863,547
Ivan R. Sable* (3)                    $196,771                     $196,771

*Nominee

     (1)  Paid to the  Francis C.  Bruno,  M.D.,  P.A.  partnership  for medical
          services  for  enrollees  of  MD-IPA,  MLH and  OCI.

     (2)  Paid to Drs. Esposito,  Mayer, Hogan and Associates,  P.A. partnership
          for medical services for enrollees of MD-IPA, MLH and OCI.

     (3)  Paid to Hanger  Orthopedic  Group,  Inc.  and  affiliates  for medical
          services for enrollees of MD-IPA, MLH and OCI.


Summary Compensation Table


          The following table shows the compensation paid to the Company's Chief
Executive Officer and the four other most highly compensated  executive officers
whose salary and bonus,  if any,  exceeded  $100,000  during 1998 as well as the
former executive officers of the Company (each a "Named Officer").


<TABLE>
<CAPTION>
                                                                                    Long-term
                                                                                    Compensation
                                  Annual Compensation                                 Awards

Name and                   Year     Salary($)    Bonus($)     Other Annual   Securities   All Other
Principal Position                                            Compensation(2)Underlying   Compensation ($)
                                                                             Options (#)

<S>                        <C>      <C>          <C>          <C>            <C>          <C>                        

George T. Jochum (1)       1998     $1,349,998   -0-            $1,062 (6)   350,000 (7)  $8,628(4)
Former Chairman of the
Board, President,          1997     $1,385,724   -0-            $   364 (6)  50,000       $8,628(3)(4)
and Chief                  1996     $1,828,280   -0-            $    446(6)  200,000      $826,918(3)(4)
Executive Officer

Thomas P. Barbera          1998     $325,369     -0-            -            135,600 (7)  $3,200(5)
CEO & President,           1997     $308,698     -0-            -            -0-          -0-
Executive Vice             1996     $305,930     -0-            -            36,000       -0-
President, Governmental
Services

J. Stevens Dufresne        1998     $268,574     -0-            -            120,600 (7)  $3,200(5)
Executive Vice             1997     $257,250     -0-            -              -          -0-
President, Provider        1996     $254,942     -0-            -            36,000           -0-
Networks

Mark D. Groban             1998     $290,735     -0-          -0-            105,600 (7)  $3,200(5)
Chairman                   1997     $278,107     $32,968      -0-            -0-          -0-
of the Board,              1996     $283,943     $20,185      -0-            30,000       -0-
President of MAPSI
and Alliance

Robert E. Foss             1998     $292,692     -0-          -0-            141,000 (7)  $3,200(5)
Senior Executive Vice      1997     $280,020     -0-          -0-            -0-          -0-
President, Chief           1996     $280,020     -0-          -0-            30,000       -0-
Financial Officer

Joseph L. Guarriello (8)   1998     $216,819                                 96,600 (7)   $3,200(5)
Former Executive           1997     $272,168     -0-          -0-            -0-          -0-
Vice President,            1996     $277,867     -0-          -0-            24,000       -0-
General Counsel
and Secretary

</TABLE>

     (1)  Effective January 8, 1999, Mr. Jochum resigned from the Board and from
          his position as Chairman, President and Chief Executive Officer.

     (2)  Perquisites  and other  personal  benefits  represented  the lesser of
          $50,000  or  10%  of  annual  salary  and  bonus.  (3)  $818,290,  and
          $1,681,605  were accrued in 1996 and 1995,  respectively,  relating to
          Mr. Jochum's  augmented  retirement benefit provided by his Employment
          Agreement.  Due to a change in pension  formula,  the  Company in 1997
          recognized  a one time  benefit of  approximately  $1.1  million.  See
          "Management Employment Agreement" below.

     (4)  Includes  $8,628 in premiums  paid by the Company in 1998,  1997,  and
          1996 for life  insurance  for  which  Mr.  Jochum  may  designate  the
          beneficiary.

     (5   Represents Company contribution to defined contribution plan.

     (6)  Represents  reimbursement  of tax  associated  with  personal use of a
          Company car.

     (7)  Other than with respect to Mr. Jochum,  the amount of options  granted
          includes  options granted as part of the voluntary  exchange  program.
          See "Stock Option Repricing" below concerning these grants.

     (8)  Mr.  Guarriello  retired from the position of Executive Vice President
          and General Counsel in September 1998.





Management Employment Agreements

         The  Company  and  MD-IPA   entered   into  an   Employment   Agreement
("Agreement")  with Mr. Jochum for the period  January 1, 1991 through  December
31, 1998. On November 21, 1997, the Company  entered into a new Agreement  ("New
Agreement") with Mr. Jochum for the period January 1, 1999 to December 31, 2001.
Because Mr. Jochum's resignation from the Company effective January 8, 1999, the
New  Agreement  was never  effective.  Except for a few  issues to be  discussed
below, the Agreement and the New Agreement  (collectively the "Agreements") were
similar in their terms.  Mr. Jochum's annual base salary under the Agreement was
$1,350,000 for 1998.


         Mr.  Jochum was entitled to  participate  in the  Company's  management
bonus program.  The amount  available for Mr. Jochum was calculated based on the
Company's  income  before  income taxes and is prior to the return of the amount
withheld, if any, by PHP-MD as part of the claims reserve risk pool. His minimum
bonus amount was 25% of that year's base salary and his maximum bonus was 50% of
base salary.  Additionally,  under the terms of the  Agreement,  Mr.  Jochum was
entitled  to a  special  bonus not to exceed  50% of his base  salary  should he
accomplish  special  performance  criteria  identified by the Company's Board of
Directors.  Mr. Jochum waived receipt of his special bonus with respect to 1998.
There is no special bonus under the terms of the New Agreement.

         The  Agreements  may be  terminated  by the  Company  in the event of a
material breach thereof by Mr. Jochum or for cause; however,  termination of the
Agreements by the Company,  even for material  breach or cause,  does not effect
any obligation of the Company or arising under the  Agreements.  The Company may
also,  with cause,  reassign Mr.  Jochum from his  position as  Chairman,  Chief
Executive Officer and President of the Company.


         In the event of a "change of control" as defined in the Agreements, Mr.
Jochum would have  received  cash equal to twice his base salary for the year in
which such "change in control" occurs.  In addition,  all stock options to which
Mr. Jochum was entitled would have immediately vested and become exercisable. In
the event of a "change in control" the value of all payments, benefits and other
consideration  received  and  contingent  upon  a  change  in  control  and  any
additional  payments  in  the  nature  of  compensation   described  by  Section
280G(b)(2) of the Code may not exceed an amount that is equal to three times the
average  taxable  compensation  to Mr.  Jochum  from the  Company  for the "base
period" as that term is defined in Section  280G(d)(2) of the Code. A "change in
control"  is  deemed  to  occur  under  the  Agreements  if,  at any  time,  (a)
substantially  all the assets of the Company or, in the Agreement only,  MD-IPA,
shall have been sold or  transferred  by sale,  merger or  otherwise,  or if any
"person" (as such term is used in Sections 13(d) or 14(d) of the 1934 Act) is or
becomes the  beneficial  owner,  directly or  indirectly,  of  securities of the
Company  or, in the  Agreement  only,  MD-IPA,  representing  50% or more of the
combined voting power of the then-existing outstanding securities of the Company
or,  in the  Agreement  only,  MD-IPA;  and  (b) Mr.  Jochum  is  reassigned  in
accordance with the Agreements  within six months of such sale,  merger or other
event;  provided,  however, that no "change in control" is deemed to occur under
the  Agreements  if Mr.  Jochum's  reassignment  is on a temporary  basis and is
attributable  to Mr.  Jochum's  illness or other  physical,  mental or emotional
disability or incapacity.


         The  Agreement  provided  that,  upon  retirement,  Mr. Jochum would be
entitled to an  augmented  retirement  benefit so that he will receive in total,
under the Agreement and under all of the Company's  retirement  plans, an annual
benefit in an amount equal to three  percent of his base salary during the final
year of the  Agreement  multiplied  by the  number  of years of  service  to the
Company. Payment, if any, of the augmented retirement benefit through 1998 would
have been made in the form of an annuity  for a fixed  term of years  payable to
Mr. Jochum, or his estate,  heirs, or assignees as determined by him. Such terms
of the annuity shall be the actuarial  equivalent of a fixed and certain term as
compared to the average life  expectancy for an individual of the age and status
of Mr. Jochum at the date of  retirement or death.  The Company is not obligated
to pay any augmented  retirement  benefit under the Agreements if Mr. Jochum was
terminated  for cause by the  Company.  In  accordance  with a personal  service
contract  negotiated by the Company,  its Chairman was entitled to  supplemental
pension benefits based upon years of service and attained salary levels. Expense
recognized  related to this plan was $818,000 and $1,682,000 for the years ended
December 31, 1996 and 1995, respectively.  During 1997, the service contract was
renegotiated,  at which  time the  supplemental  pension  benefits  package  was
amended to include a fixed payment benefit of $450,000 per year for a fixed term
of 15 years and an option to elect to reduce the supplemental  retirement payout
in the form of premium  advances on a split dollar life  insurance  policy.  The
reduction  is pension  expense  recognized  in 1997  related to this  change was
approximately  $1.1 million.  As a result of Mr. Jochum's election to reduce the
annual  fixed  benefit to  $250,000,  the Company in 1998  recognized a one time
benefit of approximately $880,000.

         The  Agreements  also  provided that either Mr. Jochum or his spouse at
the time of his death is eligible  for health  coverage  from the Company or its
successor during the term of their respective  lives, such health coverage to be
paid for by Mr. Jochum or his spouse. The Company has also agreed to obtain, pay
all premiums for and maintain a $200,000 whole life insurance policy on the life
of Mr.  Jochum for which he may designate  the  beneficiary.  The Company has no
obligation to provide such  insurance if Mr. Jochum is not insurable at ordinary
market rates and without material cost or other adjustments.

         As of January 8, 1999,  Mr.  Jochum  resigned  his  positions  with the
Company under the terms of a Settlement Agreement with the Company.  Pursuant to
the Settlement  Agreement,  Mr. Jochum received  compensation  consistent with a
termination  other than for cause  under the terms of his  Employment  Agreement
with the Company  for the period  January 1, 1991  through  December  31,  1998.
Specifically,  Mr.  Jochum  received a lump sum payment of $730,000 and 26 equal
bi-weekly  installments of $1,350,000  continuing  through the period January 8,
2000.  Mr.  Jochum is also  entitled  to the  supplemental  retirement  benefits
subject to the split dollar option that Mr.
Jochum previously elected and health insurance benefits.

         As of January 8, 1999,  the Board of Directors  elected Mark D. Groban,
M.D.  to be interim  Chairman  of the Board and Thomas P.  Barbera to be interim
President  and Chief  Executive  Officer.  The Board of Directors  also approved
employment  agreements for Dr. Groban and Mr.  Barbera,  and Robert E. Foss. The
Company's  employment  agreements  with Dr. Groban and Mr. Barbera are effective
January 8, 1999, and will continue for a period of one year from the date of the
conclusion of the search effort and the acceptance of the selected individual(s)
to serve as Chairman of the Board,  President and Chief Executive Officer unless
earlier terminated as provided in the agreement. In the event that Dr. Groban or
Mr.  Barbera  are  selected  and  agree  to serve as  Chairman  of the  Board or
President and Chief Executive  Officer,  the Company and the selected  executive
would  enter into a new  employment  agreement.  Dr.  Groban  and Mr.  Barbera's
employment  agreements  provide for a base  salary of a minimum of $475,000  per
year. In addition, Dr. Groban and Mr. Barbera's employment contracts provide for
85,000  shares of MAMSI stock  options to be granted on February 25, 1999 and to
vest on a pro-rata  basis over a one to five year period to be determined by the
percentage  increase of 1999  earnings per share over 1998 earnings per share as
adjusted for one time items and as determined by the Board.  Each  agreement may
be terminated by the Company in the event of a material breach thereof by either
Dr.  Groban or Mr.  Barbera or for cause as determined by the Board of Directors
with no payment to either Dr. Groban or Mr. Barbera. In addition,  if either Dr.
Groban or Mr. Barbera voluntarily leave employment with the Company prior to the
conclusion   of  the  search   effort  and  the   acceptance   of  the  selected
individuals(s)  to serve as Chairman of the Board,  Chief Executive  Officer and
President,  there would be no payment  made to either  person.  In the event the
Company terminates either agreement for any reason other than death,  disability
or just cause or if Dr. Groban or Mr.  Barbera  terminate the agreement  because
(1) the Company  materially  breached the agreement;  (2) the Company  reassigns
either  person  greater than 75 miles  roundtrip  from the  Company's  principal
executive offices; (3) the Company's substantially reassigns Dr. Groban's or Mr.
Barbera's duties and  responsibilities;  or (4) either Dr. Groban or Mr. Barbera
voluntarily leave employment with the Company after the conclusion of the search
effort and the  acceptance of the selected  individuals(s)  election to serve as
Chairman, Chief Executive Officer and President, the Company will pay Dr. Groban
or Mr. Barbera an amount equal to 12 months base salary paid in equal  bi-weekly
payments  over a period of one year and any  pro-rata  bonus  that he would have
been entitled to had he been  employed at the end of the year. In addition,  all
stock options which either Dr. Groban or Mr. Barbera have would immediately vest
and become exercisable under the terms of the applicable plan.

         In the event of a "change of  control"  as  defined in the  Agreements,
both Dr.  Groban and Mr.  Barbera will receive cash equal to his base salary for
the year in which such  "change  in  control"  occurs.  In  addition,  all stock
options to which either Dr. Groban or Mr. Barbera was entitled would immediately
vest and become exercisable.  In the event of a "change in control" the value of
all payments,  benefits and other  consideration  received and contingent upon a
change in control  and any  additional  payments  in the nature of  compensation
described  by Section  280G(b)(2)  of the Code may not exceed an amount  that is
equal to three  times the  average  taxable  compensation  to Dr.  Groban or Mr.
Barbera  from the  Company  for the "base  period"  as that term is  defined  in
Section  280G(d)(2)  of the Code. A "change in control" is deemed to occur under
the Agreements if, at any time, (a)  substantially all the assets of the Company
or, in the Agreement only, MD-IPA,  shall have been sold or transferred by sale,
merger or otherwise,  or if any "person" (as such term is used in Sections 13(d)
or 14(d) of the 1934  Act) is or  becomes  the  beneficial  owner,  directly  or
indirectly,  of  securities of the Company or, in the  Agreement  only,  MD-IPA,
representing  50% or more of the  combined  voting  power  of the  then-existing
outstanding securities of the Company or, in the Agreement only, MD-IPA; and (b)
Dr. Groban or Mr. Barbera is reassigned in accordance with the Agreements within
six months of such  sale,  merger or other  event;  provided,  however,  that no
"change in control" is deemed to occur under the agreements if Dr. Groban or Mr.
Barbera's reassignment is on a temporary basis and is attributable to either Dr.
Groban  or  Mr.  Barbera's  illness  or  other  physical,  mental  or  emotional
disability or incapacity.

          Mr. Foss' employment  agreement is effective  January 8, 1999 and will
continue  for a period of three  years  from the date of the  conclusion  of the
search  effort and the  acceptance  of the selected  individuals(s)  to serve as
Chairman of the Board,  President and Chief  Executive  Officer  unless  earlier
terminated as provided in the agreement. Mr. Foss' minimum base salary under the
agreement  is  $400,000  with a provision  that  allows for an annual  change in
salary  directly  related to the earning of the Company.  Mr.  Foss'  employment
agreement  provided  that his base  salary will  increase or decrease  each year
beginning in the year 2000 by an amount equal to 50% of the percentage change in
the Company's  consolidated  net after tax income during the previous  year. The
employment  agreement  also provides that his salary cannot be increased by more
than 20% or decreased by more than 10% in any one year.  In addition,  Mr. Foss'
employment  contract  provides  for 75,000  shares of MAMSI stock  options to be
granted on February 25, 1999 and to vest on a pro-rata  basis over a one to five
year period to be  determined  by the  percentage  increase of 1999 earnings per
share  over  1998  earnings  per  share as  adjusted  for one time  items and as
determined by the Board.

         Mr. Foss'  agreement may be terminated by the Company in the event of a
material  breach  thereof by Mr. Foss or for cause as determined by the Board of
Directors  with no payment to Mr.  Foss.  In addition,  if Mr. Foss  voluntarily
leaves  employment with the Company prior to the conclusion of the search effort
and the  acceptance of the selected  individuals(s)  to serve as Chairman of the
Board, Chief Executive Officer and President,  there would be no payment made to
Mr. Foss. In the event the Company  terminates  either  agreement for any reason
other  than  death,  disability  or just  cause or if Mr.  Foss  terminates  the
agreement  because (1) the Company  materially  breached the agreement;  (2) the
Company  reassigns Mr. Foss greater than 75 miles  roundtrip  from the Company's
principal executive offices; (3) the Company's substantially reassigns Mr. Foss'
duties and responsibilities;  or (4) Mr. Foss voluntarily leaves employment with
the Company after the  conclusion of the search effort and the acceptance of the
selected individuals(s)  election to serve as Chairman,  Chief Executive Officer
and  President,  the Company will pay Mr. Foss an amount equal to 12 months base
salary  paid in  equal  bi-weekly  payments  over a  period  of one year and any
pro-rata  bonus that he would have been  entitled to had he been employed at the
end of the year.  In  addition,  all  stock  options  which  Mr.  Foss has would
immediately vest and become exercisable under the terms of the applicable plan.

         In the event of a "change of control" as defined in the Agreements, Mr.
Foss will  receive cash equal to two times his base salary for the year in which
such  "change in control"  occurs and two times the amount  equal to the maximum
bonus he would have earned under the applicable bonus plan for the year in which
such change in control  occurs.  If the  "change in control"  occurs in calendar
year 2002,  Mr.  Foss would be  entitled  to an amount  equal to 12 months  base
salary  paid in  equal  bi-weekly  payments  over a  period  of one year and any
pro-rata  bonus that he would have been  entitled to had he been employed at the
end of the year. In addition, all Mr. Foss' stock options would immediately vest
and become  exercisable.  In the event of a "change in control" the value of all
payments, benefits and other consideration received and contingent upon a change
in control and any additional  payments in the nature of compensation  described
by  Section  280G(b)(2)  of the Code may not  exceed an amount  that is equal to
three times the average  taxable  compensation  to Mr. Foss from the Company for
the "base  period" as that term is defined in Section  280G(d)(2) of the Code. A
"change in control" is deemed to occur under the Agreements if, at any time, (a)
substantially  all the assets of the Company or, in the Agreement only,  MD-IPA,
shall have been sold or  transferred  by sale,  merger or  otherwise,  or if any
"person" (as such term is used in Sections 13(d) or 14(d) of the 1934 Act) is or
becomes the  beneficial  owner,  directly or  indirectly,  of  securities of the
Company  or, in the  Agreement  only,  MD-IPA,  representing  50% or more of the
combined voting power of the then-existing outstanding securities of the Company
or, in the Agreement only,  MD-IPA; and (b) Mr. Foss is reassigned in accordance
with the  Agreements  within  six months of such  sale,  merger or other  event;
provided,  however,  that no "change in  control"  is deemed to occur  under the
agreements if Mr. Foss' reassignment is on a temporary basis and is attributable
to Mr.  Foss'  illness or other  physical,  mental or  emotional  disability  or
incapacity.

     On  December  3,  1998,  the  Board of  Directors  approved  an  employment
agreement  to be given to then  Executive  Management  at  levels  18 and  above
("Executive  Agreement").  Accordingly,  Executive  Agreements were entered into
with James P. Bauer,  Paul E.  Dillon,  Vera C. Dvorak,  Catherine  M.  Fridell,
Debbie J. Hulen, John S. Hulen, Craig W. Magargel,  Derry L. Mount and Sharon C.
Pavlos.  The Executive  Agreement has a term of one year  effective  December 4,
1998 through December 4, 1999. The Agreement may be terminated by the Company in
the  event  of a  material  breach  thereof  by the  Executive  or for  cause as
determined by the Board of Directors  with no payment to the  Executive.  In the
event the Company  terminates the Executive  Agreement for any reason other than
death,  disability  or just  cause  or if  Executive  terminates  the  Executive
Agreement because (1) the Company materially  breached the Executive  Agreement;
(2) the Company  reduces  Executive's  base salary by greater  than 25% over the
initial  term of the contract  from the amount on the  effective  date;  (3) the
Company reassigns  Executive greater than 75 miles from the Company's  principal
executive  offices;  or (4) the Company's  substantially  reassigns  Executive's
duties and  responsibilities,  the Company will pay Executive an amount equal to
12 months  base  salary paid in equal  bi-weekly  payments  over a period of one
year.


1998 Options Grants Table

         The  following  table shows certain  information  regarding the options
granted to the Named  Officers  Company in 1998.  Included in these  amounts are
those options  granted  under the voluntary  exchange  program  discussed  under
"Stock Option Repricing" below. The Company did not grant any stock appreciation
rights to these individuals in 1998.


<TABLE>
<CAPTION>

                                Individual Grants

                         Number of   % of                                                   Potential Realizable Value at
                         Securities  Total Options                                          Assumed Annual Rates of
                         Underlying  Granted to      Exercise                               Stock Price Appreciation for
                         Options     Employees in    or Base       Market Price  Expiration Option Term
Name                     Granted(1)  Fiscal Year(2)  Price ($/Sh)  on Grant Date Date       5%($)       10%($)

<S>                      <C>         <C>             <C>            <C>          <C>        <C>         <C>
Thomas P. Barbera         18,000     0.29%          $13.0000        $13.0000     05/01/2003 $64,649     $142,859
                          39,600     0.63%          $16.0000        $12.3750     05/02/2000 $0          $0
                          30,000     0.48%          $16.0000        $12.3750     05/01/2001 $0          $14,133
                          12,000     0.19%          $16.0000        $12.3750     07/14/2001 $0          $5,653
                          36,000     0.58%          $16.0000        $12.3750     05/13/2002 $0          $76,256

J. Stevens Dufresne       15,000     0.24%          $13.0000        $13.0000     05/01/2003 $53,874     $119,049
                          39,600     0.63%          $16.0000        $12.3750     05/02/2000 $0          $0
                          30,000     0.48%          $16.0000        $12.3750     05/01/2001 $0          $14,133
                          36,000     0.58%          $16.0000        $12.3750     05/13/2002 $0          $76,256


Robert E. Foss            15,000     0.24%          $13.0000        $13.0000     05/01/2003 $53,874     $119,049
                          60,000     0.95%          $16.0000        $12.3750     07/01/2000 $0          $0
                          36,000     0.58%          $16.0000        $12.3750     05/01/2001 $0          $16,960
                          30,000     0.48%          $16.0000        $12.3750     05/13/2002 $0          $63,547

Mark D. Groban            12,000     0.19%          $13.0000        $13.0000     05/01/2003 $43,099     $95,239
                          39,600     0.63%          $16.0000        $12.6250     05/02/2000 $0          $0
                          24,000     0.38%          $16.0000        $12.6250     05/01/2001 $0          $19,293
                          30,000     0.48%          $16.0000        $12.6250     05/13/2002 $0          $74,527

Joseph L. Guarriello       9,000     0.14%          $13.0000        $13.0000     05/01/2003 $32,324     $71,429
                          39,600     0.63%          $16.0000        $12.6250     05/02/2000 $0          $0
                          24,000     0.38%          $16.0000        $12.6250     05/01/2001 $0          $19,293
                          24,000     0.38%          $16.0000        $12.6250     05/13/2002 $0          $59,622

George T. Jochum         350,000(3)  5.55%          $13.0000        $13.0000     04/09/2000 $227,500    $455,000

</TABLE>

     (1)  Each option becomes  immediately  exercisable in the event of a change
          of control of the Company.

     (2)  Vesting to occur 1/3 each on the first,  second and third  anniversary
          date of the date of grant  except for  repriced  shares which added an
          additional year to the vesting schedule.

     (3)  Options immediately vested upon grant date.


Aggregated Option Exercises in 1998 and December 31, 1998 Option Values

         The following table contains information regarding options exercised by
the Named Officers  during 1998 and the number and value of unexercised  options
at December 31, 1998. No information is presented for stock appreciation  rights
as none have been granted by the Company.
<TABLE>
<CAPTION>
                                                                           Number of Securities Value of           
                                                                           Underlying           Unexercised In-the-Money
                                                                           Options at           Options at
                                                                           12/31/98 (#)         12/31/98 ($) (1)

- ---------------------------------------------------------------------------------------------------------------------------------
                                  Shares Acquired      Value               Exercisable/         Exercisable/
Name                              on Exercise (#)      Realized ($)        Unexercisable        Unexercisable
- ---------------------------------------------------------------------------------------------------------------------------------
<S>                               <C>                  <C>                 <C>                  <C>               
George T. Jochum                  200,000              1,475,000           879,500/67,000       0/0
Thomas P. Barbera                 48,975               279,564             0/135,600            0/0
J. Stevens Dufresne               54,000               364,500             0/120,600            0/0
Mark D. Groban                    54,000               371,250             0/105,600            0/0
Joseph L. Guarriello              54,000               378,000             0/96,600             0/0
Robert E. Foss                    0                    0                   0/141,000            0/0

</TABLE>

(1) Based on closing  price on the New York Stock  Exchange of on  December  31,
1998.

Stock Option Repricing

         On April 15, 1998, the Stock Option Committee  authorized the voluntary
exchange of all options whose then current  exercise  price was in excess of $16
per share for newly issued options with an exercise price of $16 per share.  The
repricing  program  acknowledged  the importance to the Company of its employees
and of the incentive to employees  represented by stock  options,  especially in
considering alternative opportunities.  The Committee considered such factors as
the competitive  environment for obtaining and retaining qualified employees and
the  overall  benefit  to the  stockholders  from a  highly  motivated  group of
employees.

          As a condition of the exchange,  options holders agreed to an extended
vesting.  Options  that were  vested  on the date of the  exchange,  became,  on
exchange, unvested for a period of one year. Additionally,  the new options were
exercisable for an additional year beyond the then current  expiration date. The
Company's  Board of Directors and Mr.  Jochum's  options were not subject to the
repricing program.

<TABLE>
<CAPTION>

                                    Number of
                                    Securities  Market Price
                                    Underlying   of Stock at  Exercise Price                   Length of Original
                                     Options/      Time of      at Time of                        Option Term
                                       SARs     Repricing or   Repricing or                    Remaining at Date
                                   Repriced or    Amendment      Amendment     New Exercise     of Repricing of
Name                       Date    Amended (#)       ($)            ($)          Price ($)         Amendment
<S>                        <C>     <C>           <C>           <C>             <C>             <C>                
Thomas P. Barbera         4/22/98     12,000       12.375         17.375           16.00           2 yr, 3 mo
CEO and President,                    30,000       12.375         17.625           16.00              2 yr
Executive Vice                        36,000       12.375         19.250           16.00              3 yr
President, Govern-                    39,600       12.375         27.125           16.00              1 yr
mental Services


Paul E. Dillon            4/22/98     33,600       12.375         27.125           16.00              1 yr
Senior Vice President                 36,000       12.375         17.625           16.00              2 yr
and Treasurer                         24,000       12.375         19.250           16.00              3 yr


J. Stevens Dufresne       4/22/98     30,000       12.375         17.625           16.00              2 yr
Executive Vice                        36,000       12.375         19.250           16.00              3 yr
President, Provider                   39,600       12.375         27.125           16.00              1 yr
Networks


Vera C. Dvorak, M.D.      4/21/98     12,000       12.625         24.125           16.00           1 yr, 4 mo
Executive Vice                        18,000       12.625         17.625           16.00              2 yr
President and Medical                 36,000       12.625         19.250           16.00              3 yr
Director


Robert E. Foss            4/22/98     30,000       12.375         19.250           16.00              3 yr
Senior Executive Vice                 36,000       12.375         17.625           16.00              2 yr
President, Chief                      60,000       12.375         22.813           16.00            1yr, 2mo
Financial Officer


Catherine M. Fridell      5/19/98     16,200       12.625         27.125           16.00              1 yr
Executive Vice                         3,000       12.625         22.875           16.00           1 yr, 5 mo
President, Claims                     8,100        12.625         21.00            16.00          1 yr, 10 mo
                                      24,300       12.625         17.625           16.00              2 yr
                                      12,000       12.625         18.00            16.00           2 yr, 2 mo
                                      36,000       12.625         19.250           16.00              3 yr

Susan D. Goff             4/21/98     39,600       12.625         27.125           16.00              1 yr
Executive Vice                        24,000       12.625         17.625           16.00              2 yr
President, President                  30,000       12.625         19.250           16.00              3 yr
of MD-IPA


Mark D. Groban            4/21/98     24,000       12.625         17.625           16.00              2 yr
Chairman of the                       30,000       12.625         19.250           16.00              3 yr
Board, President of                   39,600       12.625         27.125           16.00              1yr
MAPSI & Alliance

Joseph L. Guarriello      4/21/98     24,000       12.625         17.625           16.00              2 yr
Formerly Executive                    24,000       12.625         19.250           16.00              3 yr
Vice President,                       39,600       12.625         27.125           16.00              1 yr
General Counsel and
Secretary


Debbie J. Hulen           4/21/98     14,400       12.625         27.125           16.00              1 yr
Senior Vice President                 6,000        12.625          21.00           16.00           1 yr, 2 mo
                                      24,300       12.625         17.625           16.00              2 yr
                                      15,000       12.625         19.250           16.00              3 yr

Gretchen P. Murdza        4/21/98     34,200       12.625         27.125           16.00              1 yr
Chief Executive                       36,000       12.625         17.625           16.00              2 yr
Officer of HomeCall,                  36,000       12.625         19.250           16.00              3 yr
President of HPS and
HHS

Mary E. Shocklee          4/21/98     30,000       12.625         27.125           16.00              1 yr
Vice President of                     15,000       12.625         17.625           16.00              2 yr
Accounting Operations                 12,150       12.625         23.500           16.00              3 yr
                                      21,000       12.625         19.250           16.00              3 yr


</TABLE>

      RATIFICATION OF ADOPTION OF THE 1999 NON-QUALIFIED STOCK OPTION PLAN


                                  (Proposal 2)


         The   Company's   Board  of  Directors   ("Board")   adopted  the  1999
Non-Qualified  Stock Option Plan ("1999  Plan") on October 16, 1998 and February
25, 1999 and it intends to submit the 1999 Plan to stockholders  for approval at
the Annual Meeting.  The Company is soliciting  stockholder approval of the 1999
Plan so that the 1999 Plan complies with the  requirements  of Section 162(m) of
the Code and the  Company's  ability to deduct  compensation  paid to  executive
officers under the 1999 Plan is preserved.

         The 1999 Plan becomes  effective  May 3, 1999.  However,  the 1999 Plan
will  not be  effective  unless  and  until  it is  approved  by  the  Company's
stockholders. Pursuant to the 1999 Plan, 1.5 million shares of Common Stock were
reserved  for future  issuance by the Company to  directors,  officers,  and key
employees  through the grant of  non-qualified  stock options to purchase Common
Stock of the Company.


Purpose


         The purpose of the 1999 Plan is to advance the  interest of the Company
and its  Subsidiaries  by  encouraging  and providing for the  acquisition of an
equity  interest in the Company by  non-employee  directors,  officers,  and key
employees  through the grant of options to purchase Common Stock.  The 1999 Plan
will  enable the  Company  to retain the  services  of  non-employee  directors,
officers and key employees upon whose judgment, interest, and special effort the
successful  conduct  of its  operations  are  largely  dependent  and to compete
effectively with other  enterprises for the services of non-employee  directors,
officers and key employees as may be needed for the continued improvement of its
business.  The consideration for issuance of the non-qualified  stock options is
the continued services of the non-employee directors,  officers and employees to
the Company and its Subsidiaries.




Administration


         The Board may appoint more than one  Committee to  administer  the 1999
Plan.  If it  appoints  more than one  Committee,  one  Committee  will have the
authority to grant options to a participant who is either,  at the date of grant
of the option, a "covered  employee" as defined in Section 162(m) of the Code or
who is subject to Section 16 of the 1934 Act. This  Committee will also have the
authority to grant options to other participants.  This Committee, which will be
the Stock Option  Committee,  must be composed of at least two  directors of the
Company, each of whom is a "non-employee  director" as defined in Rule 16b-3 and
an  "outside  director"  within the meaning of Section  162(m) of the Code.  If,
however,  at least two of the  Company's  directors  are not both  "non-employee
directors" and "outside directors," the Board may grant options to a participant
who is either a "covered  employee" or subject to Section 16 of the 1934 Act, in
which case the Board may also administer the 1999 Plan.

         The other  Committee  (the "Select  Committee")  will be composed of at
least one director,  who may be an officer of the Company.  This  Committee will
have  authority  to grant  options to a  participant  who is not, at the date of
grant of the option, either a "covered employee" as defined in Section 162(m) of
the Code or  subject  to Section  16 of the 1934 Act.  If,  however,  there is a
conflict between the  determinations  made by the Stock Option Committee and the
Select Committee, the determinations made by the Stock Option Committee control.

         Each  Committee  will  act by a  majority  vote  of its  members.  Each
Committee may interpret the 1999 Plan, establish and modify administrative rules
for the 1999 Plan,  select the officers and other key  employees to whom options
may be granted,  determine the terms and  provisions of the  respective  options
agreements  (which need not be  identical),  determine  all claims for  benefits
under the 1999 Plan,  impose such  conditions and  restrictions on options as it
determines  appropriate,  determine  whether the shares delivered on exercise of
options will be treasury  shares or will be authorized but  previously  unissued
shares, and take such steps in connection with the 1999 Plan and options granted
hereunder  as it may deem  necessary or  advisable.  No action of a Committee is
effective it if contravenes or amends the 1999 Plan in any respect.

         Members of each  Committee,  as directors  of the Company,  serve until
their successors are elected and qualified,  and may be removed, with or without
cause,  by the  holders  of  two-thirds  of the  shares  entitled  to vote at an
election of directors or for cause by an affirmative vote of the entire Board of
Directors  at any  regular or special  meeting  of the Board of  Directors.  The
members of the Stock Option  Committee and the Select Committee are set forth in
"Directors and Executive Officers-Board Meetings and Committees."


Option Grants to Officers and Key Employees


         Eligibility.  Any  officer  or  key  employee  of  the  Company  or its
Subsidiaries,  including  any director  who is also an employee,  is eligible to
receive  options under the 1999 Plan. As of December 31, 1998,  the  approximate
number of employees  who would be eligible to  participate  in the 1999 Plan was
1,200.

         Each employee may not receive options to purchase more than one million
shares  under the 1999 Plan  during  the term of the 1999  Plan.  Except for the
limitation  in the  preceding  sentence  and  the  limitation  on the  types  of
participants to whom the Select Committee may grant options,  each Committee has
complete authority to determine those officers and key employees to whom options
may be granted.

         Term;  Exercisability.  The grant of an option will be  evidenced  by a
written stock option agreement executed by the Company and the optionee, stating
the number of shares of Common Stock  subject to the option and other terms that
the  appropriate  Committee  may  determine.  The  term of each  option  will be
determined  by the  Committee  at the time the option is  granted.  However,  no
option  may have a term in excess of five  years  after the date of grant.  Each
option is  exercisable in such  installments  and at such times as designated by
the Committee.  Installments,  to the extent not  exercised,  accumulate and are
exercisable until the option expires, unless the Committee determines otherwise.


         Option Price and Payment;  Fair Market  Value.  The 1999 Plan  provides
that the purchase price of the shares of Common Stock issuable on exercise of an
option  shall be no less than the fair market  value of the Common  Stock of the
Company as of the date of the grant of the option.

         Fair market  value of a share of Common  Stock  means,  as of any given
date,  the closing  sales  price of a share of Common  Stock on such date on the
principal national  securities exchange on which the Common Stock is then traded
or, if the Common  Stock is not then traded on a national  securities  exchange,
the closing sales price or, if none,  the average of the bid and asked prices of
the  Common  Stock on such  date as  reported  by the  National  Association  of
Securities  Dealers Automated  Quotation System ("Nasdaq").  If, however,  there
were no sales reported as of such date, fair market value will be computed as of
the last  date  preceding  such date on which a sale was  reported.  If any such
exchange or quotation  system is closed on any day on which fair market value is
to be  determined,  fair market  value will be  determined  as of the first date
immediately  preceding such date on which such exchange or quotation  system was
open for  trading.  In the event the Common  Stock is not admitted to trade on a
securities  exchange or quoted on Nasdaq,  the fair  market  value of a share of
Common  Stock as of any given  date will be as  determined  in good faith by the
appropriate Committee, in its sole and absolute discretion,  which determination
may be based on, among other things,  the opinion of one or more independent and
reputable  appraisers  qualified  to value  companies in the  Company's  line of
business.  Notwithstanding  the  foregoing,  the fair market value of a share of
Common Stock will never be less than par value per share.

         Termination of Employment.  In general, in the event of the termination
of an  optionee's  employment  for reasons other than death or  disability,  the
optionee has the right to exercise any option with respect to all or any part of
the shares subject thereto, to the extent that the option had become exercisable
at the time of such  termination for a period of three months following the date
of  termination,  but in no event later than the expiration  date of the option.
Each  Committee  may,  however,  permit an employee  participant  to continue to
accrue service with respect to the vesting of his or her options. In general, in
the event that the  optionee's  employment  is terminated by his or her death or
permanent  disability  within the meaning of Section  22(e)(3) of the Code,  all
options  granted under the 1999 Plan to such optionee may be exercised  (whether
or not otherwise  exercisable)  at any time within one year after the optionee's
death or termination  because of disability,  but in any event no later than the
expiration date of the option.  Each Committee may,  however,  in its discretion
provide for shorter or longer periods of time in an option agreement.

         In  addition,  each  Committee  may permit the purchase of Common Stock
subject to any option granted to an employee  participant prior to the time such
option  would  otherwise  become  exercisable  under  the  terms  of the  option
agreement.  Each  Committee  also may permit any option  granted to an  employee
participant to be exercised after its expiration date. However, no option may be
exercised more than five years after its date of grant.


Non-Employee Director Options


         Non-Employee Directors;  Number of Shares. The 1999 Plan provides that,
on May 3, 1999,  each  person who is a director of the Company or PHP-MD but who
is not an  employee  of the  Company or one of its  Subsidiaries  ("Non-Employee
Director")  on such date will be granted a  Non-Employee  Director  Option.  Dr.
Bruno is considered a Non-Employee Director for this purpose. As of May 3, 1999,
the number of Non-Employee  Directors  anticipated to be eligible to participate
in the 1999 Plan is  approximately  15 (which  includes 3 Non-Employee  Director
nominees).

Each  Non-Employee  Director  Option will  entitle the holder to purchase  5,000
shares of Common Stock if the non-Employee Director is a director of the Company
or 3,000 shares of Common Stock if the Non-Employee  Director is only a director
of PHP-MD.

         Exercise  Price;  Term. The exercise  price per share for  Non-Employee
Director options will be the fair market value of a share of Common Stock on May
3, 1999. All Non-Employee Director Options will have a five year term.

         Exercisability;  Termination  of Service.  Each  Non-Employee  Director
Option will become  exercisable  cumulatively in three equal installments on May
3, 2000, May 3, 2001 and May 3, 2002.  However,  if a  Non-Employee  Director is
removed for cause, any option held by such  Non-Employee  Director will cease to
continue to become  exercisable  on or after the date of such removal.  For this
purpose, cause means removal as a director by the holders of Common Stock or the
Company's  Board of Directors for cause or, if a Non-Employee  Director is not a
director of the Company, removal as a director by the holders of common stock of
any  Subsidiary on whose Board of Directors he or she serves or by such Board of
Directors for cause.


         If a Non-Employee  Director's  service with the Company  terminates for
any reason or if such person ceases to be a Non-Employee  Director,  such option
will continue to become exercisable and may be exercised until the expiration of
the stated  term of the  option.  Accordingly,  if a  Non-Employee  Director  is
removed for cause,  he or she may continue to exercise  his or her  Non-Employee
Director Option until the expiration of the stated term of such option, but only
to the extent that (a) such option became  exercisable prior to the date of such
removal and (b) it was not previously exercised.

Exercise of Options


         Options may be  exercised by giving  written  notice of exercise to the
Company  specifying  the number of shares of Common Stock to be purchased.  Such
notice must be accompanied by payment in full of the purchase price in such form
as the Committee  may accept  (including  payment in accordance  with a cashless
exercise  program  approved  by  the  Committee).  A  participant  (including  a
Non-Employee  Director) also has the right to pay the exercise price, in full or
in part,  in the form of Common  Stock  duly owned by the  participant  (and for
which  the  participant  has  good  title,  free  and  clear  of any  liens  and
encumbrances) based on the fair market value of the Common Stock as the date the
option is exercised.  Any already issued Common Stock used for payment must have
been held by the  participant  for at least six months.  No Common Stock will be
issued on  exercise  of an option  until  payment  therefore  has been  made.  A
participant  will  generally  have the right to  dividends  or other rights of a
stockholder  with  respect  to Common  Stock  subject  to the  option  only when
certificates for shares of Common Stock are issued to the participant.


Transferability


         Stock  options  granted  under the 1999 Plan are  transferable  only by
will,  by the laws of descent  and  distribution,  or  pursuant  to a  qualified
domestic  relations  order  as  defined  by the  Code,  Title I of the  Employee
Retirement  Income  Security  Act of 1974,  as amended  ("ERISA"),  or the rules
thereunder. However, the 1999 Plan is not subject to the provisions of ERISA and
is not qualified under Section 401(a) of the Code.


Adjustments upon Changes in Capitalization; Change in Control


         Recapitalization.  The number and kind of shares subject to outstanding
options,  the purchase  price or exercise  price of such options,  the amount of
Non-Employee  Director Options to be granted, the limit on the number of options
that may be granted to an employee  and the number and kind of shares  available
for  options  subsequently  granted  under the 1999  Plan will be  appropriately
adjusted to reflect any stock dividend,  stock split, combination or exchange of
shares,  merger,  consolidation or other change in capitalization with a similar
substantive  effect  upon the 1999 Plan or the  options  granted  under the 1999
Plan. Each Committee has the power and sole and absolute discretion to determine
the nature and amount of the adjustment to be made in each case.


         Sale  or   Reorganization.   After  any   reorganization,   merger,  or
consolidation  in which the Company is the surviving  entity,  each  participant
will,  at no  additional  cost,  be  entitled  upon the  exercise  of an  option
outstanding  prior to such event to receive  (subject to any required  action by
stockholders),  in lieu of the number of shares of Common  Stock  receivable  on
exercise  pursuant  to such  option,  the number and class of shares of stock or
other securities to which such participant  would have been entitled pursuant to
the terms of the  reorganization,  merger, or  consolidation,  if at the time of
such  reorganization,  merger, or  consolidation,  such participant had been the
holder or record of a number of shares of Common  Stock  equal to the  number of
shares  of  Common  Stock  receivable  on  exercise  pursuant  to  such  option.
Comparable  rights will accrue to each  participant  in the event of  successive
reorganizations, mergers, or consolidations of the character described above.


         Options  to   Purchase   Stock  of   Acquired   Companies.   After  any
reorganization,  merger,  or  consolidation  in which the Company is a surviving
entity, each Committee may grant substituted options under the provisions of the
1999 Plan,  replacing  old options  granted under a plan of another party to the
reorganization,  merger, or consolidation whose stock subject to the old options
may no longer be issued following such reorganization, merger, or consolidation.
The foregoing  adjustments and manner of application of the foregoing provisions
will be  determined  by the  appropriate  Committee  in its  sole  and  absolute
discretion.  Any  such  adjustments  may  provide  for  the  elimination  of any
fractional  shares of Common Stock that might  otherwise  become  subject to any
options.

         Changes in Control.  (1) Upon the  dissolution  or  liquidation  of the
Company,  (2) upon a  reorganization,  merger,  or  consolidation  in which  the
Company is not the surviving corporation, (3) upon the sale of substantially all
of the  property  or assets of the Company to another  corporation  or (4) if at
least 50% or more of the voting  stock of the Company is sold  either  through a
tender offer or otherwise to a party or an affiliated group of parties, then the
1999 Plan and the options issued  thereunder will terminate,  unless  provisions
are made in  connection  with such  transaction  for the  assumption  of options
therefore  granted,  or for the  substitution for such options of new options of
the successor  corporation or a parent or subsidiary  thereof,  with appropriate
adjustment  as to the  number  and  kinds of shares  and the per share  exercise
prices. If such options terminate,  all outstanding  options will be exercisable
in full for at least 30 days  prior to such  termination  date,  whether  or not
exercisable during such period, provided that no option will be exercisable more
than five years following its date of grant. For purposes of this provision, the
Company  refers to Mid  Atlantic  Medical  Services,  Inc.,  MD-IPA,  OCI and/or
PHP-MD, jointly or separately.  The appropriate Committee determines the date on
which options may become exercisable pursuant to this provision.

Amendment and Termination of the 1999 Plan

         Amendment. The Board has complete power and authority to amend the 1999
Plan at any time it is deemed necessary or appropriate.  However,  the Board may
not,  without the  affirmative  approval of a simple  majority of the holders of
Common  Stock,  represented,  by person or by proxy,  and entitled to vote at an
annual or special  meeting of the holders of Common  Stock,  make any  amendment
that requires  stockholder approval under any applicable law or rule, unless the
Board determines that compliance with such law or rule is no longer desired.  No
termination  or  amendment  of the 1999 Plan may,  without  the  consent  of the
affected  participant,  adversely affect the right of such individual under such
option.  However,  the  appropriate  Committee  may,  in its sole  and  absolute
discretion,  make provision in an option  agreement for such amendments that, in
its sole and absolute discretion, it deems appropriate.

         Termination.  The 1999 Plan will terminate on May 2, 2004;  however the
Board has the right and the  power to  terminate  the 1999 Plan at any time.  No
option may be  granted  under the 1999 Plan  after the  termination  of the 1999
Plan.  The  termination  of the 1999 Plan will not have any other effect and any
option  outstanding  at the  time of the  termination  of the  1999  Plan may be
amended and exercised and may vest after the termination of the 1999 Plan at any
time prior to the expiration  date of such option to the same extent such option
could have been  amended  and would have been  exercisable  or vest had the 1999
Plan not terminated.


Options Currently Outstanding


         No options  have been  granted at this time  under the 1999  Plan. 
The total  market  value as of  February  26,  1999 of 1.5million reserved 
shares was $ 11,718,750 (based on the closing sales price on the NYSE).


Federal Income Tax Consequences


         The  following  summary  is a  general  discussion  of  certain  of the
principal  federal  income tax  consequences  of the exercise of options  issued
pursuant to the 1999 Plan and the later  disposition  of the shares  acquired by
such exercise.

         Under  present  regulations  and  published  authorities,  an  officer,
director or employee ("holder")  recognizes no income when he or she receives an
option under the 1999 Plan. Upon the exercise or other disposition of an option,
however,  the holder will  recognize  ordinary  income in an amount equal to the
difference  between the fair market  value of the shares on the date of exercise
and the option price  (called the "option  spread").  If an option  holder sells
shares  acquired by the exercise of an option  granted under the 1999 Plan,  the
option holder  generally  will realize  capital gain or loss in the year of such
sale in an amount equal to the difference  between (i) the net proceeds from the
sale and (ii) the option  exercise price plus the amount included in income upon
exercise of the option. If such shares are held for more than one year, then any
gain or loss on their sale will be  long-term  capital gain or loss taxable at a
reduced  rate.  The  applicable  capital  gains rate will depend on the holder's
marginal tax rate and the length of time the shares are held prior to sale.


         The Company  generally  will be entitled to a tax deduction for federal
income tax purposes for the fiscal year in which the holder recognized  ordinary
income. The amount of the deduction will equal the amount included in the option
holder's  gross  income  for  federal  income  tax  purposes  by  reason of such
exercise. The Company is entitled, under present Treasury regulations, to deduct
the amount  shown on a timely  issued Form W-2 (or Form 1099 if  applicable)  as
includible with the holder's gross income.

         Legislation   enacted  in  1993  limits  the  amount  of   compensation
deductible to a public  corporation  for U.S.  income tax purposes to $1,000,000
per  executive   officer.   This  limitation  does  not  apply  to  compensation
arrangements  that are based on the performance of the corporation and have been
approved by its shareholders.


         Under the 1999 Plan,  each  optionee  must  arrange  with the Company a
means of paying any federal, state, local or foreign withholding tax as required
by law upon the exercise of an option  under the 1999 Plan.  Such amounts may be
paid,  at the election of the  optionee,  either (i) in cash  withheld  from the
employee's salary or other compensation  payable by the Company or a Subsidiary,
(ii) in  shares of Common  Stock  already  owned or  otherwise  issuable  to the
employee upon exercise of an option that have a fair market value on the date on
which the amount of tax to be withheld is determined  equal to the amount of tax
the Company is entitled  to  withhold,  or (iii) cash paid to the Company by the
optionee.

         THE BOARD OF DIRECTORS  RECOMMENDS  THAT YOU VOTE FOR  RATIFICATION  OF
ADOPTION OF THE 1999 PLAN.


        RATIFICATION OF ADOPTION OF THE 1999 SENIOR MANAGEMENT BONUS PLAN


                                  (Proposal 3)


         The Company's Compensation Committee adopted the 1999 Senior Management
Bonus  Plan  ("1999  Bonus  Plan")  on  February  22,  1999 and the  Company  is
submitting the 1999 Bonus Plan to the  stockholders at the Annual  Meeting.  The
Company is  soliciting  stockholder  approval of the 1999 Bonus Plan so that the
1999 Bonus Plan complies with the requirements of Section 162(m) of the Code and
the Company's ability to deduct  compensation  paid to executive  officers under
the 1999 Bonus Plan is preserved. Amounts payable to participants under the 1999
Bonus Plan will not be paid  unless and until the 1999 Bonus Plan is approved by
the Company's  stockholders.  Pursuant to the 1999 Bonus Plan, participants will
receive  in  cash  a  percentage  of  their  annual  base   compensation   if  a
predetermined net income goal is met. The net income goal is selected such that,
if the goal is achieved,  the  underlying  value of the  Company's  Common Stock
should increase.  Thus, the 1999 Bonus Plan provides an incentive for management
to perform in a way that directly benefits stockholders.


Terms


         Generally,  full-time non-sales salaried employees of the Company Level
17 and above will receive a percentage of their base annual cash compensation as
a  distribution  from the 1999 Bonus  Plan if the  Company's  consolidated  1999
income  equals or  exceeds  $36  million  (before  income  taxes,  expansion  or
acquisition  costs),  one time  charges or credits not  related to current  year
operations,  and prior to the return of any  portion  or all of the  physicians'
withhold and payment of physicians' bonuses).  The percentage that a participant
will receive is based upon that individual's grade level. Salary percentages are
as follows:

                  Chairman, CEO, President                        12.5 to 45%
                  Senior Executive Vice President                 10.5 to 38%
                  Executive Staff (Levels 18 to 23, excluding
                       CEO, Chairman and Senior Executive Vice
                                  President)                       6.0 to 28%
                  Senior Staff (Level 17)                          5.5 to 25%

         If the  above  mentioned  income  target  is met in 1999,  the  minimum
percentages  as set forth  above  will be payable  to  participating  personnel.
Alternatively,  if  consolidated  income (as  adjusted)  equals or  exceeds  $42
million,  then the  maximum  percentage  set  forth  above  will be  payable  to
participants.  If the amount of such consolidated  income is between $36 million
and $42 million, then the bonus is prorated.

         The Company's  Compensation  Committee may not amend the 1999 Bonus
 Plan to materially increase the amounts payable thereunder to participants.

         The 1999 Bonus  Plan is  substantially  similar to the 1999  Management
Bonus Plan,  in which all  full-time  non-sales  level  personnel  levels  10-16
participate, except that the percentage payments are lower.


Eligibility


         All full-time non-sales personnel Level 17 and above participate in the
1999  Bonus  Plan.  As of January 1, 1999,  approximately  35  individuals  were
eligible to participate in the 1999 Bonus Plan.  Full-time  non-sales  employees
Level 17 and above who are hired during the course of 1999 are also  eligible to
participate  in the 1999 Bonus Plan,  with their bonus being prorated based upon
their actual service during 1999 or upon any other reasonable method designed to
fairly compensate and recruit a new employee,  with the approval of the CFO, CEO
or Chairman.

         In general, bonus payments will be calculated based on the salary level
on March 1, 1999.  With respect to new  participants  who are hired or initially
promoted to a full-time  non-sales  position  Level 17 or higher  after March 1,
1999,  the bonus will be calculated at the initial Level 17 or higher salary and
prorated  for the  portion of the year that the  employee  was  employed in such
position.  With respect to a participant  who is demoted during 1999, the amount
will be calculated on a pro-rata basis based on the portion of the year that the
employee  was  employed in a full-time  non-sales  position  Level 17 or higher.
Persons in interim  positions  with the Company will be credited as if they held
permanent positions for the purposes of determining bonus plan payment.

         No  bonus  will be paid to a  participant  who is not  employed  by the
Company on  December  31, 1999 unless  approved  by the  Company's  Compensation
Committee.  In the event of death or retirement,  the  participant or his or her
beneficiary will receive a pro-rated portion of the bonus.

         The  salary  levels  on  March  1,  1999  for the  following  full-time
non-sales executive officers were as follows:



                  Name                                        Base Salary

                  Thomas P. Barbera                           $475,000

                  J. Stevens Dufresne                         $277,000

                  Vera C. Dvorak, M.D.                        $263,000

                  Robert E. Foss                              $400,000

                  Catherine M. Fridell                        $204,000

                  Susan D. Goff                               $190,000

                  Mark D. Groban, M.D.                        $475,000

                  Sharon C. Pavlos                            $168,000



         The following table shows estimates of the bonuses payable to the named
individuals  and groups  under the 1999 Bonus  Plan,  assuming  the  minimum net
income goal is achieved and the maximum net income goal is achieved.

<TABLE>
<CAPTION>


Name                                         Minimum Net               Maximum
                                             Income Goal               Net Income 
                                             Achieved(1)               Goal Achieved(1)

<S>                                          <C>                       <C>    
George T. Jochum
Former Chairman of the Board,
President and Chief Executive Officer            $0                           $0


Thomas P. Barbera
President and Chief Executive Officer,
Executive Vice President,
Government Services                            $59,375                     $213,750


Mark D. Groban
Chairman,
President of MAPSI and Alliance                $59,375                     $213,750


J. Stevens Dufresne
Executive Vice President,
Provider Networks                              $16,620                      $77,560


Robert E. Foss
Senior Executive Vice President,
Chief Financial Officer                        $42,000                     $152,000


Joseph L. Guarriello
Former Executive Vice President,
General Counsel and Secretary                       $0                           $0

All executive officers as a group             $274,535                   $1,109,730

All directors who are not executive                 $0                           $0
officers as a group


All employees who are not executive           $127,561                     $584,057
officers as a group (2)

</TABLE>

     (1)  The  calculation  is based on salaries  for  executive  officers as of
          March 1, 1999 and for all other  employees as of December 31, 1998. No
          adjustments  have  been  made  for  promotions,   salary  adjustments,
          terminations  or new hires that may occur in 1999.  (2) Payable  under
          the 1999 Bonus  Plan.  Calculation  does not include  amounts  payable
          under the 1999 Management Bonus Plan.

       THE BOARD OF DIRECTORS RECOMMENDS THAT YOU VOTE FOR RATIFICATION OF
               ADOPTION OF THE 1999 SENIOR MANAGEMENT BONUS PLAN.



                         INDEPENDENT PUBLIC ACCOUNTANTS

         Ernst & Young LLP has been the Company's independent public accountants
since  June 2, 1989.  Representatives  of Ernst & Young LLP are  expected  to be
present at the Annual Meeting, and will have an opportunity,  if they so desire,
to make a statement and will be available to respond to appropriate questions.

                              STOCKHOLDER PROPOSALS


         Any proposal  that a stockholder  wishes to have  presented at the 2000
annual  meeting of  stockholders  of the Company and  included in the  Company's
Proxy  Statement  and proxy to be used in  connection  with such meeting must be
received at the main office of the Company no later than December 4, 1999.  Such
proposals should be directed to the attention of Sharon C. Pavlos, Secretary, at
Mid Atlantic Medical Services, Inc., 4 Taft Court, Rockville, Maryland 20850. If
such proposal is in compliance with all of the requirements of Rule 14a-8 of the
1934 Act, it will be included in the Proxy  Statement  and set forth in the form
of proxy issued for the next annual  meeting of  stockholders.  It is urged that
any such proposals be sent by certified mail, return receipt requested.


         The Bylaws of the  Company  require  stockholders  to  provide  advance
notice of all matters to be considered at annual stockholder meetings, including
director  nominations.  The  Bylaws  require  that a  stockholder  who wishes to
propose new business or nominate individuals to the Company's Board of Directors
at an  annual  meeting  of the  stockholders  provide  notice  to the  Company's
Secretary of such a proposal or nomination thirty days in advance of the date of
the annual  meeting.  A proposing  stockholder can provide less than thirty days
notice only if the Company  mails its notice of annual  meeting  less than forty
days in  advance  of the  annual  meeting  date.  In such  case,  the  proposing
stockholder must give notice to the Company no later than the tenth day on which
the Company mails its notice of annual meeting.

         Further,  the Bylaws require that the proposing  stockholder set forth,
in his or her notice to the Company's Secretary,  (i) a brief description of the
business  desired to be brought  before the annual  meeting  and the reasons for
conducting  such business at the annual meeting,  (ii) the name and address,  as
they appear on the Company's books, of the stockholder  proposing such business,
and  (iii)  the  class  and  number  of the  Company's  capital  stock  that are
beneficially  owned by such stockholder,  and (iv) any material interest of such
stockholder  in such  business.  In cases of a  nomination  for  director,  such
stockholder's notice shall set forth (i) as to each person whom such stockholder
proposes to nominate for election or re-election as a director,  all information
relating to such person that is required to be  disclosed  in  solicitations  of
proxies for  election  of  directors,  or is  otherwise  required,  in each case
pursuant to Regulation 14A under the 1934 Act (including  such person's  written
consent to being named in the proxy  statement  as a nominee and to serving as a
director if elected):  and (ii) as to the stockholder giving notice (A) the name
and address, as they appear on the Company's books, of such stockholder, and (B)
the  class  and  number  of  shares  of the  Company's  capital  stock  that are
beneficially owned by such stockholder.

         The Bylaws also provide that,  at any special  meeting of the Company's
stockholders,  only such business  shall be conducted as shall have been brought
before the meeting by or at the direction of the Company's Board of Directors.

                                 OTHER BUSINESS

         Management  is not aware of any  business  to come  before  the  Annual
Meeting  other  than those  matters  described  above in this  Proxy  Statement.
However, if any other matters should properly come before the Annual Meeting, it
is intended that proxies  solicited  hereby will be voted in accordance with the
judgment of the persons voting the proxies.

         After the  business  session  and a report to the  stockholders  on the
progress of the  Company and its  Subsidiaries,  a  discussion  period will take
place during which  stockholders  will have an opportunity to discuss matters of
interest concerning the Company and its Subsidiaries.


                           VOTE REQUIRED FOR APPROVAL

         A plurality of the shares present at the Annual  Meeting  together with
those present by proxy will be sufficient to elect Directors (Proposal 1). As to
Proposal 2, Proposal 3, and other matters that may be submitted to the Company's
stockholders for approval, a simple majority of the shares present at the Annual
Meeting  together with those present by proxy will be sufficient to approve such
proposals and other matters.

         Under Delaware law, shares represented at the Annual Meeting (either by
properly  executed  proxy or in  person)  that  reflect  abstentions  or "broker
non-votes"  (i.e.,  shares held by a broker or nominee which are  represented at
the Annual  Meeting,  but with  respect  to which such  broker or nominee is not
empowered to vote on a particular  proposal)  will be counted as shares that are
present and  entitled  to vote for  purposes of  determining  the  presence of a
quorum. Abstentions as to Proposals 1, 2 or 3 will have the same effect as votes
against the respective proposals. Broker non-votes,  however, will be treated as
unvoted for purposes of  determining  approval of such  proposals (and therefore
will reduce the absolute  number - although not the percentage - of votes needed
for  approval)  and will not be counted as votes for or against  the  proposals.
Under applicable rules, brokers will have discretionary voting authority to vote
on Proposals 1, 2 and 3.


                                By Order of the Board of Directors,
                                /s/Sharon C. Pavlos
                                Sharon C. Pavlos
                                    Secretary




Rockville, Maryland
March 31, 1999





                   
<PAGE>
                       MID ATLANTIC MEDICAL SERVICES, INC.
                  PROXY FOR THE ANNUAL MEETING OF STOCKHOLDERS
                            TO BE HELD APRIL 26, 1999
                  SOLICITED ON BEHALF OF THE BOARD OF DIRECTORS

The undersigned hereby authorizes Thomas P. Barbera and Mark D. Groban, and each
of them  individually,  with the power of  substitution,  to vote and  otherwise
represent  all of the  shares of common  stock  (Common  Stock) of Mid  Atlantic
Medical  Services,  Inc.  (Company),  held of record by the undersigned,  at the
Annual Meeting of Stockholders of the Company (Annual Meeting) to be held at the
offices of the Corporation located at 10 Taft Court,  Rockville,  Maryland 20850
on Monday,  April 26, 1999 at 10:00 a.m,  Rockville time, and any adjournment or
adjournments  thereof, as follows:  The undersigned  acknowledges receipt of the
Notice of Annual  Meeting of  Stockholders  and Proxy  Statement  for the Annual
Meeting. All other proxies heretofore given by the undersigned to vote shares of
Common Stock of the Company are expressly  revoked.  Unless a contrary direction
is indicated, this Proxy Will Be Voted For the Proposals Referred to in Items 1,
2 and 3. The Board of Directors  recommends votes For the Proposals  referred to
in  Items  1, 2 and 3.  This  Proxy  is  Solicited  on  Behalf  of the  Board of
Directors.  
(Continued and to be signed on the other side.)

 MID ATLANTIC MEDICAL
SERVICES, INC. P.O. BOX 11176 NEW YORK, N.Y. 10203-0176

(1)Election of Directors. 
FOR all nominees listed below  (  ) 
WITHHOLD  AUTHORITY to vote for all nominees listed below (  )
*EXCEPTIONS (  )
        
Nominees: Thomas P. Barbera; Francis C. Bruno, M.D.; John A. Paganelli; Janet L.
Norwood; Ivan R. Sabel; and James A. Wild.
(INSTRUCTIONS:  To withhold authority to vote for any  individual  nominee, 
 mark the  Exceptions  box and write  that nominees  name in the  space  
provided  below.)

*Exceptions _________________________________________________________________

(2)To  ratify  the adoption of the 1999 Non-Qualified Stock Option Plan.


        FOR             AGAINST         ABSTAIN 

(3)To ratify the adoption of the 1999 Senior Management Bonus Plan.


        FOR             AGAINST         ABSTAIN 

(4)In their  discretion upon such other business and other matters and proposals
as  may  properly  come  before  the  Annual  Meeting  or  any   adjournment  or
adjournments thereof.

Change of Address or  Comments  Mark Here ( ) 

Please sign exactly as your name appears on this card. When signing as attorney,
executor, administrator,  trustee or guardian please give full title as such. If
a  corporation,  please  sign  in full  corporate  name by  President  or  other
authorized  officer.  If a  partnership,  please  sign  in  partnership  name by
authorized person. Whether or not you plan to attend the Annual Meeting, you are
urged to execute and return  your proxy,  which may be revoked at any time prior
to its use.

Dated:_________________________ 


_______________________________        
Signature of Stockholder

________________________________        
Signature(s) of Additional Stockholder(s)
Votes must be indicated
(x) in Black or Blue ink.

please  complete,  sign,  date and return this proxy  promptly  in the  enclosed
envelope.

                     

<PAGE>
                                   Appendix A

                        1999 SENIOR MANAGEMENT BONUS PLAN
                 (to be approved by the Compensation Committee)


Participants  in the 1999 Senior  Management  Bonus Plan  ("Bonus  Plan")  shall
include all  full-time  positions  Level 17 and above  (except for certain sales
personnel who receive override  commissions),  which includes those  individuals
who could possibly be affected by Section  162(m) of the Internal  Revenue Code,
including but not limited to the Chairman or CEO. This  definition  includes all
full-time  employees  who are  Level 17 and  above  as of March 1,  1999 and all
full-time  employees  who are  promoted to or hired at a Level 17 or above after
March 1, 1999.  Bonuses will be solely  predicated on the consolidated  earnings
performance of Mid Atlantic Medical Services, Inc. (MAMSI).

Bonuses shall be paid according to the following guidelines:

1. Minimum  Bonus- Minimum  bonuses shall be paid if MAMSI and its  consolidated
subsidiaries  (the  "Company")  achieve a profit of  $36,000,000  before  income
taxes,  expansion or acquisition  costs, one time charges or credits not related
to current year operations,  and prior to the physicians' return of withhold and
payment of physicians' bonuses.

2. Maximum Bonus- Maximum bonuses shall be paid if the Company achieves a profit
of $42,000,000  before income taxes,  expansion or acquisition  costs,  one time
charges or credits  not  related to current  year  operations,  and prior to the
physicians' return of withhold and payment of physicians' bonuses.

3.  Pro-ration-  In the event that the Company  earns  between  $36,000,000  and
42,000,000 bonus payments will be pro-rated accordingly.

4. Bonus Base- In general, bonus payments will be calculated based on the salary
level on March 1,  1999.  With  respect  to new  participants  who are  hired or
initially  promoted to a full-time  non-sales  position Level 17 or higher after
March 1, 1999,  the bonus will be  calculated  at the initial Level 17 or higher
salary.With respect to a participant who is demoted during 1999, the amount will
be  calculated  on a pro-rata  basis  based on the  portion of the year that the
employee was employed in a full-time non-sales position Level 17 or higher.

5. New  Employees-  New  full-time  employees  or those  who are  promoted  to a
full-time  non-sales  position  Level 17 or higher  during 1999 are  eligible to
participate in the Bonus Plan.  The bonus payment will be pro-rated  accordingly
for the  portion  of the year that the  employee  was  employed  in a  full-time
non-sales  position  Level 17 or  higher  or upon any  other  reasonable  method
designed to fairly  compensate and recruit a new employee,  with the approval of
the Compensation Committee.

6.  Termination-  No bonus  shall be paid to bonus  participants  who  terminate
employment  with the Company or are  terminated by the Company prior to the year
end unless approved by the Compensation Committee. In the event of retirement or
death, the employee or his\her  beneficiary will receive a pro-rated  portion of
the bonus.

7. Time of Payment- Bonus payments shall be distributed following the completion
of the audit of the financial statement(s) for the Company for the year 1999.

8. Bonus  Percentages-  The  distribution  of the bonus payments to participants
shall be limited according to the following percentage ranges:

         Chairman,  CEO,  President                 12.5 - 45% 
         Senior Executive Vice President            10.5 -38%      
         Executive  Staff (Levels 18 through 23,
         excluding CEO, Chairman and Senior             
         Executive Vice President)                  6.0 - 28%
         Senior Staff (Level 17)                    5.5 - 25%

For the  purposes  of  administering  this Bonus  Plan,  any  offices  held by a
participant in an interim capacity will be credited as permanent positions.

9. Relationship to Other Bonus Plan- This Bonus Plan is substantially similar to
the 1999  Management  Bonus Plan for full-time  non-sales  employees Level 10 to
Level 16. The primary differences between the Bonus Plan and the 1999 Management
Bonus Plan are the percentage  payments available to personnel and the personnel
covered.

10.  Interpretation  of the  Bonus  Plan  by the  Compensation  Committee-  If a
question as to the  interpretation  of the Bonus Plan arises,  the  Compensation
Committee  may  interpret  the Bonus  Plan.  The  decision  of the  Compensation
Committee is final.

11.  Amendment-  The  Compensation  Committee  may not amend  the Bonus  Plan to
materially increase the amounts payable thereunder to participants.

<PAGE>


                                   Appendix B
                       MID ATLANTIC MEDICAL SERVICES, INC.
                      1999 NON-QUALIFIED STOCK OPTION PLAN

Article I.  Purpose, Adoption and Term of the Plan

         1.01 Purpose.  The purpose of the Mid Atlantic Medical  Services,  Inc.
1999 Non-Qualified Stock Option Plan (hereinafter  referred to as the "Plan") is
to advance  the  interests  of the  Company  (as  hereinafter  defined)  and its
Subsidiaries  (as  hereinafter  defined) by  encouraging  and  providing for the
acquisition  of an equity  interest  in the Company by  non-employee  directors,
officers and key employees through the grant of options to purchase Common Stock
(as  hereinafter  defined).  The Plan will  enable  the  Company  to retain  the
services  of  non-employee  directors,  officers  and key  employees  upon whose
judgment,  interest, and special effort the successful conduct of its operations
is largely  dependent and to compete  effectively with other enterprises for the
services of non-employee directors,  officers and key employees as may be needed
for the continued improvement of its business.

         1.02 Adoption and Term. The Plan shall become effective on May 3, 1999,
subject to the prior  approval  of a simple  majority  of the  holders of Common
Stock  represented,  by person or by proxy, and entitled to vote at an annual or
special meeting of the holders of Common Stock.  The Plan shall terminate on May
2,  2004,  or  such  earlier  date as  shall  be  determined  by the  Board  (as
hereinafter  defined);  provided,  however,  that,  in the event the Plan is not
approved by a simple  majority of the holders of Common  Stock  represented,  by
person or by proxy,  and entitled to vote at an annual or special  meeting at or
before the Company's  1999 annual  meeting of holders of Common Stock,  the Plan
shall terminate on such date and any Options (as hereinafter defined) made under
the Plan prior to such date shall be void and of no force and effect.

Article II.  Definitions

         For purposes of the Plan,  capitalized  terms shall have the  following
meanings:

         2.01 "Beneficiary" means an individual, trust or estate who or that, by
will or the  laws of  descent  and  distribution,  succeeds  to the  rights  and
obligations of the Participant  under the Plan and an Option  Agreement upon the
Participant's death.

         2.02     "Board" means the Board of Directors of the Company.

         2.03 "Cause" means, with respect to a Participant who is a Non-Employee
Director,  removal as a director by the holders of Common  Stock or by the Board
for cause; provided, however, that, if a Non-Employee Director is not a director
of the  Company,  removal as a director  by the  holders of common  stock of any
Subsidiary  on whose  Board of  Directors  he or she  serves or by such Board of
Directors for cause.

         2.04 "Code"  means the Internal  Revenue Code of 1986,  as amended from
time to time,  or any  successor  thereto.  References  to a section of the Code
shall include that section and any comparable  section or sections of any future
legislation that amends, supplements, or supersedes said section.

2.05 "Committee"  means a committee of the Board as may be appointed,  from time
to time, by the Board.

                  (a)  The  Board  may  appoint  more  than  one   Committee  to
administer the Plan. If it appoints more than one Committee,  one Committee (the
"Stock  Option  Committee")  shall  have the  authority  to grant  Options  to a
Participant  who is  either,  at the  Date of Grant of the  Option,  a  "covered
employee"  as defined  in Section  162(m) or who is subject to Section 16 of the
Exchange Act;  however,  such  Committee  shall also have the authority to grant
Options to other  Participants.  The Stock Option Committee shall be composed of
at least two directors of the Company, each of whom is a "non-employee director"
as defined in Rule 16b-3 and an "outside director" within the meaning of Section
162(m).  If,  however,  at least  two of the  Company's  directors  are not both
"non-employee directors" and "outside directors," the Board may grant Options to
a Participant who is either a "covered employee" or subject to Section 16 of the
Exchange Act, in which case the Board may also  administer the Plan and the term
"Committee"  as used herein  shall also include the Board.  The other  Committee
(the "Select Committee") shall be composed of at least one director,  who may be
an officer of the Company.  The Select  Committee  shall have authority to grant
Options to a Participant who is not, at the Date of Grant of the Option,  either
a "covered  employee"  as defined in Section  162(m) or subject to Section 16 of
the Exchange Act.

                  (b) The Board may, from time to time,  appoint members of each
Committee in substitution  for those members who were  previously  appointed and
may fill vacancies, however caused, in the Committee.

                  (c) The Stock Option  Committee and the Select Committee shall
each have the power and  authority to  administer  the Plan in  accordance  with
Article III with respect to particular  classes of Participants (as specified in
Section 2.05(a)) and, when used herein,  the term "Committee"  shall mean either
the Stock Option  Committee or the Select  Committee if the Board  appoints more
than one  Committee to administer  the Plan.  If,  however,  there is a conflict
between the  determinations  made by the Stock Option  Committee  and the Select
Committee, the determinations made by the Stock Option Committee shall control.

     2.06 "Common  Stock" means the Common Stock,  par value $.01 per share,  of
the Company.

     2.07 "Company"  means Mid Atlantic  Medical  Services,  Inc., a corporation
organized under the laws of the State of Delaware, and its successors.

     2.08 "Date of Grant" means the date designated by the Committee as the date
as of which it grants an Option,  which  shall not be  earlier  than the date on
which the Committee approves the granting of such Option.

     2.09  "Disability"  has the meaning  specified  in Section  22(e)(3) of the
Code.

     2.10 "Disability  Date" means the date as of which an Employee  Participant
is determined by the Committee to have a Disability.

     2.11 "Employee  Participant"  means a Participant who is not a Non-Employee
Director.

     2.12 "ERISA" means the Employee  Retirement Income Security Act of 1974, as
amended.

     2.13 "Exchange Act" means the Securities Exchange Act of 1934, as amended.

     2.14 "Fair Market Value" of a share of Common Stock means,  as of any given
date,  the closing  sales  price of a share of Common  Stock on such date on the
principal national  securities exchange on which the Common Stock is then traded
or, if the Common  Stock is not then traded on a national  securities  exchange,
the closing sales price or, if none,  the average of the bid and asked prices of
the  Common  Stock on such  date as  reported  on the  National  Association  of
Securities  Dealers Automated  Quotation System ("Nasdaq");  provided,  however,
that, if there were no sales  reported as of such date,  Fair Market Value shall
be  computed  as of the  last  date  preceding  such  date on  which a sale  was
reported;  provided,  further, that, if any such exchange or quotation system is
closed on any day on which Fair Market  Value is to be  determined,  Fair Market
Value shall be determined as of the first date  immediately  preceding such date
on which such  exchange or quotation  system was open for trading.  In the event
the Common Stock is not admitted to trade on a securities  exchange or quoted on
Nasdaq,  the Fair Market  Value of a share of Common  Stock as of any given date
shall be as determined in good faith by the Committee,  in its sole and absolute
discretion, which determination may be based on, among other things, the opinion
of one or more independent and reputable appraisers qualified to value companies
in the  Company's  line of business.  Notwithstanding  the  foregoing,  the Fair
Market  Value of a share of Common  Stock shall never be less than par value per
share.

     2.15 "Non-Employee Director" means each member of the Board or of the Board
of Directors of  Physicians  Health Plan of Maryland,  Inc., in each case who is
not an employee of the Company or of any of its Subsidiaries; provided, however,
that Francis C. Bruno shall be considered to be a Non-Employee Director.

     2.16  "Non-Employee  Director Option" means an Option granted in accordance
with Article VII.

     2.17 "Option Agreement" means a written agreement between the Company and a
Participant  specifically  setting  forth the terms and  conditions of an Option
granted to a Participant under the Plan.

     2.18  "Option"  means any option to  purchase  Common  Stock  granted to an
Employee Participant pursuant to Articles V and VI or to a Non-Employee Director
pursuant to Article  VII.  All Options  granted  under the Plan shall be Options
that do not qualify as incentive stock options under Section 422 of the Code.

     2.19  "Participant"  means  any  employee  of  the  Company  or  any of its
Subsidiaries  selected by the  Committee  to receive an Option under the Plan in
accordance  with Articles V and VI and, solely to the extent provided in Article
VII, any Non-Employee Director.

     2.20  "Plan"  means  the  Mid  Atlantic   Medical   Services,   Inc.   1999
Non-Qualified  Stock  Option  Plan as set forth  herein,  and as the same may be
amended from time to time.

     2.21 "Rule 16b-3" means Rule 16b-3  promulgated by the SEC under Section 16
of the Exchange Act and any successor rule.

     2.22 "SEC" means the Securities and Exchange Commission.

     2.23 "Section  162(m)" means Section 162(m) of the Code and the regulations
thereunder.

     2.24 "Subsidiary"  means a company more than 50% of the equity interests of
which are beneficially owned, directly or indirectly, by the Company.

     2.25  "Termination  of  Employment"  means,  with  respect  to an  Employee
Participant,  the  voluntary  or  involuntary  termination  of  a  Participant's
employment  with  the  Company  or any  of  its  Subsidiaries  for  any  reason,
including, without limitation, death, Disability, retirement or as the result of
the sale or other  divestiture  of the  Participant's  employer  or any  similar
transaction in which the Participant's  employer ceases to be the Company or one
of its Subsidiaries. Whether entering military or other government service shall
constitute Termination of Employment, and whether a Termination of Employment is
a result of Disability, shall be determined in each case by the Committee in its
sole and absolute discretion.

Article III.  Administration

         3.01 Committee. The Plan shall be administered by the Committee,  which
shall have exclusive and final authority in each determination,  interpretation,
or other action  affecting the Plan and its  Participants.  The Committee  shall
have the sole and absolute  discretion  to interpret  the Plan, to establish and
modify  administrative  rules for the Plan, to select the officers and other key
employees to whom Options may be granted,  to determine the terms and provisions
of the respective Option Agreements (which need not be identical),  to determine
all  claims  for  benefits  under  the  Plan,  to  impose  such  conditions  and
restrictions on Options as it determines  appropriate,  to determine whether the
shares  delivered  on  exercise of Options  will be  treasury  shares or will be
authorized but previously  unissued shares, and to take such steps in connection
with  the  Plan and  Options  granted  hereunder  as it may  deem  necessary  or
advisable.  No action of the Committee  will be effective if it  contravenes  or
amends the Plan in any respect.

         3.02  Actions of the  Committee.  Except  when the  "Committee"  is the
"Board" in the circumstance described in the fourth sentence of Section 2.05(a),
all  determinations  of the  Committee  shall be made by a majority  vote of its
members.  A majority of a  Committee's  members shall  constitute a quorum.  Any
decision  or  determination  reduced to writing and signed by all of the members
shall be fully as  effective  as if it had  been  made by a  majority  vote at a
meeting  duly  called  and  held.   The   Committee   shall  also  have  express
authorization  to hold Committee  meetings by conference  telephone,  or similar
communication  equipment  by means of which  all  persons  participating  in the
meeting can hear each other.

Article IV.  Shares of Common Stock

         4.01 Number of Shares of Common Stock Issuable.  Subject to adjustments
as provided in Section 8.05, 1,500,000 shares of Common Stock shall be available
for Options under the Plan. Any and all of such shares may be issued pursuant to
Options  granted to Employee  Participants  or to  Non-Employee  Directors.  The
Common  Stock to be offered  under the Plan  shall be  authorized  and  unissued
Common  Stock,  or issued  Common Stock that shall have been  reacquired  by the
Company and held in its treasury.

         4.02 Number of Shares of Common Stock  Awarded to any  Participant.  In
the event the purchase price of an Option is paid, or related tax or withholding
payments  are  satisfied,  in whole or in part through the delivery of shares of
Common  Stock  issuable  in  connection  with  the  exercise  of the  Option,  a
Participant  will be deemed to have  received  an Option  with  respect to those
shares of Common Stock.

         4.03 Shares of Common Stock Subject to Terminated  Options.  The Common
Stock covered by any  unexercised  portions of  terminated  Options may again be
subject to new Options under the Plan.

Article V.  Participation

         5.01 Eligible Participants.  Employee Participants in the Plan shall be
such  officers  and other key  employees  of the  Company  or its  Subsidiaries,
whether or not  directors  of the  Company,  as the  Committee,  in its sole and
absolute   discretion,   may  designate  from  time  to  time.  In  making  such
designation,  the  Committee  may take into  account the nature of the  services
rendered  by the  officers  and  key  employees,  their  present  and  potential
contributions  to the  success of the  Company,  and such  other  factors as the
Committee,  in  its  sole  and  absolute  discretion,  may  deem  relevant.  The
Committee's designation of an Employee Participant in any year shall not require
the Committee to designate such person to receive Options in any other year. The
Committee  shall  consider  such  factors  as it deems  pertinent  in  selecting
Employee Participants and in determining the type and amount of their respective
Options.  A  Participant  may hold more than one Option  granted under the Plan.
During the term of the Plan,  no Employee  Participant  may  receive  Options to
purchase more than one million shares of Common Stock under the Plan.

         Non-Employee  Directors shall receive Non-Employee  Director Options in
accordance  with  Article  VII,  the  provisions  of  which  are  automatic  and
non-discretionary in operation.  Non-Employee Directors shall not be eligible to
receive any other Options under the Plan unless they are no longer  Non-Employee
Directors on the Date of Grant of such Options.

Article VI.  Stock Options

         6.01 Grant of Option. Any Option granted under the Plan shall have such
terms as the  Committee  may,  from  time to time,  approve,  and the  terms and
conditions of Options need not be the same with respect to each Participant.

         6.02 Terms of Options.  Options granted under the Plan shall be subject
to the following terms and conditions and shall be in such form and contain such
additional terms and conditions, not inconsistent with the terms of the Plan, as
the Committee shall deem desirable:

                  (a) Option  Price.  The option price per share of Common Stock
purchasable  under an Option shall be determined by the Committee at the time of
grant but shall  not be less  than 100% of the Fair  Market  Value of a share of
Common Stock on the Date of Grant;  provided,  however, that, except as required
by Rule 16b-3 with respect to Options  granted to persons  subject to Section 16
of the  Exchange  Act, no amendment of an Option shall be deemed to be the grant
of a new  Option for  purposes  of this  Section  6.02(a).  Notwithstanding  the
foregoing,  the option  price per share of Common Stock of an Option shall never
be less than par value per share.

                  (b) Option Term. The term of each Option shall be fixed by the
Committee,  but no Option  shall be  exercisable  more than five years after the
Date of Grant.

                  (c)  Exercisability.  An  Option  Agreement  with  respect  to
Options may contain such performance  targets,  waiting periods,  exercise dates
and restrictions on exercise (including,  but not limited to, a requirement that
an Option is exercisable in periodic installments), and restrictions on transfer
of the  underlying  shares of Common Stock,  if any, as may be determined by the
Committee at the time of grant. To the extent not exercised,  installments shall
cumulate and be  exercisable,  in whole or in part,  at any time after  becoming
exercisable,  subject to the limitations set forth in Sections 6.02(b),  (f) and
(g).

                  (d)  Method  of  Exercise.  Subject  to  whatever  installment
exercise and waiting period  provisions  that apply under Section 6.02(c) above,
Options may be  exercised in whole or in part at any time during the term of the
Option,  by giving  written  notice of exercise to the  Company  specifying  the
number  of  shares  of  Common  Stock  to be  purchased.  Such  notice  shall be
accompanied  by  payment  in  full of the  purchase  price  in such  form as the
Committee may accept  (including  payment in accordance with a cashless exercise
program  approved  by  the  Committee).  If  and to  the  extent  the  Committee
determines  in its sole and absolute  discretion  at or after grant,  payment in
full or in part may also be made in the form of shares of Common  Stock  already
owned by the Participant (and for which the Participant has good title, free and
clear of any liens or encumbrances) based on the Fair Market Value of the shares
of Common Stock on the date the Option is exercised; provided, however, that any
already  owned  Common  Stock  used  for  payment  must  have  been  held by the
Participant for at least six months. No Common Stock shall be issued on exercise
of an Option  until  payment,  as provided  herein,  therefor  has been made.  A
Participant  shall  generally  have the right to  dividends or other rights of a
stockholder  with  respect  to Common  Stock  subject  to the  Option  only when
certificates for shares of Common Stock are issued to the Participant.

                  (e)   Non-Transferability  of  Options.  No  Option  shall  be
transferable by the  Participant  otherwise than by will, by the laws of descent
and distribution, or pursuant at a qualified domestic relations order as defined
by the Code, Title I of ERISA or the rules thereunder.

                  (f) Acceleration or Extension of Exercise Time. The Committee,
in its sole and absolute discretion,  shall have the right (but shall not in any
case be  obligated)  to permit  purchase of Common  Stock  subject to any Option
granted to an Employee Participant prior to the time such Option would otherwise
become  exercisable  under the terms of the Option Agreement.  In addition,  the
Committee, in its sole and absolute discretion,  shall have the right (but shall
not in any case be  obligated)  to permit  any  Option  granted  to an  Employee
Participant to be exercised after its expiration date,  subject,  however to the
limitation set forth in Section 6.02(b).

                  (g) Exercise of Options Upon  Termination of  Employment.  The
following provisions apply to Options granted to Employee Participants:

     (i) Exercise of Vested Options Upon Termination of Employment.

     (A) Termination. Unless the Committee, in its sole and absolute discretion,
provides  for a  shorter  or longer  period  of time in the  Option
Agreement or a longer period of time in accordance with Section 6.02(f), upon an
Employee  Participant's  Termination of Employment other than by reason of death
or Disability,  the Employee  Participant may, within three months from the date
of  such  Termination  of  Employment,  exercise  all or any  part of his or her
Options as were  exercisable at the date of  Termination  of  Employment.  In no
event,  however,  may any Option be  exercised  later  than the date  determined
pursuant to Section 6.02(b).

     (B) Disability.  Unless the Committee, in its sole and absolute discretion,
provides  for a  shorter  or  longer  period  of time in the  Option
Agreement or a longer period of time in accordance with Section 6.02(f), upon an
Employee Participant's Disability Date, the Employee Participant may, within one
year after the  Disability  Date,  exercise all or a part of his or her Options,
whether or not such Option was  exercisable on the Disability  Date, but only to
the extent not previously  exercised.  In no event,  however,  may any Option be
exercised later than the date determined pursuant to Section 6.02(b).

     (C) Death. Unless the Committee, in its sole and absolute discretion, 
provides  for a shorter or longer  period of time in the Option  Agreement  or a
longer period of time in accordance  with Section  6.02(f),  in the event of the
death of an Employee  Participant while employed by the Company or a Subsidiary,
the right of the Employee  Participant's  Beneficiary  to exercise the Option in
full  (whether  or not all or any part of the Option was  exercisable  as of the
date of death of the Employee Participant, but only to the extent not previously
exercised)  shall  expire upon the  expiration  of one year from the date of the
Employee  Participant's  death  or on the  date  of  expiration  of  the  Option
determined pursuant to Section 6.02(b), whichever is earlier.

     (ii) Expiration of Unvested Options Upon Termination of Employment. Subject
to Sections 6.02(f) and  6.02(g)(i)(B) and (C), to the extent all or any part of
an Option granted to an Employee  Participant was not exercisable as of the date
of  Termination  of  Employment,  such  right  shall  expire at the date of such
Termination of Employment.  Notwithstanding the foregoing, the Committee, in its
sole and absolute  discretion and under such terms as it deems appropriate,  may
permit an Employee Participant to continue to accrue service with respect to the
right to exercise his or her Options.

Article VII.  Non-Employee Director Options

         7.01 Grant of Non-Employee  Director Options;  Exercise Price; Term. On
May 3, 1999,  each person who is a  Non-Employee  Director on such date shall be
granted a  Non-Employee  Director  Option to  purchase  the  number of shares of
Common Stock determined in accordance with Section 7.02. A Non-Employee Director
shall only receive one  Non-Employee  Director Option on May 3, 1999, even if he
or she serves as a Non-Employee Director of the Company and/or of one or more of
its Subsidiaries.

         The exercise price per share for Non-Employee Director Options shall be
the Fair  Market  Value of a share of  Common  Stock on the Date of  Grant.  All
Non-Employee Director Options shall have a five year term.

         7.02 Number of Shares. Each Non-Employee  Director Option shall entitle
the holder to purchase 5,000 shares of Common Stock; provided, however, that, if
a  Non-Employee  Director is not a  Non-Employee  Director of the Company on the
Date of Grant of the Option, his or her Non-Employee  Director Option shall only
entitle him or her to purchase 3,000 shares of Common Stock.

         7.03  Exercisability.  Each  Non-Employee  Director Option shall become
exercisable cumulatively in three equal installments on May 3, 2000, May 3, 2001
and May 3, 2002; provided,  however, that, if a Non-Employee Director is removed
for Cause, any Option held by such Non-Employee Director shall cease to continue
to become exercisable on or after the date of such removal.

         7.04 Termination. If a Non-Employee Director's service with the Company
terminates  for  any  reason  or if  such  person  ceases  to be a  Non-Employee
Director,  such Option shall continue to become  exercisable in accordance  with
Section 7.03 and may be exercised until the expiration of the stated term of the
Option.  Accordingly, if a Non-Employee Director is removed for Cause, he or she
may  continue to exercise  his or her  Non-Employee  Director  Option  until the
expiration  of the stated term of such  Option,  but only to the extent that (a)
such Option became  exercisable prior to the date of such removal and (b) it was
not previously exercised.

         7.05 Other  Plan  Provisions.  All  applicable  provisions  of the Plan
(other than  Sections  6.02(f) and (g)) not  inconsistent  with this Article VII
shall apply to Options granted to Non-Employee Directors.

Article VIII.  Terms Applicable to All Options Granted Under the Plan

         8.01 Plan Provisions  Control Option Terms. The terms of the Plan shall
govern all Options  granted under the Plan,  and in no event shall the Committee
have the  power to grant to a  Participant  any  Option  under  the Plan that is
contrary to any provisions of the Plan. In the event any provision of any Option
granted  under  the Plan  shall  conflict  with any of the  terms in the Plan as
constituted  on the  Date of  Grant  of such  Option,  the  terms in the Plan as
constituted on the Date of Grant of such Option shall control.

         8.02 Option Agreement. No person shall have any rights under any Option
granted under the Plan unless and until the Company and the  Participant to whom
such Option shall have been granted  shall have executed and delivered an Option
Agreement  authorized  by the  Committee  expressly  granting the Option to such
person and containing provisions setting forth the terms of the Option. If there
is any conflict  between the provisions of an Option  Agreement and the terms of
the Plan, the terms of the Plan shall control.

         8.03  Modification  of Option  After  Grant.  Except as provided by the
Committee,  in its sole and absolute  discretion,  in the Option Agreement or as
provided in Section 8.05, no Option granted under the Plan to a Participant  may
be modified (unless such modification does not materially  decrease the value of
the Option) after the Date of Grant except by express written  agreement between
the Company and the Participant,  provided that any such change (a) shall not be
inconsistent  with the  terms of the  Plan,  and (b)  shall be  approved  by the
Committee.

         8.04 Taxes.  The Company shall be entitled,  if the Committee  deems it
necessary or desirable,  to withhold (or secure payment from the  Participant in
lieu of withholding)  the amount of any withholding or other tax required by law
to be withheld or paid by the Company with respect to any Common Stock  issuable
under such  Participant's  Option,  and the Company may defer issuance of Common
Stock  upon  the  grant or  exercise  of an  Option  unless  indemnified  to its
satisfaction  against  any  liability  for any  such  tax.  The  amount  of such
withholding  or tax payment shall be determined by the Committee or its delegate
and  shall  be  payable  by the  Participant  at  such  time  as  the  Committee
determines.  A  Participant  shall be  permitted  to  satisfy  his or her tax or
withholding obligation by (a) having cash withheld from the Participant's salary
or other compensation payable by the Company or a Subsidiary, (b) the payment of
cash by the  Participant  to the  Company,  (c) the  payment in shares of Common
Stock already owned by the Participant  valued at Fair Market Value,  and/or (d)
the withholding from the Option,  at the appropriate time, of a number of shares
of Common  Stock  sufficient,  based upon the Fair  Market  Value of such Common
Stock, to satisfy such tax or withholding  requirements.  The Committee shall be
authorized,  in its  sole  and  absolute  discretion,  to  establish  rules  and
procedures  relating  to any such  withholding  methods  it deems  necessary  or
appropriate  (including,  without  limitation,  rules and procedures relating to
elections by Participants who are subject to the provisions of Section 16 of the
Exchange Act to have shares of Common Stock withheld from an Award to meet those
withholding obligations).

         8.05     Adjustments to Reflect Capital Changes; Change in Control.

                  (a) Recapitalization. The number and kind of shares subject to
outstanding  Options,  the purchase price or exercise price of such Options, the
amount of Non-Employee  Director Options to be granted on any date under Section
7.02, the limit set forth in the last sentence of the first paragraph of Section
5.01 of the Plan,  and the  number  and kind of  shares  available  for  Options
subsequently  granted under the Plan shall be appropriately  adjusted to reflect
any stock  dividend,  stock split,  combination  or exchange of shares,  merger,
consolidation  or other  change in  capitalization  with a  similar  substantive
effect upon the Plan or the Options  granted under the Plan. The Committee shall
have the power and sole and  absolute  discretion  to  determine  the nature and
amount of the adjustment to be made in each case.

                  (b) Sale or Reorganization. After any reorganization,  merger,
or consolidation in which the Company is the surviving entity,  each Participant
shall,  at no  additional  cost,  be  entitled  upon the  exercise  of an Option
outstanding  prior to such event to receive  (subject to any required  action by
stockholders),  in lieu of the number of shares of Common  Stock  receivable  on
exercise  pursuant  to such  Option,  the number and class of shares of stock or
other securities to which such Participant  would have been entitled pursuant to
the terms of the  reorganization,  merger,  or consolidation  if, at the time of
such  reorganization,  merger, or  consolidation,  such Participant had been the
holder of record of a number of shares of Common  Stock  equal to the  number of
shares  of  Common  Stock  receivable  on  exercise  pursuant  to  such  Option.
Comparable  rights shall accrue to each  Participant  in the event of successive
reorganizations, mergers, or consolidations of the character described above.

                  (c) Options to Purchase Stock of Acquired Companies. After any
reorganization,  merger,  or  consolidation  in  which  the  Company  shall be a
surviving  entity,  the  Committee  may  grant  substituted  Options  under  the
provisions of the Plan,  replacing  old options  granted under a plan of another
party to the reorganization, merger, or consolidation whose stock subject to the
old options may no longer be issued following such  reorganization,  merger,  or
consolidation.  The  foregoing  adjustments  and  manner of  application  of the
foregoing  provisions  shall  be  determined  by the  Committee  in its sole and
absolute discretion. Any such adjustments may provide for the elimination of any
fractional  shares of Common Stock that might  otherwise  become  subject to any
Options.

                  (d)  Changes  in  Control.   (i)  Upon  the   dissolution   or
liquidation of the Company, (ii) upon a reorganization, merger, or consolidation
in which the Company is not the  surviving  corporation,  (iii) upon the sale of
substantially  all  of  the  property  or  assets  of  the  Company  to  another
corporation,  or (iv) if at least 50% or more of the voting stock of the Company
is sold either  through a tender offer or otherwise to a party or an  affiliated
group  of  parties,  then  the  Plan and the  Options  issued  thereunder  shall
terminate,  unless  provisions are made in connection with such  transaction for
the assumption of Options theretofore  granted, or for the substitution for such
Options of new options of the  successor  corporation  or a parent or subsidiary
thereof,  with  appropriate  adjustment as to the number and kinds of shares and
the per share  exercise  prices.  In the event such Options shall be terminated,
all outstanding  Options shall be exercisable in full for at least 30 days prior
to such  termination  date,  whether  or not  exercisable  during  such  period,
subject,  however, to the limitation set forth in Sections 6.02(b) and 7.01. For
purposes of this Section  8.05(d),  the Company  refers to Mid Atlantic  Medical
Services, Inc., MD-Individual Practice Association,  Inc., Optimum Choice, Inc.,
and/or  Physicians  Health Plan of Maryland,  Inc.,  jointly or separately.  The
Committee  shall  determine  the date on which  Options  may become  exercisable
pursuant to this Section 8.05(d).

         8.06 Surrender of Options.  Any Option  granted to a Participant  under
the Plan may be surrendered to the Company for cancellation on such terms as the
Committee and holder approve.

         8.07 No Right to Option; No Right to Employment.  Except as provided in
Article VII, no director, employee or other person shall have any claim or right
to be granted an Option.  Neither the Plan nor any action taken  hereunder shall
be  construed  as giving any  employee any right to be retained in the employ of
the Company or any of its Subsidiaries.

         8.08 Options Not Includable for Benefit Purposes.  Income recognized by
a  Participant  pursuant to the  provisions of the Plan shall not be included in
the  determination  of benefits under any employee pension benefit plan (as such
term is defined in Section 3(2) of ERISA) or group  insurance  or other  benefit
plans applicable to the Participant that are maintained by the Company or any of
its  Subsidiaries,  except as may be  provided  under the terms of such plans or
determined by resolution of the Board.

         8.09  Governing Law. The Plan and all  determinations  made and actions
taken  pursuant  to the Plan  shall  be  governed  by the  laws of the  State of
Delaware  other than the conflict of laws  provisions of such laws, and shall be
construed in accordance therewith.

         8.10 No Strict  Construction.  No rule of strict  construction shall be
implied  against  the  Company,  the  Committee,  or  any  other  person  in the
interpretation  of any of the terms of the Plan,  any Option  granted  under the
Plan or any rule or procedure established by the Committee.

         8.11 Compliance with Rule 16b-3 and Section 162(m). It is intended that
the Plan be applied  and  administered  in  compliance  with Rule 16b-3 and with
Section  162(m).  If any  provision of the Plan would be in violation of Section
162(m) if applied as written,  such  provision  shall not have effect as written
and shall be given effect so as to comply with Section  162(m) as  determined by
the  Committee in its sole and absolute  discretion.  The Board is authorized to
amend the Plan and the Committee is authorized to make any such modifications to
Option  Agreements to comply with Rule 16b-3 and Section 162(m),  as they may be
amended  from  time  to  time,  and  to  make  any  other  such   amendments  or
modifications  deemed necessary or appropriate to better accomplish the purposes
of the Plan in light of any  amendments  made to Rule 16b-3 and Section  162(m).
Notwithstanding  the  foregoing,  the  Board  may  amend the Plan so that it (or
certain of its provisions) no longer comply with either or both of Rule 16b-3 or
Section 162(m) if the Board  specifically  determines that such compliance is no
longer  desired and the Committee may grant Options that do not comply with Rule
16b-3  and/or  Section  162(m)  if the  Committee  determines,  in its  sole and
absolute discretion, that it is in the interest of the Company to do so.

         8.12 Captions.  The captions (i.e.,  all Article and Section  headings)
used in the Plan are for convenience only, do not constitute a part of the Plan,
and  shall  not be  deemed  to  limit,  characterize,  or  affect in any way any
provisions of the Plan,  and all provisions of the Plan shall be construed as if
no captions have been used in the Plan.

         8.13 Severability.  Whenever  possible,  each provision in the Plan and
every Option at any time  granted  under the Plan shall be  interpreted  in such
manner as to be effective and valid under  applicable  law, but if any provision
of the Plan or any Option at any time granted under the Plan shall be held to be
prohibited by or invalid under  applicable law, then (a) such provision shall be
deemed  amended to  accomplish  the  objectives  of the  provision as originally
written to the fullest extent  permitted by law, and (b) all other provisions of
the Plan and every other Option at any time granted  under the Plan shall remain
in full force and effect.

         8.14 Legends.  All  certificates  for Common Stock  delivered under the
Plan shall be subject to such  transfer  restrictions  set forth in the Plan and
such other  restrictions  as the Committee may deem  advisable  under the rules,
regulations,  and other  requirements  of the SEC, any stock exchange upon which
the Common Stock is then listed,  and any applicable federal or state securities
law.  The  Committee  may  cause  a  legend  or  legends  to be put on any  such
certificates to make appropriate references to such restrictions.

         8.15  Investment  Representation.  The  Committee  may, in its sole and
absolute  discretion,  demand that any Participant  awarded an Option deliver to
the  Committee  at the time of  grant  or  exercise  of such  Option  a  written
representation  that the shares of Common Stock to be acquired upon exercise are
to be  acquired  for  investment  and  not  for  resale  or  with a view  to the
distribution thereof. Upon such demand,  delivery of such written representation
by the Participant  prior to the delivery of any shares of Common Stock pursuant
to the  exercise  of his or her Option  shall be a  condition  precedent  to the
Participant's right to purchase or otherwise acquire such shares of Common Stock
by such grant or  exercise.  The Company is not  legally  obliged  hereunder  if
fulfillment  of its  obligations  under the Plan would violate  federal or state
securities laws.

         8.16     Amendment and Termination.

                  (a)  Amendment.  The  Board  shall  have  complete  power  and
authority to amend the Plan at any time it is deemed  necessary or  appropriate;
provided, however, that the Board shall not, without the affirmative approval of
a simple majority of the holders of Common Stock,  represented,  by person or by
proxy,  and  entitled to vote at an annual or special  meeting of the holders of
Common  Stock,  make any  amendment  that requires  stockholder  approval  under
applicable law or rule,  unless the Board  determines  that compliance with such
law or rule is no  longer  desired  with  respect  to the Plan as a whole or the
provision to be amended.  No termination  or amendment of the Plan may,  without
the consent of the  Participant to whom any Option shall  theretofore  have been
granted under the Plan, adversely affect the right of such individual under such
Option;  provided,  however,  that the  Committee  may, in its sole and absolute
discretion,  make provision in an Option  Agreement for such amendments that, in
its sole and absolute discretion, it deems appropriate.

                  (b) Termination.  The Board shall have the right and the power
to terminate  the Plan at any time.  No Option  shall be granted  under the Plan
after the  termination  of the Plan,  but the  termination of the Plan shall not
have any other effect and any Option  outstanding at the time of the termination
of the Plan may be amended and exercised and may vest after  termination  of the
Plan at any time prior to the expiration  date of such Option to the same extent
such Option could have been amended or would have been  exercisable  or vest had
the Plan not terminated.

         8.17  Costs  and   Expenses.   All  costs  and  expenses   incurred  in
administering the Plan shall be borne by the Company.

         8.18 Unfunded Plan.  The Plan shall be unfunded.  The Company shall not
be  required  to  establish  any  special  or  separate  fund or make any  other
segregation of assets to assure the payment of any award under the Plan.





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