MID ATLANTIC MEDICAL SERVICES INC
DEFA14A, 1999-04-02
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)) 
      [ ] Definitive Proxy Statement 
      [X] Definitive Additional Materials
      [ ] Soliciting Material Pursuant to Section 240.14a-11(c) or
          Section 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: ______________________________________



                                      - 2 -
<PAGE>


                       MID ATLANTIC MEDICAL SERVICES, INC.
                                  4 TAFT COURT
                            ROCKVILLE, MARYLAND 20850
                                 (301) 762-8205

                        CHANGES TO PROXY STATEMENT DATED
                                 MARCH 31, 1999

Dear Shareholder:

      The Company's Proxy Statement dated March 31, 1999 is hereby amended to
correct two technical errors. If you have already voted and wish to change your
vote, a light yellow proxy card and return envelope is enclosed. IT IS NOT
NECESSARY TO RETURN THE NEW PROXY CARD IF YOU DO NOT WISH TO CHANGE YOUR VOTE.
IF YOU HAVE NOT YET VOTED, PLEASE USE THE ORIGINAL BALLOT YOU RECEIVED WITH YOUR
PROXY STATEMENT.

      The following provides corrections to the Proxy Statement text.


1. On page 29, under the heading RATIFICATION OF ADOPTION OF THE 1999
   NON-QUALIFIED STOCK OPTION PLAN - NON-EMPLOYEE DIRECTOR OPTIONS -
   EXERCISABILITY; TERMINATION OF SERVICE, the text now reads:

      "Each Non-Employee Director Option is exercisable in full on the date of
      grant. 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 may be exercised until the expiration of the stated term of
      the option. Accordingly, if a Non-Employee Director ceases to serve for
      any reason, he or she may continue to exercise his or her Non-Employee
      Director Option until the expiration of the stated term of such option."



2. On page 22, second full paragraph , under the heading EXECUTIVE MANAGEMENT
   COMPENSATION - MANAGEMENT EMPLOYMENT AGREEMENTS, the text now reads:

      "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 of January 1, 1991 through
      December 31, 1998. Specifically, Mr. Jochum received a lump sum payment of
      $730,000. He is to receive an additional amount totaling $1,350,000
      payable in installments, for the period January 22,1999 through January
      21, 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."


<PAGE>

Letter to Shareholders
Changes to Proxy Statement
dated April 2, 1999





      Any questions concerning these corrections to the Proxy Statement dated
March 31, 1999 should be directed to Sharon C. Pavlos, Executive Vice President,
General Counsel and Secretary to the Company at 301-251-4075.

                                          By Order of the Board of Directors,



                                          /s/ Valerie I. Shealer
                                          Valerie I. Shealer
                                          Assistant Secretary
                                          Mid Atlantic Medical Services, Inc.










April 2, 1999
Rockville, Maryland


<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 nominee's name in the space provided below.)

*Exceptions _________________________________________________________________

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

FOR             AGAINST         ABSTAIN
( )               ( )             ( )

<PAGE>


(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:_____________________________, 1999

_________________________________________
     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

                       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


<PAGE>


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
<PAGE>


      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


                                       3
<PAGE>


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.


                                       4
<PAGE>


      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.


                                       5
<PAGE>


      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


                                       6
<PAGE>


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,


                                       7
<PAGE>


                            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.


                                       8
<PAGE>

   
      7.03 EXERCISABILITY.   Each   Non-Employee   Director  Option   shall   be
exercisable in full on the Date of Grant.

      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 may be exercised  until the expiration of the stated term
of the Option.  Accordingly,  if a Non-Employee Director ceases to serve for any
reason,  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 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


                                       9
<PAGE>


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


                                       10
<PAGE>


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


                                       11
<PAGE>


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.


                                       12
<PAGE>


      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.


                                       13


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